Common breastfeeding problems

The success of breastfeeding and prevention or relief of problems lies in the latch – i.e. how the baby latches on to the breast. Be familiar with how a baby should latch on and point mums to other services, such as health visitors, local breastfeeding groups and resources, including a video available on the NHS Choices website.

Here are some of the most common breastfeeding problems, and what can be done to overcome them:

Painful or cracked nipples

Some breastfeeding mums may find that their nipples become sore and painful while they are feeding their baby. Firstly, advise them to check that their baby is in the correct position to latch on properly. Other tips include drying the nipples carefully after feeding and keeping a dry breast pad in place until the next feed.

Creams and ointments that are applied to the nipples between feeds (e.g. Kamillosan – chamomile ointment or Lansinoh or Purelan – lanolin) and heated or chilled gel pads can also offer relief. Nipple shields or protectors can be used during feeds to prevent sore nipples becoming worse.

Sore breasts

If a mum is producing more milk than her baby needs, her breasts can become tender and feel heavy. Advise mums to feed their baby as regularly as they can and suggest they express some milk before a feed. Mums should also check the fitting of their bra to ensure it is not too tight.

Hard or lumpy breasts

Blocked milk ducts can cause a mother’s breasts to become hard or lumpy, also known as engorgement. This needs to be treated quickly by draining the breast (by feeding or expressing milk). Mums should feed their babies ‘on demand’ and try to massage the lumps towards the nipple during feeds. Mums can massage out the lumps whilst in the shower and should ensure underwear is not pressing into the breast.

A warm flannel can also be applied to the breasts to soften the lumps. Mums may also need to be shown feeding positions that empty different parts of the breast – suggest they contact a breastfeeding counsellor, who will be able to help with this and offer further advice.

Hot or painful breasts

If mums have painful, red or swollen breasts along with flu-like symptoms (e.g. fever or aches), they may have mastitis (inflammation of the breast). This condition can lead to an infection. Mastitis can occur two to four weeks after giving birth, and affects one in 10 breastfeeding women. Mums who have these symptoms may need to see a GP for a course of antibiotics.

Some of these difficulties can be overcome with help and support. Mums should be encouraged to breastfeed for as long as possible. Information, advice and support are widely available to help mums prolong breastfeeding (see useful websites).