Breastfeeding Pain: Causes and Solutions

Breastfeeding is hard, but is it supposed to be painful? While finding the most comfortable way to breastfeed your baby may take some time, it shouldn’t hurt. So, what’s a mom to do if she’s got cracked nipples, engorged breasts, or generalized soreness?

We’re breastfeeding moms too, so we understand what you’re going through. If you find yourself frustrated by pain, we’re here to help.

In this article, we’ll take a closer look at the common causes of breastfeeding pain, explain what you can do about it, and discuss who you can turn to for help.

Causes of Breastfeeding Pain

Let’s go over a few common causes of breastfeeding pain. While there’s a good chance your symptoms will align with one or more of these, it’s always a good idea to check with your doctor or a lactation consultant for an accurate diagnosis.

1. Improper Latch

Your baby’s latch refers to how they attach their mouth to your breast as they nurse. If your baby has an improper latch, it can have a significant negative effect on breastfeeding, including a large amount of pain for you.

With a proper latch, your baby’s mouth will cover most or all of the areola. However, there are reasons your baby may struggle with this.

• They might have a weak suck.
• They may be tongue-tied — a condition known as ankyloglossia.
• You may not be holding them in the best position.
• They might have nipple confusion.

An improper latch can lead to nipple trauma and overall pain and soreness in the breast.

2. Engorged Breasts

Do your breasts seem overly full and hard? There’s a good chance they’ve become engorged. You need to express your milk by nursing or pumping consistently.

Engorged breasts are more likely to happen when your milk supply first forms and your body adjusts to how much milk your baby needs each day ⁽¹⁾. Missed feedings, bottle feeding, and your own genetic makeup can lead to engorged breasts.

If you have engorged breasts, they’ll feel swollen, tight, and heavy.

3. Clogged Milk Ducts

Each breast comprises an internal system of ducts and glands to produce and carry milk to your nipple. If a milk duct becomes clogged, it causes the breast to swell and become tender ⁽²⁾. You may also notice a lump forming in your breast.

The most common cause of clogged milk ducts is unexpressed milk building up. Your breasts need to be thoroughly drained; if they’re not, a literal clog occurs.

Clogged ducts are fairly common but are more likely to happen if your baby is struggling to nurse for any reason. Wearing tight bras or shirts that compress the breast may also lead to clogged milk ducts.

4. Mastitis

If a clogged milk duct isn’t treated quickly, mastitis can occur. Mastitis is an infection triggered by bacteria in the breast, causing the tissues to become inflamed. It also leads to redness, pain, and fever ⁽³⁾.

Bacteria from your baby’s mouth or broken skin on the nipple may also lead to mastitis.

While mastitis can be painful, it doesn’t mean you have to stop breastfeeding. Continue breastfeeding to help the infection go away as the milk ducts are cleared ⁽⁴⁾.

5. Thrush

Thrush is a specific type of fungal infection similar to mastitis and is most often caused by the overgrowth of yeast, which thrives in warm, moist environments ⁽⁵⁾. It manifests in shiny or flaky skin on the breast accompanied by pain.

The easiest way to know if thrush is likely involved is to inspect your baby’s mouth. Thrush is often passed to both mother and baby if either has the infection. If your baby has thrush, their mouth will likely have white patches that look like leftover milk and can’t be easily wiped off.

6. Let-down Pain

The phrase “let-down” describes the biological process by which your milk ejection reflex is activated ⁽⁶⁾. Your hormones work to produce milk, which is then sent through your milk ducts so your baby can nurse. For some, the milk let-down can cause a painful sensation.

You’re more likely to experience let-down pain directly after birth as your body adjusts. It most often manifests itself as a tingling feeling in the breast.

7. Sore and Cracked Nipples

No mom can escape a little tenderness to the nipples, especially at the start of breastfeeding. However, some women experience soreness, cracking, and even bleeding on and around their nipples. This can make the process of nursing extremely painful.

Damage to the nipples is generally caused by an improper latch. If your baby doesn’t have much of the areola in their mouth, there can be undue pressure and stress on the nipple itself.

Certain personal care practices may also cause extra irritation ⁽⁷⁾. This includes using harsh hygiene products, wearing tight bras and shirts, or not taking proper care of the delicate skin of your breast. The excess saliva from your baby’s mouth may also cause dryness.

8. Blebs

Blebs are as strange as they sound. Blebs are small, milk-filled cysts on your nipples. They often feel and look like whitehead pimples ⁽⁸⁾. They’re associated with clogged milk ducts and are believed to be an external sign of blocked milk in your breast.

Some women with blebs experience no discomfort, while others have shooting pains, especially during breastfeeding.

9. Vasospasms

Vasospasm occurs when the blood vessels in your nipple suddenly constrict. The sensation it causes can be extremely painful. Because blood flow stops, your nipple turns white, which may last a few seconds to a few minutes ⁽⁹⁾.

If your nipple has already experienced some form of trauma, you’re at a higher risk of having vasospasm. Cold may also trigger or cause it. If you have vasospasm in your fingers or toes, you are more likely to experience nipple vasospasm.

10. Breast Pumps

Do you use a breast pump? It may be the culprit behind your breast pain, and there are multiple reasons why. Here are just a few:

• You may be using your breast pump on too high a setting.
• The nipple tunnel and other parts may not be fitted correctly.
• You may be pumping too frequently or for too long.
• You may be sensitive to some of the materials.

Just as with breastfeeding, breast pumping takes some practice and adjustments.

How to Deal With Breastfeeding Pain

No matter what’s causing your breastfeeding pain, you should act quickly to find remedies that work for you. The following ten remedies are easy for any mom to do and can be effective for a wide variety of conditions. They’re especially good to try if you haven’t figured out what’s causing your pain.

1. Breastfeed Early

Ideally, your baby should begin feeding as soon as possible after birth.

It takes a few days for your milk to fully come in, which will cause your breasts to become firmer and full ⁽¹⁰⁾. By starting to breastfeed when they’re softer, your baby can learn to latch in a more forgiving way and grow accustomed to your breast.

2. Improve Your Latch

An improper latch is one of the most common causes of breastfeeding pain. Working on your baby’s latch can help prevent engorgement, sore nipples, and a host of other problems. Experiment with positions and make sure to examine your baby’s mouth to see if there is any sign of trouble.

When latching, aim the nipple at your baby’s nose. As soon as your baby opens their mouth wide, quickly bring them toward your body. You should bring your baby to the breast rather than vice versa. Your baby’s body should face your body with no space between the two of you.

Editor's Note:

Michelle Roth, BA, IBCLC

3. Find a Lactation Consultant

If you struggle to improve your baby’s latch on your own, consider reaching out to a lactation consultant.

Lactation consultants are trained to help mothers find the best breastfeeding techniques for them and can work with you to determine why your baby is struggling and what you can do about it.

You can find a lactation consultant through your doctor or midwife, your baby’s pediatrician, referrals from friends or family, or online websites.

4. Consistently Breastfeed

It’s important to keep a schedule as you breastfeed. For most women, they create a natural rhythm with their baby’s feeding patterns. However, if you work away from home or if your baby has difficulty nursing, it becomes easier to go without feeding or expressing breast milk.

If you cannot breastfeed for any reason, be sure to pump or hand express your milk as often as your baby would be feeding to ensure your milk ducts don’t become clogged or your breasts engorged.

5. Continue Breastfeeding

It may seem counterintuitive, but continuing to breastfeed even with a painful condition can help to cure it. If you’re able to and you haven’t been told to stop by a doctor, try to breastfeed as much as possible.

Rubbing some breast milk into your skin (with a clean finger) has even been shown to heal sore and irritated nipples ⁽¹¹⁾.

6. Use a Nipple Cream

A nipple cream may help moisturize and soothe dry or irritated skin. Most balms are made of natural substances that are safe for both you and your baby. Here are a few examples:

• Lansinoh Lanolin Nipple Cream
• bamboobies Organic Nursing Balm
• Bella B Nipple Nurture Butter
• Motherlove Nipple Cream

Make sure to test any cream or balm on a small skin patch before putting it on a sensitive area. Some chemicals may make certain conditions worse. Unless otherwise directed by a health professional, do not put anything on broken skin.

7. Warm and Cool Compresses

A simple compress may help alleviate pain temporarily. Depending on your condition, try a warm or cold compress. You can make your own with a damp cloth or purchase some from the store.

The cold alleviates pain and brings down swelling, while heat can loosen tight muscles and soreness.

8. Use Nipple Shields

A nipple shield is a special breastfeeding device that is placed over the areola and nipple. Made of thin rubber, silicone, or plastic, it’s soft and pliable. Small holes at the tip of the synthetic nipple allow milk to pass through ⁽¹²⁾.

Though not typically recommended for sore nipples, if you’re struggling with nipple trauma and are thinking about no longer breastfeeding, a nipple shield may help protect your sensitive skin and maintain your nursing relationship.

9. Loose Clothing

Breast pain can be brought on by tight, restrictive clothing, including bras. The fabric rubs and constricts.

Switch to clothes that provide good airflow and movement. Go without a bra when you’re at home.

10. Visit Your Doctor

No matter what you’re experiencing, there’s no harm in visiting your doctor, especially if your pain lasts longer than a week or so. They’ll be able to properly diagnose any condition you may have and provide you with some peace of mind.

Breastfeeding Pain FAQs

What Does Breast Mastitis Feel Like?

Breast mastitis typically feels like a painful, swollen area in one breast, often accompanied by flu-like symptoms such as fever and fatigue. The affected breast may feel hot and tender and appear red.

How Can You Tell the Difference Between Mastitis and Engorgement?

Mastitis usually affects only one breast and is accompanied by severe pain, redness, and systemic symptoms like fever. Engorgement affects both breasts, making them feel overly full, hard, and sometimes painful, but without the infection’s localized redness or fever.

Why is Letdown So Painful?

Painful letdown can be due to the rapid flow of milk causing discomfort or due to the milk ducts stretching as they release milk.

Some women experience a pins-and-needles sensation. If the pain is severe or persistent, it’s a good idea to consult a lactation specialist as it might indicate an underlying issue.

What is the Fastest Way to Heal Sore Nipples?

The fastest way to heal sore nipples includes ensuring a proper latch, changing feeding positions, keeping the nipples dry and well-aired, and applying nipple cream or expressed breast milk. If soreness persists, consult a healthcare provider or lactation consultant.

How Can I Sleep Comfortably With Engorged Breasts?

Sleep comfortably with engorged breasts by wearing a supportive but not too tight bra, using nursing pads to absorb any leaks, and lying on your back or side with a pillow for support. If engorgement is severe, express a little milk before bedtime for relief.

How Can I Get My Baby to Latch Deeper?

To get your baby to latch deeper, ensure you’re in a comfortable position, support your breast with your hand, and guide your baby to open wide before latching.

Aim for the baby’s mouth to cover more of the areola beneath the nipple than above. If you’re struggling, seek help from a lactation consultant.

When Should I Call it Quits on Breastfeeding?

Deciding to stop breastfeeding is a personal choice and can be based on various factors, including physical, emotional, and lifestyle considerations.

It’s important to weigh the pros and cons and seek support from healthcare providers or lactation consultants. Ultimately, the right time is when it feels like the best decision for you and your baby.