Breastfeeding is hard. It is difficult to get it right but it is very important for your baby. There are many problems associated. Here are the common breastfeeding problems and how you can fix them. I have split the problems up into breast issues, milk issues and baby issues.

breastfeeding mum in nursing chair

Breast issues

Cracked or Bleeding nipples

Generally caused by your baby not latching on properly. If your baby doesn’t take a large enough mouthful then your nipple gets squished between the tongue and the hard palate. The nipples get sore and then crack and bleed. You can continue to feed if the pain is bearable.

To reduce the problem:

  • Ask your midwife about how you can improve the latch.
  • Use white paraffin – this can ease the  pain and speed up healing. This does not need to be removed prior to feeding.
  • Use lanolin ointment- this eases pain  but is not proven to increase healing (it may also irritate eczema). this does not need to be removed prior to feeding.
  • Take Paracetamol or Ibuprofen to ease the pain.
  • If nipples are not healing then see your doctor, midwife or health visitor.
  • Make sure you wash your hands before feeding to reduce infection.
  • Do not use soap or scented lotions on the nipples.
  • Try temporary nipple shields or expressing if you are unable to cope with the pain.

Mastitis

A condition where the breast tissue becomes painful and inflamed. It usually only affects one breast.

Symptoms include:

  • A red, swollen, painful area on your breast.
  • A breast lump or area of hardness.
  • Burning pain which may occur when feeding or may be continuous.
  • White or bloody nipple discharge
  • May be infected and cause a fever.

How to treat:

  • Contact your GP if you suspect you have mastitis. You may require antibiotics if you have developed an infection.
  • Get plenty of rest and stay well hydrated.
  • Try Paracetamol and Ibuprofen.
  • Avoid tight-fitting clothes.
  • You can continue to feed.

Thrush

Cause by a yeast called Candida. You may have thrush if you have pain in both nipples and breasts after feeding. Having not previously had pain after feeds. The pain can be quite severe and can last for up to an hour. Thrush doesn’t affect only one breast so if you only have symptoms on one side, there is a different problem.

Baby may also show signs of oral thrush:

  • Creamy or white spots in the mouth.
  • Your baby is unsettled when feeding.
  • A white film on the lips.
  • In some babies a persistent nappy rash.

How to treat:

If you suspect either you or your baby has thrush then see your GP. They can take swabs and rule out other breast problems. They can also start appropriate treatment. You can carry on breast feeding whilst you are being treated.

Inverted Nipples

Nipples come in all shapes and sizes. Inverted nipples may make breast feeding more difficult. Your baby takes breast tissue into its mouth as well as the nipple. The nipple will likely protrude during the sucking motion. 

How to treat:

  • Stimulate the nipple prior to feeding, this makes it protrude more.
  • Pull back on the areola before latching baby on.
  • Try a nipple shield.
  • Discuss your problem with a lactation consultant, your health visitor or your midwife. 
Breastfeeding mum, skin-to-skin

Milk Issues

Clogged or Plugged milk ducts

Milk gets backed up in the duct, the tissue becomes inflamed and compresses the duct, causing blockage. Normally felt as a small hard lump that is very tender to touch. There can be associated redness, a hot sensation or swelling that may feel better after nursing. It can also can develop into mastitis.

Causes include:

  • An improper latch.
  • Breast pump not being powerful enough to empty breast.
  • Abrupt weaning of baby.
  • An ill fitting bra.
  • Stress – can cause reduced oxytocin production and therefore reduced release of milk.
  • Illnesses e.g. cold – you might not feel like feeding as often.
  • Surgery e.g. biopsy – this may interfere with milk drainage.

How to treat:

  • Feed, feed, feed.
  • Start with the sore breast first.
  • After feeding pump or hand express to empty breast.
  • Massage.
  • Vary nursing position.
  • Get more rest.
  • Eat and drink well.
  • Paracetamol and Ibuprofen.
  • A hot or cold pack may help.

If there is no improvement after 24 hours or you develop a temperature then seek medical help.

Painful let down

Some women have mild to severe pain when milk lets down instead of pins/needles or a tingling sensation. The let down is when milk ducts constrict to force milk into the nipple from the milk glands.

Causes include:

  • Producing too much milk.
  • Clogged or plugged ducts.
  • Mastitis.
  • Thrush

How to treat:

  • See relevant sections of this post.

Engorgement

Breast engorgement is when your breasts become overfull. They feel hard and tight. Engorgement may be normal in the early days when your milk is coming in. If your breast is engorged you may find baby doesn’t latch on properly. You may find that you get engorged when you make a lot of milk or you haven’t fed baby for a while.

How to treat:

  • Try hand expressing a small amount of milk to relieve the pressure. A lactation consultant your midwife or health visit can show you how to hand express.
  • Wear a well fitting nursing bra.
  • Take paracetamol or ibuprofen to ease the pain. 

High milk supply

 Occasionally some women make too much milk, and their babies struggle to cope. This can lead to baby spitting up after feeding or gagging on the milk.

How to treat:

  • Get your midwife or health visitor to observe a feed, they might be able to see why it is happening. 
  • Keep baby on the breast longer before switching sides. 

Low milk supply

When you first start feeding you will worry that baby is not getting enough milk. It is also very difficult to gauge exactly how much they are drinking. 

As long as baby is urinating and pooing frequently, and they have moist lips, they are probably getting enough milk. If you are worried then speak to your midwife or health visitor.

How to increase milk supply:

  • Skin-to-skin. 
  • Offer both breasts when feeding.
  • Alternate the starting breast.
  • Try pumping between feeds to encourage more milk production. 

Remember, milk production is supply and demand. To increase the supply you must increase the demand.

Breastfeeding outside

Baby issues

Latching pain

Pain on latching can be quite common. It is normal for this pain to be present for up to one minute. If it lasts longer than this you may have a problem.

Causes:

  • Poor latch technique
  • You may need an adjustment period. Nipples need time to toughen up when you just start feeding.

How to treat

  • Try different feeding positions, this may help baby latch on better.
  • If it persists contact a lactation consultant, your health visitor or your midwife.

Baby falling asleep on breast

This is very common. Breast milk contains hormones that make baby sleepy. They also get tired when they have a full stomach.

Some babies fall asleep when they have only had a small amount of milk. This may be because they get tired easily or there isn’t enough milk supply. If baby is frequently falling asleep and is struggling with weight gain then see your midwife or health visitor.

Things to try:

  • Switch breasts just before baby nods off.
  • Compress the breast during feeding so the baby gets a hit of milk.
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