Breastfeeding: Common Issues and Support Services

If your baby is not latching on well, your nipples may get sore. When you bring your baby onto your breast, make sure they have a wide-open mouth to get your breast and as much of your areola (the dark area around your nipple) into their mouth as possible. If your baby is sucking only on your nipple, break the suction by placing your pinky finger gently into the corner of their mouth and remove your breast from their mouth. Then, try to latch them on again.

Ask a lactation specialist for help in getting a good latch.

If you are experiencing sore nipples, you can also try the following:

• Try a different breastfeeding position.
• Nurse more frequently for shorter periods of time.
• Start on the less sore side first.
• After feedings, coat your nipples with breast milk and let them air dry.

Your breasts will swell when you start to make more milk. This is normal and will usually happen within the first few days after giving birth. If your breasts swell so much that they feel too full and painful, this is called engorgement.

To prevent engorgement, make sure your baby is latched on well and feeding frequently. Ask your lactation consultant for help in relieving engorgement and preventing it from happening again.

If you are engorged, try the following:

• Continue to feed or express your milk frequently — eight or more times in a 24-hour period. Try not to go more than two hours without nursing or expressing breast milk.


• Alternate which breast you use to start feeding and offer both breasts at each feeding, without time limits. Your breasts should feel softer (not hard or tight) after a good feeding.


• Express some milk before you offer the breast to relieve discomfort and reduce swelling. This can also help your baby latch on if they are having trouble because of the swelling.


• Shower or apply warm, moist washcloths to your breasts before you breastfeed. If you can, gently massage your breasts towards the nipples. After you feed, apply cold washcloths or compresses.

Milk may clog the ducts and create blockages. This can feel as if you have a lump or marbles in your breasts, which can become red and painful to touch. The best way to clear a clogged duct is to continue to breastfeed, as babies are the best at moving milk.

To prevent clogged ducts:

• Continue to feed frequently — eight or more times in a 24-hour period.


• Drink plenty of fluids and get some rest.


• Make sure your bra fits properly and is not too tight.


• Avoid sleeping positions that put pressure on your breasts, such as sleeping on your stomach.

If you think you have a clogged duct, in addition to the tips above, try the following:

• Try not to go more than two hours without nursing or expressing your breast milk.


• Shower or apply warm, moist washcloths to your breasts before you breastfeed. You can also try soaking the breast in a bowl of warm water and massaging the clog.


• Before and during nursing, gently massage the breast over the area of the blockage and toward the direction of your nipple.


• Start feeding on the affected breast first, then offer the other breast. A baby will suck strongest when they start a feed and they can help clear a clogged duct. Try to keep the breast as empty as possible, but continue to offer both breasts.

If a clogged duct does not go away in a day or two, see your health care provider or lactation consultant.

Mastitis is a serious breast infection and should be addressed immediately. If you have a lumpy, painful red area on the breast and chills, aches or a fever, contact your health care provider or lactation consultant immediately. Your health care provider may prescribe antibiotics to treat the infection. Antibiotics commonly used to treat mastitis are safe for breastfeeding.

Start following the steps for resolving a clogged duct and contact your health care provider as soon as possible to discuss your treatment plan.