Breastfeeding in focus - tackling common problems

To celebrate World Breastfeeding Week which falls in August, our Child and Family Health teams tackle some common breastfeeding problems parents can encounter.

Nipple pain/cracked nipples

This can be common in the first few days of breastfeeding due to heightened sensitivity. It may also be due to incorrect attachment. Hand expressing some milk prior to a breastfeed to help soften the areola and lubricate the nipple can help to alleviate some pain. Offering the less sore side first and trialling various feeding positions may also assist. The expression of hindmilk to smear over the affected nipple (allow to air dry) can aid in healing. If the pain is too much for continued feeding, temporarily express for the baby and gradually start feeding when possible.

Low supply

True low supply is rare. Often mothers feel they do not have enough milk to satisfy their baby when the majority of times this is untrue. Babies will naturally feed more frequently during periods of rapid growth. Signs of a well-fed baby are five to six good wet nappies, one to two soft bowel movements and weight gain. The best way to increase supply is by feeding the baby more frequently and allowing the baby to finish feeding from the first breast before offering the second breast. Expressing after a feed if the baby is failing to drain the breast may also help. Mother should also ensure they are practising self-care by resting and following a healthy, adequate diet.

Blocked ducts

Signs of a blocked duct are usually palpable lumps, soreness and redness. It is important that blocked ducts are treated immediately in order to avoid progression to mastitis. The mother should be encouraged to rest, whilst continuing to feed frequently and hand express between feeds if necessary. Warm compresses applied to the area prior to a feed and gently massage can also help. If the mother develops a fever or the lumps fail to clear within 12 hours referral to a lactation consultant, child and family health nurse or GP is warranted.

Engorgement

This is distension and swelling of the breast that occurs as milk volume increases. The treatment of engorgement involves feeding frequently, breast massage, warmth application and/or expression prior to feeding to help soften the breast, use of a cold compress in between feeds for relief and regular analgesia as required. Mastitis Signs of mastitis include pain, swelling and redness at the breast and general aches, pains and fever in the mother. The word mastitis means inflammation of the breast tissue. Medical advice should be sought as soon as possible as the mother may require antibiotics. The mother should be advised to continue breastfeeding to help empty the breast and reduce pain and swelling.

Breast refusal

This is usually a temporary phenomenon and it is important to reassure the mother not to feel it as a personal rejection. Breast refusal can sometimes occur if the baby is unwell. Tips and tricks to try include creating a calm environment (singing, rocking baby), feeding the baby when they are a little bit drowsy, changing positions or express and feeding with a cup/bottle for a short period. Ongoing refusal past a few days should be referred for review by a lactation consultant, child and family health nurse or the Australian Breastfeeding Association.

See our parent Fact Sheet.

World Breastfeeding Week – empower parents, enable breastfeeding. World Alliance for Breastfeeding Action (WABA) is a global network of individuals and organisations dedicated to the protection, promotion and support of breastfeeding worldwide.

*Disclaimer: This information is for education purposes only. Please consult with your doctor or other health professional to make sure this information is for you or your child.