Thursday, October 30, 2014

Breastfeeding Shouldn't Hurt But That Doesn't Mean it Won't

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If you have ever breastfed or even talked with a lactation consultant or just known someone else that has breastfed, then chances are you have heard the phrase: Breastfeeding shouldn't hurt. But tell that to the millions of women who have breastfed and experienced pain. I'm willing to even bet there isn't a woman out there that has breastfed that can say it never, ever hurt. Even if she has no nipple tenderness or problems with latching, then she's sure to have at least experienced engorgement or a bite or two...and, yeah, that HURTS!

So, then why do we always hear again and again that breastfeeding shouldn't hurt? Well, I guess because, in theory, it really shouldn't (minus those occasional bites - nothing will make a bite to the nip not hurt!). The biggest problem with those 3 little words is that breastfeeding typically takes some learning, and in those beginning weeks, there is often pain or in the least tenderness. But after hearing that pain-free statement over and over it actually plants the thought in the mom's head that she is clearly doing something very wrong because, for some, it hurts a LOT. I strongly believe that this innocent phrase that is uttered so frequently can cause a lot of breastfeeding problems. I, myself, have even said it many times without thinking what the ramifications could be. If breastfeeding isn't pain-free, there is a hope that a mom will ask for help. But, unfortunately, it often leads to a mom feeling as though she is 'failing at breastfeeding.' Maybe a better phrase would be: If you experience pain while breastfeeding, immediately ask for help to determine the cause. And we could even add; Breastfeeding should be comfortable and pain-free but, for a lot of moms in the beginning, it isn't.

There are actually many, many reasons why breastfeeding could hurt and if it does hurt - you aren't a failure. But you do need to determine the cause. If you continue to try to nurse and 'push through the pain' that is actually setting yourself up for failure. In the beginning, you have to nurse a baby constantly and it's not a sustainable activity if you're in pain constantly. (Not to mention, moms are already recovering and many are in pain from the birthing process). Once you have experienced pain while nursing, you will often fear the pain, and then your body will become tense, positioning will become awkward and you will be in even more pain. The cycle needs to be broken. The cause of the pain needs to be determined so you can be pain-free. 

I believe the best defense for pain is knowing some of the most common causes for breastfeeding pain before you even begin nursing. Even if you have already nursed before, it won't hurt to look into this again before your little one is born (because every baby is so different). Make sure you have some kind of buddy system established before the baby's arrival. Find an experienced breastfeeding mother that you know you can call anytime. Trust me, if you have a friend that is passionate about breastfeeding, she won't mind one bit if you call her and ask for help. I promise! And while friends and family are great - sometimes a professional is necessary so plan to have the local Le Leche League or lactation consultant numbers programmed into your phone.

Here are some common causes of pain:

Nipple Tenderness from frequency of nursing: This may seem so obvious but a little problem such as this can lead to a big problem very quickly. Chances are your nipples will become a little tender in the beginning. The hospital where I gave birth supplied me with a small tube of lanolin cream and told me to use it after every single feed. I did as they said and am so thankful for this. I didn't wait until after I became tender, I used it each time from the first feed on.

Let-down: The day my milk came in I was quite surprised by the zings of let-down. Without realizing what I was experiencing, I actually assumed my baby had suddenly (on day 4) developed a poor latch. I was actually taking her off the breast and repositioning her. I thought this was the solution because when I reattached her, I had no pain (because the milk had already come down). Thankfully, I have a good friend who was an experienced breast feeder. She recognized my milk had come in and asked about let-down. I told her I was experiencing pain suddenly and she told me what it was. Sure enough, after a few seconds I felt those zings and then they disappeared (without unlatching and re-latching). And soon enough, I never felt them at all.

Latch: This is probably the biggest contributor to breastfeeding pain. And it can be one of the hardest thing to figure out. If you are having any pain at all during breastfeeding, you should definitely seek help to see if there are any issues with latch including significant problems such as tongue or lip tie or cleft lip or palate. More often though, a baby may have a shallow latch or baby is causing too much drag on the nipples (which can occur, for example, when the baby is fed from the lap instead of propped on pillows). This can cause significant pain AND lead to low supply. An improper latch or poor positioning can ultimately lead to sore and even cracked nipples. This can, of course, lead to very serious pain and other complications. A LC can work with you on different holds, determine if you need to try things such as a C hold or nipple shields and much, much more.

Vasospasms: This is not something I am all that familiar with but I know someone who experienced it and made them very uncomfortable. There was no obvious cause for the vasospasm in my friend's case but latch can often be a contributor. Again, this is why it's so important to contact the LLL or a lactation consultant. KellyMom has some absolutely great info on nursing vasospasms.

Engorgement: In a lot of ways, engorgement is actually a wonderful thing. It means you are producing a whole lot of milk. If your baby is a few months old, it may also mean you just had a luxurious four (or more!) hours of sleep. Engorgement is extremely common in the first few weeks while your baby and body has not quite figured out the entire supply and demand thing. It just happens to be really uncomfortable, too. Unfortunately, many moms turn to their pump when engorged. This does allow for immediate relief but ultimately makes the problem worse because that pump just told your body to go ahead and make some more milk! Check out some fantastic tips on engorgement (as well as some other fantastic breastfeeding info).

Clogged Ducts: Preventing or decreasing engorgement is so important because it can lead to clogged ducts. Clogged ducts are very painful and, worse, it can lead to mastitis - a very serious infection. The best way to avoid clogged ducts is to avoid engorgement. You can do this by ensuring that you don't skip or even delay a feed. When you are beginning to feel pain from engorgement, it's past time to take care of it. This is probably one of the biggest challenges of breastfeeding. It's no longer possible, for example, to just go out for a marathon shopping spree child-free. You have to either bring along baby or your pump or cut your shopping trip short. This becomes a very difficult balance for most women during some point of their breastfeeding journey. It's okay to try to be creative and find ways to get time away but delaying or skipping a feed will likely not be worth the risk of a clogged duct or mastitis. There's lot of info out on the web regarding treating a clogged duct or, again, contact that lactation consultant!

Infections: As mentioned above, mastitis can be a serious breast infection. Thrush is also very common. Both of these require medical treatment. If you ever experience red, tender breasts with itching, burning or a fever contact your doctor or midwife. And don't delay doing this!

These are just some of the causes of breastfeeding pain. The truth is, there are actually many more. But just remember: while breastfeeding shouldn't hurt that doesn't mean it won't and if you experience pain while breastfeeding immediately ask for help to determine the cause.

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