Comfortable breastfeeding: positioning baby well, preventing pain

For many new mothers, breastfeeding is a natural gesture... but not an instinctive one. It often takes a bit of practice for baby to latch well and for mom to be comfortable. As lactation consultants like to say, "breastfeeding should not hurt". If the pain lasts beyond the first few seconds, or if you start to dread every feed, it is usually a sign that the technique needs adjusting. Let's go back to the basics for pain-free breastfeeding.

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The latch: the key to comfortable breastfeeding

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The main cause of sore nipples is an incorrect latch: baby does not take in enough of the areola, pinches the nipple and causes friction, cracks and pain. To make sure the latch is good:

• Position baby correctly: tummy against you, body in a straight line, head tilted slightly back, nose facing the nipple.
• Wait for a wide-open mouth: stimulate their upper lip with the nipple and wait for a wide opening before bringing them to the breast.
• Baby takes the areola, not just the tip: their chin should be pressed against the breast, their nose just brushing it, and their lips flanged outward. Seeing more areola above than below is a good sign.
• Check the suck: there should be no sharp pinching. The first sucks can be intense, but the pain should ease after 20-30 seconds. If it does not, slide a finger into the corner of their mouth to break the suction and start again.

If the pain persists or becomes strong, do not carry on: repositioning baby is the key. These adjustments take a little patience, but they lay the groundwork for comfortable, lasting breastfeeding.

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Different breastfeeding positions

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Do not hesitate to try different breastfeeding positions to find the one that suits you: cradle hold, football hold, lying down at night, and so on. Some positions can also help with specific difficulties. For example, the biological nurturing position (leaning back, semi-reclined) lets baby feed at their own pace and can be useful with a strong let-down reflex.

Alternating positions also changes the pressure points on the nipples, which can relieve an irritated area.

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How can you soothe sore nipples?

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It is normal for nipples to be tender in the first few days, but the goal is to keep that from turning into cracks. Here are the key steps:

• Check the latch first: once the cause is corrected, the damage can finally heal.
• Apply a few drops of breast milk at the end of the feed and let it air dry: it is naturally healing and antibacterial.
• Use a pure lanolin cream after feeds to moisturize and protect.
• Let your breasts breathe: avoid prolonged dampness from nursing pads, or change them often.
• If the pain is sharp, a pain reliever such as acetaminophen can help, but it should not mask a poor latch.
• Breast shells can protect very irritated nipples between feeds.
• If you have cracks, start with the less painful breast: once the let-down reflex is triggered, the other breast will be subjected to less pulling. Keep applying milk and cream regularly.

In most cases, improving the latch is enough to make the pain disappear within a few days. If every feed becomes an ordeal, see a lactation consultant quickly: a small adjustment often changes everything.

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My baby hurts me by biting - what should I do?

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It is a common worry: "My baby has teeth, I am afraid he will bite me during the feed!" Keep in mind that when baby is latched correctly, their tongue covers their lower gum or teeth, which makes biting almost impossible. Babies often bite at the end of a feed (when they are bored or playing) or when they are distracted. To prevent it:

• Watch for the signs that the feed is ending. If they slow down and seem full, take them off before they start chewing.
• If they nibble as a game, stay calm but firm: stop the feed right away while saying "no, you don't bite mom". Putting baby down for a few moments can be enough to get the message across that biting = the feed stops (and that is no fun for either of you). They will quickly connect biting with an unpleasant reaction (feed cut short, firm voice) and avoid doing it again.
• Some babies bite because of pain (gums that are working, an ear infection...). Offer them a teething ring before the feed to soothe their gums. If their nose is blocked, they may bite out of frustration: clear their nose well before putting them to the breast.
• Do not shout (even if it startles you in the moment), because it could frighten baby, who might then refuse the breast for a while. Take them off calmly, but show that this behaviour is not acceptable.

Rest assured, not all babies bite, and many do it only once or twice in reaction to something (teething, and so on). With the right reflexes, it will be nothing more than a bad memory.

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Other common problems and prevention

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• Blocked ducts / engorgement: A hard, painful spot on the breast suggests a blocked milk duct. Have baby feed often on that side, varying the positions (pointing the chin toward the engorged area helps with drainage). Massage gently during the feed, apply heat before and cold after. A blocked duct treated quickly resolves in 24-48 hours; otherwise it can turn into mastitis.
• Mastitis (inflammation/infection) :  Fever, flu-like symptoms, a red and very painful breast: keep breastfeeding to empty the breast well, rest and stay hydrated. Do see a health professional, because bacterial mastitis may require antibiotics, even though massage, frequent drainage and rest are often enough. Never stop breastfeeding abruptly, as that makes milk stasis worse.
• Thrush (yeast infection) :  Bright pink nipples that burn between feeds, white patches in baby's mouth: this may point to a yeast infection. See a health professional for antifungal treatment for both mom and baby, and sterilize soothers and breast pump parts.
• Breast pump and pain: A setting that is too strong or a poorly fitted flange can cause pain. Choose the right size and a comfortable suction level: pumping should not hurt.

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In short, pain-free breastfeeding is entirely possible once the right adjustments are made. If you start to dread putting baby to the breast because of pain, the solution almost always lies in improving the technique. As the Institut national de santé publique (Quebec's public health institute) points out, "the most frequent cause of pain is an incorrect latch".

Never hesitate to ask for help : nurses, lactation consultants, groups for moms... A few sessions are often enough to transform the experience. Your comfort matters as much as feeding baby, because a mom who is calm and pain-free breastfeeds longer and with pleasure.

Soon, these difficult beginnings will be just a memory, and you will be able to fully enjoy this beautiful breastfeeding relationship.