Will it hurt? Pain and breastfeeding

For years I have been teaching breastfeeding classes with this description of the pain involved with breastfeeding:

Those of us who are breastfeeding advocates may have glossed over the issue of pain because we didn’t want anyone to be put off by the idea of pain. You might not try to breastfeed because of it. There may be pain. I’d like to reframe the question: What kind of pain is it?

I describe three kinds of pain: two are normal and will go away; one means trouble, get help.

#1 The pain of doing something new with a part of your body that hasn’t experienced it before. I describe this pain like, “wearing new shoes for a whole day at work, when I should have broken them in first.” While it may be sharp, especially if I develop a blister, I know it is minor and will go away soon. It doesn’t make me want to throw my new shoes away. This “newness” nursing pain will go away and be a minor part of your nursing experience.

#2 Even though your special hormone mix makes the shaft of your nipples very elastic, it is true that there can be a tug-and-pull kind of pain when the baby first latches on. As the baby gets the nipple positioned in his mouth this pain goes away. This means it should last about 10-30 seconds into the feed. I’ve seen moms do a little labor breathing for a few minutes as they work through this pain. But even that level of pain is unusual, I think.

#3 This is the pain that means you should get help. Your baby is doing something to your nipple creating this pain and can be taught better technique. You may see damage on your nipple: a crease or raw skin or bleeding. The pain lasts through the whole feed and beyond, making you dread the next feeding. The bad news is that the baby probably isn’t transferring milk very effectively either; and some babies will try to compensate for this with more aggressive action like chomping or pulling. The good news is that this is fixable. You don’t have to live with this. This is exactly what lactation consultants are trained to help with.

My question is this: How close to the truth are my descriptions? Am I still downplaying the role of pain in breastfeeding? I imagine there are many moms out there whom I would never see as a lactation consultant because breastfeeding is not painful. Am I off base? Help me out with your experience, please

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