10 Common Breastfeeding Issues And Solutions

Lactation Consultant, Rebecca Agi, talks about the most common breastfeeding issues she encounters in her practice and how to manage them.

crying baby refusing to latch

Breastfeeding isn’t always easy. Especially in the early days. There can be a whole host of reasons as to why you may be experiencing difficulties. Don’t be discouraged. It is really common for new moms go through an adjustment period as they learn how to breastfeed and tune in to their baby’s needs.

In this article we will discuss the 10 most common breastfeeding issues and solutions for:

  1. Engorged breasts
  2. Sore nipples
  3. Sleepy baby
  4. Back pain
  5. Overactive letdown
  6. Breast preference
  7. Leaky breasts
  8. Plugged ducts
  9. Nursing strike
  10. Bottle refusal


10 Breastfeeding Issues & Solutions


  1. Engorged breasts

Many women experience engorgement as milk volume increases between the second and fifth day after birth. As milk changes from colostrum to more mature milk, the breasts may feel swollen, hard, heavy and/or painful.

Solution: Regular and frequent breast feedings are the best way to prevent and resolve engorgement. If your tot is having difficulty latching on, hand express some milk first. Expressing even a few drops can help soften your areola and allow for a deeper latch. If that’s not enough, apply cold compresses to your breasts between feedings to help reduce swelling and relieve pain. With proper treatment, engorgement symptoms typically subside within 12-48 hours. If engorgement is not resolved or if your tot is unable to latch, be sure to contact your lactation consultant or health care provider.

  1. Sore nipples

Blisters, scabs, cracks, or bleeding are not normal when breastfeeding and are signs that there is a problem. Many women experience some nipple tenderness during the early days of breastfeeding, but abrasions and cracks need closer attention. Nipple soreness can also be a sign of unusual anatomy in the baby like tongue-tie, which limits a baby’s tongue movements and can cause painful breastfeeding. Whether you experience nipple soreness early on or later, a visit with a lactation consultant is always recommended to help get to the root of the issue.

Solution: To treat your pain until you can get help, follow these steps:

  • Begin each feeding on the breast that is less sore. If both breasts are sore, apply a clean warm, wet washcloth on the breast and gently massage from the chest wall toward the nipple area to start the flow of milk.
  • Rub expressed breast milk onto the nipples after feedings. Breast milk has antibacterial properties that help to promote healing.
  • Apply a natural nipple ointment or a hydrogel dressing between feedings to help protect nipple tissue.
  • If nursing is too painful, consider giving your nipples a break by pumping every 2-3 hours in place of feedings for 24 hours. A hospital-grade electric breast pump is the easiest, most effective pump for this use.
  1. Sleepy baby

Many newborns will let their parents know when they need to feed, but some are too sleepy to wake up on their own. In the newborn’s first two weeks, or until the baby has regained birth weight, it’s really important to gently wake the baby every three hours for a feeding. Labor drugs, maternal medications or jaundice all contribute to sleepiness in newborns.

Solution: If you have a really sleepy baby, try undressing him so he’s only in a diaper and place him skin-to-skin for breastfeeding. Breast massage and compressions during feedings can help increase the flow of milk and keep the baby awake and interested. Changing the baby’s diaper while talking or singing is also a wonderful way to wake him up.

  1. Back pain

Proper posture and alignment are so important when it comes to breastfeeding. Lots of moms experience shoulder and back pain while breastfeeding simply because they hunch forward when breastfeeding. Sound familiar? Straining the muscles in the neck will quickly lead to shoulder and back pain so be sure to make the following adjustments.

Solution: Always bring baby to breast, not breast to baby. This simple modification can make the world of a difference. Investing in a small footstool is also helpful since elevating your feet can give you more of a lap, making feedings more comfortable. The footstool is especially helpful if you’re petite. A nursing pillow can also be helpful for alleviating back and shoulder strain.

  1. Overactive letdown

A mother with an overabundant milk supply makes much more milk than her baby needs. As a result, her milk flows too fast for the baby to manage. If your baby gasps, chokes, coughs, arches his back and sputters when your milk ejects, you probably have overactive letdown.

Solution: A different nursing position could be all your baby needs. To help your baby adjust to overactive letdown, try nursing in an “uphill” position so that gravity can work against the flow of milk. You can nurse in a cradle or football hold while leaning back or lying down; just make sure the baby’s head is above the level of the nipple. Your baby might take in extra air with an overactive letdown and may need to be burped more frequently. 

  1. Breast preference

It’s not uncommon for babies to have periods of preferring one breast to the other when nursing.

Solution: To get your baby nursing on the less preferred side, experiment with different nursing positions, try expressing some milk to give the baby an instant reward when he latches, or slide the baby over to the less preferred side without changing the position of his body. For example, if you start out in the cradle position on the right side (preferred side), slide the baby over into the football position on the left side. This won’t change the baby’s body position and may even help the baby have a more comfortable feeding. It may take some time, but most babies will eventually accept the less-preferred breast.

  1. Leaky breasts

When your breasts are very full or when you are away from your baby and miss a feeding, your breasts will start leaking. Leaky breasts are your body’s way of telling you that you should either pump or breastfeed soon.

Solution: To prevent wet spots on your clothing:

  • Avoid letting your breasts get overly full.
  • Wear disposable or cotton breast pads like Kushies Nursing Pads. Just make sure to change your pads when they become wet.
  • If you don’t have nursing pads, use your elbow to apply direct pressure to your nipple when you feel milk starting to flow.

After about six weeks of breastfeeding, most women find that leaking becomes less of an issue since the hormone levels have adjusted to breastfeeding.

  1. Plugged ducts

When milk sits in the breast for too long it can thicken and create a tender spot, reddened area, or sore lump on the breast known as a plugged duct. Plugged ducts often occur when a baby starts sleeping through most or all of the night, or when a mother misses a feeding or wears a tight-fitting bra.

Solution: Frequent and thorough feeds are key to preventing and treating plugged ducts since the feeds keep the milk moving. It’s always recommended to start with the sore side first. Gentle breast massage can stimulate the milk flow. When the milk is flowing, massage toward the nipple to help move the plugged milk toward the nipple and then out. The thickened milk is perfectly safe for the baby to ingest.

Women who suffer from recurring plugged ducts are recommended to take 3600-4800 mg of lecithin per day. Lecithin helps prevent breast milk from thickening in the milk ducts but just be sure to consult your doctor before starting any supplements.

  1. Nursing strike

If your tot has been nursing happily for months and suddenly stops nursing, he’s probably on a nursing strike. A nursing strike doesn’t mean your tot wants to wean; weaning is a gradual process that could take several weeks or months. A strike is something that comes on abruptly, but usually only lasts a few days.

Solution: To get your tot back in the nursing groove, you can start by providing skin-to-skin contact by placing your baby’s bare torso against your chest. Providing a soothing and relaxed environment can help your baby accept the breast again. Your tot might also be more willing to breastfeed if you try a new nursing position. If you usually nurse sitting in a chair, try laid-back nursing. Laid-back nursing elicits a baby’s natural breastfeeding instincts while gravity helps keep the baby in place. Unlike other positions, babies can’t arch away in this one. Lastly, try nursing the baby in his sleepLost of babies take the breast more willingly when in a relaxed, sleepy state.

Almost all nursing strikes end happily. With a little patience and persistence, everything should smooth out within a few days. The most important thing to do during this time is to continue feeding your baby and to protect your milk supply by pumping or expressing milk as often as your baby normally feeds.

  1. Bottle refusal

Getting a breastfed baby to take a bottle is not always as easy as it sounds. If you eventually want to give your baby a bottle, it’s recommended to wait until your milk supply is fully established and breastfeeding is going well. Introducing the bottle somewhere between 3 or 4 weeks is a good idea. Sometimes waiting too long can result in a baby who might strongly refuse it altogether.

Solution: To begin, have someone else introduce the bottle. Some babies will refuse the bottle if they know mom is available for breastfeeding. Try different bottles and nipples to see which works best for your baby. The best nipples are ones that require the baby to keep his mouth open wide while sucking, just like the Comotomo bottles. Your baby will usually accept a bottle if not too hungry and if the bottle is not forced. Also be sure to check out the Paced Bottle Feeding Method, a simple technique that is easy for parents or caregivers to master.


Disclaimer: This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.


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