Breastfeeding problems

You may have sore nipples until your breasts become used to breastfeeding. Nipples are usually most sore in the first week after baby’s birth. They should feel better 7 to 10 days after baby’s birth.

During that first week the initial soreness should wear off 15 to 30 seconds after the baby has latched. If it does not, ask your midwife for help. You may need help with positioning and latching your pēpi (baby).

If nipple soreness continues into the second week, or gets worse rather than better, get help. If there is a problem with baby’s latch this can be corrected. Or, the soreness may be due to another issue.

Many people’s breasts start to feel full, sore and hard as their milk supply increases (the milk 'comes in'). This feeling is most common 3 to 5 days after baby’s birth. If your breasts are really sore and hard, and feel too full, it helps to put something cool on them after a feed. This can reduce the hot, swelling feeling.

If your pēpi is finding it tricky to get a good latch, you can hand express a little milk first. This will soften the areola (the darker area around the nipple) so that it is easier for pēpi to latch — and less painful for you.

Talk to your midwife or doctor straight away if:

• you feel unwell, and
• part of your breast is red or feels sore, hot or lumpy.

You may have a local inflammation caused by a blocked milk duct or a more general breast infection (mastitis). It is better for you and pēpi if you continue breastfeeding.

It is important to empty the sore breast often. If this is too hard to begin with, feed from the other side until the sore side 'lets down'. Be sure to empty the sore side by feeding or expressing. Massaging the sore area gently at the same time can help too. Emptying the breast will help to reduce the blockage and keep your milk flowing. It is important that you have bed rest for at least 24 hours and that you drink plenty of fluid.

Applying a cold pack to the sore area on the breast can help and you can also take paracetamol to feel more comfortable. Your midwife or doctor may prescribe an antibiotic to reduce the inflammation, but if caught early this is not usually necessary. Wear a supportive bra that does not cause painful pressure.

Some babies will be able to empty both breasts every time they feed. Others will be full after one. Although babies often prefer one breast, make sure that baby feeds from both breasts throughout the day to avoid blocked milk ducts.

Some breastfeeding problems may be caused by a tongue tie. To make sure that you and your pēpi receive support with this, your midwife or Lead Maternity Carer can offer to refer you to a health professional who is an expert in breastfeeding. This is usually a Lactation Consultant, who can also provide support and advice with latching and maintaining breast feeding.

Sometimes you may feel as if you do not have enough milk. This is hardly ever the case. Babies normally have some breastfeeds close together (this is called cluster feeding). They also breastfeed more often when they are going through a growth spurt. Sometimes they are fussy and unsettled, but that is just because they are new babies and going through normal newborn unsettled periods.

Remember that the more often that breast milk is removed from the breast by your pēpi, the more milk will be produced.

You need to look after yourself while breastfeeding, which might mean asking others to help you too. Make sure that you eat a well balanced diet and drink lots of water. Avoid alcohol, caffeine and smoking, as these can affect your milk supply and your baby’s health.

Looking after yourself (internal link)