Experiencing nipple pain while pumping is a common concern, ranging from mild tenderness to sharp, intense discomfort. While some sensitivity is normal as the body adjusts, persistent or severe pain signals an underlying issue that needs attention.
Pumping Technique and Equipment
One of the most frequent causes of nipple pain during pumping stems from issues with technique or the equipment used. The breast pump flange, the funnel-shaped part that fits over the breast and nipple, plays a significant role in comfort and milk expression. An improperly sized flange can lead to considerable discomfort. If the flange is too small, it can compress the nipple, causing friction and pain as the nipple rubs against the sides of the tunnel. Conversely, a flange that is too large may pull in too much of the areola along with the nipple, leading to soreness and potentially reducing milk removal efficiency.
To determine the correct flange size, it is recommended to measure the diameter of the nipple at its base in millimeters, excluding the areola. Many pumps come with standard 24mm flanges, but individual needs vary, and one breast might even require a different size than the other. The nipple should be centered in the flange tunnel and move freely without rubbing or pulling in excessive areola. Applying a small amount of oil, such as vegetable or olive oil, to the nipple before pumping can help reduce friction and improve comfort.
Beyond flange fit, the suction level of the pump can also cause pain. Setting the suction too high, even if the goal is to extract more milk, can damage nipple tissue and lead to pain. It is more effective to use the highest comfortable suction level, gradually increasing it as needed. Pumping duration and frequency also matter; prolonged or overly frequent sessions, especially with incorrect settings, can contribute to nipple soreness.
Nipple Conditions
Pain during pumping can also arise from specific conditions affecting the nipple itself. Nipple trauma, such as cracked, blistered, or bruised nipples, is a common source of intense pain. This damage often results from an ill-fitting flange, excessive suction, or improper pumping technique. Such injuries can make each pumping session excruciating and may increase the risk of infection.
Thrush, a yeast infection caused by Candida albicans, can affect the nipples and breasts, causing burning, itching, or stinging pain. Nipples affected by thrush may appear red or deep pink, shiny, or flaky, sometimes with a rash or tiny blisters. The pain associated with thrush can be persistent, even after pumping, and may be described as a shooting sensation deep within the breast. Both the individual and the baby may require antifungal treatment to prevent reinfection, as thrush can pass between them.
Another condition, nipple vasospasm, involves the tightening or spasming of blood vessels in the nipple, which reduces blood flow. This can cause intense pain, often described as throbbing, stabbing, or burning, and is frequently worse in cold temperatures. The nipple may change color, appearing white, blue, or purple before returning to its normal color, particularly after a pumping session. Vasospasm can be triggered by nipple trauma or conditions like Raynaud’s phenomenon. Keeping the nipples warm and addressing any underlying nipple damage can help manage this condition.
Breast Health Issues
Beyond nipple-specific concerns, internal breast conditions can also manifest as pain during or after pumping. Clogged milk ducts occur when milk becomes blocked within a duct, leading to a tender lump in the breast. This lump may feel sore or painful to the touch and can be accompanied by localized redness or warmth. Pumping can exacerbate the discomfort associated with a clogged duct, but continuing to empty the breast is important to resolve the blockage. If left untreated, a clogged duct can potentially progress to a more serious infection.
Mastitis is an inflammation of the breast tissue that often involves a bacterial infection. Symptoms typically appear suddenly and can include breast pain, swelling, warmth, and redness, sometimes in a wedge-shaped pattern. Individuals with mastitis may also experience flu-like symptoms, such as fever, chills, and body aches. Pumping with mastitis can be painful, but continued milk removal is generally recommended to help clear the infection.
Mastitis requires prompt attention, as an untreated infection can lead to complications such as a breast abscess, which may need surgical drainage. Risk factors for mastitis include cracked nipples, pressure on the breast from tight clothing, and improper nursing techniques. While a clogged duct typically presents with localized pain and a lump, mastitis often involves more widespread breast tenderness and systemic symptoms like fever.
Seeking Professional Help
While many causes of pumping pain can be addressed with self-care and adjustments, there are situations where professional help is necessary. It is advisable to seek consultation from a healthcare provider or a lactation consultant if pumping pain persists beyond the first two minutes of a session, or if pain continues after pumping. New or worsening breast pain that does not improve within the first two weeks of nursing also warrants professional evaluation.
Certain symptoms serve as red flags indicating a need for immediate medical attention. These include a fever of 101°F (38.3°C) or higher, spreading redness on the breast, severe pain, or the presence of pus or blood in milk. A lactation consultant can provide guidance on proper flange sizing, optimize pumping technique, and offer strategies for pain management. They can also help identify the underlying cause of pain and recommend appropriate interventions, which may include referral to a medical doctor for conditions like severe infections. Timely intervention can prevent complications and support a more comfortable and effective pumping journey.