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Breastfeeding Challenges

Rachel O'Reilly

By Aaryn Leineke

In honor of Breastfeeding Awareness Month, I wanted to give light to new moms who may be nervous to breastfeed, or are just starting and having challenges.

First and foremost, know that if you are a mother who always planned to breastfeed, and then faced challenges when the time came, you’re not alone. In a previous post, I listed the amazing benefits of breastfeeding and feel 100% confident in saying that breast milk is best for you baby. But, what if you need to be on a medication that is not safe for you baby, or your milk just didn’t come in, or you’ve had to undergo surgery?

If you know you’re healthy and had a “normal pregnancy” but still face breastfeeding challenges, the best thing you can do is seek help. Many hospitals provide lactation consultants during your first days after birth. Many midwives and doulas specialize in breastfeeding as well, so they can help you find what works best for you and your baby. So always ask for help, because it’s available.

Below are a few challenges with breastfeeding that many women will face.

Sore nipples: During the first few days, many new moms complain of sore nipples. It’s good to know that breastfeeding should feel comfortable once you and your baby get the hang of it, and baby gets a good latch. If you are feeling discomfort, see below for a few things you can do.

  • A good latch is the answer for many challenges you may face. If you notice that your baby is only sucking on the nipple, gently release their suction to your breast by placing your finger at the corner of their mouth and have them try again. Your nipple should look round and long after a good breastfeeding session, not flat and compressed.

  • Try changing positions for both you and your baby. And use breastfeeding support pillows to ensure that you are not working to hard and are relaxed. If you are tense your baby will feel the tension.

  • If you feel like it is too painful and you’re not able to feed your baby, find a lactation consultant for guidance. Not having a regular feeding cycle with your baby can cause more pain due to engorged breasts and oversupply of milk.

  • Change nursing pads frequently.

  • Use natural creams or balms to keep your nipples soft and protect from cracking.

Low milk supply: Most mothers are able to make plenty of milk for their baby. But it’s also not always easy to know exactly how much milk is the right amount for your baby. It’s good to keep an eye on your baby’s weight gain and growth, and to let your doctor know if you are concerned. Here are a few tips to help ensure your baby is getting enough milk.

  • Always make sure you and your baby are positioned well, and they have a good latch.

  • Breastfeed often and let your baby decide when to end the feeding.

  • Empty each breast before switching sides. The milk at the back end of the breast has all the good fats.

  • Avoid giving your baby formula in addition to breastmilk as much as possible. If the latch is good and you are getting the hang of it with your schedule, it’s best to avoid other forms of food. It is common the baby will get “lazy” or “lose interest” in the boob and your breast supply could decrease as a result.

Engorgement: It’s normal for your breast to become larger, heavier, harder and tender especially when your milk first comes in. Engorgement is a result of milk build-up. You could also feel warmth, throbbing or even a low grade fever. If it gets to this point, it’s possible to get an infection or plugged duct so there are a few things you can do below:

  • Let your baby feed as much as they’d like after birth and during the first few weeks. As long as your baby is latching and sucking well, allow them to feed when they seem hungry.

  • Talk to a professional to make sure the baby is latched on well.

  • Use a warm compress or get in a warm shower to hand express to soften the breast and nipple. This can help with the baby’s latch if the breast is too engorged.

  • Massage breasts.

  • Get lots of rest, stay hydrated and aim to get proper nutrition.

  • Avoid tight bras.

Plugged ducts: Plugged ducts can be common for breastfeeding mothers. When a duct is clogged it can feel like a sore lump in the breast. This happens when a duct does not drain milk properly. Pressure builds up behind the the clog and the surrounding tissues get inflamed and sore. A few ways to relieve the pressure and unclog the ducts are below.

  • Aiming your baby’s chin at the duct that is clogged can help focus the suck on the area that is affected.

  • Breastfeed on the affected side frequently and as often as every two hours. Moving the milk down and out will help loosen the plug.

  • Softly massage your breast from behind the plug, in circular motions. Using a hot compress or massaging in a warm shower or bath is also helpful.

  • Rest, catch up on sleep and nourish yourself with the best food and fluids. Boosting your immune system with sleep will help your body recover.


Mastitus (breast infection): Mastitus is soreness or a lump in the breast that can cause symptoms such as fever and/or flu like symptoms (nausea and vomiting), and breasts that feels warm or hot to the touch. These types of infections can happen when your immune system is down, and when others in your family were recently sick with cold or flu. Usually mastitus only affects one breast at a time.

If you have these symptoms and could not get a clogged duct to relieve itself using the above suggestions, go to your doctor to see if they can help -- especially if you get to the point of vomiting or feeling flu-like symptoms. A doctor may provide medication if you do in fact have an infection.

Thrush (yeast infection or fungal infection): Thrush can form on your nipples and in your breast. Like any other fungal or yeast infection, it thrives on an excess amount of candida in the body, when the body’s natural bacteria level is upset.

If you’ve been breastfeeding successfully for some time and all of a sudden your nipples become sore, pink, flaky, itchy or even cracked, these are all signs that you could have thrush. Thrush can be caused if your baby has thrush in their mouth and passes to you, if you’ve recently taken antibiotics and your natural bacteria levels were affected (thrush can be passed to the baby in this case), by chronic illness, or simply when your immune system is struggling. Below are a few things you can do to help.

  • Wash and wear clean clothing that has contact with your breast.

  • Change breastfeeding pads frequently.

  • Boil pacifiers, bottle nipples, or toys your baby puts their mouth on every day.

  • Take a close look at your diet and elliminate all foods that turn into sugars, on which candida thrives.

  • Consult with your healthcare provider and make sure to get the best probiotics you can find, to help balance your good bacteria.

Very large, flat or inverted nipples - Some women have inverted nipples, or nipples that become flat when their breast size increases due to the milk coming in. These types of nipples can make it hard to get the hang of breastfeeding, especially for first-time moms. Inverted or flat nipples may protrude after your baby catches a good latch and feeds for some time.

  • Get help right away if you feel like your baby is not latching well.

  • Use a nipple guard that can help with guiding your nipple out, and still give your baby the chance to feed from your breast.

  • Use your hands to express milk and guide our nipple outwards.

These are just a few challenges some women can face. Many women will not encounter any of these and most will absolutely not come across all challenges. But it’s good to be aware, and it’s best to know if you to face challenges, to not give up before asking for help. You’re not alone!