Nipple Pain in Breastfeeding

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

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All kinds of advice and myths abound when it comes to breastfeeding and preparing nipples for the experience or what to do when there is pain. Dire warnings and emphasis on getting a “good latch” can make it seem as though it is tricky, inevitably painful, and consuming. (Do you need to worry about your baby’s latch? See here for more on what to look for in a good latch and what to do if it is causing problems.)

But there’s good news! While some do experience nipple pain, many do not and for those that have pain, there is usually an answer and steps that can help resolve the underlying cause. Breastfeeding shouldn’t hurt but that doesn’t mean it won’t and it doesn’t mean that if it does it is your fault or that you did something wrong. Seeing a professional breastfeeding helper such as an IBCLC (International Board Certified Lactation Consultant) may help identify the cause of the pain and find a resolution that will help you reach your breastfeeding goals.

Here are a few points on nipple pain in breastfeeding and tips for how to handle such pain. It is our hope that nobody goes through pain in feeding their babies but if you do, most of the time it doesn’t have to stay that way.

bamboobies nipple pain

Is it serious? Figure out if this is the type of pain that indicates an issue or is within the range of normal sensitivity with initial latch. If it lasts for 30 seconds or so and doesn’t bother you when you’re not breastfeeding or pumping then it is possible it isn’t serious and just an adjustment period while your nipples are a little sensitive. If it is toe-curling, swear-worthy pain that makes you hold your breath and try not to scream obscenities or toss your baby far, far away from you, then it is serious and you need to be seen by an expert professional breastfeeding helper. Any tissue damage, cracking, bleeding, scabbing, inflammation, bloody expressed milk, etc., will require proactive treatment and you need to see a health care provider. Keep in mind that if your pain tolerance is high, you may push through pain that is a warning sign that something is wrong, don’t wait too long to get help from a breastfeeding helper such as an IBCLC.

What is the cause? It could be a number of causes from baby’s physiology such as a high palate or tongue-tie (frenulum restriction) to your anatomy such as flat or inverted nipples, bifurcated nipples, or Raynaud’s syndrome (vasospasms), or from a pathology such as a bacterial infection or yeast overgrowth, to a damaging latch. Unfortunately sometimes the case is baby just needs to grow more and it will take time but there may be ways to improve things until that time comes and a breastfeeding helper should be able to help you with that.

What’s the treatment? Working with an experienced breastfeeding helper, once the cause is determined, the first step is to address the underlying cause. This may mean changing positioning and learning latch techniques (such as this “Flipple” technique for latching), a prescription to treat thrush or a bacterial infection, using a device to pull flat or inverted nipples out, a procedure to correct frenulum restriction, therapeutic suck training, and a number of other possibilities. We should start with the easiest to implement first, such as positioning and latch but an early diagnosis can mean resolving the underlying cause for the nipple pain quickly and getting back to reaching those breastfeeding goals.

How to heal? Pain, particularly pain that was ongoing for a while, usually means some tissue damage that’s going to need to heal and until it does, the pain will continue. Treating the underlying cause of the pain is essential for complete healing but there are ways to encourage healing even as the cause is addressed.

bamboobies nipple pain 2

Air drying is important for healing, as much as possible, allow your nipples to air dry before closing up your bra. Air is healing and having the area dry prevents bacteria and yeast from growing in a dark, damp environment. Additionally, rinsing them several times a day (not after each feeding but frequently) can also reduce possible irritation from baby’s saliva.

A good nipple cream, one that is plant based, breathable, and safe enough to leave on during breastfeeding can not only help with healing but can prevent chapping in the early days of breastfeeding as a preventative measure. Wiping off an ointment from sensitive and damaged tissue is painful and can cause further injury so picking one that is safe for baby to ingest in tiny amounts is ideal. Apply after every feeding after allowing the area to dry and pick nursing pads that won’t stick to damaged tissue and your nipple cream.

Your own breastmilk may help your nipples heal. Breastmilk is full of good things that can expedite healing, including stem cells! Be careful though, the sugars in breastmilk will feed a yeast overgrowth, making thrush worse.

Air and sunlight may help nipples healing from thrush as yeast thrives best in dark, damp areas. Make the environment hostile for yeast by exposing your nipples to sunlight and taking a probiotic and cutting out refined sugar.

Heat or cold packs can provide comforting relief, it’s personal, some will love these and others will find them uncomfortable for addressing nipple pain. For those with Raynaud’s Syndrome there is no cure or way to permanently resolve the problem but a heat pack like this one may help minimize the symptoms, apply immediately after feeding.

Cold shredded carrots in the bra (will stain!) promotes healing and is soothing. After breastfeeding or pumping, put shredded carrots stored in the refrigerator in your bra (if you don’t mind your nursing pad turning orange, they can help hold the carrots in place).

Protect the nipples with a nipple shield may be necessary. Nipple shields should be used with caution and hopefully with the guidance of an experienced breastfeeding helper such as an IBCLC because there is a risk of lowering milk supply with using a breast shield (not everyone experiences this, just a factor to be aware is a possibility), but they can be a good option for some to help with tissue healing for a short time.

Take a break if you need to. Sometimes damaged tissue just can’t heal until it has the chance to rest. Regularly empty your breast to protect your supply and have breastmilk for your baby, be sure that you’re using the proper flange size so as not to potentially cause more damage.

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What are your tips for preventing and healing nipple pain and tissue damage?

Share with us in the comments, together we can support each other in reaching our baby feeding goals.

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JMW headshot

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.
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Understanding, Treatment, Prevention, and the Emotional Toll of Mastitis: The Red-Eyed Steaming Pooh Pile Jerk-Monster of Breastfeeding

by Jessica Martin-Weber
This post made possible by the generous sponsorship of Ergobaby and their Natural Curve Nursing Pillow.

Ergobaby

 

Not going to sugarcoat it: Mastitis is a jerk. A real jerk. It hurts.

Other than being a jerk though, what is mastitis?

mastitis definition

Inflammation of a boob. A boob infection. A boob infection that may turn into a boob abscess. And it can spread from there.

This jerk is no joke.

Mastitis can present as a range of severity from engorgement when milk comes in to a blocked duct, redness, swelling, pain, and a fever. Sometimes bacteria or infection isn’t always actually present.

The symptoms of mastitis can include:

  • Redness
  • Tenderness
  • Heat radiating from the area
  • Pain
  • Fever
  • Chills
  • Body aches
  • Hard area under skin indicating a blocked duct
  • Abscess
  • Feeling like someone electrified your joints when you already had the flue, punched you in the boob, and then handed you a baby and told you to feed it with the boob that was punched.
  • The desire to punch someone in retaliation.

Pretty much, you feel like a steaming hot pile of aching pooh with an infant to care for and dinner to make.

the emotional impact of mastitis

It is officially miserable. Women with mastitis have been known to compare the experience to torture and generally agree that it is worse than childbirth and dental work combined.

Oh yeah, this steaming pile of pooh just got real.

There are a range of treatment options including but not limited to:
(This is not intended to be health care advice, just information. Your health care provider can address your specific needs in care.)

  • Milk removal– get it all out! Repeatedly. (This milk is safe for baby to consume unless otherwise instructed by your health care provider)
  • Heat– this may provide relief and help with let down to empty the breast. Wet heat, such as a warm compress or soaking in a tub or shower (if you can stand it) or even a bowl of warm water is effective and provides a lubricant for massaging the effected area as well.
  • Massage– Nothing like massaging the area that hurts when you touch it but some breast massage can go a long way in relieving mastitis. This method is one to try very gently.
  • Rest– you’ll want to after that massage anyway but rest has a big role in helping the body heal itself.
  • Pain relief– such as Ibuprofen. Reducing inflammation won’t just help you tolerate the pain, it can help you heal.
  • Natural remedies– from cabbage to lecithin to arnica to garlic, there are tried and true natural options worth trying if you catch it early. If you experience recurring mastitis, lecithin supplements on a regular basis may help you avoid it again in the future if mechanical issues regarding milk removal do not appear to be the cause.
  • Pharmaceuticals– If caught early, you may be able to beat this monster on your own but it can rapidly progress to a much more serious condition if left untreated. The most effective known treatment is antibiotics.

Hopefully you’ll catch it soon enough to not have to pack up your children and monster boob to see the doctor but if you end up there most women respond quickly to antibiotics.

So how do you avoid this jerk in the first place?

There are some solid steps you can take to protect your boobs but as powerful and wonderful as they are, they’re not invincible. Still, here’s what we do know.

  • Treat damaged breast tissue ASAP. Nipple damage is pretty much an invitation for mastitis. Get that taken care of and address the underlying issue with a qualified health care professional (see an IBCLC) to prevent it from reoccurring. (Could it be tongue tie?)
  • Effective milk removal. This can be more difficult to tell but if your baby or pump isn’t removing milk well from your breast you could be set up to do the tango with Jerk-face here. Reoccurring mastitis could be a sign that your breasts aren’t getting emptied. This would be the time to see an IBCLC for some answers and hands-on support.
  • Frequent milk removal. Responding to baby’s cues for feeding rather than the clock not only helps ensure you have a consistent milk supply it also helps you frequently empty the breast (which tells your body to make more milk) which in turn helps you avoid mastitis. Feel like you’re feeding baby all the time? Yay! Hopefully baby’s helping you avoid mastitis! Listen not only to your baby but also to your boobs. When they feel full and particularly if they start to become painful when you’ve missed a feeding, be sure to empty them. This goes for pumping too!
  • Different positions for milk removal. It’s normal to have your favorite position or two but changing it up a couple of times a day will help ensure that the milk removal happening is more complete. If you’re pumping, try using breast compressions to full empty the breast. If you think you may have a plugged duct or the beginning of mastitis, try a dangle feeding position. It’s not cute or fun but it can be incredibly effective.
  • Free of restrictions. Make sure your bra, nursing tanks, and anything else that comes in contact with your breast isn’t constricting (check your seat belt placement). Red lines would be an indicator that there is pressure on your breasts that could block the flow of milk and increase your chances of infection.
  • Take care of you. Rest, eat well, hydrate even better. Giving your body the resources it needs to be healthy is the best preventative measure we can take.
  • Respond. If something is up with your breast and you notice tenderness, a hard area, a white bump (called a milk bleb) on the tip of your nipple, or anything that just seems off, take care of it by resting, massaging, and calling your health care provider.

ErgoBaby breastfeeding nursing pillow mastitis prevention tip

It is important to note that sometimes mastitis is resistant to treatment. If this happens to you, you can request your health care provider to do a culture to determine if a more targeted treatment protocol is in order and to detect possible other causes for mastitis-like symptoms that don’t respond to conventional treatment measures.

The emotional and psychological impact of mastitis can’t be ignored. It’s far more than a pathology, more than a clinical diagnosis. Anyone that has experienced mastitis can tell you that it is a soul crushing, mind altering invasive monster-jerk. Women have been known to question everything about their lives in the midst of battling mastitis.

I shared my emotional unraveling and how I ended up beating the Red-Eyed Monster of Breastfeeding here, including my detailed home treatments and a “flattering” photo demonstrating dangle feeding here. It’s not pretty. It’s war.

What is mastitis and how to care for it The Leaky Boob

If you find yourself entrenched in such a battle for your soul boobs, ask for help. Virtual help (head over to our FB pageFB group, and Instagram for a real dose of virtual help that’s chicken soup for your mom soul) and in person real life help. Trying to be super mom and super boob monster-jerk fighter isn’t going to position you well to win. Beg a friend to bring dinner, reach out to a family member to do a load of laundry, be cool with Netflix babysitting so you can get down to booty kicking the jerk and getting well.

Just turn on My Little Pony, give your kids the peanut butter jar and a spoon (as long as they aren’t allergic), and sit on the floor with a warm wet wash cloth massaging your boob and cry.

There’s no sugarcoating mastitis.

Mastitis is a jerk (I’m writing “jerk” but I’m thinking a different word) but with information, help, and some mom-moxie, most moms can kick it to the curb. Demand help from your health care provider when you need it, nobody will blame you for being a bit on edge with your breast invaded by the Red-Eyed Monster of Breastfeeding, Jerk Mastitis. Do what you need to do.

This a-hole jerk is no joke.

Sources: Academy of Breastfeeding Medicine mastitis protocol,  LLLI Mastitis Tear-off sheetThe Nursing Mother’s Companion,  The American Academy of Family Physicians Management of Mastitis in Breastfeeding Women, the CDC

 

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Have you survived mastitis? How did you get through?

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Jessica Martin-Weber Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and co-creator of OurStableTable.com, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book and a children’s book.
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Tension and Breastfeeding, How Relaxing Save Her Breastfeeding Relationship

by Vivian Muehlen
this post made possible by the generous support of KoalaKin.
Vivian & Luc KoalaKin

The author and her son.

 

I still wince when I think that I had to give up breastfeeding 5 months after my son was born, due to a myriad of issues ranging from low milk supply, tendonitis, mastitis and lower back pain. And that was almost 12 years ago!

When my second son was born, I was again 100% committed to breastfeeding, but now I also had a preschooler running around the house. Not only that, but I was again afflicted with mastitis (caused by a poor latch) and arm, neck and shoulder pain from breastfeeding my little guy 8-12 times a day. Wait! Wasn’t breastfeeding supposed to be natural? It was then that I realized that breastfeeding may be natural, but its not instinctual. I needed help ASAP!

I tried slings and wraps, but they didn’t work for me. They weren’t supportive enough and my son’s face always ended up not perfectly aligned with my breast, or his latch would slip as soon as I moved.

I was at my wits end, almost giving up, when I decided to create my own solution. As soon as I developed a halfway functioning prototype of the KoalaKin and began using it with my son, a flood of relief ran through me as I was finally able to relax a little bit. My son was supported, his latch was firm and I had not one, but two free hands. Not longer feeling any strain, I was able to give my boy all my attention. I noticed his teeny, tiny fingernails, his fine hair, and the insane cuteness of his little feet… Words cannot explain the feeling of empowerment, confidence and GRATITUDE I felt when I realized that after all these years of struggle, I was finally able to effortlessly breastfeed my child.

And best of all: I now loved just staring at him breastfeed, knowing I was giving him the absolute best. There’s no feeling like it. No pain, all gain.

One of the best pieces of advice I received in my breastfeeding journey, was that it was important to minimize stress as much as possible. When moms are stressed, their breast milk supply usually decreases dramatically. Also, some studies even show that elevated levels of stress also cause a defective let down reflex.

Paradoxically, breastfeeding in itself is actually calming. The hormone prolactin is released during breastfeeding, which gives mom a feeling of peace and tranquility. That being said, the worry ABOUT breastfeeding (is my baby getting enough, what, he’s hungry again?, when is the laundry going to get done?), causes stress amongst moms and may interfere with a mom’s ability to establish a good milk supply.

KK Jade Comp LR KoalaKin

Vivian created the KoalaKin to offer other women the kind of support she found she needed to help her relax during breastfeeding and reach her breastfeeding goals. To learn more about how the KoalaKin could support you and to determine if it is right for you, click here.

 

What I wish I had known on how to relax during this special time:

Don’t wait until your baby is crying. Nothing stresses out a mom more than hearing her baby cry. Fussiness is the first cue that a baby is hungry. This is the time a mom should calmly sit or lay down with her baby and nurse. Not waiting until the baby cries will greatly reduce feelings of stress and overwhelm.

Listen to calming music. Take a moment to pop in your favorite calming tunes. Don’t focus on what kind of music you listen to, focus on how the music makes you feel. Classical music may be relaxing to some, and annoying to others. I personally liked to listen to yoga music, which always drove my husband crazy!

Create a favorite breastfeeding spot. Be it a bright space by a window in your living room or a dimly lit corner in your child’s nursery, creating a favorite breastfeeding spot can immediately relax and calm a tired, overwhelmed mom. Again, choose a spot that makes you feel warm and fuzzy inside. That’s the feeling you want over and over again when you breastfeed.

Make sure you are seated in an ergonomic way. There is virtually no way a mom can relax if her body is feeling any level of discomfort. Back or arm strain can make a nursing session torturous, and therefore it is very important to ensure mom is comfortable, and can stay that way for the next 20-40 minutes. A chair with excellent back support and an armrest is a must. Breastfeeding pillows, slings or a KoalaKin can help support the baby’s weight, allowing mom to relax any areas of strain and enabling a more ergonomic breastfeeding position.

Prepare a light snack to eat while breastfeeding. Don’t they say “sleep when the baby sleeps”? Well, I’ll add to that and say “eat when the baby eats!” Keep a stash of healthy, convenient snacks, like trail mix, pretzels and hummus, healthy energy bars and fruits where you can just grab and go. Once the baby is latched on and contently nursing away, treat yourself to these delicious snacks. Since nursing sessions can take up to 40 minutes, moms can take their time and really enjoy nourishing themselves!

Read a good book or watch TV. After a good snack, there’s nothing better than indulging in a good book or favorite TV show. As much as breastfeeding can be bonding, it’s not practical to expect to stare into your little one’s eyes through every session any more than every meal with your romantic partner should be a candlelit dinner. Getting comfortable and enjoying something that has you looking straight ahead can also help relieve tension in the neck and shoulders when you have good support.

While breastfeeding is something we do for our babies, with a little bit of organization and practice, this can also be a time that moms can use to take care of and nourish themselves.

Thanks to the KoalaKin, I was able to bond more with my son, and most importantly, I was able to breastfeed longer than I would’ve been able to, because the KoalaKin helped ease the strain I was feeling.

I’m a big believer that a mom should use any tool she thinks might help her successfully nurse her baby. After all, breastfeeding is one of the most beautiful, healthy and natural things a mother can do with her baby. There isn’t any one tool that work for every mom or even with every baby for the same mom. Be flexible and willing to try new things and take care of yourself to better be able to take care of your baby. Relax, you’ve got this!

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The KoalaKin Hands-Free Nursing Pouch was created by Vivian in 2009 after she suffered through several very frustrating breastfeeding attempts, where a poor latch coupled with arm, neck and shoulder pain from holding her baby in the same position for 30-40 minutes several times a day, took away from the wonderful experience that breastfeeding should be.
Tired of the pain and frustration, Vivian decided she needed help fast and turned to products such as slings and wraps.  However, she quickly realized there was nothing in the market that addressed her needs … so the first prototype of the KoalaKin was born!  With the goal of becoming the product that provides the best possible breastfeeding experience, Vivian worked tirelessly with lactation consultants and other birthing professionals, and turned her early prototypes into the KoalaKin that is available today. 
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