Pain: General

IT HURTS WHEN MY MILK “LETS DOWN.” WHAT COULD BE CAUSING THIS AND HOW CAN I REMEDY THIS SITUATION? WHAT IF MY PAIN IS DEEP IN MY BREAST?

A painful let-down reflex can occasionally happen while your body adjusts to feeding your baby. You may find that using relaxation techniques that were helpful during labor might help you cope with this early discomfort.

Make sure you are using good positioning techniques and are not straining or leaning over your baby as you are breastfeeding your baby. Your back, arms, feet and elbows should be well-supported, and your shoulders and neck muscles relaxed.

Some deep breast twinges during let-down can occur as the milk ducts constrict to force the milk toward the nipple. As your body becomes more used to breastfeeding, these disappear.

There can be several other causes of painful let-downs that you may want to consider:

  1. Lots of milk. Some nursing parents find they make a great deal of milk and/or their milk-ejection reflex (let-down) is very strong. If this is the case, you will notice your baby choking or sputtering on the volume and intensity of the milk as it is let-down. Breastfeeding only on one breast per feeding can be helpful. When your milk lets down, you may find that your baby is more comfortable if you gently break suction, allow the milk to spray into a towel, and then re-latch when the flow slows down. In time, your supply and let-down will become more manageable for the baby to handle and your discomfort should lessen.
  2. Yeast. Another cause of painful let-down may be yeast (a candida yeast infection) that has entered the milk ducts of the breasts. Please note that it has been suggested by some researchers that thrush cannot spread in milk ducts. Contact your local La Leche League Leader or your health care provider if you suspect you have yeast.
  3. Engorgement. Engorgement can cause breast discomfort.
  4. Muscle strain or injury during birth. Straining or injuring chest muscles which support the breasts may also cause what seems to be deep breast pain.
  5. Breast infection or plugged ducts. Sometimes pain can be an indication of a breast infection or clogged ducts. This may occur when milk is not sufficiently removed from the breast in a timely manner, or when an injury to the nipple allows bacteria to enter the breast. If you have a fever, red streaks on your breasts, or if you feel like you have the flu, contact your health care provider to rule out a case of mastitis, which is an infection of the breast, and can require an antibiotic for healing. Clogged ducts can feel like a pea or string embedded deep within the breast; it is milk that is trapped in the breast and can’t get out. In either case, you should continue to nurse a lot, rest a lot and drink a lot of fluids.

Several other causes of deep breast pain (not necessarily during let-down) are:

  • Vasospasms and/or Raynaud’s Syndrome
  • Improper breast pump usage
  • An ill-fitting bra
  • Injury or surgery to the breast tissue
  • Premenstrual pain
  • Fibrocystic breast pain

Also, some mothers with very large breasts have experienced deep breast pain.

One other cause of deep breast pain or painful let-down is that the baby might be clamping down instead of suckling. You will not hear the baby doing much swallowing if this is the case. Your local LLL Leader can help you review good latching and sucking signs.

Breastfeeding without pain is important not only for the comfort of the nursing parent, but also for your baby. Pain is typically a sign that something is not going well. Resolving your pain goes a long way toward your baby getting sufficient milk and your milk production remaining strong so you can meet your breastfeeding goals.

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