How to avoid nipple pain while breastfeeding or chestfeeding

The number one cause of nipple pain is a shallow latch. The first thing I recommend is to work on getting a deep latch.

Right after birth, this means the biological nursing position: i.e. laying down with your baby, lots of skin to skin, and letting the baby have lots of control to bob around on your chest and find your nipple themselves to latch on.

If you baby is still struggling after sometime trying the biological nursing position or you are ready to be more out and about with your baby, a semi-reclined position can be covenient and beneficial.

This article provides an update on and earlier post, "How to get a good latch".

Avoid nipple pain by getting a good latch

This video shows you step by step how to get a good latch. Please like and follow if you found the video useful! You can read the full transcript below.

Steps to latching

1. Get yourself comfortable: in a semi-reclined position on a couch or bed works best. You likely want extra pillows to make sure you're well supported, as you will be spending a lot of time feeding your baby over the coming weeks and months.
2. Lay your baby face down on your bare chest; hold them diagonally across your body.
3. Make sure their chin is pressed into your breast/chest tissue.
4. Baby's nose should be in line with your nipple.
5. Hold them firmly to you with your hand high on their back, between their shoulder blades at the top of their neck.
6. Wait for them to open their mouth wide.
7. As they reach up with an open mouth, as soon as their top lip comes over the nipple, pull them in close.
8. They will be in a great place to latch on, they likely will but you may have to be a little persistent. Trying repeatedly is know uncommon, especially at first.

Reasons why you might need a lactation consultation

Make an appointment online or find a local lactation consultant if you are unable to resolve any of the following problems.

Older babies

Older babies can take some time to learn to latch differently. Be persistent, but if you feel like you aren't able to make progess a consultation can help.

Muscle tension

If your baby is unable to tilt their head back as shown in the video, they may have muscle tension that may need some interventions to resolve quickly. (please make an appointment online or with a local LC)

Painful nipples

Painful nipples likely indicate:

• That your baby isn't transferring well, or that they may not continue to transfer well.
• Cracked, damaged nipples can also allow a pathway for bacteria to enter the body and cause mastitis, an infection in breast/chest.
• Continued pain can cause challenges for parents' emotional health, as well as their relationship with their baby.

Other concerns

Also seek guidance if your baby isn't peeing or pooping as often as your primary care provider has indicated, your baby isn't gaining enough weight, or you would like support or reassurance.

Transcript

When you have gotten to the point where you have done your first latches and you are starting to latch your baby more often and you want a little bit more control over what you are doing, I suggest sitting up a little bit more, the more you sit up the more you are able to be in control and the less the baby is in control.

[How to get a good latch]

[Start by getting comfortable!]

On this couch I might even suggest going this way and getting pillows or on a bed having pillows supporting you in every direction. And then having your little one semi reclined at somewhat of an angle. And then thinking about (you don’t want to grab the back of their heads but sometimes with my stuffed cloth one I have have to), you're thinking about using the backs of their shoulder blades to help you latch on, and thinking about pointing their nose to your nipple. And then ideally you let them do the work of kind of reaching up and over and as they open their mouth up big and wide.

[Let's try a diagram here!]

[Diagram: Line drawing of baby getting ready to latch, with open mouth, nose aligned to nipple]

Then they’ll actually get the kind of they will reach up to get the nipple in their mouth.

[Steps to latching]

[Chin pressed in deeply]

Make sure their chin is nice and pulled in close and pressed deeply into your body.

[Nipple in line with nose]

And that your nipple is inline with their nose.

[Firm pressure on shoulders]

And then pulling tight on their shoulders, so that now your waiting for them to lean their head back and open their mouth wide.

[Wait for a wide open mouth]

And then as soon as they do that you can pull them in nice and close.

[Pull them in close!]

[Diagram: Cross section of latching baby with nipple in mouth, showing tip of nipple against back of mouth. Labels distinction between hard palate and soft palate.]

And what that will do is give it an asymmetric latch where the nipple is closer to the top of the roof of the mouth and closer to the soft palate and that is where you want it to be so that it doesn’t get compressed. When it's farther forward close to the hard palate, that’s when you get that pinchy feeling.

[Hope you found this helpful!]

Disclamer

This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website are for informational purposes only.

Tags

Laura Howells (she/her) is an IBCLC and postpartum doula who works with clients in the San Francisco Bay Area. She has been happily supporting growing families during pregnancy, birth, postpartum, and the first years since 2009.