Troubleshooting Solutions for Every New Mother
Breastfeeding is natural, but it doesn’t always come easily. Most mothers face at least one challenge in the early weeks. Understanding common problems and their solutions can help you overcome obstacles and reach your breastfeeding goals. Remember: these challenges are temporary and solvable with the right support.
Sore Nipples
The Problem: Nipple pain is the most common breastfeeding complaint. While some tenderness during the first few days is normal, persistent or severe pain is NOT normal and indicates a problem that needs fixing.
Normal vs. Problem Pain:
- Normal: Mild tenderness for first 30 seconds of latch during first few days, then comfortable
- Problem: Severe pain throughout feeding, pain lasting after feeding, cracked or bleeding nipples, dreading feeds
Most Common Cause: Poor Latch The overwhelming majority of nipple pain results from baby not taking enough breast tissue into their mouth, causing friction and compression on the nipple itself.
Solutions:
Fix the Latch:
- Review proper latching technique (see our Positioning & Latching page)
- Wait for baby’s mouth to open WIDE before bringing baby to breast
- Ensure baby’s chin touches breast first
- Baby should take large mouthful of breast, not just nipple
- If it hurts, break suction and try again—never nurse through pain
Position Changes:
- Try different positions—sometimes a slight angle change makes huge difference
- Football hold often works well for sore nipples (better visibility and control)
- Ensure baby’s body is completely facing you (not twisted at waist)
Healing Sore Nipples:
- Let nipples air dry after nursing (or use hair dryer on cool setting)
- Apply expressed colostrum or breast milk to nipples—it has healing properties
- Use purified lanolin cream (like Lansinoh) after every feeding—no need to wash off before nursing
- Change nursing pads frequently to keep nipples dry
- Avoid soap on nipples—plain water only
- Wear soft, breathable bras or go braless when possible
Pain Relief:
- Take ibuprofen before nursing if needed (safe while breastfeeding)
- Apply cold compresses after nursing
- Some mothers find hydrogel pads soothing
When Should Pain Improve: With correct latch, nipple pain should significantly improve within 2-3 days and resolve within a week. If pain persists despite latch correction, other issues may be present (thrush, vasospasm, tongue-tie).
Low Milk Supply Concerns
The Problem: Many mothers worry they don’t have enough milk. However, true low supply is rare—most concerns are actually misunderstandings about normal newborn behavior.
Real vs. Perceived Low Supply:
Signs That Do NOT Mean Low Supply:
- Baby wants to nurse frequently (newborns eat 8-12+ times daily—this is normal)
- Baby nurses for short periods (some babies are efficient)
- Baby nurses for long periods (some babies are leisurely)
- Breasts feel soft (after first weeks, this is normal—doesn’t mean empty)
- Can’t pump much milk (pump output doesn’t reflect what baby gets)
- Baby is fussy in evenings (normal “cluster feeding” behavior)
- Baby suddenly wants to nurse more (growth spurt—feed more to increase supply)
True Signs of Low Supply:
- Fewer than 6 wet diapers per day after day 5
- Infrequent, scanty stools (after the first week)
- Baby not gaining weight appropriately (check with pediatrician)
- Very long feeds (over an hour) with baby seeming unsatisfied
- Baby completely lethargic and not demanding feeds
Solutions for Increasing Supply:
Feed More Frequently (Most Important): Milk production works on supply-and-demand. More frequent nursing = more milk production.
- Nurse at least 8-12 times in 24 hours
- Don’t watch the clock—let baby nurse as long as they want
- Offer both breasts each feeding
- Wake sleeping baby if going more than 3 hours between feeds during first weeks
Empty Breasts Thoroughly:
- Let baby finish first breast completely before offering second
- Breasts produce more milk when well-drained than when kept full
- Consider “switch nursing” during growth spurts (switch breasts several times during one feeding session)
Stay Hydrated:
- Drink to thirst (8-12 glasses daily)
- Keep water bottle with you at nursing station
Eat Well and Rest:
- Adequate nutrition supports milk production
- Lack of sleep and stress can impact supply
- Accept help so you can rest
Pump to Increase Supply: If baby isn’t effectively draining breasts, pumping after or between feeds can help:
- Pump after nursing to signal body to make more milk
- Or pump between nursing sessions
- Even if you get only drops, you’re telling your body to increase production
Avoid Pacifiers and Bottles Initially: In first 3-4 weeks while establishing supply, minimize artificial nipples. All baby’s sucking should be at breast to maximize milk production signals.
Consult Lactation Expert: If truly concerned about supply, see a lactation consultant. They can:
- Weigh baby before and after feeding to measure intake
- Assess latch and milk transfer
- Rule out anatomical issues (tongue-tie)
- Create plan to increase supply if needed
What About Supplements? Galactagogues (milk-boosting substances) may help but shouldn’t replace frequent nursing:
- Fenugreek: Common herb (start with 3 capsules 3x daily)—can cause maple syrup smell in urine
- Blessed thistle: Often combined with fenugreek
- Brewer’s yeast: In lactation cookies
- Prescription medications: Domperidone (not available in US) or metoclopramide—discuss with doctor
Always prioritize frequent, effective nursing over supplements.
Engorgement
The Problem: Your breasts feel extremely full, hard, hot, and painful. This typically happens when milk first comes in (day 3-4) but can occur anytime milk isn’t removed regularly.
Solutions:
Before Nursing:
- Apply warm compress or take warm shower to encourage letdown
- Gently massage breasts toward nipple
- Express a little milk by hand to soften areola if too full for baby to latch
Nurse Frequently:
- Feed baby every 2 hours or more often
- Don’t skip or delay feedings
- Offer breast whenever baby shows interest
After Nursing:
- Apply cold compresses or ice packs (in cloth) to reduce swelling
- Cold cabbage leaves inside bra (really!)—replace when wilted
- Take ibuprofen for pain and inflammation
If Extreme:
- May need to pump just enough to relieve pressure (don’t fully empty, which signals body to make more)
- Hand expression is often more effective than pump for severe engorgement
Prevention: Frequent nursing in the early days prevents severe engorgement. If baby isn’t nursing well, pump regularly to prevent engorgement and protect supply.
Blocked Ducts
The Problem: A tender, firm lump in your breast, possibly with overlying redness. Milk isn’t draining from that area. No fever (that would indicate mastitis).
Causes:
- Inadequate milk removal
- Pressure on breast (tight bra, sleeping position)
- Skipped feedings
- Sudden decrease in nursing
Solutions:
Nurse Frequently:
- Offer affected breast first when baby is hungriest and sucks strongest
- Position baby with chin pointing toward blocked area for best drainage
- Nurse from all positions to drain all areas
Heat and Massage:
- Apply warm compress before nursing
- Massage firmly but gently from blocked area toward nipple while nursing
- Take warm shower and massage under water
Dangle Feeding:
- Position yourself on hands and knees over baby, letting gravity help drain the affected area
- Awkward but effective!
Rest:
- Blocked ducts often occur when mother is run down
- Rest as much as possible
Don’t Wear Tight Bras:
- Avoid underwires
- Wear comfortable, properly fitting bra or none at all
Resolution: Most blocked ducts clear within 24-48 hours with frequent nursing and massage. If not improving after 24 hours or if fever develops, see your doctor (may be developing mastitis).
Mastitis (Breast Infection)
The Problem: Inflammation or infection of breast tissue causing flu-like symptoms: fever (over 38.5°C/101.3°F), chills, aching, breast pain, hot red area on breast. Feels like you’re getting the flu.
Causes:
- Untreated blocked duct
- Bacteria entering through cracked nipple
- Inadequate milk removal
- Exhaustion and stress
Solutions:
Continue Breastfeeding:
- Do not stop nursing—this is essential for clearing infection
- Breast milk is safe for baby even with mastitis
- Stopping nursing can lead to abscess
- Nurse frequently from affected breast
See Your Doctor:
- You likely need antibiotics—call doctor same day
- Take full course of antibiotics prescribed
- Antibiotics used are safe for breastfeeding
Rest Immediately:
- Go to bed with your baby
- Accept all offers of help
- Mastitis is your body’s way of saying you’re doing too much
Pain and Fever Relief:
- Take ibuprofen (safe while breastfeeding) for pain and fever
- Apply warm compress before nursing, cold after
Hydration:
- Drink plenty of fluids
Prevention:
- Frequent, complete breast emptying
- Treat blocked ducts immediately
- Don’t delay or skip feedings
- Rest when possible
- Eat well to support immune system
When It’s an Emergency: Seek immediate care if:
- Symptoms worsen rapidly
- High fever persists despite antibiotics after 48 hours
- Abscess suspected (very swollen, tender area)
Thrush (Yeast Infection)
The Problem: Fungal infection affecting mother’s nipples and baby’s mouth. Causes sudden, severe, burning nipple pain during and especially after feeding that doesn’t improve with latch correction.
See our dedicated Thrush/Candidiasis page for complete information.
Key Points:
- Sudden severe pain unexplained by latch issues
- Shiny, itchy, or flaky nipples
- Baby has white patches in mouth or red diaper rash
- Both mother and baby must be treated simultaneously
- Continue breastfeeding through treatment
Oversupply and Fast Letdown
The Problem: Too much milk can cause issues: baby gulps, chokes, pulls off breast, very fussy, gassy, green frothy stools. While many mothers wish for this “problem,” it’s genuinely challenging.
Solutions:
Block Feeding:
- Feed from only one breast per feeding (or 3-4 hour period)
- Allows other breast to get fuller, signaling body to slow production
- If other breast becomes uncomfortably full, express just enough to relieve pressure
Laid-Back Position:
- Reclined nursing lets gravity slow milk flow
- Baby has more control
Pop Off During Letdown:
- When letdown occurs (you’ll feel it, baby will start gulping), remove baby
- Let milk spray into towel until flow slows
- Relatch baby for calmer feeding
Avoid:
- Over-pumping (increases supply)
- Frequent breast switching (baby gets foremilk only)
Most oversupply issues resolve naturally after first few months as supply regulates.
Getting Help
Many breastfeeding challenges can be solved with proper support. Don’t wait days or weeks hoping problems resolve—get help early when issues are easier to fix. Lactation consultants exist for exactly this reason—use them!
Remember: Breastfeeding is a learned skill. Be patient with yourself and your baby. Most challenges that seem overwhelming in week one become distant memories by week four.