How to prevent wrist pain while breastfeeding

When Cheryl Jameson’s second child, Trinity, was about four months old, Jameson started to experience aching, burning and stabbing pain in her left wrist while nursing. Sometimes it was so severe she’d have to shake her wrist aggressively to make it stop. The mom from Sherwood Park, Alta., soldiered on, breastfeeding her daughter, who’s now two years old, until she was one.

Ignoring the pain came at a cost. Almost a year and multiple medical appointments later, Jameson is still searching for a solution. “I’ve seen a chiropractor and a physiotherapist. I’ve had numerous X-rays and an MRI. I’ve tried taping, wearing a brace and a steroid shot with no luck.” Jameson has also consulted with two surgeons. They’ve ruled out triangular fibrocartilage complex (TFCC) and carpal tunnel syndrome. She is hoping to find some answers and relief. “I can’t work out, pick up my kids, drive properly—basically, anything that involves twisting the wrist or strength, I can’t do.”

According to Teresa Pitman, a La Leche League leader and co-author of Dr. Jack Newman’s Guide to Breastfeeding, wrist pain while breastfeeding is typically caused by trying to hold the baby’s weight with your hand, wrist or forearm throughout each feeding. “A baby is likely to breastfeed up to 12 times a day, with each session lasting 20 to 40 minutes, so you can see that in some positions it can put a lot of strain on the mother’s arms.”

As Jameson has learned, there is a spectrum of repetitive strain injuries (RSIs) related to breastfeeding that can impact the wrist, thumb, fingers and even the forearm and elbow. And sometimes diagnosis can be tricky. Carpal tunnel or tendinitis are common RSIs, but there are also other lesser-known syndromes such as De Quervain’s tenosynovitis. Some telltale signs of De Quervain’s are pain or swelling on the thumb side and back side of the wrist, and pain when forming a fist, holding things or turning the wrist. There may also be a catching feeling when moving the thumb. The key is to seek medical advice early. Typical treatments for mild to moderate RSIs are rest (a brace can help), icing and anti-inflammatory painkillers like ibuprofen. Sometimes corticosteroid injections are recommended (while generally considered safe, make sure to let your doctor know you’re breastfeeding). In severe cases, surgery may be required.

According to Pitman, pain happens most often when women continue to use the cross-cradle hold beyond the newborn stage (which is the hold Jameson used). Cross-cradle, which involves using the arm opposite from the breast that the baby is feeding from to hold the baby’s weight, can put a great deal of strain on the hand, wrist and forearm. “This position is really just intended as a teaching position, but I sometimes see mothers with babies who are seven or eight months old still breastfeeding this way,” says Pitman.

She recommends using an alternate hold as both a means of preventing and alleviating wrist pain. “Most lactation experts today are recommending that mothers start off using a semi-reclined position. That means the mother gets herself comfortable leaning back on pillows and the baby lies tummy-down against her chest. He can then move (with some help from the mother) to find the breast and latch on. In this position the baby’s weight is supported by the mother’s body.” Other options for mothers who are comfortable with the cross-cradle hold are to support the arm holding the baby with their free arm or a nursing pillow. Or, once the baby is latched in this position, to try leaning back against a support so gravity isn’t further adding to the problem.

If using a pillow or cushion to take the pressure off, make sure the pillow is under your arm and not under the baby. Otherwise, it will be difficult to move your baby closer as she latches on, and she may only get a shallow latch, which can lead to another big pain: sore nipples.

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