beth israel deaconess medical center a harvard medical school teaching hospital

To find a doctor, call 800-667-5356 or click below:

Find a Doctor

Request an Appointment

left banner
right banner
Smaller Larger

Breastfeeding: Common Concerns

In addition to getting comfortable with the process of breastfeeding, many new moms experience changes in their breasts that can cause anxiety and discomfort. Here are a few of the most common complaints experienced by women who are beginning to breastfeed:

Nipple Soreness

Almost all breastfeeding mothers report some nipple soreness at the start of a feeding session. This initial latch-on soreness decreases after 15 to 30 seconds and the baby begins to eat with a suck-swallow-suck-swallow feeding rhythm. If your nipples still hurt after 15 to 30 seconds, you should make sure there was effective latch-on. You may need to break the suction and reposition him. Limiting the frequency or duration of feedings in the first few postpartum days does not prevent nipple soreness.

To help start milk flow, try massaging your breast, applying a warm towel or pack to it, and/or stimulating some milk to come out before your baby latches on (called hand expression). These actions ease his first strong sucking motions and may decrease the soreness. Soreness usually improves within two to three weeks or sooner.

Engorgement

Engorgement results in very firm, painful, warm breasts and possible flattening of the nipple. By breastfeeding right after delivery and for as long and as often as your baby demands, you may avoid painful engorgement.

If your nipples are so firm that your baby cannot get adequate hold of your nipple and areola, try taking a hot shower or applying hot, wet towels to your breasts three minutes before you nurse. Massage all around the breast from outer areas in toward the nipple. Hand expression of a small amount of breast milk before attempting to nurse also will help. Once the fullness around the areola is relieved, the baby will be able to latch on better. Feeding more frequently for a day or two will help, too. If your baby cannot nurse as frequently as needed to decrease the engorgement for you, try hand expressing or using a breast pump to remove the excess milk. All of these actions can allow your milk to let down, decreasing the discomfort from engorgement. If your breasts do not soften after these measures, apply ice wrapped in a thin towel for 20 minutes.

Wearing a well-fitted, supportive bra 24 hours a day, starting when you begin to feel your breasts becoming heavier, will help give your breasts the support they need while you are breastfeeding. In addition, wearing a bra continuously will provide more comfort when your breasts are very full. A nursing bra with flaps makes breastfeeding access easier.

Nipple Care

As mentioned above, most breastfeeding women experience some nipple soreness during the first 10 days of feedings. If you follow the techniques described in previous sections, nipple soreness should diminish.

Cracks or blisters on the nipples may occur when the baby is not latched on correctly or is not sucking properly. It is essential to discover the reason for this trauma, and a lactation consultant can help to diagnose the problem. Until then, moistening your nipples with expressed milk and letting them air-dry before putting your bra back on may alleviate your discomfort. If the cracked nipple is absolutely too painful to have the baby nurse from, consider hand expressing or pumping on that side in place of direct infant feedings until the crack heals more.

Many women report some relief with the proper use of a medical-grade lanolin product made specifically for breastfeeding mothers. Your healthcare provider may recommend this once all the important actions described above have been tried. It can be applied sparingly once expressed milk has been applied and allowed to air-dry. You may also want to work with a lactation consultant, who can assess how your baby latches on to determine if this is contributing to the problem.

The best advice for nipple care is to avoid drying agents like soaps or alcohol. Change moist nursing pads or bras as soon as they get wet, and avoid the routine application of creams and ointments to your nipples. Moisten your nipples with breast milk and allow them to dry for 10 minutes after each feeding and before covering your breasts.

Plugged Ducts or Breast Infection

Occasionally, you may feel lumps (plugged ducts) forming in your breasts. If you also have a fever, localized pain, or redness in your breasts, you may have a breast infection (mastitis). Notify your obstetrician, nurse-midwife, or nurse practitioner. Most healthcare providers encourage you to continue nursing through mastitis and will prescribe an antibiotic to help clear the infection.

Leaking

Many new mothers experience leaking at the onset of breastfeeding because muscles in the nipple pores may not be able to hold back the milk. You cannot control leaking, but be reassured that it tapers off by itself. To halt the flow when you sense it happening, gently put pressure against the nipple with your palms or by crossing your arms across your chest. If necessary, nursing pads, either disposable or reusable, can be placed inside your bra cups to absorb any leaking between feedings.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2012

Contact Information

Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
East Campus
330 Brookline Avenue
Boston, MA 02215
617-667-0475

RELATED LINKS