Using a breast pump should not be painful. While the sensation should feel like a strong pulling or tugging on the nipple, any feeling beyond this normal sensation indicates an issue that needs attention. Pain signals that milk removal is inefficient or that delicate tissue is being damaged. With proper technique and equipment, pumping can be a comfortable and effective process.
Understanding Pumping Sensation Versus Pain
The expected feeling during an effective pumping session is a noticeable, rhythmic pulling sensation, often described as a strong tug on the nipple, which should not persist uncomfortably beyond the first minute or two as the milk ejection reflex, or “let-down,” is initiated. Some may also experience a tingling or pins-and-needles feeling in the breast tissue as milk flow begins.
Abnormal sensations, such as sharp, pinching, aching, or burning feelings that continue or worsen, indicate a problem. This discomfort signals either mechanical friction and damage or an underlying physiological issue. Ignoring pain can lead to nipple trauma, reduced milk volume, and infections, making immediate attention necessary.
Mechanical and Technique-Related Causes of Discomfort
The most common causes of pumping pain are directly related to the equipment and how it is used. The flange, or breast shield, must fit correctly, as an incorrect size is a frequent source of discomfort. A flange that is too small causes the nipple to rub excessively against the tunnel walls, leading to friction, blistering, and pain.
Conversely, a flange that is too large pulls in too much of the areola tissue along with the nipple. This excessive tissue pull can cause friction, swelling, and restrict the milk ducts, which hinders flow and leads to inefficient draining. When the flange is the correct size, the nipple should be centered and move freely within the tunnel without the areola being significantly drawn in.
Suction settings that are too high are another frequent cause of pain. Many users mistakenly believe that higher suction leads to greater milk volume, but excessive vacuum pressure can actually compress the milk ducts and breast tissue. Pumping above the Maximum Comfortable Vacuum (MCV)—the highest suction level that remains completely comfortable—can cause tissue damage and is counterproductive to effective milk removal. Proper alignment is also necessary, ensuring the nipple is perfectly centered in the flange tunnel before turning on the pump.
Physiological Conditions That Cause Pain
Pain not resolved by adjusting equipment or technique may be due to underlying physiological conditions requiring medical attention. Plugged ducts and mastitis are related inflammatory conditions. A plugged duct presents as a hard, tender lump where milk flow is obstructed, making pumping painful as suction attempts to clear the blockage.
Mastitis is an infection or inflammation of the breast tissue, often presenting with flu-like symptoms, fever, and a warm, red, wedge-shaped area of pain. In these situations, milk needs to be removed regularly, but the pain during pumping is often intensified due to the inflammation and pressure within the breast. A healthcare provider or lactation consultant (IBCLC) should be consulted for diagnosis and treatment.
Nipple vasospasm, sometimes related to Raynaud’s phenomenon, is another specific cause of pain. This condition involves the blood vessels in the nipple suddenly constricting, often triggered by cold air exposure after pumping or by nipple trauma. The symptom is a sharp, burning pain, and the nipple may turn white, then blue or purple, before blood flow resumes. Other trauma, such as cracked, bruised, or blistering skin, can be caused by improper flange size or technique, or by an underlying infection like thrush (candidiasis), which causes a deep, burning or stabbing pain.
Immediate Adjustments and Long-Term Prevention
To improve comfort immediately, applying a small amount of pumping lubricant, such as coconut oil or specialized balm, to the inside of the flange tunnel before starting can help the nipple glide smoothly. Start the pump on a low suction setting and gradually increase the vacuum level. This allows the tissue to acclimate and helps the user identify their Maximum Comfortable Vacuum (MCV). During the session, using gentle breast compression or massage while the pump is running can help encourage milk flow, potentially shortening the pumping duration.
For long-term prevention, ensure that all pump parts are maintained and replaced regularly, especially the valves and membranes. Worn parts reduce pump efficiency, which can tempt the user to increase the suction to an uncomfortable level to compensate for the lost vacuum power. Maintaining warm breast temperature after pumping, particularly for those prone to vasospasm, can also prevent painful blood vessel constriction.