5 Common difficulties with breastfeeding

Establishing breastfeeding can sometimes be hard work, but it gets better and easier with time. Problems like engorged breasts, inflamed breast tissue, and cracked nipples are all too common, but can be easily cured. Stick with it, and the process will be immensely rewarding, and use these tips to help you get through the discomfort.

It may feel odd at first, but it shouldn’t hurt


The key to breastfeeding is getting the right latch. Your baby should have a wide-open mouth and should take in the areola as well as the actual nipple. If the shape of your nipple is distorted after a feed, your latch may need adjusting, and if it hurts when your baby is feeding, it is more than likely because he or she isn’t latched on properly. Move the baby to your breast, rather than moving your breast to your baby’s mouth.

Engorged breasts are common when milk comes in


Sometimes when your milk comes in, your breasts can become painfully full and hard, and it can be difficult for your baby to latch on. Keep trying to feed, as that is the best way to drain your breast. To make it easier for your baby to latch on, you could try expressing a bit of milk before they feed – either with a breast pump or by hand-expressing. Try expressing in a nice warm bath. Many women find alternating hot and cold compresses can help ease the pain of engorgement. Cold Savoy cabbage leaves from the fridge are ideal, as are hot water bottles wrapped up in a towel.

Inflamed breast tissue can make feeding difficult


Mastitis is when your breast tissue becomes inflamed, possibly because of a blocked milk duct. Your breast may become tender and swollen and develop angry red patches, and you may develop flu-like symptoms. The best thing is to keep feeding your baby, as engorgement will make the symptoms worse, and to rest as much as you can. You should also talk to your GP to find out if you need a course of antibiotics, or to discuss what painkillers are appropriate.

Cracked or bleeding nipples are usually caused by an incorrect latch


This will almost certainly be caused by an incorrect latch; keep trying to get it right. Ask your midwife to watch, as she should be able to help you. Speak to your GP about which painkillers are safe to take during breastfeeding, or try using AVENT nipple shields, which can offer immediate relief. Applying nipple cream immediately after a feed can also be a good idea, and avoid using soap on your nipples when you wash.

Extreme nipple sensitivity could mean you have thrush


If you have sharp, shooting pains while feeding that increases over the course of a feed (and sometimes continue for up to an hour after the feed is over), you may have thrush. Another symptom is itchy nipples, or extreme nipple sensitivity – even to clothing. Your nipple may be pinker or shinier than usual, and the roof of your baby’s mouth may have white patches. You both need to be treated, as otherwise the infection will continue to be passed between you – make an appointment with your GP as soon as possible.

Leaking breasts


Leaking breasts are the norm, not the exception. One breast may leak during feeding, when the baby is busy nursing on the other. You may leak during the early days of breastfeeding, or later, when your baby is weaned. For some, leaking can even start during pregnancy! The point being, leaky breasts are common and nothing to worry about. Breasts may leak due to two reasons. They may overflow because too much milk is being produced, or the letdown reflex is being triggered. Too much milk can be eased by nursing more frequently. If the baby isn’t hungry, you can just pump for comfort. Be careful not to pump too much also as that will just boost your milk supply. It is important to relieve the pressure of an engorged breast because otherwise it could lead to mastitis or a clogged breast duct. Letdown reflex is triggered by certain stimuli. For example, your baby’s cry, smell, or sight may trigger a release of oxytocin, which leads to leakage.


If nursing or pumping aren’t always viable options, you can apply pressure to the breasts by crossing your arms and limiting the flow. Alternatively, you can use nursing pads to absorb the leaks. When going out, dress for leaks, and pack extras like a jacket or sweater which you can easily wear if you happen to leak. 

Poor breastfeeding latch


A good breastfeeding latch is essential to good breastfeeding. That goes without saying. However, a poor latch can be the main culprit behind several breastfeeding problems. These problems include breast engorgement, plugged milk ducts, or even a breast infection such as mastitis. Here are signs of a poor breastfeeding latch.


  1. Your baby is latching only to the nipple, instead of the nipple and the surrounding areola
  2. You cannot hear or see your baby swallow
  3. You hear a clicking or smacking noise, as the baby tries to suck to no avail
  4. Your child is sucking in their cheeks, instead of them being full and rounded
  5. Your baby does not have fish lips (turned out and flat against the breast)
  6. You experience breastfeeding pain as your nipples become sore
  7. Breast milk supply is low, and your breasts are still engorged after every feed
  8. After breastfeeding, your child seems unsatisfied, and continues showing signs of hunger
  9. Your newborn is losing weight, or not gaining weight at a healthy rate


If your baby shows signs of a poor latch, break the suction and try to latch again. However, if you continue to have problems, please consult a healthcare professional, or a lactation consultant.

Anatomical mouth problems


Breastfeeding difficulties, such as a poor latch, may arise because of a defect in the anatomical structure of the mouth. Here are the most common mouth problems that babies are born with:

  1. Cleft lip/Cleft palate – There are three kinds: lip, palate, or lip and palate. It is an opening or split in the lip, or the roof of the mouth (or both).  A very common birth defect, it doesn’t allow the baby to form a sealed oral cavity to generate suction.
  2. Short frenulum – Widely known as a ‘tongue-tie’ or ‘short tongue’, it refers to the tissue that attaches a baby’s tongue to the bottom of the mouth. A simple procedure can be done to cut the frenulum, thereby enabling the baby’s tongue to move freely.
  3. Retracted jaw/tongue – Sometimes, in order to improve a latch, you may need to make sure the baby’s head and neck are properly aligned. This can be done through exercises where you stroke the baby’s tongue from the tip to the back, and start wearing a nipple shield.
  4. Micrognathia – A condition where the chin may look recessed due to a small and ‘pushed back’ jaw. The tongue is positioned further back with relation to the oral cavity. Because of the smaller jaw, the baby’s tongue may not be able to come forward adequately enough to be positioned under the nipple. One technique that helps is gently pulling forward under the jaw.

Poor milk supply


Consistent weight gain will reassure you that your baby is on the right track. However, if that isn’t the case, it might be due to a low milk supply. Poor milk supply can be due to several reasons. These are:

  1. Prior breast surgery – These days, both breast reduction and enhancement surgeries are common, for medical or cosmetic reasons. However, it may have damaged the milk ducts in the nipple. This is a sign that you may need to supplement milk.            
  2. Hormonal birth control – Many moms who are on hormonal birth control notice a drop in milk supply, especially before the baby is four months old. The first step is to stop the medication. However, talk to your doctor before doing so, and consider the alternatives such as prescription medication, herbal supplements, or pumping.
  3. Not feeding at night – Being a mom is exhausting, and you deserve a good night’s sleep. But without overnight feedings, milk supply starts to drop. This is because the levels of prolactin are higher during night feedings. If you are skipping out on night feedings, consider adding one or two back into the feeding schedule.
  4. Insufficient glandular tissue – Some women’s breasts may not have enough milk-making ducts to do their duty. Talk to your doctor, or breastfeeding expert, as you may need to take a prescription, or start supplementing.

Nipple confusion


This refers to the odd phenomenon when babies who are used to being bottle-fed have a hard time getting back on the teat. They have difficulty latching on, as the different size and texture may not be agreeable to them. In order to avoid nipple confusion, make sure your baby gets in the groove of breastfeeding. Ideally, they should be three weeks (or however long it takes) into breastfeeding, before being given the bottle.

Newborns learn quickly that they don’t have to work as hard getting milk from a bottle when compared to breastfeeding. With a bottle, gravity is on their side, and they can suck with their lips until they get all the milk they want. Feeding from the breast is a fine art as they have to take the nipple far back into their mouth and use the tongue to pump out the milk (which often takes a minute or so before initiating). Babies are opinionated more than confused. They prefer the bottle as it is an easier way to feed. All you have to do is make sure they are well adept at feeding from the breast before you get them started on feeding from the bottle. Otherwise, you may have to face problems with latching and preference changes. 


Please be aware that the information given in these articles is only intended as general advice and should in no way be taken as a substitute for professional medical advice. If you or your family or your child is suffering from symptoms or conditions which are severe or persistent or you need specific medical advice, please seek professional medical assistance. Philips AVENT cannot be held responsible for any damages that result from the use of the information provided on this website.

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