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Know your boobs

When trying to determine the root cause of discomfort, first identify, “Is this breast pain, nipple pain, or both?”

Each set of breasts is unique. The better you know your own breasts and the more you are willing to look at and touch your breasts and nipples, the higher the likelihood that you will notice a problem emerging early enough to prevent severe pain or infection.

First, an anatomy lesson. You have two breasts. On your breast is an areola. In the middle of that areola is a nipple.

Breast Pain

When we say “breast pain,” we are talking about the breast itself, not the nipple. This includes tissue that goes all the way up into your armpit. 

Once a day, fully inspect your breasts in a mirror, perhaps before showering. make sure you can see coloring all around. 

Feel your boobs often

Get an idea of what they feel when they have more milk before a stimulation and when they have less milk after a stimulation.

Notice where it feels full and firm but not tender

Notice spots that maybe feel tender or very tender to the touch. If you feel tenderness, always look for redness. Is that tender section bright red or discolored?

Also pay attention to how your breasts feel before, during, and between feeding or pumping sessions. 

Do you feel sensations in your breasts:

  •  As they fill
  • When they are very full? 
  • As your milk is starting to flow while nursing or pumping? 
  • Are they uncomfortable or painful?
  • That are always the same spot or does the sensation move ? 
  • When you touch that spot, is it tender to the touch? 
  • Is there a hard spot there? Redness?

If you find any hard spots that aren’t draining or spots that are tender to the touch, you are having breast pain.

Nipple/Areola Pain

Always wash or sanitize your hands before touching your nipples, especially if you have pain, as there may be hidden or obvious breaks in the skin tissue. 

The bullseye on your breast is your areola. 

There are sometimes a lot, sometimes a few little bumps on your areola. Those are your Montgomery glands. They rarely (but sometimes) get irritated. It is not as common to have areola pain as breast or nipple pain, but it certainly can happen, especially with a lot of pumping or a poorly fitting pump flange. 

You would know if you are having areola pain if you look at your areola and they are dry, cracked, or a different color than usual. Occasionally, those little Montgomery glands can get infected or irritated. That looks and feels kind of like a pimple. 

Your nipple is that nub in the middle of the areola. This is where most breastfeeding pain originates. Take a close look at your nipple. Nipples are very unique to each woman and often different on each side. It is really important that you know your nipples so you can notice when something changes. 

Just like with your breasts, you want to look at your nipples before and after breastfeeding and/or pumping. 

  • Before breastfeeding/pumping, look at their general color. Does this seem like your normal nipple color? Are they more pink or red than usual? Do they seem purplish or bruised? Do they seem pale or white like there is decreased blood flow?  
  • How do they feel at rest without yet touching them?

Look more closely at each nipple. Are there any breaks in tissue? Cracks can be sneaky and hide in between nipple lobes. There are often a lot of crevices in nipples. It is only considered a “crack” if it is painful and there is raw tissue there. Are there any white spots that look a little like a blister or a wet scab? Are there any darker, drier scabs? 

  • How do your nipples feel when you touch them? 
  • How do your nipples feel when you latch or pump for the first 30-60 seconds?
  • How do your nipples feel after this first 30-60 seconds?

After the baby unlatches or you turn off your pump and remove your flanges, how does your nipple feel? Look at your nipple. It should be a lot or a little bigger, fatter, and longer, but it shouldn’t be misshapen, compressed, or look like a new tube of lipstick. 

  • If you saw cracks before latching, how do your nipples look now? You probably have a better view of those wounds.
  • How do your nipples look and feel five minutes after finishing breastfeeding or pumping? 15 minutes after? An hour after?

If you are noticing any visible damage, pain, or discoloration in your nipples or areola, you are having nipple pain.