As much as we hear that nipple pain during breastfeeding is not normal, it IS common. Our mothers and grandmothers (and even our friends) will tell us that our nipples will “toughen up” but is that true? What is the deal with nipple pain? And will it go away? It is a complex issue and at the risk of oversimplifying it, let’s wrap our minds around it at a high level.
In the early days a lot of feeding on nipples that have never experienced so much traffic ;-). You can imagine if you licked your lips over and over again they’d become chapped. Similarly, if a baby is licking your nips all day long, a baseline of freshly-nursed-on nips will be pretty chapped. (Insert a good oil based nipple balm here. I love lanolin, MediHoney or Earth Mama etc). Nipple pain that is persistent beyond the first week or so can be looked at in three main ways in terms of root causes.
1) Physiologic
Shallow latch/ friction, inverted nipples, pump trauma, biting, pulling off without breaking suction, persistent tight mouth, tongue tie or recessed jaw, unusual palate shape, body tension in baby, positioning issues, infection (fungal or bacterial), skin problems, milk overproduction, vasospasm, engorgement, pregnancy/menstruation, wounds, D-Mer etc.
2) Neuropathic
Nerve pain can present as a long-lasting pain caused by damage to the somatosensory nervous system. It may feel a shooting/stabbing or electric pain, tingling, burning, or hypersensitivity. This can sometimes be caused by a pinched nerve, nerve damage, poor posture, sitting in one position for too long, muscle imbalances, injury, fatigue, or stress.
3) Psychological
This is complex and multifaceted but it can include anticipation of pain from prior trauma to the nipple that may be resolved, sexual trauma, prior poor breastfeeding memories.
This is not meant to diagnose or be a comprehensive list of reasons or root causes but to give you some basic ideas of looking at nipple pain through this simplified framework. If you have persistent nipple pain contact a qualified IBCLC in your area for a visit.
Sources:
- physicianguidetobreastfeeding.org
- “Breastfeeding Answers Pocket Guide Second Edition” By Nancy Mohrbacher, IBCLC FILCA, 2021.
- “Counseling The Nursing Mother - A Lactation Consultant’s Guide - Seventh Edition” By Judith Lauwers and Anna Swisher, 2021.
