Breastfeeding is a personal choice that can bring up a lot. That’s why we have a series of Breastfeeding 101 content, all created to support you on your journey.
Much of the imagery around breastfeeding makes it look like the most glamorous and natural thing in the world. But that isn’t always the case for many moms and parents who experience breastfeeding problems, and find breastfeeding to be hard and frustrating.
The CDC and World Health Organization recommends exclusively breastfeeding babies for six months. But parents who want to follow those guidelines (or do extended breastfeeding) may choose to stop once it starts to feel like more trouble than it’s worth due to breastfeeding problems like latch issues and bleeding nipples. The baby’s crying, you’re crying, it’s a lot.
Breastfeeding doesn’t have to be painful or overwhelming. And while it usually doesn’t look like a Vogue cover shoot either, it can be a beautiful bonding experience for you and your baby that provides your baby with all of the health benefits breast milk provides.
Finding the breastfeeding support you need is key. So is having some go-to fixes for common breastfeeding problems. We asked certified lactation educator counselor and doula Jennifer D. Evans to provide a breastfeeding 101 for us and share solutions to issues that keep parents from breast and chestfeeding for as long as they would like.
Note: This article includes images of breastfeeding.
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Latch Problems
According to the CDC, one of the reasons why moms stop breastfeeding early is because of latch and lactation issues, so we’ll start with those two first.
Key to breastfeeding 101 is learning about latching. A good latch means that your baby is able to effectively retrieve milk from your breast in a way that’s comfortable for both of you. When the baby isn’t latching properly, it causes a number of breastfeeding problems. There’s nipple pain for one (“Besides some initial pain at the beginning breastfeeding should not hurt,” Jennifer says), but it can also affect the baby. When the baby isn’t getting milk, it affects the number of dirty diapers they produce and their ability to gain weight.
“If baby is latched properly,” Jennifer says, “you will hear a small swallowing noise after a few sucks. You should be able to see baby’s jaw moving in a circular motion as well. A baby with a good latch will have lips flanged out like a fish. [Your] nipple should be drawn deep into their mouth.”
You should be able to see baby’s jaw moving in a circular motion…
Not noticing any of these signs? Make sure you’re comfortable first. Then do skin-to-skin and try the laid-back breastfeeding position, if the usual football and cross cradle positions aren’t working.
“You’re basically laying back with very comfortable pillows around you and letting baby self-attach,” she explains. “Baby’s going to lay tummy to tummy, and the baby will just find its way toward your breast.”
Make sure that the baby’s mouth is wide open, covering your nipple and areola and not centralized on your nipple. If you’re still having latch issues, then reach out to a lactation consultant for help.
When babies 3 months and up have latch issues, it may signal that they’re just distracted. To get your baby’s attention, try breastfeeding in a sling.
“You can cover their face a little bit; they’re really close, almost like skin to skin; and it’s a good way of slowing down and just focusing with them,” Jennifer says.
If you’re at home, move breastfeeding to a distraction-free space.
“Go into a dark room, nurse them in a rocking chair if you have one… Set the mood more,” she says, laughing. “‘It’s time to nurse, it’s not time to play.’ At that point, they know what to do, but they get a little lazy with it.”
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Low Milk Supply
As breastfeeding pump company Medela puts it, breast milk is purely “supply and demand” based—the more milk leaves your body, the more milk your body will produce. (An important lesson to learn in Breastfeeding 101!)
“The best thing to boost milk supply is milk removal,” Jennifer agrees, “so either pumping, hand expressing, or feeding the baby at breast, and skin to skin. Getting that oxytocin flowing, and all those feel good hormones… that’s going to help you create more milk.”
The best thing to boost milk supply is milk removal.
But what about those oatmeal lactation cookies and teas made of fenugreek and milk thistle that are said to help you produce more milk? The research on their effectiveness is limited, Jennifer says, but “if you find one of these things works for you, then sure!”
If you’re still worried that you’re not producing enough milk, take a look at how you’re taking care of yourself. Are you staying hydrated and eating enough? (“I know I’m starving when I’m breastfeeding,” Jennifer says.) What are your stress levels like?
“Stress is a huge, huge factor on our milk supply,” Jennifer says. “It’s hard to make milk when we’re stressed out.”
Do what you can to eliminate stress, “whether that’s getting a support system in place, talking to your partner about breastfeeding and how they can support you, or [dealing with] any other regular stresses,” Jennifer says. “Even if it’s going to therapy if you need it, especially postpartum.
“I know that it’s hard to prioritize yourself and we’re giving and giving and giving, and we think that all the cookies and things are going to save us,” she continues, “but honestly it’s taking care of ourselves.”
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Engorgement
When your breasts have too much milk in them, it leads to a tight, painful condition known as engorgement. Besides being painful, it also makes breastfeeding harder, so softening your breasts is a top priority.
Letting more than 2-3 hours go before feeds and expressing can lead to engorgement.
Engorgement usually happens when your milk increases, Jennifer explains.
“Your milk is still trying to regulate, so what you don’t want to do is pump too much,” she says. “You don’t want to pump for over 10 minutes because that’s going to cause you to make more milk and fill up even more.”
Learning how to find comfort is a key part of Breastfeeding 101. Try hand expressing a little before using the laid-back position to breastfeed—it will be more comfortable for you. Also breastfeed regularly—letting more than 2-3 hours go before feeds and expressing can lead to engorgement.
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Clogged Duct
A clogged duct Is exactly what it sounds like: Milk stuck inside a duct in your breast. It presents as a hard bump and can be incredibly painful. But there are a few ways to treat them, Jennifer says.
Massage from above where the duct is, towards your nipple.
To push it out, “massage from above where the duct is, towards your nipple,” she advises. “Another way is to face the baby’s chin on the duct area [when nursing ] so when the baby’s mouth is opening, it’s massaging that area.”
People also use vibrators (or really anything that vibrates) to massage the area. Pumping provides relief, too.
“Also taking a warm shower and letting the water flow on your breasts while massaging them or a warm compress on the breast can help,” Jennifer adds.
To avoid getting clogged ducts, wear sports bras or nursing bras instead of tight or underwired bras. (There could be a whole Breastfeeding 101 session on finding clothes that make breastfeeding easier!)
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Milk Bleb
Often confused as a clogged duct, a milk bleb is essentially a pimple.
“If you have excess milk supply or a latch issue, it can cause a milk bleb to start,” Jennifer explains. “It’s a little blister that’s filled with milk.”
Milk blebs can hurt, but don’t try to pump them out—use a Haakaa manual pump and Epsom salt instead.
“Soak your breast in warm water and Epsom salt while massaging your breast, or you can put Epsom salt and very warm water at the bottom of a Haakaa—that can help draw it out,” Jennifer advises.
And if you’re going to pop your milk bleb, do it with a sterile tool.
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Mastitis
This is one of the most dreaded breastfeeding problems out there. A clogged milk duct can lead to mastitis, a serious bacterial infection that requires a doctor’s intervention and antibiotics.
“This can come along with fevers and chills,” Jennifer explains. “A lot of people tend to get it when they’re not emptying their breast enough.”
“If you believe you have mastitis please see your doctor so that they can properly diagnose and treat you,” she continues. “There’s a few antibiotics that they use in this instance—dicloxacillin, amoxicillin-clavulanate, and cephalexin are the main ones.”
You can avoid this scary condition by fully draining your breasts of milk.
You can avoid this scary condition by fully draining your breasts of milk, Jennifer says.
“Even if your baby’s not feeding on that side, at least hand express or pump right after to get some of that milk out,” she says.
Although it’s hard, you should still breastfeed your baby, Jennifer says. The antibiotics prescribed by your doctor will clear the infection and are safe to breastfeed on.
One thing you’ll learn in Breastfeeding 101 is that being stressed and incredibly tired are two other factors that can lead to mastitis. (Which is very rude considering how stressful and tiring being a parent is).
So make sure to take care of yourself and get your community to support you in breastfeeding. You will need a lot of rest to recover from mastitis, Jennifer says.
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Sleepy Newborn
How many “When that milk hits…” milk-drunk baby memes have you seen? They’re super cute… but when your baby falls asleep every time you try to feed them, it can make breastfeeding a lot harder.
A solution for this common breastfeeding problem? A little Breastfeeding 101 advice: Keep your baby engaged and awake, Jennifer says. Do skin to skin, blow on their faces while they’re feeding, play with their hands, tickle the bottoms of their feet, change breastfeeding positions every 10 minutes…whatever you can do to keep them up.
“You want to make the baby a little uncomfortable to make sure that they get their calories in,” Jennifer explains. “If their weight is down and your lactation consultant or your doctor feels that their weight needs to go up, that’s when you would want to wake that newborn up and feed them every two hours or so, or whatever your doctor or lactation consultant says.”
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Cracked and Sore Nipples
A common complaint for chestfeeding and breastfeeding people, cracked and sore nipples can be attributed to not finding the right breastfeeding position and/or having a poor latch.
“If you feel like there’s very, very painful and you feel it’s a latch issue, I would definitely see a lactation consultant,” Jennifer says. “They can give you the right tools if you need a nipple shield or something to get through those next few weeks.” (Lactation consultants are like if a Breastfeeding 101 class were a person.)
There are a lot of creams and oils out there for treating cracked and sore nipples. (Jennifer’s favorite is Motherlove Nipple Cream, which doubles as a lip balm.) But you can also make a free treatment: squeeze a little breast milk on it and let it dry on your nipple, Jennifer says.
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Thrush
Thrush is caused by an overgrowth of candida, a fungus that lives on our skin and in our digestive tract. It’s essentially a yeast infection on your breasts and nipples, in your breast milk, and/or in the baby’s mouth and tongue.
Thrush symptoms include itchy and burning nipples for mom and white patches inside the baby’s mouth.
“[It] can be very painful and is very contagious,” Jennifer explains. “Moms and babies can often reinfect each other. This is why if you have thrush, you and baby need to be treated. Anything that touches your breast and baby’s mouth can spread the infection.”
Contact your doctor if you think you’re dealing with thrush. Thrush is treated with an antifungal prescription or over-the-counter medication for you and baby. (Make sure you get the medication off your breasts before breastfeeding, Jennifer advises.)
“Keep your breasts as dry as possible as thrush thrives in moist, sugary warm environments,” she adds. “It’s also a good idea to make sure you are taking a good probiotic to get your body into balance. Make sure you complete the cycle of medication that your doctor prescribes for you and baby so that there is no reinfection.”
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Flat Nipples
Do you have flat nipples and think you won’t be able to breastfeed because of them? Don’t worry.
“People with flat nipples can breastfeed,” Jennifer says.
Working with a lactation consultant can provide some guidance and insight into your body and how it’ll affect the way you breastfeed. For example, “some people’s nipples even come out as they feed,” she says. “It’s something you might not know if you haven’t done it.”
For breastfeeders who know they have flat nipples, “you’re going to want a really strong deep latch for flat nipples,” Jennifer says. “You can do things like sandwich your breast to make sure the baby … gets a wide enough part of your nipple and areola in its mouth. Because it’s not nipple feeding, it’s still breastfeeding.”
Inverted Nipples
The Milk Manual has tools people with inverted nipples can use to improve their latch.
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Over Supply
When people think about breastfeeding problems and milk supply, their first thought most likely goes to not producing enough milk. But there are people who have the opposite problem and have an oversupply of breast milk. (“You’re more prone to it if you’ve breastfed another baby,” Jennifer explains.)
Some people may also experience a form of oversupply known as “overactive letdown,” or the forceful ejection of milk.
“The milk is spraying really hard, really fast at the baby,” making it harder for them to nurse, keep food down, and breathe during feedings.
It may even lead to baby getting too much milk, Jennifer says.
“Normally they say breastfed babies can’t be overfed, but they’re feeding a little bit more because the milk is spraying out like a bottle would,” she explains.
To address oversupply and/or overactive letdown, don’t “pump and save” or “pump and dump.”
“That just makes the problem worse,” she explains. “You’re just triggering your body to make more and more milk.”
Choose breastfeeding positions where your breast is not on top of the baby. Leaning back and laying down or on your side will keep the milk from spraying down the baby’s throat. And if you can feel your let down happen, apply pressure to your breast to slow down the flow before putting baby on.
There are ways to decrease your milk supply, but Jennifer suggests working with a lactation consultant before doing so.
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Leaking
Comfortable nursing pads are the solution to this common breastfeeding problem. Nursing pads slip into your bra to soak up excess milk, and hopefully keep your breast milk from spotting or staining your clothes.
Nursing pads come in all types of materials, so finding the right one takes a bit of trial and error, Jennifer warns.
“I found I didn’t like a lot of the disposable ones because sometimes they’re itchy or too bulky,” she says. “I wouldn’t go out and buy a huge box of a certain brand at the beginning because you might not like it.”
Applying pressure when you feel your let down coming can help with leaking, and emptying your breasts helps, too.
“[Make] sure you’re not away from your baby for too long, because that’s usually what happens,” Jennifer advises. “Feeding your baby on demand and not waiting too long in between feeds [helps].”
So don’t let the ‘gram fool you—breastfeeding takes a lot of work. But with a little Breastfeeding 101 learning, the support of a positive breastfeeding community, and these tips, you’ll be able to meet the challenge and feed your baby the way you want to.
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