Does Breastfeeding Hurt? What's Normal and What's Not

Plenty of new parents are told that breastfeeding is natural and then find that it hurts. Both can be true. Early tenderness is common, but pain that sticks around is a sign that something can be adjusted, and most causes can be fixed once someone looks at a feed.

Here’s how to tell normal from not normal, what usually causes the pain and what to try. If your nipples are already sore or cracked, our guide to sore nipples goes into healing in detail.

What’s normal

The NHS says nipple pain is common in the first few days of feeding. The Academy of Breastfeeding Medicine (ABM) agrees that pain and discomfort are common in the first few weeks, although it also says pain severe enough to cause early weaning shouldn’t be written off as physiological.

A comfortable feed usually looks like this, according to the NHS and CDC:

• Once your baby is well latched, feeding is not painful (CDC)
• Your baby has a wide mouth and a big mouthful of breast, with the chin touching your breast
• More of the darker skin around the nipple shows above your baby’s top lip than below the bottom lip
• Your baby’s cheeks look full and rounded as they feed
• Your nipple is not flattened, wedged or white at the end of the feed (a sign of poor attachment, per the NHS)

The CDC says thinner, whiter milk typically arrives by about 3 days after birth, and it can take longer for first-time parents. Your breasts may feel full and tender, and the CDC says feeding often should help prevent severe engorgement and relieve the discomfort. See engorged breasts if yours feel hard or painful.

What’s not normal

The CDC says breastfeeding should not be painful once your baby is well latched. Get help if you notice:

• Pain throughout most feeds, or at every feed
• Nipples that are flattened, wedged or white at the end of a feed, which the NHS says can mean your baby isn’t attached properly
• Cracked or bleeding nipples. The NHS warns that cracks raise the risk of nipple infection
• Pain that doesn’t improve over the first 1 to 2 weeks (CDC)
• Pain together with a fever (CDC)
• Burning or shooting pain, color changes in the nipple, or pain between feeds

Common causes of breastfeeding pain

Cause	Clues	What helps
Shallow latch or poor positioning	Pain throughout the feed, flattened or creased nipple afterward. The ABM says positioning is often cited as the most common cause of sore nipples.	Re-latch and adjust positions; get your feed watched. See how to breastfeed and breastfeeding positions.
Tongue-tie or other oral differences	Ongoing nipple damage; baby has restricted tongue movement. The ABM says not every baby with tongue-tie causes problems.	Assessment by a trained clinician. See tongue tie.
Breast pump trouble	Nipple bruising or injury after pumping. In a US survey cited by the ABM, 14.6% of 1,844 mothers reported injuries related to pump use.	Check flange fit and suction level; get your pumping observed. See our flange size calculator.
Nipple vasospasm	Shooting or burning pain with white or purple color changes, sometimes after feeds or in the cold, per the ABM.	See nipple vasospasm.
Infection, including thrush	The ABM says the role of bacteria and yeast in pain is unclear. A burning pain and a pink, shiny or flaky nipple can go with candida.	Needs a clinician’s assessment. See thrush while breastfeeding.
Clogged duct or mastitis	Painful breast area, sometimes with fever (CDC).	See clogged milk duct and mastitis.
Skin conditions	Red, itchy or flaky skin. The ABM lists irritant and allergic contact dermatitis, eczema and psoriasis.	Needs a clinician’s assessment.

What to try first

Fixing the latch comes first, because the NHS says self-help tips won’t work if your baby is poorly attached.

1. Get comfortable and bring your baby to you. The NHS suggests your baby’s head and body in a straight line and close to you, with their nose level with your nipple.
2. Wait for a wide mouth. Let your baby’s top lip brush your nipple, then bring the baby to the breast chin first so they get a big mouthful of breast.
3. Avoid holding the back of your baby’s head. The NHS says that letting them tip their head back helps the nipple reach the soft palate at the back of the mouth. Pain happens when it’s pinched against the hard palate near the front.
4. Try a different position. MedlinePlus says to learn different holds so your nipples don’t get sore.
5. Look after your nipples. The NHS suggests dabbing expressed breast milk onto cracked nipples after feeds, changing breast pads at each feed and wearing a well-fitting bra without underwire. It says to avoid nipple shields if you can, because they can affect how your baby attaches. See nipple shield for when they are used.
6. Keep milk moving. If you can’t feed from one side for a while, express by hand or pump.

Pain that lasts longer than 2 weeks

The ABM defines persistent pain as breastfeeding-related pain lasting longer than 2 weeks. It reports that as many as one in five women have persistent pain at 2 months postpartum. In one study of 1,323 mothers who stopped breastfeeding in the first month, 29.3% cited pain as an important reason, so you’re far from alone if you’re struggling.

The protocol’s own caution matters too: evidence on persistent breastfeeding pain is limited and mostly based on expert opinion. That’s why a hands-on assessment of you and your baby, with a lactation consultant, doctor or midwife, is the best next step. They look at the feed, your baby’s mouth, any pump use and your skin, and may consider treatments for specific causes.

When to call a doctor or lactation consultant

Contact a lactation consultant (IBCLC), your doctor or midwife if:

• Pain lasts through feeds or hasn’t improved after the first 1 to 2 weeks
• Your nipples are cracked or bleeding, or look flattened, wedged or white after feeds
• You have burning or shooting pain, color changes or pain between feeds
• Your baby seems unsettled after feeds, isn’t gaining weight or has fewer wet or dirty diapers than expected

Call your doctor the same day if you have a fever or flu-like symptoms with a red, hot or painful breast, as this may be mastitis. If you’re feeling very low, anxious or hopeless, tell your clinician. In an emergency, call 911, or call or text 988 if you are in crisis. Our breastfeeding support page lists where to find help. For more problems and fixes, visit the common challenges hub.