There are many reasons for early breastfeeding pain, especially in the first few days postpartum. Sometimes pain is due to something that we expect in these first days of your new baby’s life. Other times, pain may be due to a problem with breastfeeding. In this article, we will look at discomfort that you should anticipate and pain that needs extra evaluation from a lactation consultant.
Uterine Cramps
One of the benefits of breastfeeding your newborn in the early hours postpartum is that you have a decreased chance of postpartum bleeding and hemorrhage. This association is due to a hormone called oxytocin. Not only is this hormone involved in breastfeeding, but it is also involved in causing your uterus to shrink down. As your uterus returns to its pre-pregnancy size, you may notice some uncomfortable uterine cramping. These cramps are especially noticeable while you are nursing your new baby. Nipple stimulation causes the release of oxytocin.
Thankfully, this cramping is less and less noticeable after the first few days postpartum. After a few days, you should be able to nurse your baby without expecting to experience this discomfort.
Engorgement Can Be Painful
Around 3-5 days postpartum for the majority of breastfeeding mothers, your breast milk will increase in volume. This increase in milk will cause your milk ducts to expand and fill. As they fill, some of the milk will leak out of the ducts and get into the surrounding breast tissue. The body recognizes this milk as a foreign invader and sends cells from the immune system to get the problem under control. This movement of cells leads to inflammation and engorgement. Not only do your breasts fill with milk, but the surrounding breast tissue fills with extra fluid as well. This leads to a full and sometimes painful sensation in both breasts.
Gratefully, engorgement generally lasts for a day or two as your body is regulating your milk supply down to the needs of the baby. During this time, you may notice that your baby is getting full from one breast per feeding instead of taking both breasts. This can lead one breast to feel especially full and painful. First, make sure to start with that breast for the next feeding and next, you can hand express to relieve some of that fullness.
In addition, you can use cool compresses on your breast tissue after each feeding to calm down the inflammation. If you are still experiencing discomfort, the use of an anti-inflammatory medication like ibuprofen can provide additional relief. Be cautious if you decide to use an electric pump during this period of time. It is best to avoid using one if possible. However, if you need to pump, only pump for relief and not all the way to empty your breast. Pumping to empty will signal your body to produce more milk instead of down-regulating your supply to feed your baby.
Sore Nipples Can Be Expected
Nipple pain can be normal or it can signal a problem. If you have never breastfed before, you might experience some amount of nipple pain as your body is adjusting to this new biological process. Generally, this time of nipple pain starts when the baby first latches and decreases as the feeding continues. On the other hand, if you experience pain that does not improve as the feeding continues or gets worse, this may mean that the baby is not latching correctly.
You can achieve a comfortable latch by positioning the baby’s nose in line with your nipple, waiting for the baby to open wide and then bringing the baby to your body for a latch on. In addition, be sure to grasp your breast in a C-shaped hold behind the areola in order to encourage the baby to get a mouthful of breast tissue and not just land on the nipple. Not only is latching just to the nipple painful for you, but it does not allow the baby to effectively transfer enough breast milk.
Relieve Nipple Pain
In medicine, we heal wounds by employing the technique of moist wound healing. Your nipple wounds are similar to other wounds on your body. You never want to express milk or put ointment on your nipples and “let them dry.” This is a breastfeeding myth that has been passed down through the generation. We prefer moist wound healing instead.
First, start by applying a nipple cream or balm. Then, use a hydrogel pad to cover your nipple to protect it and allow it to stay moist but not wet. For extra relief, you can put the hydrogel pad in the refrigerator for a few minutes to cool it down first. You can definitely use one of those silver coverings that are popular among breastfeeding mothers, just avoid bathing your nipple in milk first before you put it on. You want your nipple to be moist, but not sitting in liquid.
If your nipple damage is severe, you may need to rest your nipples. This would be an excellent time to involve a lactation consultant in your care to help guide you to more comfortable and effective breastfeeding.
Other Causes of Breast Pain
There are several other possible causes of breast pain that may not be associated with engorgement or incorrect latching.
- Breast infections such as mastitis or breast abscess
- Trauma from the breast pump
- Blocked milk ducts
- Cancer (very rare)
How can 127 Pediatrics and Dr. Wadley help you?
At 127 Pediatrics, we offer concierge level pediatric and breastfeeding care. If you are near Colleyville, Texas and would like to know more about our in person services, fill out a contact form on our website for a free meet and greet. If you are not close to our practice, but would like breastfeeding support, we offer an array of services. From free resources like this blog or our YouTube channel all the way up to paid resources such as our online breastfeeding overview course. We would be honored to be part of your breastfeeding journey.
© 127 Pediatrics, January 2024
Please note that this article is purely for informational purposes and should not be interpreted as medical advice.
Dr. Andrea Wadley owns and operates 127 Pediatrics, a pediatric and lactation practice in Colleyville, TX. She specializes in pediatrics, breastfeeding medicine and offers house calls only. Additionally, Dr. Wadley is the owner of the 127 Pediatrics Online Breastfeeding Medicine and Education Center. We have many free resources for breastfeeding mothers. Subscribe to our YouTube channel or download a free breastfeeding checklist.
