Return to: Breastfeeding Basics

Common Breastfeeding Challenges

Susie Hamilton Breast Pumps Direct Product Expertby Susie Hamilton
Breast Pumps Direct
Product Expert

Breastfeeding is the most natural and rewarding way to provide nourishment to your infant. Although it is a natural process, some women may encounter challenges or obstacles while establishing a breastfeeding relationship with their child. Fortunately, many of these common difficulties are easily prevented and treated.



Engorgement refers to an extreme fullness of the breasts, and although it is often thought of as a problem, the onset of engorgement is actually quite positive. It happens anywhere from 2 to 6 days after giving birth and is a definite sign that you milk has come in. Symptoms of engorgement usually subside within 24 to 48 hours. Nursing your infant frequently is one of the best ways to relieve engorgement. How Do I Know If My Breasts Are Engorged? explains engorgement in more detail and provides methods for treating engorged breasts.

Breasts that feel hard, skin that is stretched to the point that it is shiny, throbbing in the breasts and a low-grade fever identify persistent engorgement. If symptoms endure, several problems can occur. The baby may have difficulties latching on properly, milk supply may decrease, and you may develop plugged ducts or mastitis.


Sore or Cracked Nipples

Experiencing Sore or cracked nipples is not a normal part of breastfeeding. These problems develop as a result of improper latch on and positioning. Often the best way to begin treating cracked or sore nipples is to fix the cause of the problem, which for many mothers consists of improving the baby’s latch and using a better feeding position.

Applying pure lanolin to cracked nipples can help to speed up the recovery process. A few drops of breastmilk on your nipples can also help with healing.


Flat or Inverted Nipples

Flat or inverted nipples may initially make breastfeeding more difficult, but successful breastfeeding is still possible because babies actually breastfeed on areolas, not nipples.

A number of products are available to make breastfeeding with flat or inverted nipples more manageable. Some of these products include breast pumps, breast shells, and the Avent Niplette. A technique called Hoffman’s exercises can help to stretch nipples; however, most experts no longer recommend prenatal nipple preparation.

The best way to overcome difficulties with flat or inverted nipples is to have your alert baby latch on and suck well. While feeding, the baby will draw out the nipple to the proper shape and size needed. If you are trying to determine whether you have flat or inverted nipples read our article Do I Have Flat or Inverted Nipples? for help.



Thrush is a common yeast infection that may develop orally in a breastfed infant or on the nipples and breasts of the mother. For an infant thrush is usually detected by creamy white lesions in the mouth. Many often say that these lesions look very cottage cheese like. Cases of thrush are most often harmless, but for some babies it may cause pain and can interfere with proper nursing. A mother with thrush may experience breast pain while nursing or after feedings. White spots or a rash on her nipples could also be an indication of thrush.

If you and your baby develop thrush while breastfeeding then you will both need to seek treatment; otherwise, the two of you will continue to pass it to each other. You should also be sure to wash all bottles and pacifiers as well as your nipples everyday until the thrush is cleared up. Cotton nursing pads can also help to prevent the spread of thrush to your clothing. The article Thrush and Breastfeeding offers indepth information on the signs of thrush as well as treatment options for you and your baby.



Mastitis is an inflamed breast infection. A case of mastitis is generally detected when a mother experiences breast tenderness, redness, pain and swelling as well as flu-like symptoms. You may be at a higher risk of developing mastitis if you have missed feedings, are feeling stressed and run-down, or if you have experienced problems with cracked or bleeding nipples. You can prevent mastitis by breastfeeding frequently and relieving engorgement promptly because milk that doesn’t flow and remains in the breasts becomes thicker and may clog ducts.

When affected by mastitis it is important for the mother to get plenty of rest, drink lots of fluids, and continue to breastfeed on the affected side. Varying the baby’s feeding position and gentle breast massages can help to alleviate pain and pressure. For some treatment may also involve a round of antibiotics. If left untreated mastitis can lead to the development of a Breast Abscess, which must be surgically drained.

It is important to remember that weaning your baby at this time can be more harmful than helpful to the healing of your breast. The breast must be completely drained as often as possible to relieve the painful engorgement caused by mastitis and NOT left holding milk. Please read our article Weaning:Helping Your Baby off of the Breast for important information you will need to begin the weaning process.

More Information
Additional information about breastfeeding challenges can be found at the American Academy of Pediatrics website and This article is intended for informational purposes only. If you are experiencing a breastfeeding difficulty, please consult with your physician or a lactation consultant for advice on your condition.

You can also call the La Leche League 24 Hour Breastfeeding Helpline at 1-877-4-LALECHE (1-877-452-5324) for assistance and advice.


Return to: Breastfeeding Basics