Hi mamas, I’m Stephanie Weight Hadfield, an International Board Certified Lactation Consultant (IBCLC) and mom of 4. I’m here to talk about common causes and solutions for breast pain in breastfeeding mothers.
We are often asked about various kinds of breast pain so today I am sharing some information and resources for how to deal with common types of breast pain. Note: this article is discussing breast pain. If you’re concerned about nipple pain, you can read more about that here.
Common causes & solutions for breast pain in breastfeeding mothers
Engorgement. Your breasts may feel very full and firm in the first couple of weeks of breastfeeding, while your body is enthusiastically gearing up to churn out plenty of milk for your baby. Breast pain related to engorgement is felt in both breasts, during and/or between feedings. This pain will go away as your breasts settle into their milk-making role and engorgement resolves, usually by the time your baby is about 2 weeks old.
For relief from engorgement, first make sure that your baby is latching deeply and nursing frequently, at least 8-12 (for a newborn) or more times a day. You can hand express a small amount of milk before feeding to help soften the areola and make it easier for baby to latch well. You can also hand express just enough milk between feeds to relieve uncomfortable pressure. Cold compresses on your breasts between feedings can help reduce swelling and pain. Read more about relief from engorgement here.
Strong Milk Letdown. If your breast pain happens in both breasts and starts at the beginning of a feed when your baby starts gulping, it could be due to a strong milk letdown. Ultrasound studies have shown that this is due to the stretching of the milk ducts as the milk is released. The wider the milk ducts opened, the more discomfort mothers reported. This pain doesn’t typically last through the whole feed and usually decreases and disappears on its own over the first month or so of breastfeeding. Relaxation or distraction techniques can help you get through it. Many mothers find slow deep breaths or counting to be helpful, and babies seem to handle the strong flow of milk better in a side-lying or laid-back position.
Referred pain. Breast pain can a problem when neck, back and shoulder muscles are strained by leaning forward in an uncomfortable position to nurse. This referred pain can happen because the breasts and the muscle strain share the same nerve pathways. Gentle stretching of the shoulders and back to relax tight muscles can provide immediate relief in these cases. Many moms find it helpful to place their hands on either side of an open doorway and leaning forward. Nursing in a laid-back position can reduce the strain on your body, and help you be more comfortable.
Plugged Ducts or Mastitis. Both plugged ducts and infectious mastitis can cause a firm, painful area in one breast, and your plugged duct has probably transitioned to mastitis if you have fever and flu-like symptoms such as body aches and chills. The basic treatment is the same for both situations: keep your milk moving.
Research has shown that it is safe for your full-term, healthy baby to breastfeed while you have plugged ducts or mastitis. Continue to breastfeed often, and change up your feeding positions. Positioning baby’s nose or chin towards the firm, tender area of the breast for will allow for better drainage. Massage the breast from the blocked area towards the nipple while the baby nurses to help move the milk and clear the blockage. Pump and/or hand express the affected breast after feedings to drain the breast as thoroughly as possible and speed healing.
More tips for feeling better soon:
- Talk with your doctor or midwife about using an over-the-counter pain reliever to help with pain. Pain can inhibit milk letdown, so keeping it under control could help encourage better milk removal. Ibuprofen is a good option because it is also an anti-inflammatory and is considered compatible with breastfeeding.
- Use heat (a shower or hot pack) and gentle massage before feeding to improve milk flow. Use cold packs on the breasts between feeds to help reduce pain and swelling. Lil’ Buds are a great option for this and you can use code LLINK for 10% off.
- Rest, hydrate, and eat nutritious foods. Put on your robe and jammies and put your feet up! Call in extra help from friends or family members for childcare, carpools, meals, etc.
Contact your healthcare provider if:
- After 24 hours of home treatment your symptoms are the same or worse
- You have been running a fever for some time or it suddenly spikes higher
- You have visible pus in your nipple or milk
Breast pain can be caused by lots of things and also be worrisome and confusing. Don’t hesitate to reach out to an IBCLC if you need help figuring out your situation. We can even help on an eConsult. (Pro-tip: Use you Healthcare Spending Account card to book!) I hope this post gives you the knowledge you need to feel more confident with breastfeeding!
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Thanks for stopping by,
Stephanie Weight Hadfield, BS, IBCLC
Amir, L. H. (2014). ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeeding Medicine,9(5), 239-243. doi:10.1089/bfm.2014.9984
Lauwers, J., & Swisher, A. (2011). Counseling the nursing mother: a lactation consultant’s guide (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Mohrbacher, N. (2010). Breastfeeding answers made simple: a guide for helping mothers. Amarillo, TX: Hale Publishing.