Will breastfeeding hurt?

“Oh my God! It’s no more hurting!!! And it is actually so pleasant!” – exclaimed the mother having her one-week-old-baby breastfeeding for the first time without pain during one of my home visits recently, – “You did magic! Breastfeeding became completely painless although I thought my nipples needed more time to “toughen up”. In fact, I was ready to switch to formula if it would not get better soon. I’m so glad I can continue breastfeeding and now actually enjoy it!”

This story is not unusual in Lebanon. Many and many new moms give up breastfeeding because their experience becomes so painful that they cannot stand it. But what they don’t know is that it is not supposed to be this way. The mother, whose story you just read, emailed me explaining that breastfeeding “hurts like hell” and that she started using nipple shields to help her cope with pain. As soon as I arrived to her place we put the shields away and positioned the baby at the breast with slight “magical” adjustments. The result was immediate – no more pain! The baby was content as well – he started suckling and swallowing the milk loudly.

It is true, the nipples might be sensitive in the early days after birth and it may cause some discomfort at the beginning of every breastfeeding session, but it should never be painful to the point that the mother has to clutch her teeth to bear the pain and often break into tears. If the pain is acute, lasts more than a few seconds from the beginning of breastfeeding and continues past the first 4-5 days after birth, it’s a sign that if nothing gets changed the results may be devastating – decrease of milk supply and severe nipple damage with cracks and bleeding. The good news is that if there is pain while breastfeeding, it can be fixed.

The secret of pain-free and efficient breastfeeding is having the baby’s mouth very wide open taking inside not only the nipple but also a large part of the darker area of the breast, called areola.  Ideally he should take all the areola inside the mouth! If it’s not possible (his mouth is too small for it) then he should take 2/3 of it from the bottom and 1/3 from the top. The angle of his mouth when he is at the breast must be about 130 degrees, not 90 as you usually see when the baby is eating from a bottle.

When the child takes the breast deeply into his mouth together with the areola, he massages hidden points there which cause the breast to release the milk, the effect known as a ”letdown”. Only during the letdown (and sometimes the child stimulates 2 or 3 of them during each feeding) the child can receive sufficient amount of milk and satisfy his hunger.

However, when the child sucks only on the nipple, which is a very common mistake in Lebanon (and it should be called “nipplefeeding” instead of breastfeeding)  the letdown might never happen at all and after long and inefficient suckling at the breast the child will fall asleep tired while still being hungry. He would wake up hungry, cry to eat, fall asleep hungry again and the same pattern will continue repeating hour after hour till the worried parents will start doubting whether breastmilk is enough for their child and decide to introduce formula. At first, the mother’s milk WAS enough but the child was not able to remove it, and soon, as a result, the milk production started dropping as the amount of milk is determined by “demand and supply” rule. This means that the more milk the child takes from the breasts, the more milk will be produced for the next feeding. That is why, it is so important to ensure that the child takes the breast deeply into his mouth and there is no pain while nursing. Pain is the body’s sign that something needs changing as the baby might not be receiving milk.

So how to help the baby take the breast deeply into his mouth? It’s very simple! First, try a laid-back position for breastfeeding. This position by itself without you doing anything else different might fix the problem as the gravity will be helping the child take more breast tissue into his mouth. (See biologicalnurturing.com for more info).  If the child did not like the position, then you might try the following in the position that you both like:

1)   Pull the child’s body as close as possible to you so there are no gaps in between you too.

2)   Have the child’s body aligned to you with his front towards your front. Make sure the baby does not need to turn his head towards your nipple and his ear, shoulder and hips are all in one line.

3)   Touch child’s nose with your nipple first to encourage the baby open his mouth wide and try to reach “from below” to take the breast. This way the child will be encouraged to take more areola into his mouth having the nipple enter last and pointing more towards the top of the mouth.

If your baby is taking the breast correctly there will be no pain! If you experience pain you will need to remove the baby from the breast by first inserting your pinkie into the corner of baby’s mouth to break the suction and then start over again. Some babies catch on quickly, while others need more time. This training during early weeks is well worth the effort. Not only it prevents sore nipples, but it also ensures the baby gets the most milk for his efforts and stimulates a full milk supply. Within a short time, it will become quick and automatic, but in the meantime plan to spend some time at each feeding helping your baby take the breast so it does not hurt you.

A lady in her 7th or 8th month of pregnancy was shaking my hand enthusiastically after talking to me at Mother and Baby show in Biel last month: Thank you so much! You have taken a huge worry off my chest and now I’m no more afraid to breastfeed. Instead I’m sincerely looking forward to it! I’ve been afraid of breastfeeding more than of giving birth.  My mom had breastfed 4 of her children enduring pain and bleeding till with the birth of the 5th the nipple damage was so much that the doctor asked her to stop even trying to breastfeed. I knew I wanted to breastfeed as this is the best nutrition for the baby and it has many benefits for the mom as well, but I was truly petrified of the coming painful experience, as I expected it to be. I wish you could tell every woman who gives birth what you just told me –breastfeeding is not supposed to hurt and if it does, then something needs changing so that  it can become completely painless and enjoyable, as nature intended it to be!”.

I hope that this article in Moms and To Be magazine will find its way to thousands of women in Lebanon and help everyone to have a great breastfeeding experience without discomfort! And if the information here seemed useful, then attending one of our workshops might also be of interest!

-By Nadiya Dragan El-Chiti,
Breastfeeding Counselor and an Experienced Nursing Mother
Trained and Certified by World Vision in “Exclusive Breastfeeding”

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