Breast pain

Why do my breasts hurt?

There are many reasons why breasts may be painful. Some are associated with making milk, including the weight of the breast, filling with milk, and let-down pain. Excess filling may be caused by engorgement, having a large milk supply, going more than five hours between feeds, or feeding ineffectively can cause pain, as can ineffective expressing. Other causes of breast pain include infections, plugged ducts, nipple pain, and cancer. On rare occasions, no cause can be found.

Consider using our quick assessment tool, “Why do I have breast pain?” to guide you through this concern.

A) Describing breast pain

Breast pain can arise from the process of making milk, from excess filling, from infection, or other causes (Berens 2016).

Sometimes the cause cannot be identified. It is possible that some mothers experiencing nipple and breast pain have a genetic risk for increased sensitivity (Lucas 2020). Authors have proposed using blood pressure medication (propranolol) or antihistamines (cetirizine), but the evidence for this is limited to a few patients (Muddana 2018). 

Some problems are easily solved but others need the help of a  health-care provider

B) Tenderness associated with making milk

Breasts may be tender as they produce milk. This is called physiologic tenderness and can be caused by the following:

C) Excess filling

Breast pain from excess breast filling can be caused by the following:

E) Other causes of breast pain

Other causes of painful breasts include the following:

References

Berens P, Eglash A, Malloy M, et al. ABM Clinical Protocol #26: Persistent Pain with Breastfeeding. Breastfeed Med. 2016 Mar;11(2):46-53

Lucas R, Zhang Y, Walsh SJ, et al. OXTR rs53576 Variation with Breast and Nipple Pain in Breastfeeding Women. Pain Manag Nurs. 2020 Dec 7:S1524-9042(20)30196-X

Muddana A, Asbill DT, Jerath MR, et al. Quantitative Sensory Testing, Antihistamines, and Beta-Blockers for Management of Persistent Breast Pain: A Case Series. Breastfeed Med. 2018 Apr 9