Solutions to Common
Breastfeeding Problems

I was shocked when I saw recent breastfeeding problems research pulished on Pediatrics Online shows only 32% of mothers are meeting their breastfeeding goals!  My passion is to help get breastfeeding working well so hopefully I can answer your questions!

My baby falls asleep before finishing a breastfeed

Do you want to know how to overcome or avoid those breastfeeding problems that stop so many women from breastfeeding?

The following is a list of breastfeeding problems that I have solutions for further down the page.  These are ones which I see really commonly and can usually be overcome with a few tricks and the right support from your family, friends and health professionals such as lactation consultants:

• My baby falls asleep before finishing a breastfeed
• My baby breastfeeds all the time and still isn't full
• I don't have enough milk for my baby
• My baby doesn't stick their tongue out or open their mouth wide
• My baby refuses to breastfeed
• My baby swallows too much air and gets painful wind
• My nipples are too sore to keep breastfeeding
• My baby can't latch on because I have engorged breasts
• I'm getting blocked ducts/mastitis and my breast is very painful
• I'm too nervous to breastfeed in public
• My wrist and thumb are really hurting during breastfeeding

And by the way, can I just put in here, the research shows that not using any supplemental milk helps you improve your supply. This is because your breasts may slow down their production of milk if your baby is not feeding from them, and also your baby may like the faster flow from a bottle and may refuse the breast after getting milk from a bottle so easily.

So many mothers I see have wound up with breastfeeding problems such as low supply or their baby refusing to breastfeed and preferring the bottle purely because of a few well intentioned comment.

Pacifiers should also be used cautiously in the first month. Again this will help you to establish your supply before offering your baby anything else to suck on. The sucking motion is also different and can exacerbate latching on difficulties.

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My Baby Falls Asleep Before
Finishing a Breastfeed

This is a really common breastfeeding problem for mothers of newborns. They are often naturally very sleepy for the first month. A useful thing to know at this stage is that babies respond to flow. Once you notice that your baby has stopped swallowing milk and is now just comfort sucking and falling asleep it means that they are no longer getting a good mouthful of milk.

To remedy this it is useful to learn how to use breast compressions to help them get all the milk you are producing for them.

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My Baby Breastfeeds All the Time and
Still Wants More

This is another really common breastfeeding problem for new mothers. First it helps to be aware of what normal breastfeeding patterns are like for a newborn. Breast milk is very easily absorbed and quickly digested by a baby. Feeding every 2-3 hours is not uncommon (and there are plenty who feed every hour in those first weeks, so don't feel you're doing something wrong).

The time this becomes a problem is if:

• Your baby is not getting enough and so not putting on enough weight (check out the low milk supply page)
• Your baby is getting a lot of colic/wind/bloating and is really unsettled between breastfeeds (this is could be acid reflux or lactose overload)
• Your baby is feeding for such a long time that you have a lot of nipple pain
• You aren't coping in general with your baby breastfeeding so much

Again, breast compressions will help you shorten the duration of a breastfeed as you will be eliminating the comfort sucking time and fully draining your breast. Most mothers I see don't know when to finish a feed. My advice is always it is up to you.

Watch the breast compressions video. It is probably one of the most common solutions to many different breastfeeding problems. In it you can see when the baby starts to comfort suck as the milk supply decreases. If after a breast compression your baby doesn't start drinking again, you will know you don't have any milk left on the side and your baby will just be comfort sucking. you can choose to let this continue or to stop the feed.

If this does not work for you it is possible you have low milk supply or your baby has reflux or colic.

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I Don't Have Enough Milk for My Baby

Many mothers tell me that they have low milk supply, and this is a breastfeeding problem you can usually do something about. If you think you have low milk supply I want to help you feel more ease by telling you that your breasts are likely to increase their supply very quickly (within 24-48 hours) if you breastfeed on demand.

Your breast is stimulated to make more milk every time some is drained. This is why some mothers are advised to use a breast pump when their newborn is not feeding to help increase their supply.

This is usually not necessary though if you are able to breastfeed very frequently. In this early period of boosting your supply that may mean breastfeeding or expressing for around five minutes (either by hand or with a pump) every hour, but it's worthwhile in this short time as it won't be long before you will find your supply has increased and your baby is gaining weight really well.

Another useful technique to ensure that your baby is getting as much milk as you are making is using breast compressions during each breastfeed.

See the low milk supply page for other suggestions for overcoming this breastfeeding problem.

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My Baby Doesn't Stick Their Tongue Out or
Open Their Mouth Wide Enough to Latch On Well

Babies frequently don't open their mouths very wide for a breastfeed or stick their tongue out and this is one of the most common breastfeeding problems for new mothers. Some useful things to learn include baby led latch which will help to prime your baby's reflexes for breastfeeding so that they are automatically opening their mouths and sticking out their tongue for a breastfeed.

The other useful thing to learn is using a cross cradle hold as it will help you to latch your baby very quickly after they open their mouth wide. The asymmetric latch shown in this video also shows how to make the best use of baby's tongue so your nipple doesn't just rub against the roof of your baby's mouth.

You may also be experiencing breastfeeding problems because your baby has a tongue tie. Sometimes a new breastfeeding position can help, but some babies need their frenulum to be released.

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My Baby Refuses to Breastfeed

My heart goes out to you, this is such a stressful situation - having a screaming baby who won't latch on and take the milk that's right there.

There are so many reasons this breastfeeding problem may occur. The most common one for newborns is a stressful breastfeeding experience, such as having their head forced onto the breast early on, makes them not want to breastfeed. Other reasons include having had nasogastric tubes or suction equipment in their mouth or having pain after a stressful delivery such as forceps.

In these cases a useful technique is baby led latch. This is basically a cuddle which becomes a breastfeed and is a very non threatening way to establish breastfeeding. Make sure you start this process well before your baby gets hungry. It doesn't work if your baby is distressed.

Tongue tie - This can be diagnosed by a lactation consultant, but means that the baby's tongue doesn't protrude far enough

If you had already successfully started breastfeeding and your baby suddenly stops , some reasons include:

• A very strong let down reflex - try expressing until the initial flow subsides
• A slow let down reflex - keep your feeds calm and very routine to help your reflexes. Also try expressing a little before a feed to start the reflex
• Engorgement - this makes the breast too hard to latch on to. Try some gentle pressure on the breast and a little bit of hand expression to soften it before a feed
• Poor positioning - can make it uncomfortable for a baby to latch on. Make sure your baby is able to extend their neck a little and is close enough to the nipple
• Low milk supply - this can happen if you've supplemented a feed, not eaten or drunk enough or gotten too stressed or tired. Try to express if you are supplementing a feed, and make sure you are getting enough food and water and ask for help if you are tired or stressed out
• Baby is too distressed to feed - you may have waited too long to feed. Try expressing some milk onto your nipple, if this doesn't work you will need to calm your baby with a finger in their mouth or some cuddles before trying again. you can also try using a bit of expressed milk in spoon or small cup to help quell the initial hunger for your baby.
• Teething - this hurts and can makes babies very unsettled. Try feeding some expressed milk with a cup or spoon. In general just keep offering. Your baby will choose to restart when they are ready
• Milk tastes different - if you have had antibiotics, a blocked duct, mastitis or you are beginning to ovulate again/are pregnant your milk will taste different. Some babies get used to this if you continue to offer feeds, some don't
• Middle ear infection - if your baby has a middle ear infection it will be very uncomfortable for them to lie down. Try using the saddle position and get your baby checked by their doctor

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My Baby Gets Painful Wind

Having a colicky, windy baby is awful. I often get to experience the stress that new parents havewhen they bring in their colicky babies for treatment. Lots of parents don't realise though that it can often be due to a breastfeeding problem.

Wind happens for a few reasons:

• Poor latch on leading to sucking in of air
• Blocked nose leading to difficulty breathing while breastfeeding
• Reflux, Lactose Overload (from too much fore milk, not enough hind milk, see breast compressions for some ways of dealing with lactose overload)

In any case get the latch on going as well as you can and then learn a few burping techniques. Burping halfway during the feed is very useful, and sometimes the saddle position or baby led latch position can also help as it is an upright position and will allow gas to escape more easily.

Some babies may also be making a clicking sound whilst feeding. This is often indicative of a poor latch due to their jaw not opening well after a tough birth or a tongue tie, though the mother will usually also have nipple pain from feeding.

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My Nipples are Too Sore to Keep Breastfeeding

I can totally empathise with you on this point. I had blood blisters after a few weeks of breastfeeding. It was awful and I was dreading every feed.

This breastfeeding problem may start straight away, but more commonly begins in the first week or two of breastfeeding. This means your baby is not latching on well and is rubbing your nipple across the roof of their mouth. Learning the asymmetric latch is really useful for this.

Most mothers also have their baby positioned too far across their body. Make sure your baby's upper lip and nose is in line with your nipple. This will help them get their neck extended so they can open their mouth really wide and have their tongue in the best place on your areola rather than on your nipple.

Using a baby led latch can be useful to help improve your baby's ability to open their mouth wide and poke out their tongue further.

If your baby seems to have difficulty with opening wide or moving their tongue, it is well worth considering the possibility of a tongue tie also. This is where the baby's frenulum holds their tongue down and they are unable to get a good latch. There will often be a clicking sound with feeding and the nipples will be quite deformed.

Above all,if this information doesn't help you sort out the problem quickly, make sure you find a lactation consultant who makes everything work better. If, after a consultation you are still in a lot of pain see someone else. Don't settle for nipple pain in the hope that it will get better, because it can lead to mastitis.

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My Baby Can't Latch On Because
I Have Engorged Breasts

Ouch! This is a common breastfeeding problem in the first few months until your breasts get used to how much milk your baby needs. Using a little bit of hand expressing until the first let of milk subsides or gentle pressure against the nipple prior to the feed are useful in this situation.

I also found that in the very early days, if I just breastfed every hour or so my breasts didn't have time to become engorged (be careful to not keep your baby breastfeeding any longer than they want to though so you don't cause lactose overload).

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I'm Getting Blocked Ducts/Mastitis and
My Breast is Very Painful

Mastitis is where my nipple pain lead me.... I totally understand the mastitis pain and I feel for you.

This is a breastfeeding problem for mothers with good supply who are either stressed and overtired, whose babies aren't latching on well or who aren't keeping a regular breastfeeding schedule and their breasts are making milk that is not being drained (sometimes in the early months it's just because your breasts really docreate an oversupply)

Breastfeed your baby as frequently as possible when this begins to happen to help drain the milk from the affected duct. Using a breastfeeding position with your baby's chin towards the affected duct is also useful. It will hurt until the duct is cleared so make sure you have some support around you if possible to help you cope.

Plenty of water, gentle massage, good positioning and latch, hot and cold compresses and sleeping when your baby sleeps are all important ways of treating blocked milk ducts and mastitis.

If the pain lasts longer than 24 hours and you are getting a fever or feeling more unwell see your doctor.

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I'm Too Nervous for Breastfeeding in Public

Breastfeeding in public need not be a breastfeeding problem. Although it is a bit daunting initially, and research shows that it's the number one reason mothers don't continue to breastfeed (or start in some cases), persistence is well worth it for the convenience of not taking sterilised bottles and warm water etc.

I found the best thing was to practice latching on discreetly at home with a soft bra that was easy to push under my breast, and to buy some excellent breastfeeding tops. An opening that is from below your breast means that the top of your breast is covered and to a passer by it actually just looks like you are giving your baby a cuddle.

There are also great breastfeeding covers available for those who aren't confident enough to just use a breastfeeding top.

You can also use a receiving blanket or muslin wrap to help cover yourself if you're feeling really self conscious. Try tucking a corner into the bra strap on the side you aren't using, taking it around over your other shoulder and then over your baby's body (this helps to keep it in place).

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I Get Wrist and Thumb Pain While Breastfeeding

This is called De Quervain's tenosynovitis and is inflammation around the muscles inthe wrist and thumb.  It's usually cause by a feeding posture and you can alter the way you're breastfeeding to help it!

Check out this page for more information

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