Whether you're new at it or an experienced pro, breastfeeding can inspire a ton of questions about your body that you may never have thought of before. When I started breastfeeding my daughter, one of the earliest questions I had was, “Why are my nipples sore?” — a common discomfort breastfeeding parents might face at some point. But what does it mean if your nipples hurt while breastfeeding? Here’s what the experts want you to know about the potential causes.
Reasons for sore nipples while breastfeeding
One major cause of nipple pain is poor positioning. "I tell all moms I work with that the latch should not be painful,” international board-certified lactation consultant (IBCLC) and registered nurse (RN) Jennifer Passwaters tells Romper. “A painful latch means baby isn't getting good milk transfer.” While feeling a tugging or pulling sensation is normal, feeling a pinching sensation is not. "Some soreness is normal, especially in first few minutes, but pain never is," Passwater explains. You can definitely do some research and try out different positions on your own to help, but the easiest way to fix the problem is to see a lactation consultant.
“The most common reason for nipples to hurt during a breastfeed is due to a shallow latch,” Chrisie Rosenthal, an IBCLC with The Lactation Network, tells Romper. “Luckily, this issue is often addressed fairly easily by working with an IBCLC who will guide you with latch and positioning techniques to maximize both comfort and milk transfer.”
If the problem is a bad latch, there are signs to look out for. "When the baby comes off, the nipple should be round," IBCLC Tera Hamann tells Romper. "But if it is flat, or lipstick shaped, it's a sign that there is a bad latch." She notes that often even the slightest changes in positioning can make a big improvement.
Another common cause of pain in the nipples is tongue ties or lip ties in the baby. "These situations require the help of a knowledgeable IBCLC who can refer mom and baby to a provider who can perform a clip procedure," Passwaters says. While it is possible for a tongue tie to resolve on its own, often it will need to be treated with surgery, such as a frenotomy or a frenuloplasty.
“Another reason that a parent may be experiencing nipple pain when breastfeeding is overactive milk ejection reflex,” Rosenthal says. “Parents who have very strong milk supplies often have milk that lets down quickly, and babies will sometimes hesitate to latch deeply and clamp on the nipple to control the flow.”
You may not know this is the source your pain until you visit a professional, which is why talking to a lactation consultant or OB-GYN about nipple soreness is a must. “Your IBCLC can work with you to both suggest positions for giving baby more control of the flow — and for fine-tuning your supply, if needed.”
A vasospasm, as IBCLC Michelle Kunschke explains, is when blood is pushed out of the nipple due to situations with poor latch or positioning, poor suckling mechanics in the baby (such as a tongue tie), or if the mother has Reynaud's syndrome, in which vasospasm causes the nipple to turn white after the baby unlatches, and it may then turn blue, purple, or red-toned. Kunschke adds that those with Reynaud's often have painful fingers, toes, or nipples in the cold. "An IBCLC will be able to offer support and guidance and help the parent find out the cause and therefore appropriate solutions," Kunschke says.
Your menstrual cycle, or even pregnancy, can also be the culprit. Hamann notes that hormones, whether they are due to pregnancy or just your period, can make nipples sore and tender. According to Hamann, when you are breastfeeding, cycles can be irregular, and pregnancy may not be on your radar. "When everything else has been going well for weeks to months and there is no obvious explanation, it's not a bad idea to take a pregnancy test," she suggests.
Since there are so many things that can cause nipple pain while you are breastfeeding, it is a good idea to enlist the help of a medical professional, be it a lactation consultant or OB-GYN. Nipple pain beyond some mild discomfort is never a normal thing that you just have to put up with, so you'll want the support of someone who can give you the best advice to help you through it and on to a more pleasant breastfeeding journey.
Jennifer Passwaters, IBCLC and registered nurse
Tera Hamann, IBCLC
Michelle Kunschke, IBCLC
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