Barriers to breastfeeding and how to overcome them

Soothing soreness, addressing milk supply and getting help are keys to success

Young mom nurses her newborn baby while in the child's nursery.

I’ve had many women tell me breastfeeding has been one of the most challenging things they have ever done. But they all said they are glad they persisted and succeeded.

So if you are breastfeeding, don’t be discouraged. It takes some time and patience as you go through the adjustment period. The rewards will be momentous for you emotionally and for your baby physically and emotionally.

Here are some suggestions for handling the common problems moms encounter in the early stages of breastfeeding.

Soothing sore nipples

Breastfeeding should feel comfortable once you and your baby have found a good latch, which helps ease nipple pain and discomfort. Follow your baby’s lead. If your baby sucks only on the nipple, gently break the suction to your breast by placing a clean finger in the corner of your baby’s mouth. Then try again to get your baby to latch on correctly. Change positions every time you breastfeed to find one that makes it easier for your baby to get a good latch.

Breast milk has natural healing properties in it; so let your nipples air dry after feeding. This will help eliminate sore, cracked nipples. There is no need to express milk and rub it on your nipples, as your baby’s mouth is already filled with breast milk that will serve the same purpose.

Use purified lanolin cream or ointment specifically made for breastfeeding on your nipples. Wear bras and clothes that are loose-fitting, change nursing pads frequently to avoid trapping in moisture and avoid using soap on your nipples. Water is all that is needed to keep your nipples and breasts clean.

Worrying about milk supply

Most mothers make plenty of milk, but many still worry that their baby isn’t getting enough milk. The best way to measure that is by checking your baby’s weight and growth. If you want daily reassurance, purchase a home scale for baby. Your baby will also be weighed at doctor appointments, and your doctor will tell you if your baby is gaining weight appropriately.

  • Nursing longer and more often will help build up your supply.
  • Breastfeed often and let your baby decide when feeding is done.
  • Offer baby both breasts every feeding.
  • Let your baby stay at the first breast until they are no longer sucking and swallowing, then offer the second breast.

Do not supplement your breast milk with formula or cereal, especially in the first six months. If your baby’s interest in breastfeeding declines, your milk supply will decrease. If you feel you must supplement feedings, talk to your doctor or a lactation consultant first.

Know what to expect in terms of baby’s breastfeeding habits. From 6 weeks to 2 months old, your baby is getting better at breastfeeding and may not nurse as long. Your breasts may not feel as full. That is normal. During growth spurts, your baby may nurse longer and more often. These spurts usually occur around 2 to 3 weeks, 6 weeks and 3 months, but they can happen at any time.

Controlling milk oversupply

If your breasts are taxed by having more milk than your baby takes, try these ideas.

  • Feed your baby before they are overly hungry and burp them often.
  • Breastfeed on one side for each feeding.
  • Offer the same breast for at least two hours until the next full feeding, gradually increasing the length of time per feeding.
  • If the other breast is too full before you are ready to switch to it, hand express until pressure reduces. A cold compress or washcloth can reduce discomfort too.

Reducing engorgement

Your breasts become larger, heavier and often tender when you are breastfeeding. When your breasts feel very hard and become painful, this is called engorgement, which is caused by milk buildup. Engorgement can cause breast swelling, breast tenderness, warmth, redness, throbbing, flattening of the nipple and even a low-grade fever. It can also lead to plugged ducts or breast infection, so take steps to avoid it.

  • Wear a well-fitting bra and be sure it is not too tight.
  • Breastfeed frequently, especially in the first five days after giving birth when engorgement is most likely to occur.
  • Allow your baby to feed for as long as they like and be sure they are well attached.
  • Breastfeed often on the affected side to help remove the excess milk.
  • Massage the breast and use cold compresses on it between feedings to ease the discomfort.
  • Get enough rest, proper nutrition and fluids.

Reaching out for help

Get help from a lactation consultant earlier rather than later. Don’t wait until discouragement sets in. A lactation consultant can help you find the right solutions for you and your baby’s needs and work with you down the line if you encounter other challenges.

Talk to a lactation consultant or your doctor immediately if:

  • Your baby isn’t latching properly.
  • Your nipples are so sore you are delaying breastfeeding or crying while breastfeeding.
  • You are thinking about using breast aid products such as hydrogel pads for nipple soreness or a nipple shield to cover the breast nipple while breastfeeding. Some of these products are not recommended in certain situations.

Other possible breastfeeding challenges include plugged ducts, breast infection, fungal infections and nipple irregularities such as inverted, flat or very large nipples that require adaptation for easier breastfeeding. Some babies also go on a “nursing strike,” where they will breastfeed well for several months and then suddenly beginning to refuse the breast. That doesn’t mean the baby is ready to wean. It means something is wrong and your baby is trying to tell you.

Don’t go it alone if you encounter difficulties nursing. A little bit of help can make the difference between giving up in discouragement or successfully breastfeeding for as long as you want.

Sanford Health offers support for every mom, whether you’re breastfeeding, pumping or formula feeding. Learn more about lactation services.

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Posted In Children's, Health Information, Women's