Breastfeeding Problems and Solutions

Common Issues and How to Deal With Them

Young mother trying to breast feed crying baby
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Some babies latch on and breastfeed well right from the start, but it doesn't always go so smoothly. Many moms and babies need time to learn how to breastfeed together. During the first week after your child is born, you may run into some struggles that can interfere with breastfeeding. But, even once breastfeeding is established and going well, issues can still pop up. Breastfeeding problems can be painful and distressing to a new mom, and they can cause a baby to become fussy, and frustrated.

It can be scary to face a problem that you don't know how to deal with, so sometimes these unexpected issues lead to early weaning. But, by learning about and understanding these common breastfeeding problems, you will be more prepared to handle them and get through them successfully. From the newborn stage to weaning, here are some of the common breastfeeding problems you may experience along with the solutions to help you deal with them.

Sore Nipples

You can expect a little bit of nipple tenderness during the first few weeks of breastfeeding. That's normal. However, very sore, cracked, and bleeding nipples are not. They're a sign that something is not quite right. If your nipples are so sore that it's painful to breastfeed, that's a big problem. You'll want to try to prevent sore nipples as much as possible, but if they do develop, continue breastfeeding and treat them right away. Talk to your doctor or a lactation consultant for help if you need it.

 

  • Make sure your baby is latching on correctly.
  • Try a different breastfeeding position and change positions at each feeding. 
  • Gently break the suction from the latch with your finger before removing the baby from the breast.
  • Offer short, frequent feedings.
  • Start breastfeeding on the breast that is the least sore.
  • Apply warm, moist compresses to the nipples.
  • Rub freshly expressed breast milk on your nipples to help them heal.
  • If your nipples do not show signs of improvement within a few days, notify your healthcare provider. Any opening in the skin can allow an infection to enter your body and that can make the situation even worse.

Breast Engorgement

When your breast milk fills your breasts by the end of the first week, your breasts can become swollen, and tight. Breast engorgement can be painful for you, and it can make it hard for your newborn to latch on to your large, hard breasts. This initial phase of engorgement usually lasts a few days or weeks as your milk supply adjusts to your baby's needs. While your body is adjusting, try to focus on relieving the pain and pressure. 

  • Breastfeed very often, at least 8 - 12 times a day.
  • A good latch and correct positioning can help your child breastfeed more efficiently and remove more milk.
  • If your child isn't breastfeeding well or you still feel full after breastfeeding, use a breast pump or a hand-expression technique to remove more breast milk and relieve the pain and pressure. 
  • Remove a little breast milk before you begin to breastfeed to soften the breast tissue and make it a little easier for your baby to latch on. The removal of breast milk also helps to release some of the pressure, so the flow of milk out of your breasts will not be too forceful for your baby. 

Plugged Milk Ducts

Plugged milk ducts are small, hard lumps in the breast. They form when breast milk clogs up and blocks the narrow milk ducts. The area around the plugged duct may be tender, swollen, and red. Plugged milk ducts will often go away on their own within a few days. Here's what you can do to help it along.  

  • Make sure your baby is latching on correctly and removing the breast milk from your breasts efficiently.

  • Breastfeed very often to prevent your breast milk from building up and clogging the milk ducts.

  • Breastfeed on the side with the plugged duct first. Your baby's strong suck at the beginning of the feeding may help to unblock the duct.

  • Alternate breastfeeding positions to drain all the areas of your breast. Different holds can help target the area of your breast where the blocked duct is and dislodge it.

  • Apply warm compresses to the plug to encourage the breast milk to flow better in that spot.

  • Massage your breast while your breastfeeding to help relieve the plug.

  • Make sure to get enough rest and drink enough fluids.

  • If the lump does not go away, it grows, or you develop a fever, call your doctor.

Mastitis

Mastitis is swelling or inflammation of the breast tissue, and it's often called a breast infection. Other common issues such as breast engorgement, blocked milk ducts, fatigue, or illness can lead to mastitis. You may suspect mastitis if you have redness or tenderness of the breast, flu-like symptoms, and fever.  

  • If you think you may have mastitis, call your doctor. You may need to take an antibiotic if you have an infection.

  • You may think that you can't breastfeed with mastitis, but you can and should continue to breastfeed often.

  • Try to get plenty of rest while you recover

  • Apply warm compresses to help ease     

Thrush

Thrush is a yeast infection that can appear on your nipples and in the baby's mouth. The symptoms of thrush can include breast pain, redness, and itchy nipples with or without a rash. It may also show up as white patches or areas of redness in your baby's mouth.

  • If you think you or your child have thrush, notify your doctor as soon as possible for an examination and the proper treatment. An antifungal medication may be necessary for you and the baby.
  • Clean and sterilize all pacifiers, bottles, toys and breast pump parts that come in contact with your breasts or the baby's mouth.
  • Good hand washing is very important to prevent spreading the infection.

A Low Breast Milk Supply

A low breast milk supply can cause fear and frustration. It's scary for a new mom to believe that she isn't making enough breast milk for her child, and it can be frustrating for a baby is she isn't getting enough. The good new is that the common causes of a low breast milk supply are often easily correctly. 

  • Check your baby's latch. Your newborn needs to take in all of your nipple plus part of the breast tissue surrounding your nipple to breastfeed well. Your body will increase milk production based on how much breast milk your child removes from your breasts.
  • Breastfeed your baby more often. Your newborn needs to breastfeed every 1 to 3 hours around the clock. The more you breastfeed, the more breast milk you'll make.
  • Keep your baby at the breast longer. Breastfeed at least 10 minutes on each side and try to keep your little one awake and actively sucking during each feeding. 
  • Use a breast pump after and in-between feedings. The extra stimulation at the breast can help increase your milk supply.
  • Eat well, get enough rest, and drink plenty of fluids.

Too Much Breast Milk

An overabundant supply of breast milk can be a challenge. It could cause problems such as plugged milk ducts, breast engorgement, and mastitis. The pressure of having too much milk build up in the breasts can also cause a hyperactive let-down reflex and a fast flow of breast milk out of your breasts. A fast flow can make your baby may gag and choke while he's breastfeeding which can cause gassiness, fussiness, and spitting up. 

  • Try offering only one breast at each feeding and offer the same breast if the baby wants to breastfeed again within an hour.
  • You can also try breastfeeding while laying back or reclining in a chair. Breastfeeding against gravity may help slow down the flow of milk.
  • Be sure to burp your baby frequently. Your baby is likely to swallow to more air while trying to gulp down a large amount of fast flowing milk.

When to Get Help

Most of the common complaints that you may experience with breastfeeding will resolve in only a few days.  However, if any of these issues continue beyond a few days or gets worse, seek help from your doctor or a lactation consultant. The earlier you can identify and correct a problem, the better it will be for you and your baby.  

 

Sources:

Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol# 4: Mastitis. 2008.

Cadwell, Karin, Turner-Maffei, Cynthia, O'Connor, Barbara, Cadwell Blair, Anna, Arnold, Lois D.W., and Blair Elyse M. Maternal and Infant Assessment for Breastfeeding and Human Lactation A Guide for the Practitioner Second Edition. Jones and Bartlett Publishers. 2006.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding: A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.

Scott JA, Colin WB. Breastfeeding: reasons for starting, reasons for stopping and problems along the way. Breastfeeding Review. 2002 Jul;10(2):13.

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