
Trouble Shooting Breastfeeding Issues
What to do when breastfeeding gets tricky
Most first-time mums start out intending to breastfeed, but things don’t always go to plan once baby comes along. Pain, engorgement, latch problems, low supply, clogged ducts, infections – there are several common issues that can make feeding your baby more difficult than you expected. When you’re recovering from birth, dealing with lack of sleep and hormonal changes, and inundated with messages about the benefits of breastfeeding, it can be heartbreaking when it doesn’t come easy.
There’s no shame in switching to formula or supplementing if that works best for you. But if you’re determined to stick with breastfeeding, most problems are fixable – and many are very short-lived.
Here’s our guide to troubleshooting some of the most common issues:
1: Engorged breasts
When your milk comes in a few days after birth, you’ll probably have at least a couple of days when your breasts feel heavy, hard, and tender to the touch – this is completely normal. As your body starts to regulate its milk production, engorgement should subside. Later, if you go too long between feedings, it may occasionally happen again.
Troubleshooting: The easiest way to relieve engorgement is by breastfeeding frequently. If your baby struggles to feed from an engorged breast, try hand expressing for a minute or two first, to soften the breast and make it easier to latch. For pain between feeds, use a cold compress and massage your breasts to relieve pressure. You can also try putting cabbage leaves in your nursing bra between feeds – it’s an old wives’ tale, but many mothers report that it helps.
2: Latch issues
A bit of nipple pain is – unfortunately – common when you first start breastfeeding. But if you’re feeling extreme pain or pain throughout feeding sessions, your baby may not be latching on properly. A shallow latch means your nipple isn’t far enough into your baby’s mouth, so it’s pressed against their hard palate rather than their soft palate as they feed. This is not just painful, it can also make it more difficult for your baby to feed efficiently.
Troubleshooting: To get the best possible latch, gently rub under your baby’s chin to encourage them to open their mouth. Position your baby so their bottom lip is below the base of your nipple, then lift baby onto your breast – don’t bring your breast to them. Baby will be latched properly when their chin is touching your breast, their mouth is wide open, and your entire nipple is inside.
Of course, latch issues are not always that easy to solve. If your baby struggles to latch for more than a week or two, seek help from your midwife, doctor, or a lactation consultant. In some cases, physical issues with your baby’s tongue or palate can make it impossible to latch properly.
3: Cracked nipples
It sounds horrifying, but cracked and even bleeding nipples are pretty common in the first week or two of breastfeeding. These can be the result of a shallow latch, over pumping, or simply your body adjusting to breastfeeding.
Troubleshooting: Heal cracks and soothe pain with a natural nipple cream – lanolin-based ointments are best. Use special soothing gel pads to relieve pain, and take a mild painkiller like paracetamol before feeds. To prevent further damage, make sure your baby is latched properly during feeds, and talk to your doctor or midwife if your nipples don’t heal within a few weeks.
4: Low supply
Many mothers worry that they have a supply issue, but very few actually do. Misconceptions around the signs of undersupply don’t help – it’s normal for new babies to feed very frequently, have short feeds, and wake to feed during the night. These are not signs of undersupply.
However, if your baby isn’t gaining weight, or if they shows signs of dehydration – like few wet nappies – you could have a supply issue. This can be the result of blood loss during birth or certain medical issues. If your baby was premature or has special needs, this can sometimes make it difficult for them to take enough milk during feeds, which can lead to a lack of supply as well.
Troubleshooting: If you’re concerned that your baby isn’t getting enough milk, talk to your midwife or see your doctor straight away – particularly if you’re noticing signs of dehydration. In rare cases, they may prescribe medication to increase milk production.
If your doctor or midwife gives you the all-clear, but you’re still concerned, try pumping between feeds to boost supply. You can also eat supply-boosting foods – fenugreek, oats, fennel seeds, yeast, and garlic have all been used to promote milk production for hundreds of years. Or try special lactation cookies for a simple and delicious breastfeeding boost.
5: Inverted nipples
Before you have a baby, you don’t spend much time thinking about the shape of your nipples – afterwards, it can become a big issue. Pinch your nipple gently – if it retracts, it may be inverted. Flat or inverted nipples can make it harder for your baby to latch, which can cause pain or prevent your baby from getting enough milk.
Troubleshooting: Most people with inverted nipples can feed successfully with a bit of help from an expert. If you’re concerned, ask your midwife for help with your latch or talk to a lactation consultant. They may be able to help you finesse your latch, or recommend a nipple shield – a soft silicone shield that fits over your breast and helps pull your nipple into the best position for feeding. You can also try pumping for a short time before feeds, as this can also help pull your nipples forward.
6: Blocked ducts
Milk ducts can clog for a few reasons – longer breaks between feeds, a side-effect of engorgement, or the result of wearing a too-tight bra. You can tell a duct is clogged if you have a hard, painful lump on your breast.
Troubleshooting: Keeping milk flowing is the best way to unclog a duct, so feed your baby on the affected breast until the problem is resolved. Warm compresses and gentle massage can also help to break up the clog.
7: Mastitis
Mastitis, like other bacterial infections, can cause fever and pain and needs to be treated with antibiotics. Mastitis may be a side-effect of a blocked duct or cracked nipples, as both can allow infection-causing bacteria into the breast.
Troubleshooting: If you think you have mastitis, see your GP for antibiotics as soon as possible. While you’re recovering, keep feeding your baby and/or pumping frequently, as full, engorged breasts can make the problem worse. If your breasts are very painful, use warm or cool compresses between feeds.
8: Thrush
Thrush is a yeast infection, which usually starts in your baby’s mouth before spreading to your breasts. Symptoms include shooting pains in the breast, itching, and red, shiny, flaky skin on the nipples.
Troubleshooting: Like mastitis, thrush doesn’t generally clear up on its own. See your GP for an antifungal treatment – this will need to be used on your breasts and your baby’s mouth, or it will keep coming back.
Don’t be afraid to ask for help
Before you start breastfeeding, the potential issues can seem overwhelming. While there are some common problems, most people only experience one or two, and they’re usually resolved within the first few weeks or months. Many women sail through their breastfeeding journey without a single issue.
If you do have problems with your latch, worries about supply, or a medical issue like mastitis or thrush, seek help as soon as possible. Your doctor, midwife, or lactation consultant will be able to give you solutions and treatments if you need them. If you see a doctor or consultant who dismisses your concerns or doesn’t solve the problem, don’t be afraid to look elsewhere for help – breastfeeding goes far more smoothly if you have good support and understanding from those around you.
Want to know more about what to expect in the early days? Have a read through our baby care blog.