Breastfeeding is not meant to be painful. So what's going wrong for so many women?

Talk to new mothers about breastfeeding, and there’s one message sure to come through: it’s painful and it’s difficult.

Dr Pam Douglas, a researcher at the University of Queensland, says women tell her that the pain they suffer while breastfeeding is worse than labour.

“It’s just heartbreaking because women want to breastfeed,” she tells Mamamia. “I get so cross when people talk about women not persevering because I see it every day in the clinic. It’s a heroism. Women just go on and on and on through the most extraordinary pain, trying to breastfeed their baby.”

But breastfeeding is not meant to be painful or difficult. So what’s going so wrong for so many women?

Dr Douglas has spent years researching just that. She believes the fault lies in the way women are being advised when it comes to latching and positioning – or, as she calls it, “fit and hold”.

“It’s actually a health system problem,” she says. “We are not adequately helping women. We don’t know how to pick up that there’s a fit-and-hold problem.”

She also believes that a lot of the time when babies won’t latch, or they pull off the breast, arch their back and cry, the problem is with the fit and hold.

“This is heartbreaking for women,” she says. “They feel as though the baby’s refusing them.”

Dr Douglas has drawn on the work of other researchers – including Dr Donna Geddes at the University of WA, who has done ultrasound studies of babies breastfeeding – to come up with a new approach. Called gestalt breastfeeding, it has five steps.

Getting the positioning right is crucial. When starting out, Dr Douglas says the mother should be in a semi-reclined or “deckchair” position, and the baby should be in a cradle hold, tucked up under her breasts.

“The little one is across her body, face buried into her breast, above the nipple and the areola,” she explains. “She’s reclined, the bubby’s chest and tummy are flat against hers, and that starts to turn on the baby’s reflexes. So he will start bobbing away and coming down closer to the nipple and areola. When the chin and lower lip bury into breast tissue, the bubby opens up his mouth, and she uses her forearm just to help him on at that point.”

Next, the mother will make very tiny movements to get the positioning just right.

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“Often the baby will come on fairly shallow. That’s normal. But then, as that jaw drops more, which it will as a reflex, and a vacuum’s created, we’re doing our little micromovements to have the baby deeply buried into the breast.

“It’s just to find that place where there’s no pain and the mum’s breast tissue is being drawn up so deeply that the nipple is beautifully protected.”

Dr Douglas believes fit and hold has been the “big blind spot” in clinical breastfeeding support.

“We can replace a human heart but we can’t identify breastfeeding issues and help our women, clinically, to breastfeed their babies. And women so want to.”

Did you find breastfeeding painful? Tell us about your experience in the comments below...

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