You already know that “breast is best,” but just because breastfeeding is natural, doesn’t mean it always comes naturally. Whether you’re a first time mom or have more than one, there are several common breastfeeding problems you may encounter.
Not only is there a learning curve when you start breastfeeding, but other issues like low milk supply, breastfeeding pain and engorgement can crop up.
The American Academy of Pediatrics (AAP) recommended infants are exclusively breastfed for 6 months and then continue breastfeeding alongside solids for up to a year.
According to the latest statistics from the Centers for Disease Control and Prevention (CDC), although more than 83 percent of infants start to breastfeed at birth, only about 57 percent are still breastfeeding at 6 months.
Although any amount of breastfeeding is good for your baby, overcoming the challenges can make all the difference. Here, read on for 10 of the most common breastfeeding problems and solutions to make your breastfeeding journey easier.
1. Breastfeeding pain
One of the most common breastfeeding problems moms deal with is breastfeeding pain.
If you have pain when your baby latches on, it’s probably because the latch isn’t correct.
The best way to find out is to work with a lactation consultant in the hospital or birth center, or at home. A lactation consultant can show you how to position your baby, ensure the latch is right and that your baby is getting enough milk.
Another reason you may have breastfeeding pain is tongue-tie, a condition in which the piece of tissue under the tongue, or the frenulum, attaches to the bottom of the tongue and makes breastfeeding difficult.
According to a 2007 study in the journal Canadian Family Physician, between 4 and 10 percent of newborns are diagnosed with the condition.
When I had my second child, I had pain every time she latched on and when the midwife took a look, she said it was because of a slight tongue-tie.
I opted to have frenotomy, a procedure to snip her frenulum, but some providers may take a wait and see approach since it can improve.
Also, surgery to correct tongue-tie isn’t without controversy. According to a July 2019 study in the JAMA Otolaryngology—Head & Neck Surgery, 63 percent of newborns who were referred for the surgery didn’t need it.
Since there are other abnormalities that can occur which can make breastfeeding painful, it’s always a good idea to consult with a lactation consultant.
Related: My Love-Hate Relationship With Breastfeeding
2. Low milk supply
Low milk supply is one of the most common breastfeeding problems and suffice to say, one of the most common reasons moms throw in the towel early or supplement with formula.
In fact, 49 percent of mothers said they stopped breastfeeding after two months because breast milk alone wasn’t enough to satisfy their babies.
Although many moms say they struggle with low milk supply, what’s interesting is that the research doesn’t add up.
Rachel O’Brien, a lactation consultant in Sudbury, Massachusetts has a great blog series on low milk supply I recommend you check out to see what the research says and the possible reasons for low milk supply.
Another challenge is that when you feed your baby a bottle, you know how much he ate, but when you’re breastfeeding, it’s not so easy.
If your baby is gaining weight, he has a certain amount of weight diapers a day and he’s hitting his developmental milestones, your milk supply is probably adequate.
If you’re uncertain however, make an appointment with a lactation consultant who can weigh your baby right after you feed him to make sure he’s getting enough.
3. Engorged breasts
My breasts are—and always have been— super-small: I’m barely an A cup.
Yet when I was breastfeeding, I couldn’t believe how large my breasts were—porn-star big.
It turns out, it’s totally normal.
In the first few days and weeks after giving birth when your milk comes in, it’s normal for your breasts to be engorged and feel hard.
There’s no doubt it’s uncomfortable, but be sure to feed frequently, at least 10 times per 24 hours.
Make sure your baby is emptying each breast during feedings and your breasts feel soft afterwards.
You can also gently massage your breasts before nursing or try a cold compress for up to 20 minutes beforehand.
4. Leaking breasts
With my first baby, I produced a lot of milk. She had a strong, efficient suck but I was also pumping, which increased my milk supply even more.
When I sat down to breastfeed, my milk would let down so fast she would often let go of the latch to catch a breath and my breasts would spray everywhere—something that’s known as overactive letdown.
Because I was producing a lot of milk, my breasts would leak when she cried, when another baby cried and even when I thought about her.
During the first few weeks of breastfeeding when you’re feeding all the time, it’s common to have leaking breasts.
The solution? Get yourself a box of nursing pads and keep extras on hand.
5. Breastfeeding latch
When it comes to breastfeeding problems, suffice to say, getting the latch right is one of the most common obstacles. It’s part art, part science.
When the latch is right, a large portion of your areola, or the dark skin around your nipple, is in your baby’s mouth. Your nipple should be opposite his nose and aimed at his upper lip and nose, not the middle of the mouth.
Sometimes all it takes is a different breastfeeding position to get it right.
I found the Boppie nursing pillow made it so much easier and I recommend you bring it to the hospital because propping your arm on regular ‘ol pillows isn’t ideal.
One I got the positioning and latch down pat however, I found I could sit anywhere and in any position.
A proper latch also means your breasts will drain and you’ll probably hear your baby swallowing. You’ll feel a slight tug at your breast, but there shouldn’t be pain. Always check with a lactation consultant if you’re unsure.
6. Sleepy baby
One of the biggest breastfeeding problems I had with my second child was that she was very sleepy especially the first few days after she was born.
I know some people say never wake a sleeping baby, but breastfed babies need to feed regularly, and besides, she was 4 weeks premature so I wanted to make sure she was gaining weight.
Some things you can try include switching breasts frequently, burping your baby, changing her diaper, holding her upright, taking her out of her swaddle or undressing her, massaging her hands or feet, and talking and singing to her and making eye contact.
7. Nipple confusion
After I had my first child, the lactation consultant in the hospital explained that I shouldn’t introduce a bottle of pumped milk for awhile until breastfeeding was established because it could create nipple confusion and cause her to prefer the bottle over the breast.
I did wait, but within a month or so, my daughter had no problem breastfeeding most of the time and taking a bottle from my husband at night.
My second child was more apprehensive to the bottle so I guess it depends on the baby.
8. Plugged milk ducts
Sometimes when a milk duct becomes clogged, you’ll have a hard lump in your breast.
Just as you would do to treat engorgement, continue with your normal feedings, make sure you’re draining your breasts entirely, massage the area and drink plenty of fluids.
Related: 9 Food Rules for Breastfeeding
9. Inverted or flat nipples
If your nipples are flat or inverted, it can make breastfeeding challenging especially in the first few weeks when your baby’s mouth is very small and he’s still getting used to feedings.
Although a proper latch is when your baby has a large portion of the areola in his mouth, inverted (concave) or flat nipples may make it challenging to get the latch right.
The good news is that it doesn’t mean breastfeeding will be impossible.
Talk to a lactation consultant about different treatments she recommends, which may include compressing your areola during feedings, using a breast pump before feedings to draw out the nipples, or using breast shells.
When I was breastfeeding, I had a bout of mastitis and I wouldn’t wish it on anybody.
Not only did I have a large lump in my breast, but I felt like someone ran over me with a Mack truck.
Mastitis is an inflammation of the breast tissue that can cause redness, tenderness, or firmness around the breast as well as fever, fatigue and malaise.
Between 2 and 10 percent of breastfeeding moms are affected and mastitis may or may not be accompanied by a bacterial infection.
The condition usually happens when a milk duct becomes blocked from engorgement, but it can also happen from wearing a tight bra or clothing.
To clear mastitis, make sure you fully empty your breasts when you breastfeed or pump. If you have pain, applying heat to the area can also help with let down.
Your doctor may also prescribe antibiotics if the symptoms have been present for 12 to 24 hours or if you’re feeling ill.
It’s important to get plenty of rest, eat healthy and drink plenty of water.