Common Breastfeeding Problems and How to Solve Them

While breastfeeding is natural, it does not always come easily. Many mothers encounter challenges, particularly in the early weeks. The good news is that most breastfeeding problems have solutions. Understanding what is happening and knowing how to address issues can help you continue your breastfeeding journey with confidence.

Sore and Cracked Nipples

Nipple pain is one of the most common reasons mothers stop breastfeeding, yet it is usually preventable and treatable. While some tenderness in the first days is normal, persistent or severe pain is not and typically indicates a problem that can be fixed.

Causes:

• Shallow latch (most common cause)
• Incorrect positioning
• Tongue tie in baby
• Thrush infection
• Using incorrect breast shield size when pumping

Solutions:

• Work on achieving a deeper latch—your baby should take a large mouthful of breast, not just the nipple
• Ensure your baby's head can tilt back slightly when latching
• Apply expressed breast milk to nipples after feeds and let them air dry
• Use a nipple cream (lanolin or organic alternatives) for comfort
• Consider seeing a lactation consultant to assess latch and check for tongue tie

Engorgement

Engorgement occurs when breasts become overly full with milk, becoming hard, swollen, and painful. This commonly happens around day 3-5 postpartum when mature milk comes in, but can occur at any time if feeds are missed or milk is not fully drained.

Symptoms:

• Breasts feel rock-hard and heavy
• Skin appears shiny and tight
• Nipples may flatten, making latching difficult
• Low-grade fever may occur
• Pain and discomfort

Solutions:

• Feed your baby frequently—at least 8-12 times in 24 hours
• Apply warm compresses before feeds to help milk flow
• Gently massage breasts during feeding
• Hand express or pump just enough to soften breasts if baby cannot latch (but avoid fully emptying, which can increase supply further)
• Apply cold compresses or chilled cabbage leaves between feeds for comfort
• Use "reverse pressure softening" around the areola to help baby latch when nipples are flattened

Blocked Milk Ducts

A blocked duct occurs when milk becomes trapped in a milk duct, creating a painful lump. If not cleared, it can lead to mastitis.

Signs of a blocked duct:

• A hard, tender lump in the breast
• Pain localised to one area
• Redness over the lump
• Slow milk flow from that breast
• A small white spot on the nipple (milk blister) may be present

Solutions:

• Continue breastfeeding frequently from the affected breast
• Position baby with their chin pointing toward the blocked area
• Apply warm compresses before feeds
• Massage the lump gently toward the nipple during feeds
• Ensure bras and clothing are not too tight
• Get plenty of rest

Mastitis

Mastitis is a breast infection that requires prompt medical attention. It can develop from an untreated blocked duct or from bacteria entering through cracked nipples.

Symptoms:

• Red, hot, painful area on breast (often wedge-shaped)
• Fever (38°C or higher) and chills
• Flu-like symptoms—body aches, fatigue
• Feeling very unwell

Treatment:

• See your doctor promptly—antibiotics are usually needed
• Continue breastfeeding (the milk is safe for baby)
• Rest as much as possible
• Apply warm compresses before feeds
• Take pain relievers as recommended by your doctor
• Ensure you complete the full course of antibiotics if prescribed

Low Milk Supply Concerns

Many mothers worry about having low milk supply, but true low supply is less common than perceived low supply. Understanding normal breastfeeding patterns helps distinguish between the two.

Normal signs often mistaken for low supply:

• Baby wanting to feed frequently (especially during growth spurts)
• Breasts feeling softer than in the early days (supply has regulated)
• Not feeling a strong let-down sensation
• Baby being fussy in the evening (common regardless of supply)
• Not pumping much milk (pumping is not an accurate measure of supply)

Actual signs of low supply:

• Baby not gaining weight appropriately
• Fewer than 5-6 wet nappies per day after day 5
• Baby consistently unsettled and never seems satisfied after feeds
• Signs of dehydration in baby

If you have genuine supply concerns, work with a lactation consultant to identify the cause and develop a plan. Solutions might include feeding more frequently, addressing latch issues, power pumping, or checking for underlying factors like hormonal imbalances.

Oversupply and Fast Let-Down

While less commonly discussed, having too much milk can also cause problems. Signs of oversupply include:

• Frequently engorged, uncomfortable breasts
• Baby gulping, choking, or pulling off during feeds
• Baby fussy at the breast
• Excessive leaking
• Frequent blocked ducts
• Baby having green, frothy stools (from too much foremilk)

Solutions:

• Try laid-back or side-lying positions so gravity helps slow milk flow
• Allow baby to finish one breast before offering the other
• Express just enough to relieve discomfort if needed, but avoid excessive pumping
• Block feeding (offering the same breast for 2-3 feeds before switching) may help reduce supply

Thrush

Thrush is a yeast infection that can affect both mother and baby. It often develops after antibiotic use.

Signs in mother:

• Burning, itchy nipple pain that continues between feeds
• Shiny, pink nipples
• Pain that developed after a period of pain-free breastfeeding
• Shooting pains deep in the breast

Signs in baby:

• White patches in mouth that do not wipe off
• Fussiness at the breast
• Red, persistent nappy rash

Both mother and baby need treatment simultaneously to prevent reinfection. See your healthcare provider for appropriate antifungal treatment.

When to Seek Help

Do not hesitate to seek support from a lactation consultant, maternal child health nurse, or breastfeeding support group. Seek help promptly if:

• Pain persists despite trying solutions
• You have symptoms of mastitis
• Your baby is not gaining weight
• Breastfeeding is affecting your mental health
• You are considering stopping breastfeeding due to difficulties

Most breastfeeding problems can be resolved with the right support. You do not have to struggle alone.