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Breastfeeding in the First Weeks

Managing nipple or breast pain

Prevention is the key!

You should get help with breastfeeding immediately if:

  • you are having difficulty latching your baby
  • you have nipple pain and/or damage
  • your breasts are hard and you cannot soften them
  • you have a fever and/or a red, painful area on your breast
See Breastfeeding services for places to get help

Breastfeeding should not be painful. The following are key points to preventing nipple pain and damage:

  • Ensure your baby is latched on well (see Latching your baby). A good latch is the key to successful breastfeeding.
  • Break your baby’s suction before removing him from your breast (see Latching your baby).
  • Avoid the use of artificial nipples (e.g., bottles and pacifiers). Giving your baby a bottle or pacifier too early may cause your baby to have problems latching onto your breast, which will make breastfeeding painful for you.
  • Wash your breasts every day but avoid using soap or other products on your nipples. This causes dryness that may increase the risk of damage to your nipples.
  • Use proper technique for expressing your milk by hand or with a pump (see Expressing your breast milk).

My nipples are sore, what should I do?

  • Get help with breastfeeding immediately (seeBreastfeeding services).
  • Breastfeed from the least painful side first and ensure a proper latch on the more painful side.
  • Feed when baby first stirs rather than when frantic
  • Numb the nipple for a few seconds with a cold compress or ice prior to feeding. Be careful, prolonged use of cold may affect your milk letdown.
  • Use cotton fabric against your breast/nipples to allow your skin to breathe.
  • Avoid using plastic lined breast pads, use cotton instead. Change breast pads often. Moisten the breast pad before removing it if it is stuck to your nipple.
  • use of nipple shells between feedings to prevent nipple from rubbing against clothing and to allow air circulation

What is engorgement?

Breast engorgement is the painful overfilling of the breasts with milk. It is normal to have increased breast fullness during the first week after your delivery as your milk 'comes in'. However, engorgement is an abnormal condition. Signs of engorgement include:

  • generalized warmth, swelling, tenderness, pain and throbbing in both breasts
  • very firm, hard breasts that make it difficult for your baby to latch
  • lumps under the armpit(s)
  • numbness and/or tingling of your hand and arm due to pressure on nerves in the armpit

What causes engorgement?

  • not breastfeeding within the first few hours after birth
  • not breastfeeding on demand (when the baby is hungry)
  • taking your baby off the breast before he is full
  • positioning or latching your baby incorrectly
  • using a breast pump incorrectly or too long
  • using artificial nipples and/or supplement (formula)
  • baby is not sucking properly
  • weaning your baby abruptly

How do I prevent engorgement?

  • Start breastfeeding within 30-60 minutes after delivery.
  • Breastfeed at least 8 times or more in 24 hours in the early postpartum period
  • Get help to improve your baby’s latch and encourage unlimited nursing.
  • Pump or manually express your breast milk only if advised to do so by a health-care professional and then use the correct technique (see Expressing your breast milk).
  • Avoid artificial nipples and supplements (formula) unless advised to do so by a health-care professional.
  • Watch while your baby is breastfeeding to make sure that she is swallowing well. Listen for swallowing.
  • Wean your baby gradually (see Weaning Your Baby).

How do I care for my breasts that are engorged?

  • Avoid restrictive clothing (e.g., under wire bra).
  • Massage your breasts gently using circular motions just before feeding to help your milk to flow.
  • Express enough milk from your breasts to soften the areola just before you latch your baby.
  • Use of medication to decrease/dry up your milk is not considered safe and is no longer recommended.

If you continue to be engorged get help from your health-care professional. See Breastfeeding services for places to get help.

Breastfeeding in the First Weeks | Six Weeks to Six Months
Six Months and Beyond | Breastfeeding Resources | Contact Us

Revised: Wednesday January 16 2019


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