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Breast pain - Part 1

What can cause pain while I'm breastfeeding?

The letdown reflex

You may feel fleeting pain in your breasts when your milk lets down. The letdown reflex, also called the milk ejection reflex, is set off by the hormone oxytocin. It stimulates the muscle cells in your breasts to squeeze out milk.

Oxytocin is released whenever your baby feeds in the first few days after she's born. Later on, just thinking about feeding your baby can trigger this hormone release. You may even find that your breasts leak when this happens.

Different women feel the letdown reflex in different ways. You may feel:

- slight tingling, or pins and needles
- immense pressure and slight pain, ache or discomfort
- nothing at all

As time goes by, and as you get used to breastfeeding, you'll probably become less and less aware of this.

Producing too much milk

Some mums who produce lots of milk have painful twinges deep in their breasts during feeds. This painful letdown reflex usually fades in the first three months of breastfeeding. If your baby latches on well each time she feeds, your milk supply should quickly settle down to match her needs.

Thrush

Thrush, a common fungal infection, can develop in your baby's mouth and on your nipples. The moist, warm, sugary environment of your baby's mouth while she is feeding is the perfect place for thrush to flourish.

Occasionally, the thrush infection may enter your milk ducts (ductal thrush). These are the channels through which your milk flows to your nipples, and once they're infected, breastfeeding can be painful.

Unlike letdown pain, thrush pain lasts during your baby's feed and gets worse after feeds. It's unusual to get a thrush infection in your milk ducts, though. Some experts even doubt that ductal thrush exists. You're more likely to have it just on your nipples.

If you or your baby has a thrush infection, you'll need to see your doctor, so you can both be treated.

Engorgement

In the first few days after your baby is born, your breasts flood with milk, and more blood flows to your breasts, making the tissues swell.

This may lead to your breasts becoming engorged and feeling hot and painful. The milk-producing cells in your breasts become swollen, making letdown difficult. Your breasts may also look red and shiny.

This is perfectly normal. It's your body's way of making sure your new baby has plenty of milk. Once your baby starts feeding regularly, and latching on well, your breasts will regulate the amount of milk that's produced, and the discomfort should pass. If it doesn't, see your midwife, health visitor, or a breastfeeding specialist as soon as possible.