Expert Focus: Breast Pain Part 2

On Monday we looked at the variety of possible reasons why breastfeeding mums may experience nipple pain. In today’s post, Sioned shares her top tips on what a new mother can do to be prepared, know what to expect, how to treat and minimise discomfort and when to seek advice...

Anatomy of the lactating breast


  • Have a good chat with your midwife around feeding.
  • Attending a parent craft session on breastfeeding helps and having some practice with holding a doll in feeding positions will help you to handle your baby in a way that allows him to tilt his head back so that he van open his mouth wide
  • Discuss how it should feel – it is normal to have some tenderness and redness


The most common reason for nipple tenderness and soreness is attachment and positioning here are a few tips:

  • Ensure that your baby is positioned comfortably.
  • Supporting baby’s shoulders with the palm of your hand (cross cradle or underarm hold) allows your baby’s head to tip back slightly.
  • Make sure that your baby is in straight alignment i.e. His nose is in a straight line with his umbilicus or his ear is in line with his shoulder and hip – twisting will compromise his ability to open his mouth wide
  • Don’t hold your baby’s head as this pushes the chin and jaw into his chest and
  • Place baby’s nose to nipple and chin to breast.
  • Stroke his lips with your nipple to encourage him to open wide
  • The nipple will fall into his mouth and the tip of the nipple will be at the junction of his soft and hard palate.
  • If it feels wrong take him off and try again
  • His tongue will be over his gums and his upper lip may be flat or slightly flared out – you are unlikely to see what his bottom lip is doing.
  • The amount of areola will vary between women so as long as it is comfortable for you it doesn’t necessarily mean you should get as much into your baby’s mouth and size differs.
  • When you want to bring baby off before he self-detaches you need to break the seal as this can traumatise the breast. Place a clean finger in the side of his mouth and this will break the vacuum.


Further tips for Essential Breastcare:

  • To help with nipple tenderness in the early days – make sure you get good positioning and attachment. If the nipple comes out wedge-shaped your latch isn’t deep and this will make you sore. Take him off and try again.
  • Ask your midwife to assess your feeding and latch. Keep an eye on the nappies too – if stools are slow to change and nappies dry then milk is slow coming in or baby isn’t feeding well and it is usually a latch issue to effectively remove milk.
  • To treat nipple pain and soreness apply some expressed breastmilk after feeds to help with healing and use a nipple cream – Medela Purelan is a hypoallergenic balm that soothes tender and sore nipples and replenishes moisture and assists with healing.
  • Make sure you change bra pads frequently with each feed if you experience leakage as these can make the breast and nipple moist which is a great place for bugs to thrive in a nice warm place
  • If the nipple pain persists again ask your midwife to look into baby’s mouth and check for any tongue restrictions. If this is there you need to be referred to a specialist lactation consultant or tongue tie clinic for a feeding assessment and also treatment as well as support to keep milk production and guidance on feeding baby in interim.
  • If your latch is good but it still hurts and is sore and no tongue tie – it may be a high palate and high vacuum thresholds. Try feeding in a few different positions such as the laid back biological position as this can help. You may find that using a nipple shield can also support you with establishing breastfeeding so that it is an enjoyable feeding experience for you both as this can help reduce the vacuum to a level that is not painful.

Take each feed at a time – use your breathing techniques to help with the after pains, keep on practising and keep asking for help. The national helplines are available as well as the Medela Facebook page.