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Is it normal to feel pain while breastfeeding?
Q: Sometimes I have pain when I’m breastfeeding. Why is that?
A: Here are some common sources of breast pain during lactation:


Improper Latch On
If your baby is not properly latched on the breast, you may have substantial nipple pain. Proper latch on should make nursing relatively comfortable. Your baby’s lips should be wide apart on your breast, forming at least a 140-degree angle. And her lips should be located on the dark area around the nipple (the areola) rather than the nipple itself.

Thrush
Some women get yeast infection within milk ducts of the breast. This can create a burning or shooting pain that persists even when you’re not nursing. The nipples may appear reddened with cracked skin or they may look perfectly normal. This pain will not improve with better latch-on techniques and requires medical attention. If you think you have thrush, consult with a lactation consultant or your healthcare provider to obtain anti-yeast medication.

Engorgement
When breasts are overly full, they can be somewhat firm and painful to the touch. This kind of pain will subside after nursing or expressing milk from the breast.

Muscle strain
It’s important to use good positioning techniques to avoid straining your chest, shoulder or back muscles. You should not need to lean over your baby, and your arms, feet and elbows should be supported when you breastfeed. For example, if you’re in a chair, you may place a stool under your feet, and a pillow on your lap to raise your baby to the appropriate level. Additional cushions may be placed behind your back or under your elbows.

Milk let down
A painful milk let down reflex can occur temporarily as your body adjusts to breastfeeding. Milk let down can cause deep twinges as milk is squeezed through the milk ducts to reach the nipple.

Plugged Duct
A plugged milk duct can cause localized pain in one area of the breast, resulting from the backing-up of milk behind this duct. Heating this area and massaging milk through the blocked area can relieve discomfort.

Mastitis
Mastitis is an infection of the breast characterized by fever, pain, redness overlying the area of the affected breast and general feelings of malaise. Contact your doctor if you have these symptoms, as antibiotics are often necessary to cure this problem.

Laura E. Stachel M.D. Obstetrician & Gynecologist