Breastfeeding problems

Breastfeeding problems like sore nipples can happen. If you experience any pain when breastfeeding, talk to a health professional.  

Sore or damaged nipples

The most common reason for sore nipples is a poor attachment and the baby’s position at the breast. 

Other causes for nipple pain may be: 

• skin conditions such as eczema or a skin infection
• use of nipple shields
• vasospasm (which is when blood vessels tighten)
• breast engorgement
• you are not getting enough nutrition
• your baby's sucking is too strong 
• a problem in the baby’s mouth, such as tongue tie (when their tongue can’t move as much as it should). 

Tips to reduce pain and damage:

• Help your baby attach properly to your breast.
• Regularly change the way your baby is positioned on your breast when feeding.
• Express the breast milk and gently rub onto your nipple after a feed (expressing is the term for getting milk out of the breasts when a baby is not breastfeeding).
• Use a warm compress to ease the pain, before and during the feed (a compress is a cloth or other material that’s pressed against the skin).
• Make sure your nipple is dry before getting dressed.
• Change breast pads regularly.

Video by Raising Children Network:  How to breastfeed: breastfeeding positions | Raising Children Network

Watch these breastfeeding videos for more help.

If the correct position and latch on the breast does not reduce your nipple pain, seek professional help as soon as possible. 

Breast engorgement

It may become difficult for your baby to attach to your breasts and areola (the dark area around your nipple) when they become engorged (larger).

Tips:

• Express or squeeze out some milk with your hands, so your breasts feel more comfortable. This can soften the areola, making it easier for your baby to then attach better.
• Start each feeding on a different breast. For example, if you fed from the left breast 2 to 3 hours ago, start the next feeding on the right breast. 
• Take a warm shower or put a warm compress on the breast before and during feeding. This can help get the milk flowing and start a let-down (this is when your breast releases milk once the baby sucks). 
• After feeding, have a cool shower or put a cold compress or cold bra (cooled in the refrigerator) on your breast to reduce the heat and discomfort. 
• If engorgement continues for more than 1 to 2 days, especially in the early weeks of breastfeeding, try pumping both breasts completely after your baby feeds. Only do this once. It can relieve pressure and help the milk come out easier. Doing it more than once can increase your milk supply too much.

When you cannot get your baby to latch at the breast 

• You can give expressed breast milk using a cup, spoon or bottle. Go to the section on expressing breast milk and supplementary feeding to help you with this. 

Watch this video on breastfeeding challenges.

Video by Raising Children Network: https://raisingchildren.net.au/newborns/videos/breastfeeding-challenges-video

Managing mastitis or blocked ducts

Mastitis is inflammation or swelling of the breast tissue. It happens when milk is not drained well from the breast, leading to the milk ducts becoming blocked. Sometimes, the breast tissue also gets infected. About 1 in 5 mums get mastitis, more commonly with their first baby. 

Early warning signs 

The breast will usually be red, swollen, hot and painful. The skin may look tight and shiny and red. You will feel unwell, with muscle aches and fever. 

What you can do

• Wash your hands before and after breastfeeding. 
• Breastfeed frequently and start on the affected side first. If that side hurts too much, start on the other breast and switch to the affected breast once the milk starts flowing.
• Make sure the baby has a good latch and is positioned well when feeding. 
• Position your baby at the breast with the chin or nose pointing to the blocked area, as this will help drain the affected part. 
• Gently massage the affected breast during the feed. Massage from the blocked area towards the nipple. You can try using a warm compress or cloth on the affected area before and during the feed and apply a cold cloth after the feed. 
• Get plenty of rest and fluids. 

If these steps do not help with the mastitis within 24 to 48 hours or the symptoms get worse, talk to your family doctor or child and family health nurse.

Fussy feeding or breast refusal

Why are they fussing?

Sometimes your baby will fuss or refuse to breastfeed. Read more about the reasons your baby may be fussy here:

Getting support

If you are struggling to understand what works for you and your baby, or you think your baby may have a serious issue, here are some services (mostly for free) you can contact: