Common challenges include engorgement, blocked ducts, mastitis, damaged nipples, and low milk supply. Here are our tips to help overcome these challenges:
Your milk will come in approximately 2-3 days after birth. If you have engorgement, you’ll feel very full and uncomfortable for another few days. This ‘full’ feeling may continue to last weeks, until your milk becomes established.
When feeding your baby, we suggest emptying at least one breast at each session. Ensure your first breast is soft and comfortable before offering the second breast. This reduces the risk of blocked milk ducts. During the next breastfeeding session, ensure your baby starts feeding on the same breast they finished on. Depending on your baby’s appetite, they may drink a little or a lot of milk from the second breast.
Karitane Tip: If a full breast is making attaching difficult, you can hand express enough milk for comfort and softness, so your baby can latch.
Engorgement tends to decrease with time. You may find using a supportive maternity bra and applying a cold press to the breasts between feeds helpful during these early days.
Blocked ducts and mastitis:
As mentioned above, we suggest emptying at least one breast during each feed. Tight tops and bras can cause blockages, so avoid them where possible.
A blocked duct may present as a lump. Encourage your baby to feed on the affected breast first, while applying gentle massage behind the affected area for relief. You can also place a warm, moist face cloth on the breast prior to feeding to help with your milk flow, if your child is over ten days old.
If left untreated, a blockage can lead to mastitis – an infection of the breast tissue. This may begin as a red area on the breast, which progresses to swelling, pain and heat. It may also involve flu-like joint aches, chills, rigors, and/or a temperature.
Karitane Tip: If you display any of these symptoms, it is important to visit your doctor as you may need some antibiotics.
In the case of mastitis, here are some things to try:
- Feed your baby frequently
- Start with the affected breast. It is important you continue to breastfeed to drain your breasts well.
- Apply a warm cloth to the sore breast before feeding
- A warm shower will also help your milk flow more easily.
- Massage towards the nipple while feeding.
- Apply cold packs after feeding
- These will offer additional comfort.
Damaged or painful nipples:
It is common for some mothers to experience mild nipple pain when their baby attaches to the nipple in the early weeks. If your nipples become grazed or cracked, you may experience pain, bleeding or infection. Damaged nipples are often due to your attachment method.
General nipple care includes avoiding use of shampoo and soap on the nipples, allowing them to air-dry after feeding, and avoiding ointments, sprays and powders. If you use breastfeeding pads, be sure to replace them frequently.
To avoid further damage it is also important to gently detach your baby from the breast. If pain persists, see your child and family health nurse, lactation consultant, or general practitioner.
Low milk supply:
If your baby appears to want more breastfeeds, or becomes fussy at times, offer more comfort and feeding to see if the fussiness passes. If you find your supply seems low, apply these useful tips:
- This is the quickest, most successful way to boost supply. Try offering both breasts more than once during each feed.
- Offer a top up if your baby doesn’t settle after a feed
- Express after feeds and offer the expressed milk to your baby
- Make skin to skin contact
- This will help you both relax.
- Eat well
- Keep fluids up
- Accept help from friends and family
You may feel that your milk supply is low especially if your baby is unsettled after a feed, but there can be other reasons for this (see Your Crying Baby). This is one of the common challenges of breastfeeding, as you can’t measure how much your baby is drinking. There are other signs to let you know your baby is getting enough. Visit the How do I know if my baby is getting enough food? above to assess the situation.
Still concerned? Speak to a healthcare professional. This could be a child and family health nurse, a lactation consultant, an Australian Breastfeeding Association counsellor or our Karitane Careline.