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Breastfeeding is the most nutritious and natural way to feed your baby, right? Yet most women experience pain or other more severe problems while trying to nurse their infant.

Mother and baby need to learn how to breastfeed together. Below are some tips to help you overcome some of the most common breastfeeding problems you may encounter.

Latching pain

It’s normal for your nipples to feel sore when you first start to breastfeed. But if your baby has latched and the pain lasts longer than a minute into your feeding session, check the positioning.

Solution: Try to achieve an asymmetrical latch where your baby’s mouth covers more of the areola below the nipple rather than above.

Tickle his upper lip with your nipple or wait until he yawns so his mouth is wide open and seize your opportunity. When he is correctly positioned, his chin and nose touch your breast, his lips splay out and you can’t see your nipple or part of the lower areola.

If the position is correct and latching on still hurts, your nipples may be dry. Make sure to wear loose clothing and avoid washing with soap. Lanolin-based creams are good for applying between feedings and hard plastic breast shells worn inside your bra allow air circulation and protect the sore nipples from rubbing on clothing.

Cracked nipples

Cracked nipples can be the result of many different things: thrush (see below), dry skin, pumping improperly, or most likely, latching problems.

Solution: Check baby’s positioning. The bottom part of your areola underneath your nipple should be in baby’s mouth. Also, try breastfeeding more frequently, and at shorter intervals. The less hungry your baby is, the softer his sucking will be.

As tempting as it is to treat your cracked nipples with anything you can find in your medicine cabinet, soaps, alcohol, lotions, and perfumes are no good. Clean water is all you need to wash with.

Try letting some milk stay on your nipples to air dry after feeding (the milk actually helps heal them). You can also try taking a mild painkiller like acetaminophen or ibuprofen 30 minutes before nursing.

When there is a break in the nipple skin, a moist environment is recommended for optimal tissue healing.  Over-the-counter gel pads provide immediate cool, soothing pain relief while promoting healing.

Clogged/plugged ducts

Ducts clog because your milk isn’t draining completely. You may notice a hard lump on your breast or soreness to the touch and even some redness.

If you start feeling feverish and achy, that’s a sign of infection and you should see your doctor. Most importantly, try not to have long stretches in between feedings — you need to express milk often.

A nursing bra that is too tight or has underwires can also cause clogged ducts.

Solution: Try applying warm compresses to your breasts or take long, hot showers or baths, then massage them to stimulate milk movement. Breastfeeding your baby while your breast is warm will help unplug them.

Engorgement/high milk supply

Engorgement makes it difficult for baby to latch on to the breast because it’s hard and un-conforming to his mouth.

Solution: Try hand-expressing a little before feeding to get the milk flowing and soften the breast, making it easier for baby to latch and access milk. Of course, the more you nurse, the less likely your breasts are to get engorged.

Engorgement may be painful. La Leche League recommends cold therapy with ice packs, gel packs, or frozen wet towels for about 20 minutes before feeding to bring relief.


Mastitis is a bacterial infection in your breasts marked by flu-like symptoms such as fever and pain. It’s common within the first few weeks after birth, though it can also happen during weaning. Cracked skin, clogged milk ducts, or engorgement may cause it.

Solution: The only sufficient way to treat the infection is with rest, hot compresses, frequent emptying, and sometimes antibiotics.

Use hands-on pumping, making sure the red firm areas of the breast and the periphery are softened. It’s safe and actually recommended that you continue breastfeeding when you have mastitis.


Thrush is a yeast infection in your baby’s mouth, which can spread to your nipples. It causes incessant itchiness, soreness, and sometimes a rash.

Solution: Your doctor will need to give you antifungal medication to put on your nipple and in your baby’s mouth — if both you and your baby are not treated at the same time, you can continue spreading the fungi back and forth.

Be sure to rinse your nipples with water and let them air dry after each feeding since thrush thrives in a moist environment.

Low milk supply

Breastfeeding is a supply-and-demand process. Your baby should nurse eight to 12 times in a 24-hour period and he should gain at least 4 to 7 ounces every week after the fourth day of life.

Solution: Frequent nursing and hands-on pumping during the day can help increase milk supply. Encourage your baby to breastfeed frequently and allow him to eat as long as he wants.

Inverted/flat nipples

You can tell if you have flat or inverted nipples by doing a simple squeeze test:  Gently grab your areola with your thumb and index finger — if your nipple retracts rather than protrudes breastfeeding may be more challenging.  However, babies breastfeed, not “nipple feed”, and with a good latch the baby’s mouth will bypass the nipple entirely and cover most of the areola for effective milk transfer. 

Solution: Use a pump to get the milk flowing before placing baby at your nipple and use breast shells for inverted nipples, which can help draw out your nipple, between feeds.

For the mother with inverted nipples, obtaining early professional help from a skilled lactation consultant is critical to teach the baby to open his mouth wide to bypass the nipple and close his gums farther back on the areola. 

When other strategies do not work to get baby latched on, a nipple shield may be suggested.  This is a thin silicone nipple fitted to the mother’s nipple to assist with latching.  When using a nipple shield it is extremely important that the mother work closely with a lactation specialist.

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