Common breastfeeding problems and what helps: sore nipples, low supply and mastitis

Struggling with breastfeeding does not mean you are doing it wrong. Many people have pain, worry or exhaustion in the first weeks. The good news is that most of these problems can be solved with the right support. Stopping or continuing is your decision, and both are respected.

Cracked and sore nipples

A little tenderness in the first days is common. But sharp pain throughout a feed, cracks or bleeding usually mean the latch needs a second look.

• Check that your baby opens wide and takes in much of the areola.
• Do not pull your baby off the breast; gently break the suction with a clean finger first.
• Many people find a few drops of milk on the nipple, left to air-dry after a feed, soothing.
• Changing positions changes the pressure point.
• If pain does not ease within a few days, ask a midwife or lactation consultant to check the latch. Sometimes things like a tight tongue-tie affect latch; only a doctor can assess that.

Worry about low supply

Many people worry that they do not have enough milk, and most of the time the worry is not based on a real shortage. Frequent feeding, a fussy evening period or a soft-feeling breast do not mean low supply.

Signs that your baby gets enough: enough wet diapers, regular stools, alertness when awake and suitable weight gain at check-ups.

• The most effective way to build supply is frequent, effective feeding.
• If needed, expressing by hand or pump after feeds supports production.
• Resting, drinking water and eating regularly help.
• If you worry about weight gain, do not start supplements on your own; talk to your pediatrician first.

Engorgement and blocked ducts

When your milk comes in, or when feeds are spaced out, breasts can become hard and painful. This is called engorgement.

• Keep feeding often and comfortably.
• A warm compress before and a cool one after feeds may soothe.
• Support the breast with gentle massage toward the nipple; do not press hard.
• Express just enough milk to feel comfortable; emptying fully can increase production.

Mastitis: inflamed breast

If engorgement does not clear, the breast tissue can become inflamed. You may notice a red, warm, painful area, chills and fever.

• See a doctor; sometimes treatment is needed.
• Continuing to feed or express is usually advised; discuss details with your doctor.
• Rest and fluids help recovery.

What you can do

• Before birth, find the contact details of a lactation consultant or a breastfeeding support group.
• Help your partner learn about breastfeeding too.
• Do not blame yourself after a hard day; the next feed is a new chance.
• You can log feeding times and wet diapers in our baby tracking app, Mini Hug, and take them to your appointment.

Expressing and storing milk

Sometimes you may need to express milk: returning to work, being apart from your baby or easing engorgement. You can express by hand or with a pump, whichever feels easier. Keep your hands and equipment clean. For how long milk can be stored at room temperature, in the fridge and in the freezer, check a current health source and confirm the times with your doctor or midwife. Finding it hard at first is common; getting only a little milk in early tries is normal.

When to contact your doctor

• A red, warm, hard and painful area on the breast, or fever above 38 °C
• Deep cracks, bleeding or pain that does not ease
• A hard lump on the breast that does not shrink within a few days
• Few wet diapers, poor weight gain or extreme sleepiness in your baby
• Bloody or pus-like discharge from the nipple
• Sadness and hopelessness that grow during the breastfeeding period

For very high fever, shaking chills, fainting or breathlessness, call 112 (or your local emergency number).

This article is for information only; your doctor's and midwife's advice for your situation always comes first.