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Breastfeeding should NOT
hurt. Sore nipples are NOT a normal part of breastfeeding!
Although transient, initial sensitivity is common
during the first seconds of breastfeeding in the first week or
two, pain that persists or worsens and nipple damage are red flags
for underlying problems. Although each woman perceives “sensitivity”
and “pain” at varying thresholds, there is a difference
between these words.
Poor or incorrect
latch is the most common cause of sore or damaged nipples. Nipple
pain and damage are in NO WAY related to your skin type, colour
or prior nipple preparation. Your nipples are designed for
breastfeeding and need no preparation whatsoever. As a matter
of fact, so-called nipple preparation can cause serious damage
to nipple tissue, and in some cases, premature labour (see Preparing
for Breastfeeding).
If
your nipples are tender beyond a few seconds when your baby latches
on, or so painful that you cannot, or do not want to breastfeed,
the suggestions below may help. Too many new mothers are wrongly
told that their baby's latch is fine in spite of persisting pain.
Whomever tells you this is unfortunately misinformed or lacks
the skills and experience to identify the problem. However, pain
does not lie and should be taken seriously. Do not wait to contact
a skilled lactation professional, such as your local IBCLC. Together,
you and she will seek out the cause of your pain, whether it be
poor latch, infection or other. There is always a solution before
giving up!
SUGGESTIONS
1. Identify and correct the cause of your sore
nipples. Have a skilled professional observe you while you nurse
your baby.
2. Position yourself so that you are sitting upright with a pillow
behind you and your knees higher than your hips.
3. Position your baby at the breast so that he is able to get
a large amount of the areola into his mouth, and not latch on
just to the nipple. Latch should be asymmetrical, meaning your
baby should take in a larger portion of the breast with the lower
jaw.
4. Treat any engorgement you may have. Engorged breasts may make
it difficult for your baby to latch on properly. Engorgement,
if left untreated, can seriously jeopardise your milk supply,
as well as be extremely painful.
5. Reposition your baby's lips if they are not flanged out.
6. Air-dry your nipples well after each feeding and/or pumping.
Leave your breasts exposed to air as much as possible.
7. Opt for relatively short, frequent feedings, rather than longer,
spaced out feedings. Use breast compression to make feedings more
efficient. If possible, vary positioning to minimise pressure
on the affected area.
8. Offer the least sore side first. However, do not neglect the
sore side.
9. Massage the breasts before nursing, to stimulate the letdown
reflex. By doing this, you reduce the time that the baby spends
suckling more rapidly and vigorously to stimulate letdown, which
can often be most uncomfortable for sore, damaged nipples.
10. When using a breast pump, apply olive oil to the nipple and
areola before pumping to prevent the discomfort of friction on
sore areas. Begin with the pressure setting on low. Increase the
pressure as your pain tolerance allows.
If
the pain persists or worsens, seek help from a skilled professional
(IBCLC or nurse/physician with experience in breastfeeding management).
See also Dr. Jack Newman's
article Sore
nipples
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