I’ve been a lactation consultant for 3 years. After having my first baby I assumed I’d have no problems or pain with breastfeeding. But, surprise, my baby is not a lactation consultant. And, yes, I had nipple pain and damage.
I’ve told so many new moms “nipple pain isn’t normal, breastfeeding shouldn’t hurt. If it does reach out to a lactation consultant for support.” I now have a few more sentences to add after breastfeeding for the first time.
Here is what I’d want new moms to know: even if you’re doing everything right, your tiny little counterpart is learning, may cause some damage in the process, and might need extra support while figuring out how to latch well.
Babies practice self soothing in utero by sucking on their tongue or thumb. These skills don’t always line up with what we call a ‘nutritive suck pattern’ (ie rhythmic, rolling or wavelike motion of the tongue).
Teaching moms how to “get the perfect latch” is often emphasized repeatedly in the lactation world. You might have heard some of these phrases if you’ve breastfed or read any breastfeeding books:
“Baby’s nose to mom's nipple”.
“Big wide open mouth”.
“Shape the breast in the direction of baby’s mouth”.
These techniques are really important for establishing a good latch, but it leaves out the other half the equation- baby’s mouth and tongue movement. So, here are a few tips for helping your baby learn how to latch well in the first week of life.
How to improve latch and (hopefully!) save yourself some tears during your baby’s first week of life:
Rule out a tongue tie: You can check for one yourself by taking your index finger and gently sweeping under the tongue. If you run into a tight band, the frenulum, your baby most likely has an anterior tongue tie. The frenulum is the membrane that attaches the tongue to the floor of the mouth. When it is short or tight it might make it difficult for the baby to extend her tongue enough to grasp the underside of the mother’s nipple. Rub you baby’s lip from top to bottom and look to see if your baby can extend his/her tongue over the gum line. If your baby’s tongue does not extend over the gum line you are more likely to have pain with breastfeeding and nipple damage as this lack of mobility will pinch your nipple in between the gums or hard palate. If your baby doesn’t appear to have an anterior tongue tie, but you’re still having pain, you might want to check for a posterior tongue tie. To do this you will need a lactation consultant or pediatric ENT to evaluate.
Suck training: If you’re having pain without a tongue tie (or if your baby had a tongue tie that was recently snipped) you should practice something called suck training to help your baby establish a good latch. You can do this by gently introducing your (clean) index finger, palm up, into your baby’s mouth. Allow your baby to start sucking. If you notice your finger is getting pushed into your baby’s gum line, your child is exhibiting tongue thrusting. To help your baby relax gently push your finger down on your baby’s tongue. Your baby’s tongue should curl around your finger and be at the floor of the mouth. Allow your baby to suck on your finger in this pattern for 30 seconds to 1 minute before latching. By helping your baby relax her tongue before breastfeeding you spare your nipple the damage of a tight and arched tongue.
Remember it takes time for both you and baby to learn how to feed comfortably! Using a hydrogel pad in between feedings and lanolin or expressed breast milk on the nipple right before or after a feeding can help reduce the pain. Ultimately, getting baby to suck in a nutritive pattern with a nice wide open mouth and flared lips is the best treatment for sore nipples!
Additional resources for breastfeeding support: