It hurts. Help!

When meditating over a disease, I never think of finding a remedy for it, but, instead, a means of preventing it: Louis Pasteur

The site PhD in Parenting has a nice thorough article about the issue of pain.

Or perhaps you'd rather check out what Dr. Jack Newman or KellyMom have to say.
Or this article: "9 things your nipples wish you knew about them!"

I'm still working on this page.  Why not let me know what I'm missing?

Causes of pain.

• The latch or positioning of your baby at your breast is the first thing to examine.
  
  (Go to this FF page for more on this.)
• Let-down reflex, especially just at the beginning of feeds in the early days.  (You'll want to breathe calmly to relax for this, just as when you were in labour.) You'll know the let-down is the cause of your pain when you feel the same thing on hearing a child cry at the shops & start to leak.  Not everyone finds it painful.
• A tight frenulum/ tongue-tie (the little flap which joins your child's tongue to the lower jaw) which can hinder a good latch & suck.  Ask for this to be checked. Read about one Mum's challenges with her baby: here, and see pictures of an infant with tongue tie: here. Another great page about tongue-ties can be found: here.
• Bitten!  Babies jaws clamps down if they are struggling with a very fast flow of milk at the let-down.  Ask for help to regulate your Oversupply.
  
• Thrush?? Bacterial Infection?? Especially if you were pain-free, but suddenly get burning pains.
• A duct in your breast is blocked up, creating a feeling of swelling as the milk backs up.  You must pay attention to this as, if ignored, it can worsen into...
• ...Mastitis or even an abcess. (very rare, thankfully). Now you will feel sore, perhaps redness at the area of the blockage, and a horrible 'flu' feeling.  It is not helpful to stop feeding when you have mastitis or any blockages. Your child's sucking is a big part of the cure.  Don't panic about mastitis - it is actually pretty rare - and informing women about it may even put people off beginning to breastfeed??  Breastfeeding mothers simply need to be vigilant about the care of blocked ducts, and wary of any feelings of flu - as it may not just be the flu!  Do get experienced advice if you are suffering with frequent blockages/ mastitis.

Blocked Ducts
Some habits/ situations may lead you to develop blocked ducts more often.  At times when your breasts feel engorged you should be particularly vigilant.

• Tight bras, bag straps, seatbelts - anything which presses or damages your breast tissue. This can also include your hand - if you have a habit of being too rough with hand expression, or holding tight to present your breast.
• Getting kicked - hopefully not by anything stronger than your child, e.g. during nappy changes.

On the other hand, a habit of using gentle massage after feeds may help reduce the chance of getting blockages. The massage movement is best taken from the outer edge of each breast in towards the nipple. It does not need to happen after every feed - I'd hate to put anyone off breastfeeding by giving them an extra job to do.  And it's very un-public-feeding-friendly!

Other ways to deal with blockages in the breast are dealt with here.

• Use appropriate pain relief if you wish.  You don't have to suffer unnecessary pain. No medals here!
• Warmth before a feed will help milk to flow well.  Something cool applied to the blocked area will ease the discomfort & swelling - use this after a feed.
• Use your baby to draw out the milk.  Offer the blocked side first every time - when your child is hungry he or she will draw the milk from you most efficiently. (You can offer the other side later when your child is less hungry.)  Feed often throughout the time you are affected, as this will reduce engorgement problems.
• You may find it helps to feed in such a way that your child's lower jaw is pointing towards the area of the blockage (think of the breast as a series of sectors, like a slice of pie - each sector will be drawn out most efficiently by the lower jaw of your child. Although - a quick bit of small print here - sometimes the ducts are not that simple and it's more like tangled spaghetti in there; in which case you may have to shift the position about to find the right sector.) You may have to get inventive with your positions! Do ask for help if you can't work it out, or if none of this is helping.

If we had time, we'd also teach you about how to:

• clean your breast gently (to ward off thrush - no soap or hot water. Certainly many women find it help to avoid harsh soaps with strong chemicals, smells etc.);
• wear a well-fitting bra made with breathable cotton, and without any underwiring which press at the breast;
• Promote healing of any sore skin of your nipples (Advice used to be to apply expressed breastmilk, and let the skin air dry. Certainly, a constantly warm & milky-moist environment is a good breeding ground for infections. Read new advice on moist wound healing from BfN, using lanolin cream if the skin is cracked);
• find advice about how to use nipple shields (they are a last resort, do get advice - and do get the right size for you)
• often change your positioning at the breast (i.e. the way you hold your baby - to avoid always aggravating the same place, and to have your baby draw strongly at different sectors of the breast each time);
• make use of good advice about appropriate pain relief and nipple ointment (very pure lanolin cream is good to use as it does not have to be wiped off before each feed);

And we'd make sure you understood about nipple confusion & how to maintain a good milk supply by feeding on demand. All of this sort of information should be covered by any sensible antenatal class. (And in pre-bottle days we'd have learnt much of it by watching other mothers in our community.)

Please do find a source of help you trust if you are experiencing pain when you feed your child. It may make a huge difference to you both!

Drop-in groups in Flintshire - details are here.

Also helplines - details are here.