Ouch! That hurt!

The first time you breastfeed or use a breast pump, you might be surprised at how the experience differs from your expectations. While the results may be well worth the annoyances, it’s not always pain-free, particularly in the beginning.

But, though it’s true that minor discomfort can be a part of pumping and feeding, you shouldn’t be in serious or long-term pain.

For first-time parents especially, it can be difficult to know the difference between what’s normal and what isn’t. So, what’s run-of-the-mill unpleasantness and what’s cause for concern?

We explain what’s normal nipple pain and what isn’t.

Normal nipple pain 

According to the experts at Children’s Minnesota health system, some types of discomfort are common:

  • Unpleasant feeling during letdown. When your milk releases during a feeding or pumping, you may feel a quick but sharp tingling or pins-and-needles sensation.
  • Pain while collagen fibers in your nipple stretch. This is an extremely brief, 10-15 seconds of pain at the beginning of a feeding or pumping session.
  • Slight nipple tenderness after the end of a feeding or pumping session.

Cracked nipples

Nipple pain can be particularly common during the first few weeks after a baby is born. But discomfort should not be ignored, and can have many causes, including cracked nipples.

Cracked nipples, also called nipple fissures, form in your nipples or areolas, often during breastfeeding but also from other causes like exercise. They can cause your nipples or areolas to feel dry, raw or itchy, and they may bleed or form scabs. Though they’re common, you don’t have to live with them. Here are some tactics for treating and preventing cracked nipples.

  1. Use nipple creams and breast-pump lubricants. Lanolin, made from a wax secreted by sheep, is often considered the old standby. However, if you have an allergy to lanolin, there are dozens of other types of creams that are designed to prevent friction while pumping. Just make sure to use creams or lubricants that are safe for your baby to ingest.
  2. Check your flange size. If you’re pumping and have cracked nipples, make sure the flange is the ideal size for you. Your nipple should not rub against the side of the flange and your areola shouldn’t come too far into the flange while you’re pumping.
  3. Check your baby’s latch. If you’re breastfeeding, check to make sure that the baby is latching on properly. A midwife, lactation specialist or doctor can help you suss out latch issues, but clues to latch problems are that your nipple is white, flattened, wedge-shaped or bent after feedings.
  4. Consider lowering the suction on your breast pump. This may feel counterintuitive as you’re probably trying to get the most milk from each pumping session. But experts say that higher suction settings don’t necessarily translate to more milk. You may get great results from lowering the suction and instead massaging your breast while you pump.
  5. Think about what touches your nipples and areola. Your nipples can get more irritated when they rub against scratchy, rough fabrics or when your clothes are too tight. Consider cotton fabrics, and if you use breast pads, change them often.

When to Call a Doctor About Your Nipple Pain

Sometimes, however, your nipple and/or areola pain can be a sign of a serious medical condition such as mastitis, a clogged milk duct or an infection.

Here are signs you should call your doctor:

  • Hot, swollen, oozing, pus-filled or blistered nipples or areola, or bruising on your breast or nipples.
  • Hard or painful lump in your breast or underarm that does not go away with feeding, pumping or massage. This may mean you have a clogged milk duct.
  • Symptoms of mastitis, which can include fever, chills and painful or reddened spots on your breast.
  • Symptoms of thrush, a yeast infection of the nipples, that can include a burning or stinging sensation in nipples.
  • Severe pain during breastfeeding and/or pumping, or after a pumping or feeding session has ended.

If you are experiencing nipple pain or other problems with breastfeeding or breast pumping, try not to blame yourself. Our bodies are all different and what comes easily for one person may be difficult (or impossible) for another.

These issues aren’t new and they aren’t your fault. Remember, you’re working hard to give your baby the best possible start in life. Congratulations on doing such a great job!