Physiologic breast pain

Why are my breasts tender sometimes?

Some breast pain is common in the first few weeks after delivery. This “physiologic” pain is related to the normal function of the breast and may be caused by the weight of the breast, the filling with milk, or by let-down pain. Breasts grow during pregnancy. After delivery, breasts contain extra blood and nutrients. Heavier breasts pull on the skin and support structures of the breast and cause pain. This is normal and usually settles within weeks. Supportive clothes such as a firm bra can help. It is also normal to feel fuller before feeds during the early weeks. When milk fills the breast, it stretches the breast tissue, causing pain. This can be eased by massage, cold compresses, and breastfeeding when the baby is hungry. Such pain should not be persistent, increasing, or severe.

A) Physiologic pain

Some breast pain is physiologic, or related to the function of the breast. It is common in the first few weeks after delivery and gradually settles with time. It is often a sign that the mother has a good milk supply. It may be more intense and persistent if mothers have a large milk supply.

It has a number of possible causes:

  • The weight of the breast
  • Breast filling
  • The stretching of the nerves in the breast
  • Let-down pain

Persistent, increasing, or severe pain is not physiologic pain. Please see your health-care providers if this is occurring.

B) Breast weight

Breast tissues grow during pregnancy. After delivery, the breasts contain extra blood and nutrients needed to make milk and remove waste products. All of these changes make the breasts heavier.

A heavier breast pulls on the skin and support structures of the breast and on the chest wall, causing pain. This type of pain is normal and usually settles within a few weeks as the breasts and the rest of the body adjust to breastfeeding.

Supportive clothes such as a firm bra or athletic top can help.

C) Breast filling and the stretching of the nerves of the breast

In the early weeks after the baby is born, it is normal to feel fuller before feeds. This fullness may be worse in the morning, as babies tend to breastfeed a little less often during the night, allowing milk to collect in the breast. Breastfeeding the baby to sleep can help minimize this.

The extra filling stretches the breast tissue causing pain and tenderness. This type of pain is typically worse in the upper outer parts of the breast, because there is a little more milk tissue there.

Extra filling may also stretch the nerves of the breast, resulting in pain.

The treatment for excess breast filling is similar to the treatment for engorgement and includes the following:

  • Breastfeeding when the baby is hungry
  • Breast massage
  • Cold compresses