Pumps and pain

About 15% of women have nipple tissue damage or injury using breast pumps. In our research at Milkdrop, we have found that for every ten women using a breast pump, two have nipple damage or discomfort and eight feel like a cow.

Why pumping might hurt?

Breast pumps – medieval torture device or women’s health product?

When you look at a pump, it’s not hard to see why some women experience this. Your nipple is being pulled into a hard plastic or hard silicone flange, repeatedly.

  • Your nipple and areola is sucked repeatedly against a plastic or hard silicone flange until milk comes out. If you’re pumping every few hours, then you don’t really have time to recover before you do it over again. Nipple pain and discomfort is such a common and big topic that we’ll go through it in more detail in the next section.
  • Your wrists can be sore from holding a cranked position and repeating the same movements frequently, especially if you’re massaging while you pump, holding the pump in position or using a manual pump. In our research at Milkdrop, we found that women using manual pumps had higher rates of wrist pain. Although this makes sense theoretically, (because you are squeezing the handle repeatedly for the pumping session), we can’t say that manual pumps actually caused wrist pain without further study.
  • Your back and neck can ache from supporting an unnatural position, especially if you’re craning to see how your nipple is being drawn into the pump and how much milk you’re collecting.

If you’re pumping soon after birth, then these pumping pains come on top of recovery pains. They can also come on top of emotional stress if things aren’t going as you planned. 

Is nipple pain common?  

If you’re having sore nipples or breasts during or after you pump, you’re not alone.

The most commonly reported adverse events for breast pumps to the United States Food and Drug Administration (FDA) are for pain, soreness or discomfort, need for medical intervention and breast tissue damage[2](Brown et al., 2005)(Brown et al., 2005).

It’s difficult to say for sure, but our best guess is that around 1 in 5 women have nipple pain or damage when they pump. We arrive at that statistic from looking at a few studies (although really there should be more studies funded given that 20% of pumping women represents millions and millions of people in pain):

  • A study of about 900 mothers in Melbourne reported pain (17%), damage to the nipples (11%), bruising and rash[3] as the main adverse effects of pumping.
  • A study of just over 1800 women found that 15% of women had injuries from pumping, with nipple pain being the most common[4].

Most research looking at pain and pumping tends to focus on active pain and damage caused by the breast pump rubbing at the breast. However, if you are not expressing regularly (whether pumping if you’re exclusively pumping or pumping and feeding at the breast) or your pump is not effectively extracting milk, you could  . The only mention of this that we could find was in a study of 69 women with breast pain.  

Whether it’s from rubbing or inefficient milk expression, here are some   that you may recognise.

 

 

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Cracked, chaffed, bleeding, blisters, bruising

 

 

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Stretched, elastic

 

 

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Blebs (milk blisters), blocked

 

 

 

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Swollen, bloated, red, hard

 

 

 

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Itchy, Tingling, Aching

 

 

 

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Blanched

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Shooting pain

 

 

 

What can cause pain?

Few studies look at

There are no studies thoroughly investigating the cause of adverse events; however, a number of studies identify contributing factors.

Brown et al (2015) noted that long, uninterrupted suction disrupted skin and caused breast discomfort or pain.

Jones & Hilton (2009) noted that incorrectly fitting breast shields have been identified by practitioners and patients as sources of pain, damage (severe nipple excoriation), incomplete breast emptying, milk stasis, engorgement and feeling of ‘lumps’ after expressing. They state that if untreated, incomplete breast emptying can lead to blocked ducts, inflammatory and infective mastitis, poor milk production due to build-up of suppressor peptides that down-regulate volume.

Mothers in a study investigating breast pump use reported that they were poorly instructed in how to use pumps (Van Esterik, 1996). This is consistent with personal communication with a number of lactation consultants and general practitioners specialising in lactation medicine, that under-education about flange sizing is one cause of nipple pain and damage.

It can be difficult to diagnose the cause of breast and nipple pain, and even figure out best treatment, especially if you are pumping and feeding at the breast. The important thing to do is to see your doctor or lactation consultant for help.