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You’ve probably heard a stressful breastfeeding story or two. So naturally, you might be a little freaked out about the idea of nursing your own little one. Breastfeeding problems are common—but they are often fixable. “There are some horror stories that you hear people talk about,” says Marianne Pastore, R.N., a nurse and certified lactation consultant at Massachusetts General Hospital. “I tell women to stay away from the horror stories—you’re going to make your own breastfeeding story.”
Avoiding breastfeeding problems often starts with getting the right information. “Many of the commonly reported breastfeeding troubles could be completely avoided with good prenatal education of what to expect and how to get breastfeeding off to the best start,” says Diane Spatz, Ph.D., a professor of perinatal nursing at the University of Pennsylvania and nurse researcher at the Children’s Hospital of Philadelphia.
Whether you're gearing up for breastfeeding, are in the middle of it, or are just plain curious, learning all you can about potential breastfeeding issues can help you get ahead of of them. We asked the experts about 20 common breastfeeding problems and how to deal with them.
1. Latching On Hurts
Babies want milk and can be aggressive in their quest to get it. As a result, it may hurt when your little one latches on to your breast. If you're experiencing pain, make sure your babe is attaching to your breast the right way. “The mother should feel a rhythmic vacuum pressure,” Spatz says. “The baby has to have a good mouthful of breast.” That means getting your nipple and breast deeply in the baby's mouth.
2. The Baby Won't Latch at All
If you're having trouble getting your baby to latch on, the solution can sometimes be as simple as stripping down. Lactation consultants agree that skin-to-skin contact will encourage babies to latch. Remove your clothing from the waist up, and keep your baby in just a diaper. Then hold your baby at the breast and give it another go.
3. Sore Nipples After Nursing
Sometimes your nipples can get uncomfortable after nursing. It’s possible the baby isn’t latched on properly, which can lead to soreness. For immediate relief, try rubbing a little breast milk on your nipples and letting it air dry. “Lanolins and gel pads work too,” Pastore says, “but my first recommendation is mom’s own milk.”
4. Cracked Nipples after Nursing
When the skin on your nipples actually cracks, the culprit is, again, an incorrect latch. The goal is to have the baby's mouth cover the entire areola.
If your nipples continue to crack even with proper latching, trying breastfeeding more frequently for shorter intervals. With more frequent feedings, the baby won't be as hungry, and will suck more softly—and in doing so, will give your nipples much-needed relief. Behavioral pediatrician Eboni Hollier, M.D., also recommends using nipple cream or olive oil on dry or cracked breasts, or holding an ice pack or a warm compress over the nipples to relieve the pain.
5. Low Milk Supply
Some women don’t produce as much milk as their baby needs—or, at least, as much as they think they should.
First, Pastore recommends checking how your baby latches on. Next, she recommends getting some perspective. “A lot of times women think they have a problem—baby is eating a lot and they don’t seem to get a break, so they incorrectly think they’re not producing enough milk,” she says. Then, a lot of moms will supplement with formula and their milk supply, which is on a supply and demand kind of schedule, will drop. If you suspect your supply is low, she recommends talking to your doctor.
6. Breast Engorgement
Another common breastfeeding issue is having painful, engorged breasts. Engorgement happens when your breast doesn't fully empty, explains Hollier. Breastfeeding more frequently or using a breast pump to get rid of excess milk can help with this.
7. Mastitis
Mastitis is an inflammation of the mammary glands that often makes it feel like there’s a hard, sore spot in side your breast. It's about as fun as it sounds. "Signs of mastitis can include sharp or a shooting pain in the breast during or after breastfeeding, fever, chills, and flu-like symptoms," says Dr. Hollier.
Call your doctor if you see these signs, because you may need antibiotics. "Any breast pain in association with fever, lumpy/swollen breasts, reddened breasts, or cracked nipples require medical attention," says Kecia Gaither, M.D., ob-gyn and maternal fetal medicine specialist.
To lower the odds of getting mastitis, Spatz recommends avoiding underwire bras when you're nursing, making sure your bra fits your breast completely, and nursing regularly to empty your milk supply. “Don’t ever skip breastfeeding or pumping sessions,” she says. If you feel like you have a plugged duct or tender area, use heat, massage, and compression immediately. “The most important thing is to get the milk out—don’t stop breastfeeding,” Spatz says.
The bottom line: If you think you have mastitis, make sure to talk to your doctor, who may put you on antibiotics.
8. Thrush
Thrush is a bacterial infection that make breastfeeding excruciating. It's is caused by an overgrowth of candida (a type of yeast) and can crop up on your nipples while breastfeeding. Experiencing severe pain in both breasts that lasts up to an hour after breastfeeding is a sign of thrush, as is a fever or a warm, red patch on the breast. Pink nipples and shooting pains are also symptoms of thrush.
Because thrush is contagious and can spread to the baby's mouth, it's important to see your doctor as soon as possible if you think you have thrush. Remedies include antibiotics and dietary modification.
9. White Blisters Form on Your Nipple
These dots are actually milk blisters (a.k.a. blebs) that occur when is breast milk is trapped just under the skin. It can feel like a piece of sand is suck under the skin. There are two ways to fix this: you can try to massage the bleb out or, if that doesn't work, you can gently pierce the skin with a sterilized needle, which will open the blocked duct and allow milk to flow freely.
10. Brown or Red Blood Blisters Form on Your Nipple
Instead of blocked milk ducts, these blisters are, instead, caused by friction. If your baby is sucking with an improper latch or you're using an ill-fitting nipple shield, that can cause a blood blister. A breast pump that doesn't fit well can also cause these blisters.
To heal the nipple, start using a saltwater rinse. Yon can either soak the nipple in saline solution for one minute, or you can rinse the nipple with the solution. Gently dry it off, and apply Vaseline or lanolin ointment. If the blisters are infected, use an antibiotic ointment like Neosporin instead.
If you have blisters, cracks or anything else causing nipple pain, try icing the nipple right before feedings, as well, to reduce the immediate pain upon latching.
11. The Nipple Turns White or Look Pinched After Feeding
This is called a vasospasm—it's caused when blood vessels in the nipple constrict due to a shallow latch. It's a common problem, says Hollier, and your nipple might look pinched or have a white band around it when you're done nursing.
To relieve the pain, massage oil onto the nipple or apply a warm cloth, which will stimulate blood flow to the area. Next time you nurse, try moving the baby away and then back to see if they can latch on better the next time.
12. Nipples are Inverted or Flat and Latching Seems Impossible
Breastfeeding problems aren't always the result of a medical problem, says Gaither. If you have flat or inverted nipples, breastfeeding might naturally be more of a challenge for you. Try using nipple formers, which sit inside your bra and help to draw out the nipple before nursing.
You can also pump your breast before breastfeeding, which will get the milk flowing and ready for the baby.
13. Biting
It happens. To fix the issue, gently slide your pinky finger to the baby's mouth and gently remove him or her from your breast.
In these moments, don't say anything, coo, or even smile. You can even, calmly and firmly, say "No biting." It will send a signal that something is off to the baby, and with repetition, the baby will learn not to bite down during breastfeeding. This is more effective than exclaiming "ouch," which doesn't send a message to a baby that something's wrong and could end up scaring and upsetting the baby, which could lead him or her to turn down milk altogether.
14. Veiny Breasts
If you notice veiny breasts (like Chrissy Teigen did!), it's totally normal and nothing to worry about. The milk causes the breasts to expand, which stretches the skin and makes veins more prominent. On top of that, there's increased blood flow to the breasts which also leads to veins that are more pronounced during the breastfeeding period.
The veiny appearance will go away on its own after you wean your baby.
15. The Baby Falls Asleep a Few Minutes Into Feeding
If your baby keeps falling asleep quickly into feeding, optimize your breastfeeding time by always beginning with a full breast. That way, the baby will get the most possible milk in those first few minutes. You can also gently tickle the baby's back or burp the baby while breastfeeding to try to keep him or her from falling asleep for longer. The key is to keep the baby stimulated.
16. Your Baby Wants Milk Constantly
Babies nurse a lot—up to 12 times within a day. When babies nurse almost constantly, however, during a certain period, that's known as cluster feeding. It occurs for a few hours, and the breastfeeding sessions can be literally constant, or just extremely close together. Cluster feeding typically happens in the evening, but can occur at any point in the day.
If your baby is cluster feeding, know that nothing is wrong. It's not a sign of low milk supply or any other trouble. It's common, especially in young babies. Once you know what you're up against, try to accept your hours-long breastfeeding fate. Get comfortable, stay hydrated during the feeding, and don't forget to feed yourself. You can also make good use of a sling or wrap so that you can stay mobile and use your hands during the cluster feeding. Lastly, know that breastfeeding won't last forever.
17. Your Breasts Appear Lopsided
It's not uncommon for breastfeeding to cause uneven breasts. First of all, try to switch the baby from one breast to the other regularly, so the breasts have an equal chance to let out milk. The lopsidedness is temporary, and your breasts will eventually even out.
Keep in mind, babies nurse more hungrily at the beginning of a feeding, so try to begin each feeding with the smaller breast. This will stimulate more milk production in the smaller breast, as will pumping it for ten extra minutes after each feeding. If you can get the smaller breast to produce more milk, your breasts will start to even out within a few days.
If, despite your best efforts, your baby continues to favor only one breast, it could because of an infection in one breast that is causing the milk to taste off. It could also be an ear infection or other problem on the baby that is making him or her not want to press his head to you on that side, consequently leading to all the feeding going to one breast.
18. Your Baby is Choking and Gulping at the Breast
Choking and gulping at the nipple is a sign that the milk is flowing too quickly and forcefully for the baby. To make the breast produce less milk, you can try block feeding. Block feeding means you only feed the baby from one breast during a block of time (two or three hours). During that time, the breast that you're not using will become full, and that fullness will lead to less milk production. That way, when the baby does feed from that breast, the flow will be less forceful and lead to gentler nursing.
19. There's a Tender Spot in Your Breast
This type of pain could be caused by clogged or plugged milk duct. Clogged ducts are a result of breast milk that hasn't entirely drained. The solution is to get the milk flowing again. To do so, you can massage the area or apply a hot compress. Make sure to breastfeed or pump regularly to avoid plugged ducts. You should also make sure your nursing bra fits properly. If it's too tight, that can also lead to clogged ducts.
20. None of the Above, But Breastfeeding Still Hurts
If you're experiencing any other breastfeeding problems not mentioned on this list, Hollier recommends going to a lactation consultant. Furthermore, if the pain is severe or accompanied by other symptoms, go to a doctor to investigate a potential underlying problem ASAP.
And, if you do end up having issues that can't be resolved with the help of your doctor or a lactation consultant, it’s not the end of the world if you have to supplement with formula. “Formula is different than breast milk, but, at the end of the day, the important thing is that your baby is getting fed,” says Pastore.
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