There’s a common refrain in families that breastfeeding is expected to be painful.  You’ll here all sorts of stories about having to toughen your nipples up or the color of you skin/hair/eyes makes you more susceptible to pain or that it is inevitable in breastfeeding.

Of course I don’t feel that pain is okay while breastfeeding, but I do view it as a sort of vital sign in the evaluation of breastfeeding. Pain is the greater motivator to know that there is a problem and for parents to reach out for help.   That gets you to volunteer and professional breastfeeding helpers. The big communication goal of the volunteer and professional breastfeeding support community is to help families know that breastfeeding doesn’t have to be painful.

But did you know that the absence of pain does not mean breastfeeding is going well?

“Do you experience any pain” is often one of the first questions I asked when a family contacts me, but that answer does not give me the whole story.  

Common breastfeeding problems that cause pain for the parent are hypertonia (high muscle tone), torticollis, poor positioning, and tongue tie.  

Common breastfeeding problems that can exist in the absence of pain are hypotonia (low muscle tone), shallow latch, poor positioning, torticollis, poor positioning, and tongue tie.

Often times the pain free parent’s first sign something is wrong is a missed weight goal.  By then the situation is more severe and supplement may be needed prior to doing any work on the breastfeeding issue.  

What can you do?  Talk with a breastfeeding counselor or IBCLC.  Read books like LLLI’s The Womanly Art of Breastfeeding, or Nancy Mohrbacher’s Breastfeeding Made Simple.  Learn the basics:

6+ wet diapers and 2-3 quarter sized poops in 24 hours

Watch for quiet alert states where your baby is active, but not crying.  

Watch for active nursing for at least 5 minutes.

Nursing sessions should not regularly take more than 45 minutes.

Weekly weight checks at your pediatrician’s office, a breastfeeding support class or group.

Have your latch checked by an IBCLC in the early days and at least once in the first week of life after your mature milk comes in.

If you have questions or are ever concern that breastfeeding isn’t going well always ask someone trained to help you with your concerns. It will help ease your mind, or get intervention when needed.