Common Breastfeeding Problems

About Common Breastfeeding Problems

Breastfeeding is the natural way to feed your child, but it isn't always easy! There are many common problems that parents may encounter with breastfeeding, but also strategies to help.

It is important to remember that the longer you breastfeed, the greater the health benefits for you and your baby. The following section outlines some possible concerns and solutions to help you and your baby.

Sore nipples

During the first week after birth, it is common to feel some mild pain or tenderness when your baby latches onto your breast. This tenderness should disappear as your baby begins to feed. If the pain continues, remove your baby from the breast and reposition them before they latch on again.

Poor latch

The most common cause of nipple soreness is poor latch. Poor latch can quickly cause nipple damage, but it will heal quickly once your baby's latch is improved.

To help with healing:

• hand express a few drops of breastmilk
• rub the drops onto your nipple
• allow the drops to air dry after feeding

It's also not uncommon for parents to pay less attention to the latch and position of their older baby.

If fixing your baby’s latch does not get rid of the pain or nipple damage, contact a breastfeeding professional (external link) for help.

Tongue tie and lip tie

Some babies are born with structural differences in the mouth that make it hard for them to latch properly, such as tongue tie or lip tie. This restricts movement in a baby’s mouth, making it hard for them to latch properly and transfer the milk from the breast.

Some signs that may indicate a tongue or lip tie are:

• baby is sliding off the breast when feeding
• baby is making clicking noises when sucking
• you have sore or damaged nipples despite paying attention to the latch

If you are noticing any of these signs, it's possible that your baby needs a tongue or lip tie to be clipped. This is a simple and fast procedure called a frenotomy and can be done in a doctor or dentist’s office.

If the lip or tongue tie is serious, your milk supply will likely be affected so it's important to see a breastfeeding professional for help as soon as possible (ideally within a couple of days).

To find a practitioner in Halton who offers the procedure, consult a breastfeeding professional (external link) or call 311.

Infection and reaction to irritants

Irritation, bacterial and fungal infections can cause nipple pain. Signs of infection or reaction may include:

• rashes on the nipples or the breast
• scaly or shiny nipples
• shooting or burning pain in the breast

If you are experiencing any of these signs it is important that you see a breastfeeding professional (external link) as soon as possible to identify the issue and prevent further damage.

For example, if you or your baby has developed a thrush (yeast) infection, you will both need to be treated to avoid passing the infection back and forth.

Biting

When babies are teething, they may attempt to bite down while at the breast. Holding your baby nice and close, and making sure they are latched well, will help to avoid this. Don't be tempted to stop breastfeeding... biting is usually short-lived.

Sore breasts

There are several possible causes of breast pain. If the pain is not resolving after trying to manage the issue on your own, contact a breastfeeding professional (external link) right away.

Engorgement

In the early days of breastfeeding, your breasts may swell up with milk and become tender. This is called engorgement.

Your breasts produce more milk than your baby requires to ensure they get enough. Your body will gradually adapt to meet your baby’s needs.

Feeding your baby early and often can help prevent and relieve this discomfort. Feed your baby according to their hunger cues (external link). Don’t limit the frequency or length of her feeds.

Sometimes babies find it hard to latch because of the swelling. If this happens:

• hand express a small amount of milk, or use reverse pressure softening 
• use a cool compress on your breast to help reduce swelling

Discomfort from engorgement should only last for a couple of days. Contact a breastfeeding professional (external link) if the engorgement is not improving.

Lumps or Reduced Milk Flow

Hard lumps in lactating breasts are often due to inflammation or swelling in the breast tissue. This inflammation and swelling can be caused by having too much breastmilk and/or an imbalance of the good and bad bacteria in the breastmilk. Both can lead to a narrowing of the milk ducts, making it more difficult for the breastmilk to flow through.

The inflammation and narrowed milk ducts can cause breasts to be firm and tender or painful. These symptoms may occur in one part of a breast or can spread to the entire breast.

What can you do (recommendations):

• Continue to breastfeed your baby on demand (do not do extra feedings/pumping to try to reduce inflammation or “empty the breast” as it can increase your milk supply and worsen the problem).
• Minimize use of breast pumps and nipple shields if possible,
• Apply ice or cold compresses (avoid applying heat to the breast).
• Talk to your health care provider about taking medications to help reduce inflammation (e.g., ibuprofen and sunflower lecithin or soy lecithin) and for pain (e.g., acetaminophen).
• Do not use deep breast massage or vibrating devices to try to “break up a clog”.
• Wear an appropriately fitting, supportive bra.

Mastitis

If inflammation in the breast worsens, inflammatory mastitis can develop.

Symptoms of inflammatory mastitis include:

• Redness of an area of the breast
• Swelling of the breast
• Pain
• Fever and/or chills, and
• Increased heart rate

If your symptoms are mild and focused on one specific area of the breast, try the recommendations listed above to treat inflammatory mastitis. If after 24 hours your symptoms are not improving or getting worse, contact your health care provider as you may have a bacterial infection that requires antibiotics to treat.

NOTE: inflammatory and bacterial mastitis are not contagious and are not dangerous to your infant. There is no need to pause or stop breastfeeding.

If you think you may have breast inflammation or mastitis, speak with your health care provider and/or a breastfeeding professional (external link) to help address the underlying causes and prevent it from worsening or reoccurring.

Thrush (yeast) infection

Thrush can also cause burning or shooting pain in the breast. Parents with thrush may also experience red, shiny, itchy or sore nipples. The pain may happen between feedings.

If you think you may have thrush, speak with your health care provider and/or a breastfeeding professional (external link).

Breastfeeding and illness

Breastmilk has antibodies that help you and your baby fight off infection. When you are sick, your body makes antibodies specific to your illness, and you pass these along in your breastmilk to keep your baby healthy.

Washing your hands more often when you are sick, especially before caring for your baby, will help prevent you from passing your sickness to your baby. Talk to your health care provider if you have concerns or questions.

Medication and breastfeeding

Most conditions can be treated with medications that are safe for breastfeeding. This includes anaesthetic medications used for surgery.

If you have any concerns, speak with your healthcare provider or your pharmacist.

Milk supply

Did you know that it's normal for your breasts to become softer over time while you’re breastfeeding?

Many parents have more milk than their baby needs during the early weeks of breastfeeding and their breasts will often feel very full. Over time your breasts will feel softer as your body adjusts. This does not mean that you do not have enough milk – your body is just figuring out the right amount to make!

If you feed your baby according to their hunger cues (external link), your body will continue to make the right amount of milk for your growing baby.

Your baby’s wet and soiled diapers provide reassurance that your baby is drinking enough milk.

• Babies over 5 days old should have at least 6 wet diapers per day.
• Babies under 3-4 weeks should have at least three yellow, seedy poops per day.
• After 3-4 weeks, some babies will continue to poop frequently (some many times per day), while others may only poop every few days (up to 10 days is normal!).

Growth spurts

You may notice that your baby seems more hungry than normal on some days. This is likely due to a growth spurt.

Feed your baby according to their hunger cues (external link). Your body will respond to your baby’s frequent nursing by increasing milk production. The more you feed your baby, the more milk you will make.

Growth spurts are common when your baby is:

• 10 days
• 2-3 weeks
• 6 weeks
• 3 months
• 6 months
• other times (when your baby seems hungrier than usual)

Fussy baby

Crying is normal baby behaviour. It does not always mean your baby is hungry. They may be tired, uncomfortable or want to be held.

If your baby is fussy:

• start by offering the breast. If they are hungry, this will soothe them. The sucking alone may be enough to comfort them. You can't over-feed a breastfed baby.
• if they are not comforted at the breast, try placing them skin-to-skin.
• movement helps calm babies - try walking, rocking or swaying.
• check for a wet or soiled diaper.
• check that they are not too warm or cool.

Your baby picks up on your emotions, so calming yourself (e.g. by taking deep breaths) will also help your baby to calm down. Try to arrange a break for yourself when someone else can hold your baby.

Baby not latching

Sometimes babies refuse to latch onto the breast. They may push or arch away and cry when brought to the breast.

If this happens, see a breastfeeding professional (external link) to determine the cause. Make sure you maintain your milk supply if your baby won't breastfeed by hand expressing or pumping.

While you are waiting to see a breastfeeding professional, try the following:

• Choose a quiet, relaxed place to breastfeed.
• Hold your baby skin-to-skin and calm your baby before trying to latch.
• Watch for early hunger cues (external link) and begin feeding before your baby gets too hungry.
• Express some milk onto your nipple to get your baby interested.
• Soften the area around the nipple if your breast is engorged.

Thinking about feeding your baby some formula?

Call 311 to speak to a public health nurse and read this important information about feeding your baby.

Separation

If you and your baby are separated, express or pump your breastmilk at least 8 times in 24 hours, if possible. This will ensure your baby can continue to receive breastmilk. This also helps to maintain your milk supply. Expressing your milk is especially important after it's dark outside due to hormones released at night.

Your baby can be fed your breastmilk by cup or spoon. Avoid using a bottle if possible, as it can make it harder for your baby to breastfeed when you're back together. Other feeding methods may also be possible with advice from a breastfeeding professional (external link)

If the separation is caused by a medical condition in you or your baby, speak to your healthcare provider about feeding your baby your breastmilk.

Breastfeeding in public

In Canada, you have the right to breastfeed your baby anywhere, anytime. The Halton Baby-Friendly Initiative has more information on breastfeeding in public (external link).