Why does breastfeeding hurt so much?

The first few weeks you breastfeed your baby, you most likely feel a mixture of confusion and frustration. You have to admit, it’s not easy. All moms experience different situations, but for many, breastfeeding hurts. Nipples get dry and cracked and, why not, your baby may not open his mouth wide or even “pinch” you.

“When my first baby was born”, says writer Emily Oster, author of the book, Criar sin Mitos (Parenting without Myths), it seemed like I had all the problems of breastfeeding: the latch-on problem, the milk quantity problem, the how get my milk.

You may think that only you have those drawbacks.

The hours you spend in a room trying to make a newborn eat isolates you”. However, although you believe that you are the only one who goes through these hardships, the reality is that many mothers face them.

“I asked on twitter and other moms told me about their tiny nipples, the bleeding ones, the sore ones and the cracked ones. They told me about their problems in terms of the amount of milk or too much production, leaky breasts, stiff clothes from dry milk, mattresses that smell of Parmesan cheese”.

Don’t miss: 5 common breastfeeding myths

How hard can it be?

The most exhausting thing is when someone tells you, without knowing you are suffering for a few milliliters of milk, phrases like, “Millions of women do it, how difficult can it be?”. Well yes, it is difficult, and it does not help much when someone else puts extra pressure.

The reality is that breastfeeding should not hurt; if it does, it means that your baby is not latching on correctly.

According to Emily Oster, the practice of breastfeeding is a universal human experience, so we can learn from the experiences of other women. That is why she proposes the following tips so that breastfeeding does not cause pain (at least, not unbearable pain).

Skin-to-skin contact

A research in India randomly assigned mothers to either hold their babies 45 minutes after delivery or put them in baby warmers.

Moms who had their babies skin-to-skin were more likely (72% vs. 57%) to breastfeed at 6 weeks, they also reported less pain with stitches after delivery.

“Lots of randomized studies report about skin-to-skin contact improving breastfeeding success rates”, says Oster.

The latch

The baby has to open his mouth wide, take in your entire nipple, and then use his lips and tongue to suck. Many newborn babies have trouble latching on properly. Until you experience it, you will know if you have to push it a little to get a good latch.

According to the writer

“Without a good latch the baby won’t get enough milk and the suckling will be very painful for the mom. How do you know there is a good latch? Once you’ve done it for a while you’ll just know. You will also learn to recognize a strange sigh that many babies make when they succeed”.

You may feel pain

When your baby learns the latch, you may feel pain for a few seconds. If the baby is well positioned, in a good position to eat, but you still feel pain, maybe the baby has a sucking problem or a lack of tongue mobility (ankyloglossia or short sublingual frenulum).

Other reasons

Oster explains other possible reasons: “Why might newborns have trouble latching onto the nipple? Premature birth, disease or birth damage can be some causes. It could also have to do with some mothers’ nipples: some women have inverted nipples making latching difficult.

Lastly

Some babies have structural problems in their mouths. Or maybe your baby hates you! Ha, it’s a joke”.

If the problem continues, your doctor can tell you if you’ll need a special nipple shield or a procedure to treat the frenulum brevis.

You can read: This is how a lactation consultant can help you

Moisturizing

The nipples can become cracked, irritated or sore, there is no magic solution. The only thing that has scientific support is rubbing breast milk on your nipples. Most of the time the discomfort subsides after two weeks, but if you feel unbearable pain ask for help.

Most women, even those whose babies are latched on well, may feel pain at first when nursing, but should stop after a minute or two of nursing. Ongoing pain can also be caused by infections that are treatable, such as nipple thrush. If the pain persists, ask for help to determine the cause.

"Many women recommend lanoline cream, compresses and pads, but there is no scientific evidence to support its effectiveness. The only scientifically proven thing is that you put a little breast milk on your nipples. Of course there is no reason to use these remedies; if you think it works or want to try it, great", explains Emily Oster.

Milk production

A biological mechanism links feeding frequency to milk production. The system (or your breasts) are designed to have a feedback loop in which you produce more milk when the baby needs or asks for more. Many moms increase their supply by expressing milk after nursing so the body thinks the demand is higher.

Colostrum

“When your baby is just born, you will produce a small amount of colostrum, a substance rich in antibodies. In fact you start producing it at the end of pregnancy. In the first few days, as you breastfeed, your body begins to produce more milk than colostrum (in theory)”.

“The expectation is that it will change to a full milk supply; in scientific terms this is called lactogenesis and is sometimes referred to as milk “coming in”, which will occur after the first 72 hours postpartum. If this doesn’t happen, doctors say you have delayed lactogenesis”.

Some women produce milk with a delay

Many women have a very late “coming-in” of milk, in fact there are studies that indicate that a quarter of women produce milk with a delay of three days. This time is 35% longer for new mothers.

This can cause the baby to lose weight, making it difficult to continue breastfeeding. This mishap may disappoint you”.

The author’s suggestion is to use the demand feedback loop to increase production. It is always good to stay hydrated. Beer actually makes things worse, there isn’t enough evidence on herbal remedies either.

“There are more data with some drugs. It is also possible that no matter what you do you, you have very little or no milk, this is not common, but it does happen”.

Excessive milk production

On the other hand there is the excessive milk production. When it accumulates you literally feel “balls” in the breasts.

The main problems with producing too much milk are severe discomfort and increased risk of mastitis (inflammation of the breast tissue). Your breasts swell with milk, become hard, hot and sore.

"Expressing milk can prevent this discomfort, but it contributes to the cycle of feeding and to the persistence of the problem. 
If you want to decrease production, you're going to have to deal with the problem of engorged breasts".

There are a wide variety of techniques to reduce the discomfort of congested breasts: massage, acupuncture, acupressure, cold compresses, hot compresses, cabbage leaves, among others, but the author points out that the effectiveness of these is irregular.

Expressing milk

Another problem that arises from having too much milk is when the baby begins to breastfeed. When the milk comes in fast and so abundantly can overwhelm him. “Expressing milk a few minutes before feeding your baby can help”, says Oster.

Whatever the problem, remember to be patient and seek help. Don’t forget to eat healthy and drink plenty of fluids. Avoid mercury-rich fish such as tuna, swordfish, shark, or mackerel. And relax, stress is also a factor that works against you.

Translated by: Ligia M. Oliver Manrique de Lara

Spanish version

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