Using a breast pump often requires adjustments, but it shouldn’t cause prolonged pain. Although you may notice discomfort, as your breasts and nipples adjust to the stimulation and pressure of pumping, persistent pain can be a sign that something is off.

Here’s a guide to understanding painful pumping and how to find relief.

Quick Overview: Painful Pumping

• What It Feels Like: A painful, often pinching or tugging sensation around the nipples during pumping.

• When It Happens: Most common when first starting out, when flange fit is wrong, or during periods of engorgement.

The Bottom Line: You should not have to suffer through it. Pain is a signal to check your setup.

What it is

When using a breast pump, you may notice a painful—and even intolerable—sensation around your nipples that feels like pinching or tugging. This is the result of the pump attempting to suction onto your nipple and breast and express milk from it, and this discomfort isn’t something you should suffer through. You’ll need to make some adjustments.

When it can occur

Painful pumping can occur at any time during your pumping journey, but it’s especially prevalent when you’re just figuring out how to use your pump and determining whether certain accessories, especially flanges, fit well. It’s also common to experience when your breasts are engorged.

Primary Causes of Pumping Pain

Pain is almost always related to fit and settings. The two main culprits to investigate first are:

1. Incorrect Flange Size: This is the #1 cause of pain.

• A flange that is too large will pull too much of your areola into the tunnel, causing swelling and pain.
• A flange that is too small will compress and rub your nipple against the sides, causing pinching, blanching (turning white), and damage.
• Remember: Your nipple size can change in the postpartum weeks, so a flange that once fit may no longer be correct.

1. Incorrect Suction Settings:

The "stronger suction = more milk" myth is false. Suction that is too high can compress milk ducts, cause pain around the areola, and actually reduce milk output.

What to do

Painful pumping can often be remedied. Here are a few tips:

• Step 1: Check your flange size

• When you’re using the right-size flange (for the Go or 3.0 pump) or the appropriate insert, you’ll feel more comfortable and get more milk when pumping. If you notice that your nipples are shifting to the sides of the flange, you may need a smaller size. Check our sizing guide.

• Step 2: Adjust the Pump’s Pressure

•  If your suction is too high, it can pull too much of the breast into the funnel and compress your milk ducts. This can cause pain around your areola, lead to poor milk drainage, and possibly reduce your supply. (If you’re having any other issues that are challenging your ability to comfortably express milk when pumping, consult a lactation consultant for a fitting evaluation.)

• Step 3: Evaluate Your Pumping Bra

• Your pumping bra should keep the pump snug and secure, pressed uniformly against your breast. If it feels like it can move in your bra, tighten your bra straps, or try a different bra. The pump should be supported at the top and bottom by a full-coverage bra.

• Step 4: Use Comfort Aids

• Try nipple balm: Consider adding a little nipple balm before pumping, for added comfort.

Try heat and vibration: A warming massager can relieve your symptoms.

When to get help

If you try these tips and are still having problems, seek help from a lactation consultant, midwife, or postpartum doula to ensure that you have the right flange fit and help you reduce your pain.

FAQs

• Q: Is it normal for pumping to hurt a little at first?
  A: A gentle tugging sensation is normal, but sharp, pinching, or persistent pain is not. Your body may need to adjust to the sensation, but pain indicates a problem with fit or settings.
• Q: How do I know if my flange is the wrong size?
  A: Signs of a wrong fit include: your nipple rubbing against the sides of the tunnel (too small), a large portion of your areola being pulled in (too large), or your nipple appearing white or misshapen after pumping (vasospasm from compression).
• Q: Can a pumping bra really cause pain?
  A: Yes. A bra that is too loose can cause the pump to tug unevenly on your breast. A bra that is too tight can compress tissue and milk ducts. The goal is a secure, full-coverage, and uniform fit.
• Q: I've checked everything and it still hurts. What now?
  A: Stop and seek help from a lactation consultant (IBCLC). They are experts in diagnosing latch, fit, and underlying issues like vasospasm or thrush that could be causing the pain.