Breastfeeding: what to do if your breasts hurt

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Breast hurts breastfeeding

"Let's say it right away: breastfeeding doesn't have to be painful and often everything goes well". Word of the gynecologist, expert in the pathology of pregnancy and nursing of the Buzzi Children's Hospital in our city. "If though breast hurts, and it is not just a temporary discomfort linked to the first feedings, it is necessary to investigate better, to understand the causes of the pain and to remedy it ". With some precautions, a little patience and, if necessary, some medication, the situation is resolved within a few days.

In fact it is true: breastfeeding is not always an idyll, especially at the beginning. An incorrect attachment of the baby to the breast, or particular anatomical predispositions, infections, or even a strong stress of the mother can lead to fissures, traffic jams, mastitis, but also candida or vasospasm. All conditions responsible for breast pain, sometimes so strong as to be unbearable and discourage even the most motivated mothers to breastfeed.

"Cracks, traffic jams and mastitis they typically occur in the first few weeks of breastfeeding, while candida and vasospasm can also occur after months or even years, for women who breastfeed for a long time "she clarifies. So let's see what are the main conditions that can cause breast pain during breastfeeding and what to do to make it go away.

In this article

  • The pain of the first feedings
  • The fissures
  • Breast engorgement
  • Mastitis
  • The candida
  • Vasospasm

1. The pain of the first feedings

Sometimes, in the very first few feedings, you may feel discomfort or a little pain in the nipple, as if this were being pulled with force or even "uncorked". "It is a condition due to the stretching of the milk ducts, which occurs due to the suction effect that the baby makes when he latches on and sucks" explains the gynecologist.

In such cases there is nothing to worry about: "The pain - but it is often just a nuisance - lasts for a few seconds at the beginning of the first feedings. After two / three days, nothing is felt".

Breast hurt when breastfeeding, here's how to prevent it

A few small strategies can help prevent ailments responsible for breast pain while breastfeeding. Here are what they are, according to the indications of Unicef ​​and the World Health Organization on breastfeeding and the advice of.

  • Being with your baby as much as possible, from birth. "This is feasible in the vast majority of cases, unless there are special problems with the mother and baby," she comments. Immediately after giving birth, the skin-to-skin contact and rooming in, that is the possibility for mother and baby to stay together in the same room.
  • Don't be prejudiced: every child is different, there is no one-size-fits-all rule, even with respect to how breastfeeding with previous babies went.
  • Ask for help if there is any doubt that the child is not latching on properly. "In the hospital, an experienced operator should check the attachment immediately and see how the mother-baby couple interacts from the very first feedings "explains the gynecologist.
  • Try to attack the baby at the first signal of famand, that is, when he opens his mouth, he turns his head to the side, puts his hands to his mouth. "If you wait when the baby is too hungry and cries desperately, everything becomes more difficult, because positioning him well at the breast is more complicated." Information on hunger signals can also be found in the dossier Breastfeeding: between art, science and nature of the Ministry of Health.
  • Always attach it on request, although in the first few days of life this can mean doing it 15 times a day.

2. The fissures

Cracks are real lesions that form on the nipple: in some cases they are cuts, even deep ones, which can be located in the center of the nipple itself or at the edges. In other cases, the fissure has the appearance of an abrasion, as if the first layer of skin had come off. These lesions can bleed and are always accompanied by quite severe pain, especially at the time of the attack.

"Cracks form because the nipple is constantly rubbing against the baby's palate, rather than remaining fixed without moving at the bottom of the palate itself, "he explains. This can happen for two main reasons:

  • Why the baby does not latch on correctly;
  • Because some anatomical features of the mother or baby make the attack more difficult. This happens, for example, in the case of retracting nipples or if the child has a lingual frenulum that is too short.

In case of fissures, various things can be done to resolve the situation, relieving pain on the spot and preventing lesions from progressing or from forming new ones.

  • The first thing to do, obviously with the help of an expert, is review the position of the feeding, because obviously the baby is not latching on well. If you are still hospitalized you can ask for help at the hospital, or from a counseling center or a breastfeeding expert when you are already at home. The experts will explain how to attack the little one correctly, how often to do it, which positions to try (lying, cradle, crossed, rugby).
  • Keep your breasts open as much as possible, covering it little. Of course, in a way compatible with the "social" commitments of the new mother.
  • Cover the nipple with a few drops of colostrum or milk, which help wound healing. "No special ointments are needed, but if you really want to put something, you can choose concentrated creams based on vitamin E"he comments.
  • There is no reason to suffer: if needed, you can safely take a painkiller. "High-dose paracetamol or ibuprofen, to be taken three times a day, so they always work," advises the gynecologist. "These drugs reduce pain and inflammation and are obviously compatible with breastfeeding."

The correct attack

The first fundamental step for good breastfeeding is that the baby latches onto the breast correctly. Here are the clues that everything is fine, according to the Breastfeeding dossier: between art, science and nature of the Ministry of Health:

  •  The mouth is wide open and the lips are turned out;
  • In addition to the nipple, the baby also has a large part of the areola in his mouth (you must see more free areola above the baby's mouth than below);
  • The baby's chin is in contact with the breast.

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3. Breast engorgement

The breasts are tight, hard, sore and sometimes there may be a little fever, lower than 38-38,5 ° C: here are the symptoms of a breast engorgement, a condition that occurs when there is one imbalance between the baby's demand for milk and the mother's supply, which produces more than the baby can suck. In these cases, the breasts are not drained properly and can lead to congestion.

"It can happen in the first 40 days, during the so-called calibration phase, in which the milk production is adapting to the baby's requests "he explains. But the traffic jam can also form in other situations:" For example if you switch from breastfeeding on demand to one at fixed times, or if for some reason the baby changes habit: maybe the climate changes - from very hot to cooler - and the baby suddenly sterns less ". breast implants, applied in additive plastic surgery can mechanically block the flow of milk and the same can happen if you wear them very tight clothing or bras or with underwire.

Here's how to intervene in the event of a traffic jam:

  • Attack the baby more often, to help with breast drainage;
  • If the tension is unbearable and the baby does not want or cannot latch on, you can also empty the breast manually, making sure to do it only just enough to relieve the discomfort. "If you empty it completely, the message is that more milk needs to be produced, so the operation becomes counterproductive," she explains.
  • Before breastfeeding, a hot-humid compress with water, to facilitate the flow of milk. After the feed, however, a cold compress helps relieve symptoms.
  • Generally, pain relievers are unnecessary in the event of an engorgement, as this is a rather mild situation. However, if the pain is severe, or in any case such as to interfere with breastfeeding which may have just begun and is "fragile", drugs such as paracetamol or ibuprofen can be used.
Also read: Breastfeeding Positions

4. Mastitis

The symptoms of mastitis are very characteristic: a part of the breast is very red, hot, painful and hard. Other than that, there is a general malaise and the fever above 38 ° C.

Mastitis can have two main causes:

  • Inflammation of a mechanical nature, which can result from an incorrect latch, from excessive pressure on the breasts, for example in the case of bras that are too tight or with underwire, from the presence of engorgement not treated adequately. "Even a strong stress of the mother can lead to the onset of mastitis"he explains." This is because stress inhibits the synthesis of the hormone oxytocin, which is critical for the milk ejection reflex. If the mother is very stressed, it may be that the baby, even sucking correctly, is unable to get all the milk out, which stagnates causing inflammation ".
  • Bacterial infections, for example because there are deep fissures, through which bacteria penetrate, or because the mother has low immune defenses.

Mastitis can appear in the first weeks of breastfeeding or around 3/4 months, when returning to work. "In this case, the change in breastfeeding pattern can lead to imbalances in milk production, with accumulations that can lead to inflammation" explains the gynecologist.

Here's what to do in case of mastitis:

  • The first thing to do is increase the frequency of feedings, to facilitate the emptying of the breast. If the attack is too painful or if the baby cannot latch on - for example because the mother has returned to work - manual emptying of the breast is also fine.
  • Very important carefully check the position of the baby during the feeding: "Remember that the area in contact with the baby's cheek is drained more effectively", he explains.
  • If mastitis is accompanied by engorgement, it is good to carry out some compresses: hot-humid before feeding, to favor the emptying of the breast and cold after feeding, for its anti-inflammatory effect. "If there is no traffic jam, hot packs are useless, while cold ones can give some relief."
  • As in the case of fissures, there is no reason to suffer. Yes, therefore, to painkillers, paracetamol and ibuprofen. "Often you just can't do without it," she comments.
  • After 24 hours of the onset of symptoms, if there has been no improvement with the proposed strategies and the fever has not subsided, the doctor will evaluate if it is appropriate to administer an antibiotic (compatible with breastfeeding).

Mastitis is a condition that, if well treated, resolves without problems. However, it should not be neglected, because it can lead to an important complication, namely the abscess.

5. The candida

It is a fungus infection and involves a severe pain similar to pins or a stab, which may persist or even worsen even after feeding. "Sometimes, the mother even refuses to attack the baby, the pain she feels is so intense," she explains. Aside from the particular pain, there are not many characteristic signs: "The breasts may appear pink or shiny, but often nothing is seen."

There are several possible causes: conditions, such as fissures, which can facilitate the onset of infections, mother's antibiotic treatments that cause an imbalance in the populations of microorganisms that populate the body, favoring the onset of infection, baby thrush.

The treatment involves the administration of anti-fungal ointments.

Read also: Breastfeeding, 10 rules to breastfeed well and for a long time

6. The vasospasm

This is a condition that mainly affects women with autoimmune diseases, such as hypothyroidism, but it can also occur in other mothers. It is characterized by a very intense pain, also in this case like a stab, which often also affects the back. "Sometimes this pain also appears outside of the feed," she says.

It depends on a particular constriction of the blood vessels, which is typically triggered by temperature changes. For this, it can be useful to try to keep the breasts warm, by covering them or by practicing a small massage or by applying a hot water bottle.

"B vitamins and possibly a drug called nifedipine can be useful as a therapy, to be used in low doses and with care, because it causes lowering of pressure".

Questions and answers

I am breastfeeding for the first few times and I am experiencing nipple discomfort. It's normal?

In the very first feedings you may feel a discomfort or a little pain in the nipple, as if it were pulled with force or even "uncorked". It is a condition due to the stretching of the milk ducts, which occurs due to the suction effect that the baby makes when he latches on and sucks. There is nothing to worry about, usually after two / three days you do not feel anything.

I am breastfeeding and I have breast fissures: what can I do to make them pass?

The first thing to do, obviously with the help of an expert, is to review the position of the feeding, because obviously the baby is not latching on well. Then it is necessary to keep the breast in the air as much as possible, covering it little. You can also cover the nipple with a few drops of colostrum or milk, which help heal the wounds. Finally, there is no reason to suffer: if you need to, you can safely take a painkiller.  

Breastfeeding and breast engorgement: how to intervene?

In case of breast engorgement, it is advisable to attach the baby more often (this helps the breast drainage). If the baby does not want to latch on, you can also empty the breast manually, being careful to do it only just enough to relieve the discomfort. Before breastfeeding, a warm-moist compress with water can be made to help the milk flow out. After feeding, however, a cold pack helps relieve symptoms. Generally, pain relievers are unnecessary in the event of an engorgement, as this is a rather mild situation. However, if the pain is severe, drugs such as acetaminophen or ibuprofen can be used.

How to relieve the breast?

Much depends on the cause. If the breasts are swollen and painful, there may be mastitis and should be treated as such. A warm compress and an anti-inflammatory may be helpful

What does it mean if the breasts hurt?

The main cause is often linked to an incorrect position of the baby during breastfeeding: the baby does not latch on well and this causes pain in the breast. Remember that the baby's mouth must be wide open and must cover the entire areola and not just the nipple.

  • breastfeeding
  • sinus pain
  • breast pain
  • fissures
  • mastite
  • vasospasmo
  • traffic congestion
  • newborn 0-3 months
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