Pay attention to nipple sensation right throughout a feed if you have pain

It is normal, if you have nipple pain but have decided to keep on offering baby your breast, for your mind to have learnt to dissociate from the unpleasant sensations you have in your nipple and breast.

Often, women have been enduring a great deal of nipple pain but continue to put the baby on the breast anyway, because they know how good breastfeeding is for their child. This capacity to dissociate from your pain and just get the job of breastfeeding done is a remarkable kind of female heroism, the same heroic devotion to the needs of the tiny human which has ensured the survival of Homo sapiens down the millennia.

I encourage women who’ve been ignoring their pain as they breastfeed to start paying very close attention to the sensations in the nipple. This is essential for healing, though it can require quite a mental shift. It’s vitally important to bring your attention into the present moment right throughout a breastfeed if you're continuing on and you have nipple pain.

It’s normal when we have breastfeeding problems for our mind to become miserably busy, with exhausting thoughts like: I dread the next breastfeed, I’m not going to be able to do this, it shouldn’t be this hard, how ridiculous to fail as a mother in this way, if I have to use formula I am harming my baby. You could expect to have thoughts like these if you have nipple pain and damage. Some of these upset thoughts may be useful. Many of these upset thoughts don’t need to be believed.

You can find out why our minds work this way here, and how to unhook from unhelpful thoughts here.

The healing power of attention to breast sensations when you're breastfeeding with nipple pain or damage

Take deep breaths and consciously relax your shoulders and arms as you exhale, consciously relax the forearm so that it becomes a lever which allows you to subtly control your baby’s face-breast bury.

Your forearm under your baby’s head and the paddle hand between her shoulder blades allow you to make tiny micromovements (vertically, horizontally, and of the angle of the face-breast bury), noticing the sensations of your nipple and breast to find that place where there is no discomfort or pain, noticing and responding to your baby’s subtle communications – is that slight agitation and slight squirming (or big agitation and squirming!). Is this better, is this worse? Is this better, is this worse?

Applying micromovements in the three directions, millimetre by millimetre: is that better, is that worse? Throughout each feed, aim for 0 out of 10 on the pain scale where 10 is the worst pain possible. If we tolerate even a one or a two or a three, our nipples are continuing to be subjected to nipple and breast tissue drag.

You can find out more about using micromovements here.

Sometimes, there is visible damage to the nipple and you can’t quite get to zero, but I encourage you to keep trying for zero right throughout the feed anyway. This is the way you will eliminate ongoing micro-trauma from breast tissue drag, and heal. Harnessing the healing power of your attention to the sensations in your breast and nipple is essential as you experiment your way through.

It makes me cross if a woman's heroism as she continues to breastfeed through pain isn't respected by others around her. This might occur when health professionals privately use phrases such as "she’s an anxious mother", or "she's unable to let go of breastfeeding" or is "she's unable to value her own needs." As health professionals, we belong to health systems which fail to train us in the skills necessary to resolve breastfeeding-related nipple pain. We definitely don't want to be blaming the mother for her distress, or failing to respect and admire her extraordinary courage.

You can find out more about how to maintain contact with the present moment and your body's sensations here.

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What's useful to notice in the mirror before you bring baby on to your breast?