Nipple Pain and Breastfeeding: Common, Not Normal

Lindsay Moore-Ostby, MD, IBCLC explains that nipple pain with breastfeeding is NOT normal and that believing otherwise sabotages many breastfeeding parents.  

Many pearls of ‘wisdom’ about breastfeeding are confidently tossed around by parents, well-intentioned friends, and even medical professionals. This advice is generally well-meaning, but also is often wrong. This undermines the confidence of lactating parents and frequently stops them from seeking prompt and proper care. Sadly, this leads to parents losing the ability to make truly informed decisions about infant feeding and lactation. One of the most common myths I hear is the belief that nipple pain is normal. As a breastfeeding medicine physician, I am here to say NOPE. False. Untrue. Nipple pain with breastfeeding is NOT normal and believing otherwise sabotages many breastfeeding parents.

Slight discomfort is not unusual, especially in the early days with a newborn. Mom and baby are both new at this and have to learn together, hopefully under the watchful eye of someone experienced in lactation care who can give them tips for rapid improvement. But true nipple pain that continues despite help with positioning and latch, should be evaluated quickly before it gets worse and harder to fix.

To all lactating parents: you do not need to sacrifice your nipples for the cause of breastfeeding. Pain, particularly if it is worsening or persistent, is a sign that something is wrong. It is a signal your body gives to say hey – something isn’t working here! Pushing through the pain is not advisable – in fact it may set you up for infections, problems producing milk, and a host of other complications. You are not doing anything wrong or failing as a parent if the pain can’t be fixed easily. Some problems are more complicated and require more specialized care. But the right professional can help you understand what is going on and craft a care plan to help things improve. Don’t let yourself feel brushed off. Nipple pain may be common, but it is NOT normal.


To all lactating parents: you do not need to sacrifice your nipples for the cause of breastfeeding. Pain, particularly if it is worsening or persistent, is a sign that something is wrong. Click To Tweet


To all medical professionals: nipple and breast pain related to breastfeeding are common. Nipple pain is one of the most common reasons parents cite for stopping breastfeeding before they desire. I am not dismissing the lived experience and suffering of these countless lactating parents. But let me be very clear – nipple pain with breastfeeding may be common, but it should never be dismissed as normal. This pain deserves urgent evaluation and treatment before nipple trauma and a cycle of worsening events begins. If the physician or lactation consultant cannot provide prompt relief, then it is time to seek out a breastfeeding medicine physician like myself for specialized care.

As physicians, we do not generally dismiss pain as a ‘normal’ state, even though we may not always fully understand the cause. Ankle pain could be related to gout, ankle sprain, infected joint, or a host of other issues. Pain with urination could indicate a common bladder infection, a sexually transmitted infection, or abnormal bladder muscle contraction, for example. Pain is complicated and not fully understood. Some people seem to have more intense interpretations of pain stimuli, and sometimes nerve pathways seem able to ‘learn’ to experience chronic pain.


“As physicians, we do not generally dismiss pain as a ‘normal’ state, even though we may not always fully understand the cause.”


It is high time that lactation related nipple pain is recognized as common, but not normal. Myths like ‘nipples toughen up’, and ‘pain just gets better with time’ should be tossed to the curb. Lactation related pain deserves the same professional attention to diagnosis and management of dysfunction that other medical problems receive. Breastfeeding medicine physicians like myself are working to incorporate evidence based information about this and other lactation related topics into medical education. Physicians can also refer to the Academy of Breastfeeding Medicine’s protocols to assist in determining the cause and treatment options for their lactating patients’ nipple pain.

So if a patient, friend, or colleague is suffering with lactation related pain, then please help them seek care! If the first, second, or even third person isn’t able to help, keep looking. Many situations can be handled by various levels of lactation professionals. Other situations are very complex and benefit evaluation by a breastfeeding medicine physician. More of us are practicing than ever before. But we must first recognize that nipple pain is common, not normal, for help to be properly given.


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