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Breastfeeding Should Not Hurt

12/15/2021

As a midwife, I do my best to support my clients in their breastfeeding journey. One thing I've heard more than once now from my clients is that breastfeeding hurts for the first few weeks until their breasts toughen up. Breastfeeding should not hurt, ever!

Even if you are experienced with breastfeeding, every baby is different. One baby may have a perfect latch and you will experience no pain at all. The next baby may have problems latching and that can cause discomfort. Remember, breastfeeding is a new experience for every baby, and there is a learning curve they go through.

If you are having pain, here are some things you can try:

Nipple shields can be your best friend. They let baby latch while protecting your breast tissue, giving it more time to heal
Change nursing positions. If you use a different nursing position every time you latch baby on, you change the pressure points on your breast tissue which helps prevent injury to the tissue.
After nursing, express some breastmilk and rub it on your nipple and areola, letting it air dry. Breastmilk is an amazing healing substance, so take advantage of it.
Consider chiropractic care for you and baby. Sometimes muscle tightness or something out of alignment for you or baby can affect how well baby latches on.
Have baby evaluated for tongue and lip ties. Ties may cause nursing issues and a revision can resolve these issues. While ties may make things harder, babies can be nursed with them. My son had a massive upper lip tie but we still had a successful nursing season.
Sometimes pumping can be helpful. It gives your tissues more time to heal between nursing sessions. Be mindful about how the expressed milk is given to baby. I prefer cup feeding over bottle, and yes you can cup feed a newborn.
Seek help from a lactation consultant or your local La Leche League.

My favorite online resource for nursing is Dr Jack Newman's website, in particular the videos of what a good latch looks like at 24 hours after birth and beyond. Another resource I trust is Kellymom which has lots of information and answers common questions.

There are many things that are considered normal that as a midwife, I do not consider normal. Pain while breastfeeding is one of those things that many people think is normal. I do not. Breastfeeding should not hurt, ever!

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12/1/2021

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How much time does the average prenatal appointment with an obstetrician last? 15 minutes.

How long is the obstetrician with you during labor and birth? They may come in for 5 minutes or less to check on you a few times before birth, and then they come in shortly before the baby is born and leave as soon as they are done with any suturing you may need. Based on the hospital births I've attended, you might see the doctor for up to an hour total.

How many postpartum appointments do you have with an obstetrician? 1 at 6 weeks is typical. In 2018 ACOG recommended that OB's have contact with patients starting at 3 weeks. Given that it takes 17 years on average for a new recommendation to become mainstream practice, not every doctor will have implemented the new guidelines. In just the past 30 days I attended a hospital birth. That patient's postpartum visit is scheduled for 6 weeks, with nothing before then.
How long is the average postpartum appointment with an obstetrician? 15 minutes, perhaps a little longer if the patient is having a cervical check such as pap smear.

Who decided that 15 minutes is enough time to assess how well pregnancy is progressing, how well Mom and baby are doing? It seems that Medicare prompted it in 1992 and the health insurance industry followed suit. There was no research into how long an appointment should last. The decision was made as a monetary decision, not a health care decision. In the years since that decision, time for actual care has decreased to about 8 minutes.

How much time does the average prenatal appointment with me last? One hour. Why? I feel that fifteen minutes is not nearly enough time to assess how well Mom and baby are doing. I do more than just taking blood pressure, and listening to the baby's heartbeat. I take the time to understand how Mom is feeling, how she is adjusting to the changes that come with pregnancy and how well she is preparing for birth and postpartum. I want to have plenty of time to answer questions, discuss changes and what to expect. I want to know more than how my client is doing physically, I want to know how she is doing emotionally. I want to take the time to make sure she understands the risks and benefits of procedures and tests and what her options are. I want to take the time to discuss what to expect at the birth. I want to be sure my client knows what to expect in the postpartum period and has help lined up for the first few weeks. I want to know my client well enough to recognize when something is starting to creep outside of normal. In my midwifery practice, I focus on my clients, and I take the time to provide the best possible care I can. I do not focus on the clock.

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Breastfeeding Should Not Hurt

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