Pieta Woolley, Vancouver, British Columbia recently wrote in an article on straight.com, “[But] what the pro-breastfeeding propagandists don’t tell you is it can really, really hurt. A lot. For a long time. Apart from the pain of one’s breasts just getting used to nursing (and this is after hurting during pregnancy), you can also experience cracked nipples and blocked ducts. God forbid you get mastitis. Shiver.”

Makes you want to run right out and sign up to breastfeed—NOT!

On the flip side, Dee Kassing, IBCLC, RLC, Collinsville, Illinois was quoted in the Wichita Eagle as saying, “Breastfeeding should never be painful. If breastfeeding is painful, it means your baby is doing something incorrectly. If baby is breastfeeding correctly, it will not hurt even when he breastfeeds frequently.”

Research suggests that the truth lies somewhere in between.

Moreland and Hill in a systematic review of the literature found that 34 to 96 percent of mothers reported nipple pain that tended to peak on day 3, decrease by day 7, and occasionally lasted as long as 6 weeks. They listed as possible causes of nipple pain—improper positioning, misuse of nipple shields or breast pumps, use of creams or ointments, breast engorgement, breast infection, and frequency and duration of breastfeeding.

Many would argue that pain is a matter of perception. To paraphrase the words of a former U.S. President, who will remain anonymous, it depends on your definition of pain. What one mother reports as painful, another might describe as uncomfortable, but the fact remains that each person’s perception is real.

So what do mothers need to know? Given the reported prevalence of nipple pain, expectant and new mothers would benefit from knowing the following:

• Some but not all mothers experience pain.

• Pain typically occurs at the start of a feeding, when the baby first latches on to the breast and draws the nipple and surrounding breast tissue into his/her mouth. (The nipple stretches to 3 times its resting length, so it’s not surprising that many mothers find this “painful”.)

• If the baby is positioned well, the pain will only last a few seconds. But if the baby is positioned poorly, the pain can persist.

• If the pain persists, you can break the suction by sliding your finger into your baby’s mouth, removing the baby from the breast, and trying again.

• If you continue to breastfeed despite the pain, nipple damage can occur, so be sure to get help from someone you trust. An IBCLC (International Board Certified Lactation Consultant) can be a great source of knowledge and support.

• Still concerned? A trick of the trade is to check your nipple before and after you breastfeed. If your baby is positioned well, the shape of the nipple should look the same before and after you breastfeed. If the baby is positioned poorly, the nipple will look flattened or creased, like it’s been ironed, and breastfeeding will be painful!

It’s important for all mothers to know that breastfeeding is the normal way to feed a baby.

Most babies come into this world with the ability to suck and swallow. They have the tools they need to breastfeed, now they need to acquire the skill that comes with PRACTICE.

At the same time, most mothers have the tools they need to breastfeed (a breast, brain, and baby), now they need to figure out how to get the milk out of the breast and into the baby, a skill that comes with PRACTICE.

Do you see a pattern?