#WorldBreastfeedingWeek: A Look at Common Breastfeeding Myths and Questions (Part 1)

In honour of #WorldBreastfeedingWeek this year, I have been trying to share resources on my Twitter in support of breastfeeding – Maggie and I will be at 7 months of breastfeeding the day after breastfeeding week ends! A very exciting milestone for us. I thought that busting some breastfeeding related myths & curating the answers to common questions might be helpful for those who are just curious; who are just starting to breastfeed; or are thinking about breastfeeding in the future.

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

If you read my blog or know me, you’re probably aware that I support feeding your baby anyway you can/want to. I’ve written about it before here, if you’re interested. This blog post is meant to inform, not to criticize or stigmatize anyone who doesn’t breastfeed.

Is breastfeeding supposed to be painful?

49.4% of 164 voters said “maybe/a bit”. I agree – I think it is normal for breastfeeding to be uncomfortable for a bit in the beginning (and this belief is echoed by research discussed here, among other research) – as your nipples and breasts adjust to their new job. There are a few other things related to breastfeeding that may make it unpleasant for a bit as well…

I remember worrying about this so much when my milk came in & when my nipples started to hurt (about a day or so into breastfeeding for me). My discomfort lasted a few weeks, and at the beginning I have to admit I had moments of pain. I think it’s important to be honest and realistic about it – and also important to recognize that some people will have no issues or very little. Everyone is so different, it’s hard to predict.

In moments of panic I spent a lot of time looking for answers to this question – I worried that Maggie had a lip or tongue tie, that her latch would never get better and we may have to stop our journey before it even began. It’s funny how the thought of “failing” at breastfeeding is even a concern… but it is one I’ve noticed other mothers have had. We should know that by deciding to stop breastfeeding or physically (or mentally) being unable to breastfeed (or even not wanting to breastfeed), we are not failing but doing what may be best for ourselves and our babies.

Amidst my worried google searches, I came upon a lot of websites that said pain was not normal. I agree with this to a certain extent – I recently saw a viral video of a woman in a lot of pain while breastfeeding (she was doing many things that weren’t supportive of a good latch, but beyond that…) and I know that is not normal. I do think that breastfeeding does hurt early on though – like I said, as your breasts and nipples adjust to feeding a baby – the constant friction and moisture.

All I have to say is – I am very thankful for Kellymom. When someone recommended this resource to me, I found that sore nipples were common in the early days of breastfeeding. I also liked that the site differentiated between transient” pain (that is essentially, expected) and pain that you may need to address with an expert such as a lactation consultant. It wasn’t exactly reflective of my situation, since my nipple and/or breast pain (it alternated) probably lasted closer to a month – however I did suffer from cracked nipples, a milk bleb, and a clogged duct – all things that can certainly cause pain during feeding.

So what is not normal?

  • Pain that is constant – through the entire nursing session and also in between sessions (although, you may have some residual soreness in between from my experience especially the first few days)
  • Pain that is unbearable (although pain is subjective so what one person finds to be minor pain may be very painful for another person)
  • Pain that does not go away after a few weeks of breastfeeding
  • Pain that is accompanied by nipple damage such as blisters, cracks, or bleeding
  • Pain in the breast that is associated with other symptoms too – such as fever, malaise

If your pain sounds like any of the above – then you may have another issue going on. I mentioned a few possibilities, but one of the most common culprits would be latch issues as well. Mastitis can also occur. All of these issues are explored in detail on the Kellymom page I linked to.

In short: studies have shown that nipple pain is common in the early days of breastfeeding (or more accurately, the first 2 or so weeks) due to various causes, but shouldn’t (generally) meet any of the above criteria.

If you are having extreme pain, or have any concerns – a consult with your HCP or a lactation consultant is a good idea. It’s best to do this right away, but if you don’t there is still time to address your issue!

Why else might breastfeeding be uncomfortable?

There are a few non-nipple/breast related reasons why you might not necessarily feel pain, but feel discomfort or dislike for breastfeeding. One is of course that it just doesn’t appeal to you for whatever reason – this is common and not abnormal. Please don’t feel like you are doing something wrong by not enjoying breastfeeding – if this is the case, do what is best for both you and the baby.

Another is a condition called D-MER, or Dysphoric Milk Ejection Reflex. This involves the association of negative emotions/sadness with letdown during breastfeeding. It is actually related to let-down itself, and not how you feel about breastfeeding (which I just mentioned). It is also not a sadness or negative emotional experience that continues much beyond letdown – so if you are feeling sad, angry, or just not right most of the time, then I advise you book an appointment with your provider to discuss this asap.

D-MER is also not the same as Nursing Aversion and Agitation (NAA). This goes beyond just let-down associated negative emotions, and has to do with the breastfeeding experience overall. There is also a component to it involving intrusive thoughts about wanting to escape, stop breastfeeding, or feeling overwhelmingly “touched out”.

Another common complaint related to breastfeeding, which I myself experienced for several weeks early on requiring prescription medication, was nausea related to letdown. It is likely tied to the release of the hormone oxytocin. It was very similar to what I experienced in first trimester and third trimester (when I also had nausea quite bad).

Some women may feel discomfort when the idea or feeling of breastfeeding due to past history of abuse as well.

Whatever your reason – you may be able to work through it (sometimes with assistance from a professional), but in the end it is your choice and you should always do what is best for your baby and yourself/your mental health.

How should I care for my breasts while breastfeeding?

80% of 90 voters said you do not need to wash your breasts before each nursing session – this is correct (unless your breasts are of course, covered in germs or dirt? Which I hope they generally are not!), though I understand the logic behind this myth.

It seems that it’s something you should do – wash your breasts before putting them in your baby’s mouth. I mean you wash your hands before you eat, right? Isn’t it the same?

You actually only need to wash your breasts when you normally would – in the shower (again, unless you get very dirty on a regular basis). The small sebaceous glands around your nipples, called Montgomery glands, have many important roles related to breastfeeding and your baby, and one of them is related to nipple moisture.

As a sebaceous gland they contribute to protecting the skin from bad bacterial invasion – but allow the good bacteria on the breast to stay, which is good for baby (so yes, you would also not wash them prior to pumping to reap the same benefits).

Washing the nipples too much, or using soaps or body washes can be damaging because it removes the moisture (seems like the opposite of what you’d believe, but it does), potentially leading to irritation.

Ways you can care for your breasts if you’re breastfeeding or pumping are:

  • For breastfeeding – Make sure you are promoting a good latch (good position, see PCP, work with an LC if needed) to avoid nipple damage; For pumping – make sure you are using the pump correctly
  • Seek treatment as soon as possible for mastitis or any other complications that may require a prescription
  • Wear comfortable nursing bras and avoid clothing that is restrictive to the breast area (or if you’re comfortable, no bra is a good option at home for ease of feeding!)
  • Wash your hands before breastfeeding or pumping – this is still important! You don’t need to wash your breasts, but you should wash your hands since they are the ones touching everything in your environment (I assume you are not rubbing your breasts on the surfaces in your home – at least not on purpose, but to each their own!)
  • If you are using bra pads, make sure to change them often

Do I need to “toughen up” my nipples prior to breastfeeding?

No, although this was an old recommendation, it is not supported by current research. You don’t need to walk around your home in only a t-shirt if you don’t want to (but you certainly can for comfort purposes!).

Is there anything I can do to prevent my breasts from becoming saggy from breastfeeding?

According to a study from 2010, sagging of the breasts has been shown not to be directly related to breast-feeding. These results were also shown in a more recent study from 2018 – sagging of the breasts appears to be more related to breast size and not pregnancy or breastfeeding specifically.

One could argue that if your breasts grew substantially as a result of pregnancy and/or breastfeeding, this might contribute – but per the studies, many women breastfeed and do not experience significant effects in their breasts afterwards too.

Oh, also skin changes with aging likely also contribute to this!

Is it true that a baby will naturally go to the breast right after birth? I’ve seen those “breast crawl videos.

40.7% of 91 voters said maybe this will happen – just like everything else, this is totally different in every situation!

This is a real thing that does actually happen and it is instinctual – it is the idea that after birth, if baby is placed skin to skin they will “crawl” up to the breast. This site actually has really good information on it based on real studies, however the studies are older. It also highlights the benefits for mom and baby, if the crawl does occur.

Even the studies recognize that the breast crawl is not in the cards for every mom-and-baby unit. One factor that may decrease the chance of it happening is mom and baby separation right after birth – when this does occur, it’s usually out of the control of the mother (ie. due to emergency for either her or the baby). The use of pain medication during labor may also impact the chance of this happening – however, again this might be something that is necessary for the mother.

So can this happen? Yes – under the right circumstances, it is possible. Even with the right circumstances though, it may not occur. I personally had my baby skin to skin right away – they cut her cord while she was on me, delayed her vitamin K and weighing until an hour after her birth – but she never did the crawl. I did feed her in the first hour but I ended up having to put her to breast and when she ate she didn’t eat much because she was pretty tired!

I think it’s a great opportunity to try for it, if that is in the cards for you. But also don’t worry if you can’t make it happen – you can meet the needs of baby in other ways!

Stay tuned for part 2, coming up!

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