Ouch! What If Pumping Hurts?

Some moms assume pumping should be painful.  Not so!  “No pain, no gain” does not apply here.  Painful pumping means something needs to be adjusted. 

Pump Suction Set Too High.  The highest suction setting does not always pump the most milk. In fact, too-high suction can actually slow your milk flow.  Set your pump at the highest suction that feels comfortable during and after pumping…and no higher. (If you’re gritting your teeth, it’s too high!)

Pumping milk is not like sucking a drink through a straw. With a straw, the stronger you suck, the more liquid you get. When pumping, most milk comes only when a let-down, or milk release, happens. Without a milk release, most milk stays in the breast.

What is a milk release?  Hormones cause muscles in the breast to squeeze and milk ducts to widen, pushing the milk out. When this happens, some mothers feel tingling. Others feel nothing.  A milk release can happen with a touch at the breast, hearing a baby cry, or even by thinking about your baby. Feelings of anger or upset can block milk release.

While breastfeeding, most mothers have three or four milk releases, often without knowing it. To get more milk with your pump, you need more milk releases, not stronger suction.  To see my tearsheet on how to trigger more milk releases, click here.

Fit Issues.  Many mothers pump comfortably with the standard diameter nipple tunnel that comes with their pump. But if pumping hurts even on low suction, you most likely need another size. (You may even need different sizes for each breast.) If the standard nipple tunnel size is too small or too large, a better-fitting one will feel more comfortable and may also pump more milk.

To check your nipple-tunnel fit, watch your nipple during pumping. If you see a little space all around your nipple as it’s drawn into the pump’s nipple tunnel, you have a good fit. If your nipple rubs against its sides, the nipple tunnel is too small (click here to see fit drawings).  If too much of the dark area around the nipple is pulled in or the nipple bounces in and out of the tunnel, it is too large. 

Two pump companies, Ameda and Medela, offer many nipple-tunnel sizes and this piece is sold separately, so you can go larger or smaller as needed. Other companies may not.  (The Medela piece also fits on Hygeia pumps.) Your nipple width may change with birth, breastfeeding, and pumping, so the nipple tunnel that fit you well when you started pumping may not fit well over time.  For that reason, it’s a good idea to recheck your nipple-tunnel fit from time to time.

Breast or Nipple Issues can also cause pain during pumping.  If your pain is not due to too-high suction or too-small or too-large nipple tunnels, it is time to consider these questions.  Do you have nipple trauma?  If you had nipple trauma in the past, could you have a bacterial infection of the nipple?  Do you have an overgrowth of yeast (also known as thrush or candida)?  Is mastitis a possibility?  Does your nipple turn white, red, or blue after pumping?  If so, see your lactation consultant or other health-care provider to rule out Raynaud’s Phenomenon and other causes related to breast and nipple health.   Thankfully, in nearly all cases, pain during pumping is a solvable problem.