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.

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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.

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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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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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Healing Nips and Nipple Butter Recipe

by Carrie Saum
This post was made possible by the generous sponsorship of Wean Green Glass.

Pumping. Nursing. Weaning. Teething. Lip ties. Tongue ties. Thrush. Mastitis. Clogged ducts.

What do these have in common?

Well, for starters, they can all be painful. Super painful. When I started my breastfeeding/pumping journey, I experienced serious boob trauma. In all of the pre-baby breastfeeding classes I took, nobody prepared me for pumping, nobody showed me how to hook one up, and the diagrams in the pump directions resembled a more risqué version of Ikea furniture assembly than easy-to-follow steps. Add a poorly fitted breast shield on a double electric pump, a baby with a hard suck, partial facial paralysis, and upper lip tie and you have the recipe for some seriously ouchie boobies.

I look back now and laugh at my naïveté. After all, much of what I’d heard from other moms was that breastfeeding (and pumping) would be painful. I expected it. So when my areolae wore down to pale, oversized, paper-thin circles, I wasn’t surprised. When my nipples were a violent bright red, sometimes tending towards purpley-black hues, I thought it was normal.

IT IS NOT NORMAL.

Common, but not normal. And a sign of there being something wrong. Not that you’re doing something wrong but that there is something wrong.

For months, my breasts were off limits, even to myself. The slightest graze of my husband’s hand would cause me to shriek, and not in a good way. The needle-like spray from our low-flow shower converted me into a stinky land dweller. I white-knuckled my way through each pumping or nursing session, telling myself that this level of pain seemed excessive and prolonged, but gosh, it was supposed to be this way, right? RIGHT? Even though I had been evaluated by FOUR lactation consultants, none of their suggestions seemed to help. I began combing the internet to figure out how to make feeding my baby less painful because this just was not working.

After correcting my son’s lip tie at 8 weeks, nursing became slightly less painful. (Wonder if your little one has a tongue or lip tie? Check out these basics of tongue and lip ties here.) I wanted to enjoy it. I loved the cuddles and sweet stares between us. But damn it, my boobs still hurt! Because of some other medical issues my son faced, I still pumped 50% of the time. I wised up and began using coconut oil to lubricate my breasts during pumping sessions. I changed out my breast pads every day. I washed and sterilized all of my pump parts regularly. I soaked my bras and nursing tanks in an apple cider vinegar solution before laundering them in order to kill all of the milk/saliva/sweat bacteria. And still…the pain was nearly unbearable.

I asked our doctor, who is also our midwife, to take a look at my breasts at my son’s four month check up. She called in another one of the midwife-doctors for a second opinion and they were both visibly pained by what they saw. My doctor suggested trying a different type of breast shield, which I ordered that same day, and manuka honey breast pads for my nipples and aureolas.

Turns out, the manuka honey breast pads are very spendy. I bit the bullet and purchased them anyway. I was desperate. After $20-ish and a week of use, my boobs started to feel so much better. I showered with abandon. I slept without breast pads. Nursing felt remarkably less painful. My husband touched my breasts and I almost enjoyed it. However, I still had a long way to go before they were healed up enough to lose the super-sensitivity.

Since I’m a mom on a budget, I set out to make my own raw manuka honey breast balm concoction. (It was still expensive, but more financially viable than the pads.) Initially, I was worried about putting honey on my breasts. Honey + baby = potential botulism. But cleaning the area impeccably (and I do mean impeccably) before nursing or pumping made it safe for my little guy. I created a simple recipe, used VERY clean utensils and pots, and made certain to keep the honey in it’s most raw state possible in order to preserve its antibacterial and healing qualities.

I applied this in a micro-thin layer in the morning during my son’s longest daytime nap, and again in the evening for a couple of hours before bed, making certain to wash thoroughly with soap and warm water before pumping or feeding. I also switched out my breast pads to avoid cross-contamination. Within two weeks, the super-sensitivity vanished. I enjoyed feeding my baby, softened at my husband’s touch again, and didn’t cringe when I accidentally bumped my boobs while changing my shirt or squeezing by someone in a crowded place…like our bathroom.

So, to recap:

Pumping and breastfeeding should NOT be excruciatingly painful for prolonged periods of time. But if it is, there’s help. Find an IBCLC, (which I did not do), and have your baby’s latch evaluated. Lip/tongue tie, thrush, suck, etc. They can help you. Also, have your pump properly fitted and ask for a tutorial by someone who knows all about it…like an IBCLC. Lastly, take care of your boobies. They are amazing, miraculous milkmakers and you will only use them in this capacity for a short, but critical, window of time. Take the time to care for them (and yourself) with kindness. Healing oils, balms, spendy nursing pads, whatever. It’s worth it.

YOU are worth it.

The Nice Boobies Healing Salve

Ingredients:

3 TBSP Raw Manuka Honey (I like Wedderspoon brand, available here.)

3 TBSP Organic Virgin Coconut Oil

1 tsp Organic Beeswax

1 tsp Rosewater

4 oz tin or glass container with lid, sterilized (we used Wean Green glass.)

Directions:

1) In a small, stainless steel pot, combine coconut oil and beeswax and stir on low heat until dissolved.

2) Take pot off burner and stir in honey. Once the honey is completely incorporated, stir in rosewater.

3) Immediately transfer mixture to container and allow to cool to room temperature. Cover with lid and store

away from direct sunlight or heat.

To Use:

1) Wash hands thoroughly. Scoop out a small, pebble sized amount with a clean utensil and warm between fingers to soften.

2) Apply a thin layer of salve to nipples and areola.

3) Cover with clean breast pad or soft cloth and bra.

4) Before nursing or pumping, CLEAN THOROUGHLY, and gently. (Botulism, people. And not like Botox.)

5) Put used breast pads immediately in the hamper to reduce cross-contamination.

*This salve is excellent for healing all kinds of ouchies. I use it on minor blisters, burns, and cuts. This has replaced our first aid cream.

** If the manuka honey is cost prohibitive for you, try sharing the cost with other moms and splitting a jar.

***If you are worried about your baby accidentally ingesting some of the salve, I successfully managed to keep my baby (who is allergic to almost all food) safe and uncontaminated. But please, only use this if you are comfortable doing so!

 

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What kind of nipple issues have you struggled with? What tips and tricks have you found help?
 

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Carri Saum Bio Pic 2

Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices. Carrie has extensive first-hand experience in vast array of medical fields. She has a background in paramedic medicine and spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet the health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. She has coached countless clients on topics such as nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and blogs regularly about healthy cooking via her blog, Come Kale or High Water. She lives in Portland, Oregon with her husband and young son.
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