Breastfeeding can be challenging, especially in the early days. But remember that you are not alone. Lactation consultants can help you find ways to make breastfeeding work for you and your baby. Some women face many different problems while breastfeeding, while others do not. Also, many women may have certain problems with one baby that they don't have with their second or third baby.
Many moms say that their nipples feel tender when they first start breastfeeding. Breastfeeding should feel comfortable once you and your baby have found a good latch and some positions that work.
If you have very sore nipples, you can ask your doctor about using non-aspirin pain relievers.
Most mothers make plenty of milk for their babies. But many mothers worry about having enough milk. This video suggests that checking your baby's weight and growth is the best way to make sure he or she gets enough milk. Let your baby's doctor know if you are concerned.
For more ways to tell if your baby is getting enough milk, visit the How do I know if my baby is getting enough breastmilk? section.
There may be times when you think your supply is low, but it is actually just fine:
Check with your doctor for health issues, such as hormonal issues or primary breast insufficiency, if the above steps don't help.
An overfull breast can make breastfeeding stressful and uncomfortable for you and your baby.
Some women have a strong milk ejection reflex or let-down. This can happen along with an oversupply of milk.
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. Engorgement is the result of the milk building up. It usually happens during the third to fifth day after giving birth. 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 also cause:
Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens.
Try reverse pressure softening to make the areola soft around the base of the nipple and help your baby latch. Try one of the holds in the illustrations below. Press inward toward the chest wall and count slowly to 50. Use steady and firm pressure, but gentle enough to avoid pain. You may need to repeat each time you breastfeed for a few days.
Plugged ducts are common in breastfeeding mothers. A plugged milk duct feels like a tender and sore lump in the breast. If you have a fever or other symptoms then you probably have a breast infection rather than plugged ducts.
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 happens in only one breast at a time.
Mastitis (mast-EYE-tiss) is soreness or a lump in the breast. It can cause symptoms such as:
A breast infection can happen when other family members have a cold or the flu. It usually happens in only 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 get better within 24 to 48 hours. Some breast infections that do not get better on their own need to be treated with prescription medicine from a doctor. (Learn more about medicines and breastfeeding in the Breastfeeding fact sheet.)
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 get worse. You might need medicine. See your doctor right away if:
A fungal infection, also called a yeast infection or thrush, can form on your nipples or in your breast. This type of infection thrives on milk and is an overgrowth of the Candida organism. Candida lives in our bodies and is kept healthy and at the correct levels by the natural bacteria in our bodies. When the natural balance of bacteria is upset, Candida can overgrow, causing an infection.
A key sign of a fungal infection is sore nipples that last more than a few days, even after your baby has a good latch. Or you may suddenly get sore nipples after several weeks of pain-free breastfeeding. Other signs are pink, flaky, shiny, itchy, or cracked nipples or deep pink and blistered nipples. You could also have achy breasts or shooting pains deep in the breast during or after feedings.
Causes of fungal infection include:
Fungal infections are treated with a medicine you rub on your breasts several times a day for about a week. It may take several weeks to clear up, so it is important to follow these tips to avoid spreading the infection:
Some women have nipples that turn inward instead of pointing outward or are flat and do not protrude. Nipples can also sometimes flatten for a short time because of engorgement or swelling from breastfeeding. Inverted or flat nipples can sometimes make it harder to breastfeed. For breastfeeding to work your baby must latch on to both the nipple and the breast, so even inverted nipples can work just fine. Often, flat and inverted nipples will protrude more over time as the baby sucks more.
Very large nipples can make it hard for the baby to get enough of the areola into his or her mouth to compress the milk ducts and get enough milk.
A nursing "strike" is when your baby has been breastfeeding well for months and then suddenly begins to refuse the breast. A nursing strike can mean that your baby is trying to let you know that something is wrong. This usually does not mean that the baby is ready to wean (stop breastfeeding totally).
Not all babies will react the same way to the different things that can cause a nursing strike. Some babies will continue to breastfeed without a problem. Other babies may just become fussy at the breast. And other babies will refuse the breast entirely.
Some of the major causes of a nursing strike include:
If your baby is on a nursing strike, it is normal to feel frustrated and upset, especially if your baby is unhappy. Be patient with your baby and keep trying to offer your breasts. You may also want to pump your breastmilk to offer during the strike and to make sure you do not get engorged.
For more information about breastfeeding challenges, call the OWH Helpline at 800-994-9662 or check out the following resources from other organizations:
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Page last updated: May 03, 2017.
Content last reviewed: February 01, 2017.