What to Do to Stop Nipple Pain When Pumping
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Do you have sore nipples, pain, or damage from pumping?
Maybe you were told pumping is just uncomfortable and you have to just grin and bear it. Or maybe you just aren’t sure how to troubleshoot. Read on to learn some of the top reasons pumping can hurt and how you can fix it!
Let me start by saying - pumping should not hurt! Many times things that are common are then assumed to be normal. Pain is the way our body signals to us that something is not right. Breastfeeding and pumping - should both be pain-free! This post will dive into some of the main reasons you may be experiencing pain while pumping and how to fix them. If you continue to have discomfort despite correcting these things then it’s time to talk to a breastfeeding expert to help you troubleshoot what is going on!
You’re using the incorrect flange size.
This is so important! This is probably the #1 reason that pumping hurts or is causing nipple damage. Most pumps come with two flange sizes in the box, typically 24 mm and 28 mm. The majority of clients I size are actually WAY smaller than these “standard” sizes that come with the pumps. There are also some clients who will need larger sizes than those that come in the box. Everyone has different breast and nipple shapes and sizes.
Important note! Your flange size is determined by the diameter of your nipple, not the size of your breast!
There is no one-size-fits-all when it comes to pump flanges. It’s also important to note that one nipple might be a different size than the other and this is totally normal! Our bodies are in fact not perfectly symmetrical. Flange size can also change over time. Immediately postpartum you might have swelling and hormonal changes that cause your nipples to be a bit larger than they will be after that first month postpartum. So that means if you start to have some pain from pumping later in your journey your nipple diameter could have changed and you will need a new flange size. Keep in mind that measuring your nipple is just the first piece of this equation.
How to measure your nipples: (You should measure before pumping or breastfeeding so you get the nipple measurement without any swelling or stimulation.)
Using a printable ruler (I have a free printable ruler you can download here. If you want an inexpensive ruler you can keep handy, I like this reusable circle ruler.
Gently stimulate your nipples to evert them, and measure the right and left nipples (they could be different sizes). Measure the base of the nipple, don’t include the areola. If you have flat or inverted nipples this can be more challenging. I always suggest getting a professional flange fitting if you are uncertain about your measurements.
After you measure your nipples, then you generally add 0-2 mm to that number to get the flange size if you are using any type of standard pump. (So if both nipples measure 18 mm you want a flange that is 18-20 mm. If that is too big, then try a size down from what you measured. So in this example try a 17 mm.) There are some exceptions to this, such as the wearable Willow pump that uses constant suction. This measurement is just the starting point. You may find the most comfortable fit and milk output with a flange the same diameter as your nipples or you may need the +2 mm size for the most comfortable fit. Nipples vary in shape and elasticity so you may need some tweaks after you find your measurement. Many clients I work with need sizes that are not available through the pump manufacturer. If you need a smaller size, Maymom makes silicone inserts starting at 10 mm that are compatible with many pump flanges. They also make hard plastic flanges available in sizes starting from 10 mm up to 36 mm.
If you have the correct flange size and are still experiencing discomfort then you might want to try a silicone flange or insert. Pumpin Pal has unique sizing and design as well as silicone flanges that can help if you have elastic nipples. LacTeck BabyMotion flange is another silicone flange but it has the distinctive feature of providing nipple compression along with suction during pumping.
If you would like some guidance and help with measuring for proper flange size we offer virtual flange fitting and pumping consults! We can fit you for flanges as well as troubleshoot any other pumping issues you are experiencing.
The suction level you are using is too high.
Higher pump suction does not equate to more milk! So what suction level should you use? You should use the highest, most comfortable suction level for YOU. If it is uncomfortable, drop the level down. This might be a different number in the morning vs the afternoon, or at different times of the month, or when your period returns you may be more sensitive. If you are just starting to pump you might need a lower level now but can work your way up as you adjust to the pump and pumping. Also, level 4 on a hospital-grade pump is different from level 4 on a personal pump or a wearable pump- every pump will have slightly different pressure levels. Using a suction level that is painful for you can actually have the opposite effect of what you are trying to achieve- which is to pump an optimum amount of milk (here are some tips to boost your milk supply). Pain will disrupt the release of the oxytocin hormone which is vital for activating your let-down reflex. The goal with pumping is to get that milk to let down (multiple times)!
You have unresolved nipple damage.
Unresolved nipple damage from breastfeeding or previous pump trauma could be the source of pain. This could be from a baby who is not getting an optimal latch or from previously using the incorrect flange size. Regardless of the cause, it is important to take measures to heal your nipples. If you continue to re-injure your nipples this can become a vicious cycle of pain that could lead to things like mastitis or even reduced milk production. If the pain and damage persist despite your best efforts, it's time to seek help from a lactation professional. Without solving the root cause of the damage, you will continue to re-damage your nipples over and over.
Ways to soothe and help sore nipples heal while working on the root cause:
Saline soaks for wound irrigation and neutralizing skin pH.
Mix 1/2 teaspoon of salt in one cup (8 oz) of warm water. Make a fresh supply each day to avoid bacterial contamination. Soak nipples in a small bowl of warm saline solution for about a minute or alternately put the saline solution into a squeeze bottle and squirt it on your nipples. Rinse if desired then gently pat dry.
Nipple cream - My favorite is Motherlove Nipple Cream. It is organic, not sticky, has soothing calendula, and is safe for breastfeeding and pumping. It can also double as a lubricant during pumping. (use code beyondbirth15 for 15% off)
Hydrogel pads- If you can’t stand anything touching your nipples these pads can be super soothing and placed in between your nipples and bra. For extra relief, put them in the freezer before use. As with anything touching your nipples, make sure to change frequently to keep the area free of bacteria.
Silver nursing cups- Just like the gel pads, these protect your nipples and keep them free from contact between nursing and pumping, but they are reusable. Silver is a natural antibacterial, anti-inflammatory, and antifungal metal. Silverettes are made of 925 silver (purest form and nickel free) and can be used over and over.
Lubricate while pumping- Some pumpers find that reducing friction and soothing their skin while pumping is helpful. You can use a safe nipple cream, coconut oil, or a food-grade pump spray such as Coboo.
Again, if you continue to have pain and damage and healing is not taking place then it’s time to see a lactation professional right away to rule out other causes! If you are unsure if you are measuring your nipples correctly for the correct flange size schedule a virtual consult with us today!
