A friend of mine from grad school is responsible for the first blog topic on this post being about something unpleasant – you can go ahead and throw your tomatoes her way – but it is an interesting point she made when I asked my Facebook friends what topics I ought to discuss. She mentioned that the breastfeeding books never mentioned that it is painful, particularly in the beginning, when your milk lets down.
Well, she said it “might hurt like knives ripping open your flesh”… I don’t think I would go that far.
Some of you are probably nodding your heads in agreement, thinking, YES! NO ONE TALKS ABOUT THIS!
Some of you are probably furrowing your brow in confusion, because you have never felt this happen to you.
The fact is, not all women feel their let-downs happen. Some moms feel a tingling, or a pins and needles sensation, when their milk lets down, in the top and/or sides of their breasts. Some women feel a more painful version of this, particularly in the very early days, that I have heard described as anything from the knives my friend mentioned to bee stings to being electrocuted. It generally only lasts a few seconds at most. Some women feel nothing at all, particularly with children after the first.
So, why does this happen??? There is actually a very good explanation for this. In short, your milk production system is having contractions. Your milk is produced deep in the mammary gland in the alveoli, which collected together make little cavities called lobules (if you are interested, there is a diagram here: http://women.webmd.com/picture-of-the-breasts). In order to make the milk travel from its place of production through the milk ducts and out the nipples, something has to make it happen… otherwise it would just run like a faucet all day with no rhyme or reason, right? So the baby nurses (or you express milk in some way), and your brain sends oxytocin rushing through your system, getting you feeling all happy and lovey, and then…
BAM! The myoepithelial cells surrounding the alveoli get the message from the brain to release the milk, and they contract to squeeze it out into the ducts to flow to the nipple. So, that feeling like, WHOA, this is like a CONTRACTION in my BREAST… it’s a contraction in your breast!
The good news is that most of the time, once your supply is well established, generally in the first couple of weeks, this will stop! Some women still feel the let-down (I did, forever, it felt like a little electronic pulse, but not painful after a few weeks) after their supply regulates, some never feel it after the first few days to few weeks, and again, some never feel it in the first place. It may seem that not feeling it is the preference, although more than a few women have expressed that although it was painful, it was reassuring to know their milk was letting down.
If it hurts after a few weeks, you may want to consider whether anything else hurts. Evaluate your latch, look for signs of infection or overactive letdown, or check for any breast or nipple trauma. Pain after the first couple of weeks, in ANY part of the breast, is generally a sign of a problem. It may be an infection, it may be poor latch or poor positioning, etc., but if you are experiencing pain once you get going (or toe-curling pain any time), seek the help of a health professional.
Questions about this topic or anything on this page? Contact Megan or comment below.