Does Breastfeeding Hurt?

My new medical assistant student, who was grossed-out by breastfeeding, told me that she would never breastfeed again, because with her first child--it hurt too much.

She assisted me with a new mom who came into the office 4 days postpartum with sore nipples and swollen, red engorged breasts. Her nipples were cracked. She had mastitis on both sides. With empathy, I agreed, "Breastfeeding can hurt." My student stayed in the room and busied herself while I talked with my patient, examined her, obtained milk for culture, and formed a treatment plan with antibiotics, antifungals, and topicals. I showed her the positions and holds she could breastfeed in to minimize the pain. Our patient was better in two days.

Our patient later reflected on the mismanagement that lead up to her problems:

"After my daughter was born, I asked to breastfeed her. The were sewing me up and said I’d have time later, "When you get to your new room then you can try." I was so numb from the epidural I couldn't move in my bed for 6 hours. When we finally got to our new room, my husband fell asleep on his cot and our baby started crying in her bassinet that they had her in at the foot of my bed. I tried to wake my husband up, but when he’s out, he's down for the night. I could not get out of bed; I was so numb. I paged a nurse and said I want to hold my baby and nurse her. She said, “You really need to rest. She’ll be fine.” I told her that I wanted my baby with me and she said, “Are you sure, you’ll have plenty of time to hold her after you rest.” My breasts eventually became engorged because of the delay in nursing. My baby had trouble latching on swollen nipples and they became cracked and it was downhill from there."

My student was amazed. She thought what she had suffered was normal breastfeeding. Now she realized she had the same: mastitis, thrush, and cracked nipples. She learned that mismanagement and infection hurt. My assistant did nurse her next baby without pain.