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Common Breastfeeding Challenges

Common Breastfeeding Challenges

Difficulty latching

Your baby is having trouble getting a deep latch

Sometimes, especially when your baby is first learning to breastfeed, they may have trouble getting a deep latch.

Signs that your baby is not latched deeply include:

  • nipple pain or discomfort
  • nipple is flattened or stretched after feeding
  • baby does not appear satisfied after feedings
  • baby is making a clicking sound when feeding
  • baby’s cheeks are sucked in while feeding

If this happens, see a certified lactation consultant (external link) to get support as soon as possible. A shallow latch can quickly cause nipple damage and may mean your baby is not transferring milk well. In the meantime, protect your milk supply by hand expressing or pumping. Feed your baby any breastmilk you express. Follow the tips below while waiting to see a lactation consultant.

Your baby is refusing to latch on to the breast

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

If this happens, see a certified lactation consultant (external link) to determine the cause. In the meantime, protect your milk supply by hand expressing or pumping. Feed your baby any breastmilk you express.

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

  • Choose a quiet, relaxed place to offer your breast to your baby.
  • Hold your baby skin-to-skin and calm your baby before trying to latch.
  • Watch for early hunger cues (external link) and begin feeding when your baby shows early hunger cues.
  • Express some milk onto your nipple to get your baby interested.
  • Soften the area around the nipple, using hand expression, if your breast is engorged.
  • Try the laid-back breastfeeding position for feeding.
  • Monitor your baby for signs that feeding is going well, and see your health care provider if you have concerns.

This page is written with inclusivity in mind. Learn about the use of inclusive language in Halton’s breastfeeding information.

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 go away once your baby begins to feed. If the pain continues, remove your baby from the breast and reposition them before latching again. If the pain is moderate or severe, and/or does not improve with repositioning, see a certified lactation consultant as soon as possible (external link).

Shallow latch

The most common cause of nipple pain is a shallow latch or poor positioning. A shallow latch can quickly cause nipple damage, but this should heal quickly once your baby’s latch is improved. If adjusting your latch does not reduce the nipple pain, or if you are unsure how to get a deeper latch,  contact a certified lactation consultant (external link).

Infections

Another cause of nipple pain can be bacterial or viral infections, and/or yeast. This can cause rashes, scaly or shiny nipples, nipple pain and/or burning. If you are experiencing any of these signs, contact a certified lactation consultant (external link) or your health care provider.

Sore breasts

There are several possible causes of breast pain. If you are experiencing breast pain, contact a certified lactation consultant (external link) or your health care provider.

Engorgement

In the early days, your body may produce more milk than needed. This can cause your breasts to swell up with milk and become tender. This is called engorgement. Over time your body will adjust 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 your baby’s feeds.

Sometimes babies find it hard to latch if your breasts are very hard and full. If this happens:

Discomfort from engorgement should only last for a couple of days. Contact a certified lactation consultant (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:

  • Continue to breastfeed your baby based on their hunger cues. Do not add extra feedings/pumping to try to reduce inflammation or “empty the breast” as this can increase your milk supply and increase inflammation.
  • Minimize use of breast pumps and nipple shields, if possible.
  • Apply ice or cold compresses to the breast (avoid applying heat).
  • 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 a well fitting, supportive bra.

Inflammatory mastitis

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

Symptoms of inflammatory mastitis include:

  • redness on an area of the breast
  • swelling of the breast
  • pain
  • fever and/or chills
  • increased heart rate

If your symptoms are mild and focused on one specific area of the breast, try the recommendations in the "lumps or reduced milk flow" section to treat mastitis. If after 24 hours, your symptoms do not improve or get worse, contact your health care provider as you may require medication for treatment.

Note: There is no need to pause or stop breastfeeding. Mastitis is not contagious or dangerous to your baby.

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

For more information see this handout on mastitis (external PDF).

Not producing enough breastmilk

It is common for parents to worry they are not making enough breastmilk, especially in the early days.

It is important to remember that:

  • Young babies need to wake and feed often.
  • Over time, your breasts will feel softer and less full between feeds.

These are not signs that you are not making enough milk.

Most parents will make enough breastmilk to meet their baby’s needs, as long as:

  • your baby is able to deeply latch onto the breast
  • you are able to breastfeed or express breastmilk early after birth
  • you regularly remove milk from your breasts, at least 8 times in 24 hours

If you are concerned that you are not making enough breastmilk for your baby, look for the signs that feeding is going well.

Sometimes when parents are worried they are not making enough breastmilk, they supplement with formulas when it may not be needed. This early supplementation can cause the baby to spend less time at the breast which can lead to actual low milk supply.

Contact your health care provider right away if your baby is showing any of these signs:

  • producing less wet and dirty diapers than expect for their age
  • crystals or reddish-orange stains in their diaper after day 2
  • stool that has not turned from black to yellow by day 6
  • not waking to feed at least 8 times in 24 hours
  • showing hunger cues soon after feeding, or eagerly takes pumped milk after feeding
  • not making swallowing sounds while feeding after 96 hours
  • not latching onto the breast
  • causing intense nipple pain when feeding

If it is determined that you need to increase your breastmilk supply, contact a certified lactation consultant (external link) who can help you safely feed your baby, while supporting you in gradually increasing your milk supply to meet your baby’s needs.

Baby wanting to feed more often

It is normal and important for all newborns to have small and frequent feedings. Feeding your baby based on their cues (external link) and at least 8 times in 24 hours will help ensure they are getting enough milk. However, there are times where you may notice that your baby wants to feed more often. As long as your baby is showing signs that feeding is going well, these periods of increased feedings are a normal part of infant development. These times of increased feedings may include:

Your baby’s second night of life

  • Babies are often alert for the first few hours after birth and eager to breastfeed.
  • After this initial period, many babies are tired and sleep more deeply for the next 20 hours. You may need to wake them to feed during this time.
  • During your baby’s second night of life, they may be restless, fussy and want to feed frequently with shorter periods of sleep in between.
  • Many parents interpret these “cluster feedings” as a sign that they do not have enough milk, however, this is normal newborn behaviour and will not last.

During growth supports or times of increased development

Your baby may have other periods of wanting to feed more often when they are growing or developing more quickly (growth spurts). These can occur at any time but commonly occur when babies are:

  • 10 days to 2 weeks old
  • 6 to 8 weeks old
  • 3 months old

Your baby wanting to feed more frequently is not necessarily a sign that you do not have enough milk. Your baby should have longer periods of sleep and appear settled after these “cluster feeds”. If you are concerned, contact a certified lactation consultant (external link) or your health care provider for support.

Tongue and lip tie

A tongue or lip tie is when the tissue under a baby's tongue or connecting the baby’s lip to their gums is tighter or shorter than usual, this can make it harder for their tongue and mouth to move properly. This can cause pain or damage to the breastfeeding parent's nipples and make it difficult for the baby to transfer milk.

If you think your baby may have a tongue or lip tie, have them assessed by a professional who is trained in this area. As your baby grows, their ability to latch well and feed effectively may improve on its own.

Breastfeeding and illness

Giving your baby breastmilk, especially when given directly from the breast, provides them with antibodies to help them fight off infections. When you are sick, your body makes antibodies specific to that illness, which are passed through your breastmilk and help keep your baby healthy.

Wash your hands often, especially when caring for your baby to keep everyone healthy. Talk to your health care provider if you have any concerns or questions.

Medications and breastfeeding

Most conditions can be treated with medications that are safe for breastfeeding. If you have any concerns, speak with your healthcare provider or your pharmacist.

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