15 Common Breastfeeding Problems And Possible Solutions

Breastfeeding problems are difficulties that a mother and her infant encounter during nursing, which may include poor latching, sore nipples, and breast infections. These issues can arise soon after birth and last as long as the baby is breastfed.

Breastfeeding difficulties are usually manageable. However, a combination of these factors can sometimes result in early breastfeeding cessation, compromising the mother’s and baby’s long-term health. Lactation issues can be annoying and bothersome for a new mother, but with the correct instructions and patience, you can efficiently deal with most of them.

Read on to know the most frequent nursing problems and ways to resolve them to get symptomatic relief.

Common Breastfeeding Problems And Their Solutions

Here is a list of common breastfeeding problems with possible solutions that may promptly resolve them (1) (2).

1. Latching issues

Latching issues are one of the reasons why mothers cease breastfeeding earlier than they intend to (3). A combination of factors, such as restricted tongue movement, or cleft palate, could be the possible causes (4). Improper latching makes breastfeeding painful for mothers and bothersome for babies who do not get enough milk. Cracked or sore nipples, breast engorgement, clicking noises while feeding, fussy behavior, and refusal to feed are common signs of latching failure.

How to manage: Proper positioning of the baby and the breast are vital for successful latching. Patience and regular practice help find the right latch in most cases. However, if your baby isn’t able to latch correctly, you may consult a lactation consultant. An expert can determine the precise cause of latching failure and suggest ways to resolve them.

2. Sore or cracked nipples

Improper latching, nipple biting, oral thrush, and tight bra are a few prominent causes of sore or cracked nipples. However, medical problems, such as nipple dermatitis or tongue-tie in your baby, can also cause the issue. Often, breastfeeding with a cracked nipple is painful and may also cause bleeding.

How to manage: Applying breast milk or over-the-counter nipple balms (unrefined coconut oil or a compounded ointment from a pharmacy are safer than nipple balms containing lanolin) on the affected area and using a nipple shield may provide relief in some cases (5). Use a nipple shield after consulting a lactation expert, as its improper use can lead to problems. The untreated sore or cracked nipple could develop nipple infections, which can be extremely painful and have adverse effects on the mother-baby duo.

3. Inverted or flat nipples

A flat nipple is a type that doesn’t become erect when the nipple is pinched. On the other hand, if the nipple retracts or becomes concave on pinching, it is considered inverted. In most cases, flat or inverted nipples don’t cause any breastfeeding problems (6). However, in some cases, an inverted nipple does not stretch out when pulled, making it problematic for a baby to latch and feed.

How to manage: Different feeding positions may help the baby explore the most suitable way to latch if the mother has flat or inverted nipples. You can also express breast milk into your baby’s mouth, touch their lips onto the breast to encourage the baby to open a wide mouth (rooting reflex). Additionally, devices, such as nipple shields may help your baby latch on and nurse.

4. Low milk supply

Breast milk production is a demand-and-supply-based process. Yet, mothers experience low milk supply causing insufficient milk intake by the baby. Some of the common symptoms of low milk supply are the breasts feeling soft, the baby feeding often, or feeding for a longer duration in every session. However, these symptoms don’t necessarily indicate low milk supply and can also happen in other breastfeeding problems.

How to manage: If you suspect your baby isn’t getting enough milk, look for the particular cause and contact a board-certified lactation expert. Breastfeed your baby often and for extended periods to stimulate milk production. You can also use a breast pump or massage your breasts to promote milk supply. Eat a well-balanced diet and maintain adequate hydration to ensure a healthy milk flow.

5. Too much milk supply

Excessive breast milk production (hyperlactation) can keep your breasts painfully full and could cause issues, such as leaking breasts, plugged milk ducts, breast engorgement, and mastitis (7). Too much milk in some cases can also cause hyperactive let-down reflex. The reflex causes the breasts to pass too much milk at once, raising the risk of gagging and choking during feeding.

How to manage:  Understand your baby’s hunger cues and feed them when they are hungry and not to soothe them. Offer one breast at each feeding session and switch breasts after every two hours. Check the feeding position and ensure the baby is correctly latched and not just sucking empty. Try breastfeeding in a reclining position since milk flow against gravity could be slower. Hand or pump expression of breast milk is another alternative to remove excess milk from the breast until you attain milk flow balance.

6. Breast engorgement

Breast engorgement is when the breasts get painfully full, swell, and are hard to touch. Usually, a little breast fullness a few days after birth is expected until the baby and your body adjust to the demand and supply process of breast milk. However, if it persists or becomes severe, it could increase the risk of clogged milk ducts and breast infection (mastitis). Breast engorgement mostly happens due to missed feedings, improper breast emptying, hyperlactation, and sudden breastfeeding cessation when the baby begins weaning (8).

How to manage: Nursing on demand resolves breast engorgement in most cases. However, if it doesn’t, you might need additional measures. For instance, you can try feeding your baby in different positions and express breast milk manually or using a pump between feedings. To relieve pressure and pain, wear loose-fitted bras, apply warm breast compresses, or take a warm shower before feeding. A cold compress, ice pack, gel pack, and cabbage leaves are other methods that may ease discomfort and reduce swelling. Consult a lactation consultant before trying medicine to relieve breast engorgement pain.

7. Leaking breasts

Leaking breasts is another common problem among nursing mothers, especially during the first few weeks after delivery. However, it usually resolves once the demand-and-supply pattern establishes. Breasts may leak between feedings when the let-down reflex is triggered due to nipple stimulation or when you hear a baby cry. But, in some cases, breast milk leaks due to overfilling of the breasts (9).

How to manage:  Feed your baby when hungry and avoid skipping the feeding session as much as possible. Use disposable or washable breast pads in the bra to absorb leaked milk. In most cases, leaking breasts won’t cause an issue but if it causes pain, swelling, and inflammation, consult a lactation expert to rule out an underlying issue.

8. Clogged ducts

Clogged duct or blocked duct occurs when the breast doesn’t empty properly, which may be due to missing feeding sessions, latching issues, tight clothing, or trauma to the breast. Clogged ducts lead to the development of a tender, localized lump, which is often painful and appears inflamed (10). Identifying and correcting the cause can resolve clogged ducts effectively.

How to manage: Feeding on the affected breast frequently and gently massaging the breast over the lump before feeding will unclog the duct. Applying warm compresses and trying different feeding positions may also ease the condition. Express breast milk between feeds and wear loose-fitting bras to avoid overfilling of the breasts. If the lump persists for more than a few days, increases in size or redness, or causes significant discomfort, consult a lactation expert promptly.

9. Milk bleb or nipple blister

Milk bleb or nipple blister is a tiny, clear, white, or yellow spot on the nipple or areola that can occur due to improper latching, hyperlactation, clogging of skin around the nipple, or nipple trauma. Treating milk bleb isn’t required if it isn’t causing pain or any other significant symptoms. But, if it hurts, you can try some home remedies to treat blebs (11).

How to manage: Apply warm compresses around blisters before nursing and frequently feed to unclog the duct. Additionally, you can apply breast milk or over-the-counter ointments. Unrefined coconut oil applied to the nipple under a disposable breast pad between feedings is a great way to loosen blebs. Consult a doctor before using any medications (12).

10. Mastitis

Mastitis is breast inflammation that causes a red, hot, tender, and painful area on the breast. It could make a nursing mother feel ill and, in most cases, cause a fever. Although mastitis is common among lactating women during the first few weeks after childbirth, it may happen at any time until you are breastfeeding.  Blocking of a milk duct due to infrequent feeding, poor attachment or latching, incomplete removal of milk, untreated engorgement, tight clothing, and trauma are some of the common causes.

How to manage: Take rest and feed your baby frequently. Try different feeding positions and avoid missing any nursing session as much as possible. Apply warm compresses before feeding to unclog the duct and promote milk flow.  Temporary use of analgesics to relieve pain can be done under a doctor’s guidance. Severe cases, such as an infected nipple fissure, warrant antibiotic use to resolve infection (13). But, until the blockage isn’t removed, mastitis can’t be treated.

11. Breast abscess

A breast abscess is a painful build-up of pus in the breast due to untreated mastitis. This build-up results in the development of a red streaking throughout the affected breast and cause quite a bit of pain, and is considered to be an emergency situation. If not treated promptly, abscesses may prevent that breast from producing sufficient milk in the future (14).

How to manage: Treating abscess includes treating the infection with antibiotics and draining the pus.  Feeding on an infected breast doesn’t affect the infant, and a mother, if comfortable, should feed her infant from the affected breast. If suckling is too painful, you can express breast milk and feed the baby. In some cases, breast milk may leak from the incision, but that’s nothing to fret about. You can continue breastfeeding (13).

12. Thrush (candida infection)

Thrush is a common yeast infection that passes between the mother and the baby during breastfeeding. Cracked or damaged nipples and baby’s mouth are suitable areas for the fungus to develop. The presence of tender, deep-pink nipples and discomfort during and after nursing are common symptoms that the mother experiences (15). On the other hand, white, milky patches or areas of redness in the baby’s mouth are oral thrush symptoms.

How to manage: If you or your baby has symptoms of thrush, seek medical assistance. The use of antifungal medications is the first-line of treatment for candida infection. Prevent thrush by sterilizing equipment, such as pacifiers, bottles, toys, and breast pump parts that come in contact with your breasts and the baby’s mouth. You may wipe nipples with apple cider vinegar between feedings.

13. Nipple vasospasm

Nipple vasospasm is when blood vessels in the nipple constrict or tighten, causing extreme pain, which tends to worsen when you are cold. Pain during, between, or immediately after nursing is its common symptom (16). The pain may stay for seconds, minutes, or even longer based on the extent of blood vessel constriction. Nipple vasospasm is uncommon but possible.

How to manage: If you experience nipple vasospasm, consult a doctor or lactation consultant. Avoid triggers, such as poor latching, nipple damage, nipple infection, or exposure to cold air. Use warm compresses to relieve constriction of the blood vessels. Alternatively, you can wear an extra layer of clothing to keep the nipples warm.

14. Nipple confusion

Nipple confusion occurs when the baby finds it uncomfortable and difficult to switch between bottle nipple and breast nipple, usually before breastfeeding is adequately established. It happens as a baby suckles differently on the breast nipple and the bottle nipple. Premature babies or babies with a weaker or more uncoordinated sucking reflex may be more vulnerable to nipple confusion (17).

How to manage: Introduce a bottle to the baby only after breastfeeding is established. Prefer feeding directly from the breast for the first three months. If you wish to feed expressed breast milk in a bottle, choose bottle-feeding techniques that mimic breastfeeding, such as paced bottle feeding. You may also try alternatives, such as spoon-feeding and cup-feeding, which are unlikely to interfere with breastfeeding.

15. Sleepy baby

Infants and young babies tend to fall asleep mid-feed. There’s no medical reason for it. However, keeping the baby awake during feeding is necessary to feed them adequately and empty your breasts properly.

How to manage: Gently blow air on your baby’s face, raise their arm, or kiss their hand and break their comfort to keep them awake during feeds. Keep the room temperature at a little less warm to ensure your baby doesn’t sleep while feeding. You can also talk to your baby and stroke their cheeks to get a response.

References

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Reviewer

Mary MillerMA, IBCLC, RLC, CLC, CPD, MCH

 

Mary Miller received her degrees in Interpersonal Communications and Maternal Health and Lactation and founded the Breastfeeding Support Center of WNY in Buffalo, New York. She has 20 years of experience as a lactation specialist.

Read full bio of Mary Miller