Should Pumping Hurt?

Some moms assume pumping should be painful. Not so! “No pain, no gain” does not apply here. Painful pumping means something needs to be adjusted. What causes pain? The two most common causes are: 1) pump suction set too high and 2) flange fit issues.

Pump Suction Set Too High. First, the strongest pump suction does not always pump the most milk. In fact, too-high suction can actually slow your milk flow. Set your pump at the highest suction that feels good…and no higher. (If you’re gritting your teeth, it’s too high!)

Pumping milk is not like sucking a drink through a straw. With a straw, the stronger you suck, the more you get. When pumping, most milk comes only when a let-down, or milk release, happens. Without a milk release, most milk stays in the breast. What is a milk release?

• Hormones cause muscles in the breast to squeeze and milk ducts to widen, pushing the milk out.
• Some mothers feel tingling. Others feel nothing.
  

A milk release can happen with a touch at the breast, hearing a baby cry, or even by thinking about your baby. Feelings of stress, anger, or upset can block milk release.

While breastfeeding, most mothers have three or four milk releases, often without knowing it. To get more milk with your pump, you need more milk releases, not stronger suction. See our Q&A Series sheet Making the Most of Your Breast Pump on the MCP website under the "about breastfeeding tab" for tips on triggering more milk releases during pumping.

Flange Fit Issues. Many mothers pump comfortably with the standard size flange (25 mm diameter nipple opening). But if pumping hurts even on low suction, you most likely need another size. If the standard flange is too small or too large, a better-fitting flange will feel more comfortable and may even pump more milk.

To check your flange fit, watch your nipple during pumping. If you see a little space around your nipple as it’s drawn into the flange’s nipple tunnel, you have a good fit. If your nipple rubs against its sides, the flange is too small (click here to see fit photos). If too much of the dark area around the nipple is pulled in or the nipple bounces in and out of the tunnel, it is too large.

Thankfully, Ameda has seven different flange sizes available, so you can go larger or smaller, as needed. (Click here to see the range of fit options.) Nipple size changes with birth, breastfeeding, and pumping, so the pump flange that fit you well when you started pumping may need to change as you pump more. For that reason, you’ll want to recheck your flange fit from time to time.

Breast or Nipple Issues. There are other possible causes of pain during pumping related to breast and nipple health. If your pain is not due to too much suction or the too-small or too-large flanges, it is time to ask more questions. Do you have nipple trauma (broken skin on the nipple)? Could you have a bacterial infection of the nipple (can occur with a history of nipple trauma)? Do you have an overgrowth of yeast (also known as thrush or candida)? Is mastitis a possibility? Does your nipple turn white, red, or blue after pumping? If so, see your lactation or other health-care provider to rule out Raynaud’s Phenomenon and other possible causes.

Nancy Mohrbacher, IBCLC, FILCA, Lactation Consultant, Ameda Breastfeeding Products
Coauthor of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers

Nipple Pain and Trauma - oh what to do!

In the early weeks of breastfeeding you may experience sore or tender nipples. Tender nipples at the start of a breastfeeding are normal during the first week or two. But pain, cracks, blisters, and bleeding are not. Your comfort depends on where your nipple lands in baby’s mouth. And this depends on how your baby takes the breast, or latches on. Learning the correct latch takes practice, and the help of a Lactation consultant is often needed.

To understand this better use your tongue to feel the roof of your mouth. Behind your teeth are ridges. Behind the ridges the roof feels hard. When your nipple is pressed against this hard area in your baby’s mouth, it can hurt.

But farther back in your mouth the roof turns from hard to soft. Near this is the area some call "the comfort zone." Once your nipple reaches your baby’s comfort zone, breastfeeding feels good. There is no undue friction or pressure on your nipple.

To make this happen, let gravity help. Lean back with good neck, shoulder, and back support and your hips forward. Lay your baby tummy down between your exposed breasts. When your calm, hungry baby feels your body against her chin, torso, legs, and feet, this triggers her inborn feeding reflexes. When her chin touches your body, her mouth opens and she begins to search for the breast. In these "laid-back positions," gravity helps the nipple reach the comfort zone.

Image of proper latch. The nipple should be deep and past the hard palate.

In other positions, you need to work harder to help your baby take the breast deeply.

• With your baby’s body pressed firmly against you and her nose in line with your nipple, let her head tilt back a bit (avoid pushing on the back of her head)
• Allow her chin to touch the breast then move away.
• Repeat until her mouth opens really wide, like a yawn.
• As she moves onto the breast chin first, gently press your baby’s shoulders from behind for a deeper latch.

That last gentle shove helps the nipple reach the comfort zone. Breastfeeding tends to feel better when your baby latches on off-center, so her lower jaw lands far from the nipple.

In the process of mastering the latch, you may experience pain, and sore cracked nipples. If you feel nipple tendeness or discomfort,  Ameda ComfortGel pads can prevent clothing friction and sootheand help heal your nipples.  Ameda ComfortGel pads are comfortable to apply and easyto use. Just wear in your bra like a nursing pad. Plus, they do not stain clothing. Each water-based ComfortGel pad may last up to six days, making it an economical and convenient choice. Also, because Ameda ComfortGel hydrogel pads will not absorb any milk you can use them with Ameda No Show premium breast pads against your bra. This is the best moist would healing treatment available today. Ask for them at your pharmacy counter.