Why Aren't Moms Warned About How Painful Early Breastfeeding Can Be?

For some moms, those first weeks are excruciating. Why don’t we talk about it?
Illustration: Damon Dahlen/HuffPost Photos: Getty

Before she gave birth to her first baby four years ago, Carolyn Hulla-Meyer was excited to breastfeed, but she was quickly surprised by how painful it was—a stinging, burning feeling the nurses reassured her would lessen with practice.

It did not.

By the time Hulla-Meyer, 32, got home from the hospital, her nipples were cracked and bloody. She saw a lactation consultant who helped with her baby’s latch and suggested nipple shields. They helped some, but not enough for Hulla-Meyer to continue breastfeeding past three months.

“I was kind of like, ‘Whoa, whoa, whoa. I thought this was supposed to be a special time,’” she recalled. “This hurts.”

Data certainly suggests that early breastfeeding pain, like Hulla-Meyer’s, is common. One survey from the Centers for Disease Control and Prevention found that while 26 percent of moms had no pain on their first day breastfeeding, 3 percent were basically in agony. One week in, only 3 percent of moms said they were pain-free whereas 5 percent described it as the “worst possible pain”—and the rest fell somewhere in the middle. Surveys also show that general pain and cracked, bleeding nipples are among the top reasons why women stop breastfeeding in the first few months—trailing behind fears about not having enough milk and latch problems.

When my own son was born two years ago, I struggled enormously at the start. Despite seeing two different lactation consultants in the hospital and dragging myself to several breastfeeding classes, I effectively had two open wounds for nipples by the time I left the hospital. I spent the first weeks of my son’s life walking around shirtless because I couldn’t stand anything touching my skin, dipping my nipples into a salt solution to try and stave off an infection (I still got one) and quietly sobbing through feedings hoping that no one would notice how unglued I’d become. I saw more lactation consultants, went to support groups and read like a fiend, but nowhere did I find anything that seemed to speak to what I was going through. Resources like Kellymom and La Leche League, which were lifelines to me in so many other ways, talked about early breastfeeding “soreness” or “short-term discomfort,” not “a tiny-person-will-chow-down-on-your-bleeding-cuts-for-hours-on-end-and-it-will-hurt-more-than-unmedicated-labor” misery. Was this something other new moms endured through some kind of stoicism or magic that I lacked?

“I felt like, ‘Maybe I’m just being crazy,’” echoed Kerstin Picht, 33. (Picht is HuffPost’s Director of Editorial Partnerships, proving I didn’t have to go far to find other moms who also struggled early on.)

“I think I have a high tolerance for pain,” Picht said, “so I remember thinking, ‘This can’t be normal…but maybe it is?” Early on, her nipples cracked and bled so much that her first baby—whom she described as a “happy spitter”—would frequently spit up blood. Before feedings, her whole body tensed up.

But Picht was committed to breastfeeding, so she met with a lactation consultant several times and attended a local support group. Eventually, the pain faded and Picht was never offered a definitive explanation for why things had hurt so much at first. It was only after she gave birth to her second child—with whom breastfeeding simply clicked—that she grasped just how significant her pain had been.

“With my daughter, I was so prepared for it to be terrible. She was latched on 15 minutes after being born and it was a little uncomfortable in the first week, but it was just a completely different experience,” she said. “Part of me wonders if I lost some sensitivity, and I think it helped that I kind of knew what I was doing. I also think a lot of it comes down to the baby, and their skills.”

“Telling women breastfeeding isn’t supposed to hurt might come from a good place, but that message felt invalidating as hell when I was in the thick of it.”

Of course, in many cases there are obvious reasons for a woman’s pain—with relatively clear fixes. Issues with the baby’s latch are the big one, and they’re a major reason why clinical support—particularly with an international board certified lactation consultant (IBCLC) or a doctor with a subspecialty in breastfeeding—is essential. Experts can spend time watching and working with moms and babies, suggest changes and help diagnose any number of possible issues, like tongue- and lip-ties, which can cause the kind of nipple trauma that actually curls women’s toes during feedings.

Monica McKay, 34, had no pain at all while breastfeeding her first child, but nursing her second baby was extremely painful—to the point that she switched to exclusive pumping three weeks in. She simply could not stand it anymore. After that experience, she met with a lactation consultant while still pregnant with her third and made plans to see her after she was released from the hospital. The consultant—who wore a headlamp so she could closely inspect the baby while feeding—suspected a lip- and tongue-tie and referred McKay to a specialist, who was an hour-and-half’s drive away.

“They did do a procedure to release a lip- and tongue-tie,” McKay said. “Almost immediately, there was no pain and we’ve been able to continue on and things have been much more comfortable since then.” But the key part of McKay’s success story is that she was able to see a lactation consultant who helped her find a solution, something many moms are unable to do because it costs too much (even though under the Affordable Care Act, insurers must provide breastfeeding counseling) or because they’re not even aware it is an option.

Kate DiMarco Ruck also dealt with a tongue-tie when her first was born nine years ago. “It was really tight, and it was just unbearable,” she said of breastfeeding in the early days after her son’s birth. “Everyone said ‘Yes, there’s pain. And yes, eventually it goes away.’ And this didn’t go away. I was sore and bruised and bloody.” She eventually sought help for her son’s tongue-tie, but still felt residual pain after it was snipped. With her second, she was prepared to look for a tongue-tie and see a lactation consultant right away. DiMarco Ruck is now finishing up her training to be a lactation consultant herself so she can help moms in similar situations.

Illustration: Damon Dahlen/HuffPost Photos: Getty

But sometimes the message that moms should not have to live with breastfeeding pain gets translated in breastfeeding support groups and literature as “breastfeeding shouldn’t hurt.” (Heck, they’re words I wrote myself before becoming a mom.) And that is not a message that necessarily helps anyone. Not only does it isolate moms who are struggling early on and make them feel like they’re failing at breastfeeding ― something so many women already feel enormous societal pressure to ace ― it eliminates all nuance. Telling women breastfeeding isn’t supposed to hurt might come from a good place, but that message felt invalidating as hell when I was in the thick of it.

“I think that, and I’m trying to think about how to say this carefully, but sometimes the dynamic around breastfeeding advocacy versus breastfeeding support gets tangled up,” said Dr. Alison Stuebe, a maternal-fetal medicine physician and medical director of lactation services at the University of North Carolina at Chapel Hill, adding that both breastfeeding advocates and people who practice clinical medicine can be guilty of this.

“If you don’t tell people it might hurt and it does, they think ‘Well, there must be something wrong with me,’” Stuebe added. “I’m a strong believer that we shouldn’t sugarcoat motherhood.”

And really, if the goal is to help more moms reach their breastfeeding goals, wouldn’t greater transparency about the potential pain help? Not to scare women—because again, for so many women it is pain-free, if not blissful right from the start—but to validate the experiences of those moms who are struggling. One of the few times I felt like a non-lunatic was at my six-week postpartum checkup with my midwife who, upon seeing nipples (which were finally starting to heal) grabbed my arm to show me she had chills. Thirty years later, she viscerally remembered her own early breastfeeding pain. “No one understands, right?” she asked. And I wanted to simultaneously French kiss her and scream, “No they do not!”

“If you don't tell people it might hurt and it does, they think 'Well, there must be something wrong with me.'”

- Dr. Alison Stuebe

It is also worth noting that evidence suggests doctors have a tendency to discount women’s pain as emotional. Stuebe said there has not been any research looking at perceptions of breastfeeding pain specifically, but it’s easy to wonder if that is not one possible factor here. After all, who is more emotional than a hormonal, sleep-deprived mother of a new baby?

That is the challenge with something as dynamic as breastfeeding—there are seldom clear-cut answers, and there is not nearly enough support. Though I was lucky enough to be in a position to see a truly wonderful IBCLC and other experts, I never got a solid answer about the source of my pain. My son’s latch looked good. He was checked, multiple times, for lip- and tongue-ties. The consensus was that we just had a hard time finding our footing in the first few days, which led to nipple trauma that took a long time to bounce back from because my son was a big, hungry guy who liked to eat. We pushed through and grew to have a pretty lovely time of it together.

But it’s still so easy to transport myself back to that time, and I try to be very open with other mothers in my life about what I went through in case any of them are also feeling alone in their pain. It hurt so much. And though I knew I shouldn’t, I felt ashamed that I couldn’t hack it.

“Sometimes I feel like I should have pushed a little harder,” said Hulla-Meyer, who just had her second baby and is breastfeeding again. It’s painful this time, but nothing like it was with her first. Experiencing the difference between some discomfort and pain with a capital “p” has helped her let go of the residual guilt she felt after stopping short of her breastfeeding goals the first time around.

“Back then, I felt like something was wrong with my body, or maybe if I just gave it more time,” Hulla-Meyer said. “But now I’m like, no. It really f**king hurt.”

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