Back Pain from Breastfeeding: Tips and Positions for More Comfort

Nipple cream: check. Nursing pads: purchased in bulk. You even stocked your closet with a few easy-access shirts to make breastfeeding easier. The part you didn’t plan for: Back pain while breastfeeding. Breastfeeding moms spend long stretches of time holding babies to their chest. Position yourself in a way that strains your muscles and it can lead to neck and back pain.

How you sit and position your baby can help prevent back pain during breastfeeding. Read on to learn different feeding positions that may help you nurse more comfortably, as well as how physical therapy and exercise can ease breastfeeding-related back pain and neck pain.

Alternating Breastfeeding Positions

In their first few weeks and months, most exclusively breastfed babies will nurse every two to four hours, on average. That means you’ll be holding your baby to your breast eight to 12 times per day. Doing it in the same position each time — even if it’s back-friendly — can lead to tightness, achiness, and pain in your upper and lower back. 

"Back pain during breastfeeding is common,” says Hinge Health physical therapist Samantha Charlotin, PT, DPT. “Breastfeeding requires you to stay in one position for long periods. Given how often your baby will need to nurse, this can really add up.” 

Sustaining any position for too long may lead to aches and pains. “So when you’re not breastfeeding, focus on other postures and movement patterns,” Dr. Charlotin suggests. “And vary your breastfeeding positions to reduce the discomfort from staying in one position too long.”

Breastfeeding Positions for Back Support

Experiment to find what’s most comfortable for you and your baby. Some may work better on one side of your body than the other. Supporting your baby with a nursing pillow (or a stack of regular pillows) can make many breastfeeding positions more comfortable and help to keep you from leaning over. Consult a lactation consultant for additional help, if needed. 

Cradle Hold

In this traditional breastfeeding hold, you’ll support your baby with the arm that’s on the same side as the breast you intend to use.

• Sit up straight (ideally in a firm chair with armrests).

• Cradle your baby in the arm that’s on the same side of your nursing breast. Rest the baby’s head in the crook of your elbow, support their back with your forearm, and cup their bottom or thigh with your hand.

• Position the baby so their body faces your breast and their mouth lines up with your nipple.

• If needed, place a bed pillow or nursing pillow on your lap for extra support.

Cross-Cradle Hold

A variation of the cradle hold, it involves the same positioning except you hold your baby in the arm opposite your nursing breast.

• Sit up straight (ideally in a firm chair with armrests).

• Using the arm opposite the breast you’re feeding from, support your baby’s head and neck with your hand and rest their bottom in the crook of your elbow (or on a pillow on your lap).

• With your other hand, support your nursing breast from the underside in a U-shaped hold to help guide your baby’s mouth to your breast. Don't bend over or lean forward (which can strain your neck and back); instead, cradle your baby close to your breast.

Football Hold

Just as the name suggests, it involves holding your baby by the side of your body — like you’d clutch a football. Consider this position if you had a cesarean delivery, as it helps keep the baby's weight off your incision. It may also be useful for moms with large breasts or flat nipples, since you can see both your nipple and the baby’s mouth and can more easily control the baby’s head.

• Sit up straight (in a chair or on a couch).

• Hold your baby beside you, with their head near your breast. Support their upper back with your forearm and their head and neck with your hand. Face the baby toward your breast.

• Place a pillow under your elbow so you can position your baby high enough to reach your nipple. You can also support your breast in a C-shaped hold with your other hand.

 Reclined Hold

Also known as laid-back breastfeeding, this position helps you avoid hunching over and encourages your baby to tap into their natural breastfeeding instincts.

• Lie back on a chair that reclines or sit on a couch or bed in a comfortable position that allows you to lean back a bit. (You can use pillows for back support or neck support.)

• Position the baby on top of you, belly-to-belly. Hold the baby so their stomach is touching yours and their head is level with your breasts.

• Your baby should naturally find your nipple, latch, and begin to nurse. 

Side-Lying Hold

This position allows you to relax while nursing, may be more comfortable if you had a C-section, and helps avoid back pain.

• Lie on your side with pillows behind your back and under your head for support. (A pillow placed between your knees may make you more comfortable.)

• Place your baby closely beside you facing your breast, holding them in position with one hand.

• With your other hand, grasp your breast and touch your nipple to your baby's lips. Once your baby latches on, you can use one arm to support your own head and the other to support your baby. You can also place a pillow or rolled-up blanket behind your baby’s back for extra support.

• Don’t fall asleep while you’re nursing. When your baby has finished nursing, return them to their own bed to sleep.

PT for Breastfeeding Back and Neck Pain  

Even if you alternate positions and choose those that minimize tension, you may still find that breastfeeding leads to some back and neck pain. The normal stress of adjusting to parenthood can make your back muscles tense, leading to pain and muscle spasms. You’re also lifting your baby in and out of the crib and carrying heavy items, like diaper bags and car seats. Plus, your abdominal and pelvic floor muscles may be weaker postpartum, which can reduce support for your pelvis and spine and can cause back pain. Regular exercise and physical activity can help decrease pain and improve overall quality of life. Before you begin any postpartum exercise, get clearance from your healthcare provider. Once you get the OK, a pelvic floor physical therapist (PT) can help tailor a postpartum exercise program that is safe and appropriate for you. A PT may recommend stretches to help prevent stiffness and tightness, as well as exercises to strengthen your core, pelvic floor, and mid-back, and upper back muscles. Pelvic floor physical therapy is a comprehensive treatment that includes exercise, education, and behavioral and lifestyle strategies. 

You can see a physical therapist in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth/video visit.