Problems and discomforts when breastfeeding

How can you manage problems and discomforts when breastfeeding?

Breast milk is the best food for babies in the first year of life. But breastfeeding isn’t always easy. You may have some problems or discomforts when breastfeeding. Don’t let them get you down! They’re common for breastfeeding moms. There are things you can do to help you feel better and make breastfeeding more comfortable.

Breastfeeding shouldn’t hurt. If it does, tell your health care provider or lactation consultant. You may just need a little help to get it figured out. Ask your provider, nurses and lactation consultant to help make sure breastfeeding is going well before you leave the hospital. They can help you once you and your baby are home, too. A lactation consultant is trained to help women breastfeed, even women who have breastfeeding problems.

You can get breastfeeding help from a lot of different people:

• Your health care provider and your baby’s provider
• A lactation consultant. You can find a lactation consultant through your health care provider or your hospital. Or go to the International Lactation Consultants Association.
• A breastfeeding peer counselor. This is a woman who breastfed her own children and wants to help and support mothers who breastfeed. She has training to help women breastfeed, but not as much as a lactation consultant. You can find a peer counselor through your local WIC nutrition program. Or visit womenshealth.gov/breastfeeding or call the National Breastfeeding Helpline at (800) 994-9662.
• A breastfeeding support group. This is a group of women who help and support each other with breastfeeding. Ask your provider to help find a group near you. Or go to La Leche League.
• Friends and family members who have breastfeeding experience
• Your partner

What can you do if you’re sore after having a c-section?

A c-section (also called cesarean birth) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). You may be sore and tired after a c-section, but you can still breastfeed. Here’s what you can do:

• Ask your provider, nurse or lactation consultant how to hold your baby when you breastfeed to help protect your c-section incision (cut).
• Keep your baby with you in your hospital room so you don’t have to move around a lot to get her.
• Take pain medicine exactly as prescribed by your health care provider. Your provider makes sure that any medicine you take is safe for your baby during breastfeeding. Don’t start or stop taking any medicine without talking to your provider first.

What is breast engorgement?

This is when your breasts become swollen and full of milk. They may feel tender and sore. Most of the time the discomfort goes away once you start breastfeeding regularly. Here are some ways to help with engorgement:

• Breastfeed often. As long as your baby is latched on and feeding well, let her feed for as long as she wants. If you don’t think your baby has a good latch, tell your provider or lactation consultant. A good latch lets your baby remove more milk from your breast.
• Try not to miss or go a long time between feedings. Don’t skip night feedings.
• Express (release) a small amount of milk with a breast pump or by manual expression before breastfeeding. Manual expression is when you massage your breasts with your hands to release breast milk. Ask your provider or lactation consultant to show you how to manually express your breast milk.
• If your breasts really hurt, put cold packs on them in between feedings. Tell your provider if you have a lot of pain.
• Don’t take any pain relievers or other medicine without talking to your provider first.

What can you do about nipple pain?

Many women feel nipple pain when they first start breastfeeding. If your nipples are cracked and sore, you may need to change the position you use to breastfeed. If you have nipple pain:

• Make sure your baby is fully latched on. If she’s not latched on, remove her from your breast and try again.
• Change positions each time you breastfeed.
• Put some fresh breast milk on your nipples after each feeding. Just like breast milk is good for your baby, it can help you, too. Or use creams that are made just for breastfeeding. Ask your provider which kind to use.
• Wash your nipples with clean water. Don’t use strong soaps or shampoos that may touch your nipples.
• Don’t wear tight bras or clothes that put pressure on your nipples.
• If you use nursing pads, change them once they get wet.
• If the pain doesn’t go away, tell your provider or lactation consultant.

What can you do if your breasts leak?

Your breasts may leak milk, especially right after birth. This is common and doesn’t hurt you or your baby. Here’s how to handle leaking breasts:

• Try not to miss feedings or go a long time between feedings. Don’t skip night feedings.
• Apply pressure to your breasts by crossing your arms over your chest.
• Use manual expression to remove milk from your breasts.
• Put nursing pads in your bra to soak up leaked milk. Sleep in a nursing bra in case your breasts leak at night.

What are plugged ducts?

Breast milk can get blocked in your breast ducts. Your breast may feel sore or look red. You may feel a hard spot in your breast. You may feel that your breast doesn’t empty all the way when breastfeeding. Here’s what you can do to help with plugged ducts:

• Before you breastfeed, massage the sore breast, especially where you feel a hard spot.
• Start each feeding on the sore breast. This may hurt, but it can help get all the milk from the breast. Breastfeed as long as you can on the sore breast.
• Change breastfeeding positions.  
• After your baby feeds, use manual expression to release any remaining milk from your breasts.
• Take a warm shower or put warm, moist towels on your breast.
• Don’t wear tight clothes or bras or a bra with an underwire.
• If the hard spot in your breast lasts for more than a few days or if you have a fever or severe pain, tell your provider.  

What is mastitis?

Mastitis is a breast infection. It can happen when you have a plugged duct, you miss or delay breastfeedings or if your breasts become engorged. You may feel a tender or painful hard spot in your breast that’s warm to the touch. The area may be red. You may have a fever, chills, aches or pain. Here’s what to do if you have a breast infection:

• Don’t stop nursing your baby even if your breast is sore. The infection doesn’t harm the baby. Breastfeeding more often can help clear the infection. Or use a breast pump to express milk from the infected breast.
• Take a warm shower or put warm towels on your breast.
• If you’re in severe pain or have a fever, call your provider.
• If your provider prescribes an antibiotic to treat the infection, take it exactly as your provider tells you to. Take all the medicine until it’s gone. Your provider makes sure the antibiotic is safe for your baby. Don’t start or stop taking any medicine during breastfeeding without your provider’s OK.

What is nipple confusion?

Nipple confusion is when a breastfeeding baby has trouble latching on and sucking after being given a bottle or pacifier. This can happen if you give your baby a bottle or pacifier in the first few weeks of breastfeeding. He may forget how to latch on to your breast. Or he may not want to breastfeed at all. If this happens, your baby may struggle and cry and may not get all the breast milk he needs. And your breasts may become engorged.

To help prevent nipple confusion:

• Only breastfeed your baby in the first 3 to 4 weeks after birth. Don’t use bottles or pacifiers until your baby's breastfeeding well.
• Tell your provider or lactation consultant if you think your baby has nipple confusion.

More information

American Academy of Pediatrics