Breastfeeding can feel tender at first, especially when your baby initially latches.
But pain that continues through a feed, happens repeatedly or leaves your nipples cracked, bleeding or damaged is not something you need to simply push through.
You and your baby are learning a new skill together, and sometimes a small change in positioning or attachment can make a surprisingly big difference.
The important thing is knowing the difference between early sensitivity and pain that is telling you something needs attention.
What should a feed actually feel like?
Breastfeeding does not necessarily feel like nothing.
You may notice a strong pulling or tugging sensation once your baby begins sucking. In the early days, some women also experience brief tenderness during the first few sucks.
What you should not be feeling is sharp, pinching, burning or intense pain that continues throughout the feed.
Pay attention if:
- the pain continues after the initial latch
- every feed hurts
- your nipples are cracked, blistered or bleeding
- your nipple looks flattened, pinched, creased or white after a feed
- the pain is becoming worse rather than better
- feeding had become comfortable and suddenly becomes painful again
Those are clues that something may need to be looked at rather than something you simply have to tolerate.
Start with the latch
One of the most common reasons breastfeeding hurts is that the baby is not attached deeply enough to the breast.
During an effective latch, your baby takes the nipple and a good portion of the surrounding breast tissue into their mouth. Their lips are generally turned outward, their cheeks stay rounded while sucking, and you may hear or see swallowing once milk begins flowing.
The feed should feel like pulling rather than pinching.
It can also help to look at your nipple when your baby comes off.
Ideally, it should still look rounded.
If it comes out flattened, creased, pinched or shaped a little like a new tube of lipstick, that can be a clue that your baby has been compressing the nipple rather than taking a deeper mouthful of breast tissue.
If the latch hurts beyond the first moments, gently place a clean finger into the corner of your baby’s mouth to break the suction, reposition them and try again.
Sometimes the problem isn’t just the latch
Correcting positioning is an important first step, but persistent nipple pain can have other causes.
Restricted tongue movement, including some cases of tongue-tie, may make it harder for a baby to maintain an effective latch.
Nipple or breast inflammation, skin irritation and infection can also contribute to pain.
That is why repeatedly changing breastfeeding positions without improvement should not become an endless experiment.
If feeding still hurts despite working on the latch, it can be useful to have someone experienced observe an entire feed.
A lactation consultant, public health nurse, midwife or another healthcare professional experienced in breastfeeding support may notice something that is extremely difficult to see while you are holding and feeding your own baby.
If pumping hurts too, check the pump
Breastfeeding is not the only thing that can make nipples sore.
Pumping should not repeatedly injure your nipples either.
If your nipple rubs against the sides of the flange, becomes very swollen, turns noticeably red or feels increasingly sore after pumping, the flange fit or suction may need adjusting.
Your nipple should sit reasonably centrally within the flange tunnel and move without excessive rubbing.
More suction is not automatically better.
Use a level that feels comfortable rather than assuming the strongest setting will remove the most milk.
If pumping continues to hurt, a lactation professional can also help assess flange fit and technique.
What about nipple shields?
A nipple shield is a thin silicone cover placed over the nipple during breastfeeding.
It can be genuinely useful in certain situations, but it works best as a tool rather than a substitute for figuring out why feeding hurts.
If you are considering one because your nipples are extremely sore, getting support with the fit and having someone observe a feed can help make sure your baby is still attaching effectively and transferring milk well.
For some families, a nipple shield can make breastfeeding more manageable while a specific problem is being addressed.
The important part is making sure it is being used for the right reason.
What can actually help sore nipples?
The first priority is dealing with whatever is causing the pain.
A cream cannot compensate for a painful latch happening eight or more times a day.
While the underlying problem is being addressed, a few simple things may make feeding more comfortable.
Keep breast pads clean and change them when they become damp. Avoid repeatedly washing your nipples with soap, which can dry and irritate the skin.
If your breasts are very full and your baby is struggling to attach, expressing a small amount of milk beforehand may soften the breast enough to make latching easier.
If breastfeeding has become extremely painful, expressing milk may sometimes provide a temporary alternative while you seek help and maintain milk production.
And you do not need a bathroom cabinet full of nipple products.
If your nipples are significantly damaged or you are considering creams, medications or other treatments, speak with a healthcare provider or lactation professional about what makes sense for your situation.
Don’t ignore changes in the breast itself
Nipple soreness is one thing.
Pain accompanied by changes in the breast or feeling generally unwell deserves more attention.
Seek medical advice if you develop symptoms such as:
- an increasingly painful area of the breast
- significant redness, swelling or warmth
- pus or unusual drainage
- fever
- chills or flu-like symptoms
- symptoms that are getting noticeably worse rather than better
These symptoms can occur with mastitis or another breast problem and should not simply be treated as part of normal breastfeeding discomfort.
Getting help early can save you days of pain
You do not have to figure breastfeeding out alone.
Sometimes another person watching one complete feed can spot something you simply cannot see from where you are sitting.
A lactation consultant, midwife, public health nurse or another qualified breastfeeding professional can look at positioning, attachment, nipple damage, your baby’s feeding behaviour and whether something else may be contributing to the problem.
Getting help does not mean breastfeeding is going badly.
Sometimes it means you have caught a fixable problem before it becomes a much more painful one.
If breastfeeding hurts, pay attention
A little early tenderness and a feed that makes you brace yourself are not the same thing.
If you are watching the clock because you are already dreading the next feed, if your nipples are becoming progressively more damaged, or if you find yourself curling your toes every time your baby latches, that is enough reason to ask for help.
Sometimes the fix is surprisingly small: a different position, a deeper latch, adjusting a pump flange or having someone notice something you simply cannot see while feeding.
Breastfeeding can take practice.
Repeated pain should not be the price of learning how to do it.