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Troubleshooting Breastfeeding Issues

It is not uncommon for those new to breastfeeding to encounter challenges. The good news is that these challenges can be overcome! The best way to diagnose and treat these complications is to get help from our Breastfeeding Peer Counselors. They are here to help you succeed in meeting your breastfeeding goals. Their services are free to all WIC participants.

Plugged Ducts & Breast Infections

Issues like plugged ducts, breast infections, and thrush can create challenges to your breastfeeding. However, these are temporary conditions that can be relieved, so you can get back to breastfeeding comfortably. 

Plugged Ducts

Signs and symptoms: 

  • A tender, sore knot or lump in the breast
  • Typically happens in one breast at a time

What to do:

  • Take a hot shower.
  • Apply warm, moist cloths over the affected breast.
  • Empty the affected breast first.
  • Massage your breast during feeding, starting at the plugged duct down toward your nipple.

Other tips: 

  • Keep to a regular feeding schedule. Skipping feedings or not feeding as often can cause plugged ducts.
  • Feed from both breasts regularly.
  • Avoid things that place pressure against your breasts, such as bras that are too tight. 

Learn more:

Breast Infection and Mastitis

Signs and symptoms:

  • Breasts feel tender, warm or hot to touch, and are pink or red
  • Flu-like symptoms, including chills, fever, nausea, body aches, fatigue, or vomiting.
  • Yellowish breast discharge (may look similar to colostrum)

What to do:

  • Apply warm or hot compresses. 
  • Drink lots of fluids and get plenty of rest.
  • Keep to a regular feeding schedule. Feeding often can help mastitis get better.
  • If your baby does not completely drain the affected breast, hand express or pump that breast to thoroughly drain it.
  • If you are not better within 24 hours of trying these steps, call your healthcare provider. They may prescribe antibiotics. 

Learn more:

Thrush/Yeast Infection 

Signs and symptoms: 

  • Persistent sore nipples, even after your baby has a good, deep latch
  • Sore nipples after previous pain-free breastfeeding
  • Flaky, itchy, cracked, shiny, blistered, or pink nipples
  • Aching breasts
  • Shooting pains deep in the breast during or after feedings
  • White spots on the inside of the baby’s mouth

What to do:

  • Contact your healthcare provider immediately if you believe you or your baby has Thrush.

Other tips:

  • Yeast is highly contagious and prone to spread. Wash bras, nursing pads, or any clothing item that comes in contact with your nipples in hot water with bleach and dry on the hot setting or dry in the sun.
  • Rinse your nipples with a solution of 1 tablespoon apple cider vinegar to 1 cup of water after each feeding using a cotton pad or ball. 
  • Wash your hands thoroughly after feeding or pumping.

Learn More: 

Nipple Pain

Most sore nipples are caused by the baby not getting a proper, deep latch. Try different positions to relieve pain, such as cradle, football, or laid-back positions. You can learn more about positioning on the How to Breastfeed section of our website. You can also contact our Breastfeeding Peer Support Counselor for help getting your baby positioned correctly for a deep latch. 

Sore nipples could also be a sign of Thrush, which is explained in the previous section. 

Learn more:

Engorgement

Your breasts will feel different after your baby is born – this is normal. However, if your breasts are hard, painful, or warm to the touch, they may be too full of milk. This is known as engorgement. Sometimes a low-grade fever is also present. 

Like many other issues related to breastfeeding, you can prevent engorgement by making sure your baby has a good, deep latch , that you are feeding your baby often (8 to 12 times per day in the first few weeks), expressing or pumping frequently if you are apart from the baby, and taking good self-care measures like getting enough sleep and drinking lots of water.  

Engorgement will usually go away in just a few days if you express milk or nurse your baby frequently and massage your breasts (start from the chest wall and move toward your nipple). You can also contact our Breastfeeding Peer Support Counselor for help if you are experiencing engorgement. 

Learn more:

Frequently Asked Questions

Can I breastfeed while taking certain medications?

What you put into your body passes through to your baby in your breastmilk. It is recommended to avoid smoking, alcohol, and drugs while breastfeeding. Most medications are okay to continue while breastfeeding, but you should discuss your current medications and supplements (including over the counter medicines) with your doctor before your baby arrives.

Visit the WIC Breastfeeding Alcohol, Drugs, and Smoking Guide for more information.

How will I know if she’s getting enough to eat?

This is a common concern for breastfeeding parents. The good news is that your body will almost always produce the amount of milk your baby needs, including as they grow and consume more breastmilk. Breastfeeding frequently (8-12 times a day) in the first few days will help your milk supply to come in. Tracking your baby’s output via their diapers is the best way to tell if they are getting enough milk. Visit the link below for a helpful chart showing the number of wet and dirty diapers your baby should have during their first few weeks.

Learn More at the WIC Breastfeeding website.

Do I need a breast pump?

Breast pumps are handy tools to have and can help facilitate continued breastfeeding after you have to return to work or when you need to be away from your baby. However, they are not required and hand expressing your milk is another option. Click the button below to learn more about choosing a breast pump.

Learn More

My breasts are already leaking, should I save the breastmilk?

Your breasts will produce the amount of milk your baby needs when they arrive. You may choose to save this breastmilk, but it is perfectly okay not to. There are some advantages and disadvantages of expressing milk before the baby is born.

Learn More at the La Leche League’s website.

I’m having a c-section, can I still breastfeed?

Absolutely! After a c-section, your baby should be placed on to your chest for direct skin-to-skin contact. After about an hour, your baby will naturally seek your breast and begin breastfeeding by themselves. 

Learn More about breastfeeding after c-section at the La Leche League website.

Can I breastfeed with nipple piercings?

It is recommended that nipple piercings be removed during the entire time you plan to breastfeed. Breastfeeding with piercings in can make it difficult for your baby to get a good, deep latch and can present a choking hazard.

Learn More at the La Leche League’s website.

How can I make more breastmilk?

Most of the time your body will be making enough milk to keep up you’re your baby’s needs. However, if you are concerned about low milk supply, there are simple actions you can take to help you make more milk. Below are the top tips, but visit the site linked below for a complete list. 
1. Make sure your baby is getting a good, deep latch. 
2. Offer both breasts at feeding time. Let the baby finish one side, then offer the other. 
3. Empty your breasts at each feeding. If your baby does not drain both breasts, then hand express or pump the remaining breastmilk from each breast. By fully draining your breasts, your body gets the signal that a greater supply is needed.
4. Breastfeed every time your baby is hungry – 8 to 12 times a day in the first few weeks. Don’t observe a strict feeding schedule. Instead watch for hunger cues and feed the baby then, regardless of what time it is.

Learn More about how to increase milk supply at the WIC Breastfeeding website.

Are there any supplements I can take to increase my breastmilk?

If milk supply is still a concern after taking the steps outlined in the answer above, you can take galactagogues in the form of teas or supplements to help boost your milk production. There are also a variety of herbs and foods that may help. For example, you can try this well-rated lactation cookie recipe.

Learn More at the La Leche League website.

My baby is constantly nursing, is that normal?

Babies eat a lot during their first few weeks – 8 to 12 times a day is typical. Your baby may also engage in “cluster feeding” in the evening. This is when your baby wants to feed frequently (every 30 minutes to every hour). This is normal and will likely only last a couple of weeks. Babies also nurse more frequently when they go through growth spurts.

Learn more about cluster feeding at the WIC Breastfeeding website.

Do I need to change my diet?

Just like during your pregnancy, you should strive to maintain a healthy diet while breastfeeding. Remember that what you put into your body passes to your baby through your breastmilk. Avoid caffeine (2 or less cups a day) and alcohol while breastfeeding. Additionally, you may find that your baby is sensitive to certain foods you eat and you should avoid those foods.

Learn more about how to manage your nutrition while breastfeeding at the WIC Breastfeeding website.

Which birth control should I take while breastfeeding?

You should avoid taking hormonal birth control while breastfeeding because those hormones can reduce your milk supply and cause the baby to stop breastfeeding early. There are many highly effective birth control options that do not contain estrogen. Discuss your birth control options with your hospital care team before leaving and with your healthcare provider at your first follow up appointment. 

Learn More about breastfeeding and birth control at the La Leche League website.

Why does one breast produce more milk than the other? Can I change that?

It is normal for your breasts to be different sizes or for one to produce less milk. Generally this is not a problem and does not impede breastfeeding. If it is bothering you, you can take steps to increase milk supply on the smaller side. Additionally, be attuned to your baby’s refusal of one breast – it may be due to an injury, illness, or ear infection. Discuss this behavior with your healthcare provider.

Learn More about uneven milk supply at the Kelly Mom website.

I have a breastfeeding issue that isn’t addressed here.

Are you experiencing a breastfeeding challenge not included here? Give us a call at (410) 479-8060 or send us an email at midshore.wic@maryland.gov. We have specially trained staff who are available to help you overcome your breastfeeding challenges. Our compassionate, supportive services are provided free of charge to all WIC participants.

You can also visit the WIC Breastfeeding Support website for tips on overcoming other breastfeeding barriers or conditions. The La Leche League International breastfeeding website also has many helpful articles about breastfeeding technique and concerns organized alphabetically by topic. 

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