By Melissa Portunato MPH, IBCLC, RLC
You had envisioned yourself latching your beautiful new baby to your breast, and it would instantly be magical. Pure bliss! But breastfeeding didn’t come as easy as you thought it would, and it feels far from magical. Instead, you feel frustrated, disappointed, and feel like giving up. The truth is, for most of us, breastfeeding is not what we thought it would be like at all. Just like with anything worthwhile in life, breastfeeding takes hard work and commitment. Let us help you get past those pesky common challenges so you can begin to truly bond with your baby.
Here are the Top 10 most common breastfeeding challenges and solutions to get you through those tough times and into a happy place with breastfeeding.
#1 Painful Latch
Every time you know feeding time is coming around, your toes curl, and you start to get major anxiety because it hurts to latch your baby to your breast! Most likely, it’s because your nipple is rubbing on the roof of your baby’s mouth, causing discomfort. So how can you work on perfecting the latch to get rid of this dreadful feeling? Adjust your body, adjust your baby, and adjust your breast to what feels comfortable and relieves tension. Do this by practicing “natural breastfeeding,” or also called “laid-back breastfeeding.” If you are using a traditional hold like the cradle or football hold, start the feeding with your nipple above baby’s nose, wait for baby to open wide, and then bring baby quickly (chin first) towards you. This technique can help aim your nipple deeper into your baby’s mouth. When done correctly, you should instantly feel a difference. Phew!
#2 Sleepy Baby at Breast
You changed baby’s diaper, tickled their toes, got them all undressed, and still can’t seem to wake baby from dreamland. A newborn baby should be nursing a minimum of 8 to 12 times per day. If baby is still not at their birth weight, they most definitely need to be woken up to feed throughout the night. For the first six weeks, try NOT to swaddle baby or offer a pacifier. This can interfere with nursing cues and cause baby to feel full and cozy and not want to nurse. Hand express for a few minutes before offering the breast to soften the breast, allowing for baby to latch easier. Sometimes, just a few drops of breastmilk on a sleepy baby’s lips will get them to want to nurse. Use breast compressions while you nurse. This can help keep your baby stay awake because of the steady flow of milk.
If your chubster is already back up at their birth weight, talk to your pediatrician. It’s most likely OK to hit the snooze button on that alarm. Finally rest!
#3 Cluster Feeding
You feel your baby is practically attached to you morning, noon, and night. You can’t catch a break and you’re tapped out! Cluster feeding is when baby bunches nursing sessions close together about every 45-60 minutes. This feeding pattern is typical for young babies and coincides with growth development, but cluster feeding can be exhausting. Wearing your baby in a wrap or sling will allow you to be hands-free and get work done around the house or on the go! Check out more tips on our baby-wearing blog post here.
We promise, there is hope! These marathon feedings will increase your milk supply and are typically followed by long sleeping stretches for baby. Sit back, relax, and scroll through your favorite newsfeed. Sleep is on the horizon.
#4 Baby Refusing the Breast
If your baby was nursing and suddenly refuses the breast, you could be experiencing a nursing strike. Nursing strikes will typically last from just a few short days to over a week. They can be caused by various factors like an illness, teething, significant changes in routine, or long periods of separation from your baby.
Take it back to the basics! Dim the lights and do skin to skin with baby on your bare chest with only a diaper. Offer the breast frequently but, don’t ever force baby! It should be a gentle “wooing” back. You can even have baby gently wake up next to your bare breast. Often, babies will be more willing to nurse when just waking up. Limit bottles as much as possible and offer the breast first. Don’t wait until baby is too hungry. Try to have someone else give the bottle besides mommy.
#5 Sore Nipples
Your nipple is elastic, and as it begins to stretch, you can experience soreness. Soreness in the first few weeks is normal but should subside after about two weeks. Continued soreness, pain, cracking, and bleeding are not normal. It’s best to work closely with an International Board Certified Lactation Consultant to ensure baby is latched on properly. The best way to treat sore nipples is with your very own breast milk! Yep, pretty incredible, huh? Studies show the antibacterial properties in breastmilk make it the perfect substance to heal nipples and keep them healthy. Hand express breast milk on your nipples after every feeding and apply a cool hydrogel. Make sure you are changing your breast pads frequently. This will help prevent any infection and allow your nipples to heal faster. Your nipples will be feeling better in no time!
It’s been a few days, and your milk has officially made its grand entrance. HELLO! Engorgement can make it difficult for baby to latch. To help, you can apply a warm cloth and softly massage your breasts a few minutes before nursing. It’s crucial during this time to nurse frequently! Offer the breast often and use Reverse Pressure Softening, a technique that moves swelling upward and into the breast, providing relief from engorgement. If after nursing or pumping you still feel engorged, fill up a large basin with warm water and lean over it to let gravity naturally drain any excess milk from your breasts. After you’re done, you can ice or use a cold compress for 10 min to help bring down any swelling.
Call your healthcare practitioner if you have redness on your breasts; they feel hot to the touch; you have a fever or chills because it could sign an infection.
#7 Clogged Ducts
Ouch! Clogged ducts can be extremely painful but completely treatable. How did you even get them in the first place? A blocked duct can be caused by various reasons, from prolonged time without milk removal, shallow latch, restrictive clothing, or even stress. The fastest way to treat clogged ducts is by frequently nursing or pumping. Try nursing in the “dangling feed” position or “dangle pumping.” Practice massaging your breasts while nursing or pumping, no matter what position you use each time. You want to start massaging above where you feel the clog and gently move towards the nipple. You can use a warm compress before you nurse or pump to help with milk removal.
Alternate heat and cold on the area affected. If you find you have a milk blister or bleb, avoid trying to squeeze because it can make things worse. The milk blister or bleb will naturally draw out as the clog subsides.
The most important thing to remember with clogged ducts is that they should progressively get better, not worse. Most clogged ducts subside within 48 hours. If pain continues or other symptoms appear, give your doctor a call.
#8 Tongue Tie
You’ve spent countless hours looking under your baby’s tongue and upper lip, comparing it to pictures you found on the internet to try and assess. A tongue-tie is when the connective tissue under your baby’s tongue is too tight, too thick, or both. A tongue-tie is commonly accompanied by a lip tie – the upper lip tissue connecting to the gum can be tight or too thick. Both tongue and lip ties can restrict mobility in oral function, causing issues with breastfeeding.
Unfortunately, ties often go undiagnosed. Signs of a tongue or lip tie can include loud clicking when baby is nursing, baby is not gaining weight, has reflux, or you continue to experience nipple soreness. A specialist such as an International Board Certified Lactation Consultant or a Pediatric Dentist can evaluate your baby and provide effective treatment to ensure the breastfeeding relationship can continue.
Stabbing nipple pain, itchiness, and shiny or flaky skin on the nipple or areola can all be signs of thrush. Thrush is a common fungal infection caused by the overgrowth of yeast or “candida.” Candida can be found in its natural environment pretty much all over the human body, but when it starts to multiply, it can cause an infection. Thrush can be a side effect of antibiotics too! Talk to your doctor if you are experiencing any of the above symptoms and suspect you have thrush. Both you and the baby will need to be treated. Ask about starting probiotics for the both of you, which can help replenish the healthy bacteria in the gut for a quicker recovery and, most importantly, prevent thrush from recurring.
Rinsing your nipples with a vinegar and water solution (1 tablespoon apple cider vinegar preferred to 1 cup water) or baking soda in water (1 tablespoon per cup) can help stop the spread. Use a fresh cotton ball for each application and mix a new solution every day. Limiting sugar can also help! Make sure you wash and sanitize your pumping parts after every use.
Last but not least, you think you might have the most dreaded condition in the whole breastfeeding universe; Mastitis. Mastitis is an inflammation of the breast tissue. Symptoms of mastitis include redness of the breast, hard lumps, hot to the touch, and feeling like you’re catching a nasty flu bug. If symptoms persist or get worse after a few days, call your doctor to ensure infection is not brewing.
There are many causes of mastitis, including lack of breastmilk removal, worsening clogged ducts, change in breastfeeding patterns, and even a tight bra! It’s essential to continue to breastfeed during this time and keep your milk flowing. Make sure you REST and get plenty of fluids, as this often can occur due to a suppressed immune system. You need to take care of yourself so that you can take care of your little one!
Tips for relief are the same as when treating a clogged duct. See tip #7.
If you are experiencing any one of these common breastfeeding issues and still can’t seem to find relief, trust your mommy instincts and seek professional help from an International Board Certified Lactation Consultant. Never quit on your worst day! Always remember why you wanted to breastfeed in the first place. Surrounding yourself with breastfeeding support will make a world of difference. Join our online community on Facebook and connect yourself with other moms who will meet you exactly where you are on your breastfeeding journey. You’re not alone in your struggles, and you’re doing the very best you can!
Colson, S. D., Meek, J. H., & Hawdon, J. M. (2008). Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development, 84(7), 441-449.
Newman, J., & Newman, J. (n.d.). Are you worried your baby’s not getting enough breastmilk? International BreastFeeding Centre. https://ibconline.ca/breastcompression/.
Thrush. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/thrush/#:~:text=Rinsing%20your%20nipples%20with%20a,Wash%20your%20hands%20thoroughly.