Common Breastfeeding Challenges and Solutions

Breastfeeding can be hard at times, especially in the early days. But remember that you are not alone.  And while many women are faced with one or more of the challenges listed here, many women do not struggle at all. Also, many women may have certain problems with one baby that they don’t have with their second or third baby.

If these ideas don’t work for you be sure to seek out expert help from a lactation consultant, a public health nurse, or your doctor.



Engorgement refers to the feeling of  pain or fullness in the lactating.

It is normal for your breasts to become larger, heavier, and a little tender when they begin making milk. Sometimes, this fullness may turn into engorgement, when your breasts feel very hard and painful., before your milk supply can adjust to your baby’s needs. Engorgement is the result of the milk building up. The most common time to experience engorgement is the first week of breastfeeding. But it can happen at any time, especially if you have an oversupply of milk or are not feeding your baby or expressing your milk often.

Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated right, engorgement should fix itself.


  • Feed the baby frequently.
  • Use a warm compress (or therapearl hot & cold breast therapy) on your breasts before feeding to help soften them.
  • When done nursing, use ice packs (or therapearl hot & cold breast therapy)on your breasts to help reduce swelling.
  • Use green cabbage leaves to reduce swelling. (Keep a head of green cabbage cold in the fridge. When you’re done nursing, take a leaf, rinse with cold water and place on breasts anywhere there is swelling. This can be done in conjunction with the ice. Leave in place for about 15-20 minutes. If your nipples are sore, avoid placing the cabbage leaves on the nipples. Note: Do not use if you are allergic to sulfa medications.)
  • Make sure your baby is latching well. A deep latch can be difficult with engorgement.


Sore Nipples

Sore nipples are the result of a poor latch. Most women may have some baseline nipple tenderness after delivering their babies due to hormonal changes. Add on top of that eight to 10 nursing sessions a day, and that tenderness may turn really sore.

Breastfeeding should feel comfortable once you and your baby have found a good latch and some positions that work. Usually nipple pain happens because your baby is not taking enough of your nipple and areola into the mouth. Your baby will need to open his mouth very wide as you bring him to your nipple.



  • Start nursing on least sore side first.
  • Change your breast pads between feeds to avoid trapping in moisture.
  • Try a hydro-gel pad specifically made for sore nipples, which is worn over the nipple and areola and held in place by your bra.
  • Apply a lanolin-type nipple ointment sparingly to nipples after nursing.
  • Make sure your bra is comfortable and not too tight, which can further irritate your nipples.
  • Try changing positions each time you breastfeed.


Low Milk Supply

This is when your breasts do not make enough milk to meet the nutritional needs of your baby. Most mothers can make plenty of milk for their babies. But many mothers are concerned about having enough.

Growth spurts can cause your baby to want to nurse longer and more often. These growth spurts can happen around 2 to 3 weeks, 6 weeks, and 3 months of age. They can also happen at any time. Don’t be alarmed that your supply is too low to satisfy your baby. Follow your baby’s lead – nursing more and more often will help build up your milk supply. Once your supply increases, you will likely be back to your usual routine.



  • Rest, eat well, and increase fluids by mouth.
  • Avoid bottles and supplementation (unless medically necessary).
  • Make sure your baby is latched properly.
  • Breastfeed frequently, the more milk that is removed, the more your body will make.
  • Offer both breasts at each feeding. Have your baby stay at the first breast as long as he or she is still sucking and swallowing. Offer the second breast when the baby slows down or stops.


Oversupply of Milk

Although low supply of milk is more common, an overfull breast can make breastfeeding stressful and uncomfortable for you and your baby.

Some symptoms include: Frequent spraying of milk from one or both breasts, Excessive leaking, and sore nipples. Some women have a strong milk ejection reflex, or let-down



  • Use ice packs (or therapearl hot & cold breast therapy) to help reduce swelling.
  • Only pump to relieve pressure. If you are uncomfortable, feeling engorged, you can pump for a few minutes. By removing some milk, it will relieve the pressure but not empty the breast fully.
  • Try one-sided feedings. Let your baby finish up on one breast without offering the other. Some moms may even nurse two feedings in a row on one breast. By leaving milk in the “unused” breast, your body gets the signal to slow down production.
  • Feed your baby before he or she becomes overly hungry to prevent aggressive sucking.


Strong Let-Down Reflex

Some women have a strong milk ejection or let-down. This can happen along with an oversupply of milk.


  • Hold your nipple between your first and middle fingers or with the side of your hand. Lightly compress milk ducts to reduce the force of the milk ejection.
  • If your baby chokes or sputters when breastfeeding, unlatch him or her and let the excess milk spray into a towel or cloth.
  • Allow your baby to come on and off the breast at will.
  • Try positions that reduce the force of gravity, which can intensify milk ejection. These positions include the side-lying position and the football hold.


Plugged Ducts

Plugged ducts are common in breastfeeding mothers. A plugged milk duct feels like a tender and sore lump in the breast. You should not have a fever or other symptoms.

A plugged duct happens when a milk duct does not drain properly. Pressure then builds up behind the plug, and surrounding tissue gets inflamed. A plugged duct usually only happens in one breast at a time.


  • Breastfeed on the affected side as often as every two hours. This will help loosen the plug and keep your milk moving freely.
  • Aim your baby’s chin at the plug. This will focus his suck on the duct that is affected.
  • Massage the area, starting behind the sore spot. Move your fingers in a circular motion and massage toward the nipple. Use a warm compress (or therapearl hot & cold breast therapy) on the sore area.
  • Get extra sleep, or relax with your feet up to help speed healing. Often a plugged duct is a sign that you are doing too much.
  • Where a well-fitting, supportive bra that is not too tight, since this can constrict milk ducts. Consider trying a bra without an underwire.



Mastitis  is soreness or a lump in the breast. It can cause symptoms such as:

  • Fever and/or flu-like symptoms, such as feeling run down or very achy
  • Nausea
  • Vomiting
  • Yellowish discharge from the nipple that looks like colostrum
  • Breasts that feel warm or hot to the touch and appear pink or red

A breast infection can occur when other family members have a cold or the flu. It usually only occurs in one breast. It is not always easy to tell the difference between a breast infection and a plugged duct because both have similar symptoms and can improve within 24 to 48 hours. Some breast infections that do not improve on their own within this time period need to be treated with medicine given by a doctor.


  • Breastfeed on the affected side every two hours or more often. This will keep the milk moving freely and your breast from becoming overly full.
  • Massage the area, starting behind the sore spot. Move your fingers in a circular motion and massage toward the nipple.
  • Apply heat to the sore area with a warm compress (or therapearl hot & cold breast therapy).
  • Get extra sleep, or relax with your feet up to help speed healing. Often a breast infection is a sign that a mother is doing too much and becoming overly tired.
  • Wear a well-fitting, supportive bra that is not too tight, since this can constrict milk ducts.


Ask your doctor for help if you do not feel better within 24 hours of trying these tips, if you have a fever, or if your symptoms worsen.




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