Breastfeeding: Excrutiating pain while nursing

I am having some major breastfeeding problems! My baby is five weeks old and is not gaining weight. I have excruciating pain while nursing. I have had sore nipples since the beginning. Three weeks into nursing, I developed mastitis and was treated with dicloxycillan. A few days later I had the stomach flu. Two days later, my baby vomited blood. It was determined that the blood was coming from my breasts. For a few days I was to pump the side with mastitis and, if I saw no blood, I could feed the milk to my baby along with nursing on the unaffected side. Then we went back to nursing on both sides. During the pumping, I felt my right breast wasn't being emptied. My sore nipples have continued, although sore is an understatement! The nipples are red with little white scabs or blisters on the tips. As my baby starts to nurse, I feel very sharp, shooting pains. In the beginning the pain would lessen as the feeding continued, but now it seems to be getting worse. When I am done nursing, my breasts continue to ache and almost burn for at least half an hour. I thought I might have thrush but my pediatrician disagrees and told me it would be best for my baby if we switch to formula. If there is one more thing to try before quitting, I'm willing to give it a shot.

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ABOUT THE EXPERT

Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

It sounds like improper positioning and attachment at the breast has been the cause of most of your problems. You mentioned that your baby has not been gaining weight, that breastfeeding has been excruciating, you developed a case of mastitis, and your traumatized nipples hurt for quite a while following a feed. All of these can result from poor positioning and attachment. Be seen by a lactation consultant--pronto--if you want to continue breastfeeding. Go to ilca.org to find one. 

Even when a mother has very sore and traumatized nipples, if her baby is properly positioned and attached at the breast, nursing should not be painful. Ideally once the nipple is taken deeply into her baby's mouth, the feed should be comfortable. See Breastfeeding: Back to Basics for some help with positioning and attachment. It is very important that your baby be taking in (and keeping in) a good mouthful of your breast tissue at each feeding. Your baby should be hugged in nice and close with her nose and chin gently resting on your breast. If you feel your little one's nose needs a bit of space, pull her bottom in closer to your body, rather than pressing your finger into your breast to give her an airway. This could pull your nipple out of her mouth, causing further pain and damage.

Once nipples are damaged, the abrasions leave a perfect opening for a fungal infection (candidiasis) to take hold, complicating the situation. See a doctor for diagnosis and treatment. It's not always necessary to stop nursing during a case of mastitis. Continuing it helps in the healing process. Even though there was blood in your milk, breastfeeding is not contraindicated. The blood will not hurt your baby (although it will sometimes cause a baby to vomit following a feed).

Though I know you're in a lot of pain, it sounds as if breastfeeding is still something that is very important to you.

P.S. Since your baby is not gaining weight properly, it is critical for you to provide supplemental feeds while you are working on getting breastfeeding right.

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