Among the difficulties encountered during breastfeeding, nipple pain is the first line. Still, breastfeeding your baby shouldn’t be painful. Pain is most often a signal that the baby’s position and / or sucking is not correct. It is important to correct them as soon as possible to avoid entering into a vicious circle that could interfere with the continuation of breastfeeding. 

Many mothers experience mild pain when breastfeeding. Most often involved, a bad breastfeeding position and / or a bad sucking of the baby, the two being obviously often linked. If the baby is not positioned correctly, he latched onto the breast, does not suck properly, stretches and presses the nipple abnormally, making breastfeeding uncomfortable and even painful.  

Left untreated, this pain can progress to cracks. This lesion of the skin of the nipple ranges from simple erosion, with small red lines or small cracks, to real wounds that can bleed. Since these small wounds are an open door for pathogens, the crevice can become the site of infection or candidiasis if not treated properly.

Since breastfeeds are painful, whether there are cracks or not, it is important to correct the breastfeeding position and the baby’s mouth grip. Above all, do not let these pains set in, they may interfere with the continuation of breastfeeding.  

Positions for effective sucking

As a reminder, for effective suction: 

• the baby’s head should be slightly bent back;
• his chin touches the breast;
• the baby should have her mouth wide open in order to take a large part of the areola of the breast, and not just the nipple. In his mouth, the areola should be slightly shifted towards the palate;
• during feeding, her nose is slightly open and her lips curved outwards. 

The different breastfeeding positions

To obtain this good sucking, there is not just one breastfeeding position but several, the most famous of which are:

• the madone,
• the reversed Madonna,
• the rugby ball,
• the lying position.

It’s up to the mother to choose the one that suits her best. The main thing is that the position allows the baby to take a large part of the nipple in the mouth, while being comfortable for the mother. Certain accessories, such as the nursing pillow, are supposed to help you settle in for the breastfeeding. Be careful, however: sometimes they complicate it more than they facilitate it. Used in the Madonna position (the most classic position) to support the baby’s body, the nursing pillow tends to move his mouth away from the breast. He then risks stretching the nipple.  

Le «biological nurturing»

In recent years, the biological nurturing, an instinctive approach to breastfeeding. According to its designer Suzanne Colson, an American lactation consultant, biological nurturing aims to promote the innate behaviors of mother and baby. In biological nurturing, the mother gives the breast to her baby in a reclined position rather than sitting, her baby flat on her stomach. Naturally, she will guide her baby who, for her part, will be able to use her innate reflexes to find her mother’s breast and suck effectively. 

It is not always easy to find the right position, so don’t hesitate to get help. A breastfeeding specialist (midwife with a breastfeeding IUD, IBCLC lactation counselor) will be able to guide the mother with sound advice and reassure her about her ability to feed her baby. 

At the same time, it is important to facilitate the healing of the crevice, with healing in a humid environment. Different methods can be tested:

• breast milk to be applied to the nipple a few drops after feeding, or in the form of a bandage (soak a sterile compress with breast milk and keep it in place on the nipple between each feeding).
• lanolin, to be applied to the nipple between feedings, at the rate of a small amount previously heated between the fingers. Safe for the baby, it is not necessary to remove it before feeding. Choose it purified and 100% lanolin.
• coconut oil (extra virgin, organic and deodorized) to apply to the nipple after feeding.
• hydrogel compresses composed of water, glycerol and polymers relieve pain and accelerate the healing of cracks. They are applied to the nipple, between each feeding.

If after correcting the position, the feedings remain painful, it is necessary to see if the baby does not present a problem preventing him from sucking well.  

Situations that may hinder the baby’s good sucking

Different situations can hinder the baby’s sucking:

A tongue frenulum that is too short or tight:

The tongue frenulum, also called the lingual frenulum or frenulum, refers to this small muscular and membrane structure that connects the tongue to the floor of the mouth. In some babies, this tongue frenulum is too short: we speak of ankyloglossia. It is a small benign anatomical peculiarity, except for breastfeeding. A tongue frenum that is too short can indeed limit the mobility of the tongue. The baby will then have trouble latching onto the breast in the mouth, and will have a tendency to chew, to pinch the nipple with his gums. A frenotomy, a small intervention consisting in cutting all or part of the tongue frenulum, may then be necessary. 

Another anatomical peculiarity of the baby:

A hollow palate (or dome) or even retrognathia (a chin set back from the mouth).

A mechanical cause that prevents him from turning his head correctly:

Congenital torticollis, the use of forceps during childbirth, etc. 

All these situations are not always easy to detect, so do not hesitate, once again, to get help from a breastfeeding professional who will observe the progress of a breastfeeding, will provide advice on the breastfeeding position. more adapted to the particularity of the baby, and if necessary, will refer to a specialist (ENT doctor, physiotherapist, manual therapist…). 

Candidiasis:

It is a yeast infection of the nipple, caused by the fungus candida albicans, manifested by pain radiating from the nipple to the breast. The baby’s mouth can also be reached. This is thrush, which usually manifests as white spots in the baby’s mouth. Antifungal therapy is needed to treat candidiasis. 

A vasospasm:

A variant of Raynaud’s syndrome, vasospasm is caused by abnormal contraction of the small vessels in the nipple. It is manifested by pain, burning or numbness type, during the feed but also outside. It is increased by the cold. Various actions can be taken to limit the phenomenon: avoid exposure to the cold, put a heat source (hot water bottle) on the breast after feeding, avoid caffeine (vasodilator effect) in particular.