GW Breastfeeding ProgramInteractive Learning Module:

Breast and Nipple Pain

Continue

The questions in this interactive guide are designed to help breastfeeding mothers who are experiencing discomfort or pain to evaluate some possible causes and to learn more about some suggested plans of treatment. This guide is not intended to take the place of professional or other lactation services, and will be most effective if used in conjunction with other breastfeeding support provided by the GW Breastfeeding Program or other programs for breastfeeding mothers.

How To Use This Guide

Continue

If you are fairly certain of the cause of your breast or nipple pain, and would like to go directly to the list of resources, click on one of the links in the index below.

Biting and clamping down Pregnancy while breastfeedingEngorgement Tongue-tieLatch/positionVasoconstriction of chest musclesMastitis Vasospasm of nipplesPlugged duct Yeast Infections (thrush)

Otherwise, you will be guided through some questions designed to help diagnose the problem and find solutions.

What do you need?

Continue

Most breastfeeding pain can be described as either primarily nipple pain or primarily breast pain, even if there is some of both.

How would you describe the pain you are feeling?

Primarily nipple pain Primarily breast pain

Where is the pain?

Nipple pain is a VERY common complaint of breastfeeding mothers, especially in the early weeks. This is most often caused by the way the baby is latching on to the breast.

Nipple Pain

The baby’s mouth should be wide open,with his bottom lip turned outand as far below the nipple as possible.

Continue

Sometimes, learning to reposition the baby and encouraging a deeper latch will immediately reduce a mother’s nipple pain. In other cases a baby may be unable to achieve a good latch because of a condition known as “tongue-tie,” in which a small piece of skin connecting the tongue to the floor of the mouth prevents the tongue from moving freely.

Latch and Tongue-tie

Continue

Learn more about achieving an effective, pain free latch.

Learn more about tongue-tie.

If you don’t think your nipple pain is caused by latch problems or tongue tie, read about some other possible causes.

Do you think you knowwhat’s causing your nipple pain yet?

Yeast infections of the nipple (thrush) often cause the nipples to appear red or shiny, and the nipple pain may be accompanied by burning or shooting pain in the breast. Thrush is contagious, and the baby may have white patches in his mouth or a red, shiny diaper rash.

Yeast Infections

Continue

Other infections may be caused by bacteria that enters through cracked nipples. Bacterial infections of the breast (mastitis) cause both nipple and breast pain and may be accompanied by fever and other flu-like symptoms. Treatment may include antibiotics.

Learn more about yeast infections of the nipple.Learn more about mastitis.

Other Infections

If you don’t think your nipple pain is caused by an infection, read about some other possible causes.

In vasospasm or Raynaud’s syndrome, the nipples appear white in color and the pain is often following, rather than during, feeding. Learn more.

Nipple pain can also be caused by a baby that bites during feeding. Learn more.

Finally, sometimes nipple pain during breastfeeding is an early sign of pregnancy. Learn more about continuing to breastfeed while pregnant.

STILL NOT SURE?

Other Causes of Nipple Pain

In nipple vasospasm, the pain usually occurs after, rather than during, the feeding The nipple frequently turns a whitish color and the pain is often described as burning or throbbing.

If you suspect vasospasm may be causing your nipple pain, read more about causes and treatment.

If not, return to the other causes of nipple pain or continue.

Vasospasm of Nipple

All babies may occasionally bite if startled or when teething.

Babies who bite or clamp down on the nipple more than just occasionally, and usually beginning right after birth, may have a temporary condition known as “clamp-down bite reflex.”

Learn more about biting and clamping down, return to the other causes of nipple pain, or continue.

Biting and Clamping Down

Sometimes nipple or breast pain while breastfeeding an older baby may be an early sign of pregnancy. This is more likely to occur if the baby is only partially breastfed or has started eating solid foods.

Learn more about continuing to breastfeed while pregnant, orreturn to the other causes of nipple pain.

Still not sure?

Breastfeeding and Pregnancy

Engorgement is a common cause of pain when the baby is about 3-5 days old and the mature milk first “comes in.” The breasts may be swollen and hard and the nipples become flattened, which may make it difficult for the baby to latch on. Learn more about engorgement.

Plugged milk ducts cause milk to back up and may cause pain. Sometimes a lump can be felt in the painful area Learn more about plugged ducts.

Bacteria can enter through a cracked nipple, causing an infection of the breast (mastitis). The nipple and/or breast may be painful, and you may also feel ill or have a fever. Learn more.

Another possible, although less common, cause of breast pain is vasoconstriction of the chest muscles, which often occurs in combination with shoulder pain. Learn more.

STILL NOT SURE?

Some Possible Causes of Breast Pain

Painful engorgement can often be relieved by frequent feeding, but sometimes additional measures are helpful. Also, feeding may be more difficult if the engorgement causes the nipples to become flat.

Is engorgement causing your breast pain? Learn more.

If not, return to the other causes of breast pain.

Engorgement

Plugged ducts usually occur when the breast has not been effectively emptied, because of missed feeds, a tight bra that prevents emptying of one area, or always feeding in one position.

Plugged Duct

If you suspect that you have a plugged duct, learn more. Otherwise, return to the other causes of breast pain

Mastitis may be caused by bacteria that enters through cracked nipples. Bacterial infections of the breast can cause both nipple and breast pain and may be accompanied by fever and other flu-like symptoms. Treatment often includes antibiotics.

Mastitis

If you suspect that you have mastitis, learn more.

Otherwise, return to the other causes of breast pain

Vasoconstriction of Chest Muscles

Find out more about this syndrome, or return to the other causes of breast pain.

In vasoconstriction of the chest muscles, also known as mammary constriction syndrome, the pectoral muscles in the chest exert pressure on the blood vessels leading to the breasts and nipples, which may cause various types of pain. This is sometimes caused by muscle injury during pregnancy or labor.

What Should I Do If My Baby Bites Me? (La Leche League International)

When Baby Bites (Kellymom)

Teething and Biting (Breastfeeding Basics)

Clamp-down Bite Reflex (La Leche League International)

Biting and Clamping Down

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Breastfeeding During Pregnancy (La Leche League International)

Is it Safe to Breastfeed During Pregnancy? (Baby Center)

How to Recognize the Signs of Pregnancy While Breastfeeding (Hubpages)

Early Signs of Pregnancy While Breastfeeding (Livestrong.com)

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Breastfeeding and Pregnancy

Return to index

Relieving and Treating Engorged Breasts (Medela)

Engorgement (Breastfeeding Basics)

Engorged Breasts (Babycenter)

Engorgement (Ask Dr. Sears)

Tips to Relieve Engorgement (Pump Station)

Engorgement

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Deep Latch Technique (Youtube video)

Proper Positioning and Latch (collection of articles from La Leche League International)

Deep Latch Technique (Pump Station)

The Mother-Baby Dance: Positioning and Latch-on (La Leche League International)

Ensuring Proper Latch-on (Healthy Children)

Breastfeeding Latch (American Pregnancy Association)

Latch and Positioning

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Mastitis (Mayo Clinic)

Mastitis While Breastfeeding (WebMD)

Plugged Ducts and Mastitis (Kellymom)

Blocked Ducts and Mastitis (BreastFeeding Inc)

Mastitis

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Plugged Milk Ducts (Ask Dr. Sears)

Blocked Duct During Breastfeeding (Babycentre)

Clogged Milk Ducts (American Academy of Pediatrics)

Plugged Milk Ducts Symptoms, Causes, and Treatment (Justbreastfeeding.com)

Plugged Duct

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Tongue-tie and Breastfeeding (La Leche League International)

Tell Me About Tongue Ties (Breastfeeding, USA)

Congenital Tongue-tie and its Impact on Breastfeeding (American Academy of Pediatrics) – a good article to show medical professionals who hesitate to treat tongue-tie in breastfeeding babies

Breastfeeding and Tongue-tie (Today’s Parent)

Tongue-tied Breastfeeding (Breastfeeding-problems.com) – has a good photo of what tongue tie looks like

Tongue-tie

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Mammary Constriction Syndrome (Breastfeeding Support)

Dr. Jack Newman talks about a possible cause of breast pain and a massage technique that can help... (Kellymom)

Why Does Breastfeeding Hurt? (Massage for Mums)

Vasoconstriction of Chest Muscles

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Vasospasm and Raynaud’s Phenomenon (International Breastfeeding Centre)

Nipple Blanching and Vasospasm (KellyMom)

Vasospasm – Symptoms and Treatment (BellyBelly)

Vasospasm of Nipple

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Candida (yeast) Infection on Nipples (Ask Dr. Sears)

Yeast infections and the Breastfeeding Family (La Leche League International)

Yeast Infections or Thrush (Breastfeeding Basics)

Thrush in Breastfeeding Moms (Baby Center)

Thrush Resources (Kelly Mom) – a collection of articles about yeast infections in breastfeeding mothers

Yeast Infections

If none of these resources help to resolve your difficulty, please make an appointment to see a lactation consultant or breastfeeding counselor, or join us at a drop-in breastfeeding support group meeting on the George Washington

University campus..

RESOURCES

Return to index

Breast and nipple pain can be difficult to diagnose and treat. If you’re still not sure what’s causing yours, please consider getting some help.

If you live in the DC area, join us at a drop-in support group on the George Washington University campus. Or, contact us and we’ll get back to you with some suggestions.

Otherwise, feel free to return to the beginning of this module and try a different path.

Still not sure?