Should breastfeeding hurt?
In the first days your nipples are sensitive and many mothers feel discomfort, especially as the baby latches on. The NHS describes nipple pain in the first few days as common, and the Academy of Breastfeeding Medicine (ABM) considers initial discomfort with the early latch physiological. Pain so strong that you are thinking of stopping breastfeeding is no longer normal, and it is worth asking for help straight away.
The WHO stresses that nipple pain during a feed most often means the baby is not well attached, even if there are no other signs. Once the latch improves and the nipple is no longer being damaged, the pain eases and wounds heal quickly. The ABM calls pain persistent when it lasts longer than 2 weeks, and reports that as many as one in five women still have pain 2 months after the birth.
| Usually normal | A sign to ask for help | |
|---|---|---|
| When it hurts | At the start of a feed, in the first days | Throughout the feed, at every feed or also between feeds |
| How it changes | Eases day by day | Gets worse or lasts longer than 2 weeks |
| Nipple after a feed | Rounded, no wounds | Flattened, wedge-shaped, white, cracked or bleeding |
| Breast and how you feel | A feeling of fullness that goes after the feed | A painful lump, a hot red area, fever, chills |
How can I tell if my baby is latched on well?
The most common cause of nipple pain and damage is a latch that is too shallow. When the baby takes only the nipple, it gets pressed against the hard palate. With a good latch the nipple reaches far back, to the soft palate, and is not squeezed. The NHS lists a few signs that feeding is going well:
- Your baby opens their mouth wide, and their chin touches the breast first, with the head tipped slightly back and the nose clear.
- You can see more of the darker areola above the top lip than below the bottom lip.
- The cheeks look full and rounded, not sucked in.
- After a few quick sucks your baby sucks more slowly and deeply, and you can hear swallowing.
- Your baby comes off the breast on their own when full and is settled after most feeds.
A nipple that is flattened, wedge-shaped or white right after a feed is a sign that the latch was too shallow. Sometimes a change of position is enough to stop the pain, but the most useful step is having a midwife or lactation consultant watch a feed.
What most often causes pain while breastfeeding?
There are many causes of pain, and they can occur together or one after another. The table will help you get a sense of what may be going on, but it does not replace an assessment by a midwife or a doctor.
| Cause | Typical symptoms | What usually helps |
|---|---|---|
| Shallow latch or an awkward position | Nipple pain at every feed, nipple flattened or white after the feed | Improving position and latch with a midwife's help |
| Damaged and cracked nipples | Grazes, cracks, sometimes bleeding, pain when the baby latches on | Improving the latch, a little of your own milk on the nipple after feeds |
| Engorgement (nawał pokarmu) | Both breasts full, hard and swollen, usually on days 3-5 after the birth | Frequent feeds, softening the areola before latching, cold after feeds |
| Blocked duct (ductal narrowing) | A tender lump in one breast, sometimes slightly red, no fever | Feeding on demand, cold, painkillers, no firm massage |
| Mastitis | A hot, painful, swollen part of one breast, fever, chills, feeling unwell | Continuing to feed, rest, cold, painkillers, contacting a doctor |
| Thrush (fungal infection) | Burning nipple and breast pain also between feeds, pink, shiny or flaky nipple, white patches in the baby's mouth | Diagnosis and treatment by a doctor, usually for mother and baby at the same time |
| Nipple vasospasm | Sharp, shooting or burning pain after feeds or in the cold, the nipple turns white, then blue or red | Warmth after feeds, avoiding cold on the breasts, seeing a doctor if the pain is severe |
| Tongue-tie in the baby | Nipple pain and wounds despite a better position, long feeds, the baby slips off the breast or clicks | Assessment of sucking by a midwife or lactation consultant, a doctor if needed |
| Breast pump | Grazes, bruising or nipple pain after pumping | The right flange size, lower suction, shorter sessions |
What helps sore and cracked nipples?
The NHS and Polish lactation experts agree that the key is improving the latch. Without it, home remedies usually do little. In the meantime you can do a few things:
- Do not stop breastfeeding. If for now you cannot feed from the sore breast, express milk from it by hand.
- After a feed, spread a little of your own milk over the nipple and let it air dry. For shallow grazes this is usually enough.
- Change breast pads at every feed, ideally ones without a plastic backing, and wear a comfortable bra without underwire.
- For pain you can take paracetamol or ibuprofen at the dose on the leaflet. According to the NHS, both are safe while breastfeeding.
- Do not start using silicone nipple shields on your own. They can disrupt sucking and milk supply, so a lactation consultant should decide whether you need them.
Always show deep, bleeding or non-healing wounds to a midwife. The NHS warns that cracked nipples raise the risk of infection, and mp.pl reminds that bacterial and fungal infection should be ruled out when wounds are assessed.
How do I tell engorgement, a blocked duct and mastitis apart?
In its 2022 guidance the ABM describes these conditions as a single spectrum. Engorgement usually affects both breasts in the first days after the birth. A blocked duct (in Polish zastój) is a tender lump in one area of the breast, sometimes slightly red, without fever. According to the ABM it is not a single plug in one duct but swelling and inflammation that narrow the small ducts.
Mastitis is a red, hot and painful area of one breast, often wedge-shaped, with fever, chills and feeling run down as with flu. On dark skin the redness can be harder to see. For all of these conditions, feeding on demand, cold compresses, ibuprofen or paracetamol and a comfortable bra help. The ABM advises against firm massage, pumping "until empty" and piercing a white spot on the nipple, as they make the inflammation worse. You can read more about the first days in our article on breast engorgement.
Why do my nipples hurt even though the latch is good?
If a midwife has confirmed that your baby is well latched and the pain continues, the cause may lie elsewhere. The NHS and the WHO then recommend another assessment, because persistent pain can point to an infection or an anatomical problem.
According to the WHO, thrush causes pain that continues between feeds too, described as needles stabbing deep into the breast. The nipple may be pink, shiny or flaky, and the baby may have white patches in their mouth that cannot be wiped off easily. If the mother has symptoms, mother and baby are treated at the same time. The ABM notes that the link between yeast and breast pain is still debated, so do not treat yourself, show your nipples to a doctor.
Nipple vasospasm, sometimes linked to Raynaud's phenomenon, causes sharp, shooting or burning pain, usually after a feed, after getting out of a warm shower or in the cold. The nipple turns white and then blue or red. Some women with this problem also have constantly cold hands and feet. The ABM then recommends warmth right after feeds and avoiding cold on the breasts, so cold compresses, which help a blocked duct, may make this worse.
Tongue-tie limits the movement of the baby's tongue and makes a deep latch harder, which can cause nipple pain and wounds. Not every tongue-tie causes problems or needs a procedure. When it does make feeding difficult, a simple procedure to divide it reduces nipple pain, according to the WHO. The decision is made by an experienced specialist, and a midwife or lactation consultant will assess sucking and tell you where to go.
Can a breast pump cause nipple pain?
Yes. The ABM points out that a breast pump can damage the nipple and breast tissue when the flange is the wrong size, the suction is too strong or pumping goes on too long. In one US study, 14.6% of 1,844 mothers reported injuries related to pump use.
If pumping hurts, lower the suction and ask a midwife to check the flange fit, ideally while you pump. Express as much as your baby would drink, not "until empty", because excessive pumping drives up milk production and makes blocked ducts more likely.
When should I call a midwife, and when should I see a doctor?
Call a midwife if one or both nipples hurt at every feed, crack or bleed, if the pain does not ease after a few days, if your baby cannot latch on or if you have a tender lump in your breast. The NHS advises getting help early: a midwife will watch a feed and check your baby's position and attachment.
See a doctor urgently, and if your condition is serious, go to the SOR (hospital emergency department) or call 112, if:
- you have a fever, chills and feel as if you have flu, and the symptoms do not ease after 12-24 hours of home treatment
- part of your breast is red, hot and painful, and the redness is spreading
- a hard, very painful lump appears in your breast and does not go away, or pus comes out of the nipple
- a nipple wound is weeping, has yellow crusts or is surrounded by spreading redness
- you have been taking an antibiotic for 48 hours with no improvement
- at any point you feel clearly worse
Long-lasting pain while breastfeeding can also be a heavy emotional burden. The ABM points to a link between painful breastfeeding and postnatal depression. If you feel overwhelmed, tell your midwife or doctor about it just as you would about the pain.
Who can help with painful breastfeeding, and how much does it cost?
- POZ midwife on the NFZ (a primary care midwife funded by Poland's public health insurer): after the birth she makes 4 to 6 free wizyty patronażowe (postnatal home visits). Under the perinatal care standard she assesses your breasts and nipples, watches a feed and helps solve lactation problems. After the home visits end, she can still support you with breastfeeding.
- POZ doctor, obstetrician or neonatologist: when the problem goes beyond a midwife's competence, for example mastitis that needs an antibiotic, thrush or an assessment of tongue-tie. Under the perinatal care standard, the midwife then tells you that you need to see a doctor and passes on her assessment of the situation.
- Lactation clinic (poradnia laktacyjna): available at some hospitals, clinics and private practices. According to mp.pl, a consultation at a lactation clinic is not reimbursed by the NFZ, so it is usually paid.
- CDL lactation consultant or IBCLC: for problems that drag on or keep coming back. You can check their credentials in public registers.
- Private home visit by a midwife with lactation experience: when you need help sooner, a longer visit or a particular person. The specialist then sees the whole feed in your own home.
You will find the prices of private lactation consultations in the price list at mymidwife.pl/cennik. In October 2026 the median across midwife profiles on MyMidwife was about 250 zł. On the profiles you can also check midwives' lactation qualifications and whether they make home visits.
