Pregnancy and baby

Breastfeeding problems

What can I do about sore and painful nipples when breastfeeding?

Media last reviewed: 15/05/2012

Next review due: 15/05/2014

If your baby is unsettled

Sore or cracked nipples

Sore breasts, blocked ducts, and mastitis

Thrush

Tongue-tie

Common breastfeeding questions

Help and support

 

 

It can be hard to ask for help, but tackling breastfeeding problems quickly will give you more time to enjoy your baby's early days. In many cases, the solution is as simple as changing your baby’s position or feeding them more often.

Breastfeeding if your baby is unsettled

If your baby is unsettled at the breast and doesn’t seem satisfied by feeds, it may be that they’re not attached to the breast correctly. Go to Breastfeeding: positioning and attachment to check that your baby is feeding well. lt can also be helpful to ask a breastfeeding supporter to work with you to improve positioning and attachment of your baby. See Breastfeeding help and support for information on where to find someone in your area.

Sore or cracked nipples when breastfeeding

If your nipples hurt, take your baby off the breast and start again. To do this you can slide a finger gently into the corner of the baby’s mouth until their tongue releases. Putting up with the pain could make things worse. If the pain continues or your nipples start to crack or bleed, ask a breastfeeding supporter to help you get your baby attached effectively. Pain is not normal, so ask for help and support.

The following may help:

  • Squeeze out a drop or two of your milk at the end of a feed and gently rub it into your skin.
  • Let your nipples dry before getting dressed again.
  • Change your breast pads at each feed (if possible use pads without a plastic backing).
  • Don't use soap, as it dries out your skin.
  • Wear a cotton bra so that air can circulate.
  • Treat any cracks or bleeding with a thin smear of white soft paraffin or purified lanolin. Put the ointment on the crack (not the whole nipple) to help it heal and prevent a scab forming.
  • There's no need to stop feeding. With skilled help you should find that breastfeeding quickly becomes more comfortable again. 

Sore breasts, blocked ducts, and mastitis

An over-supply of milk can build up in your breasts for a variety of reasons. If your baby is not well attached it may be hard for them to take your milk effectively, and some parts of your breast may not be drained during a feed. This is the area of your breast that may feel sore or painful. It is worth checking to see if this is a possible cause so that you can prevent it from happening again. If you’re not sure, ask for help. Other common causes include wearing a bra that's too tight, a knock or blow to the breast, and missing a feed.

It’s important to deal with a sore breast or a blocked duct as soon as possible so that it doesn’t lead to mastitis (inflammation of the breast).

If you have mastitis you're likely to have at least two of the following symptoms:

  • breast or breasts that feels hot and tender
  • a red patch of skin that's painful to touch
  • general feeling of illness, as if you have flu
  • feeling achy, tired and tearful
  • you may have an increased temperature

This can happen very suddenly and can get worse very quickly. It's important to carry on breastfeeding as this helps to speed up your recovery. If you think you might have a blocked duct or mastitis, try the following: 

  • Check and improve the attachment of your baby at the breast – ask your midwife, health visitor or volunteer breastfeeding supporter.
  • Feed your baby more often.
  • Let your baby feed on the tender breast first.
  • If your breasts still feel full after a feed or your baby can’t feed, hand express some milk to relieve the fullness.
  • Warmth on your breast before a feed can help the milk to flow and make you feel more comfortable. Try warm flannels or a bath or shower.
  • While your baby is feeding, gently stroke the lumpy or tender area towards your nipple with your fingertips. This should help the milk to flow.
  • Get as much rest as possible. Go to bed if you can.
  • If you can, take a painkiller such as paracetamol or ibuprofen.

Mastitis may also be a sign of infection. If there's no improvement within 12 to 24 hours, or you start to feel worse, contact your GP or healthcare professional. If necessary, they can prescribe antibiotics that can be taken while breastfeeding.

Stopping breastfeeding will make your symptoms worse, so ask for help and support early.

Thrush and breastfeeding

If you suddenly get sore, pink nipples after you’ve been feeding without problems for a while, you may have an infection known as thrush. Ask your health visitor or another breastfeeding supporter to check that your baby is attached effectively. Make an appointment with your GP.

You and your baby will need treatment. You can easily give thrush to each other, so if your baby has it in their mouth you will still need some cream for your nipples or an oral thrush tablet to stop it spreading to you. You many want to ask your pharmacist for information. Some anti-fungal creams can be bought over-the-counter from a pharmacy.

Seek further information and help from your health visitor or GP if your baby continues to have symptoms.

Breastfeeding and tongue-tie

Some babies are born with a tight piece of skin between the underside of their tongue and the floor of their mouth. This is known as tongue-tie and it can affect feeding by making it hard for your baby to attach effectively at your breast.

Tongue-tie is easily treated. If you have any concerns, talk to your midwife, health visitor or GP.

The Baby Friendly Initiative provide a list of locations where tongue-tie can be divided.

Common breastfeeding questions

How often will my baby breastfeed?

All babies are different, and it may depend on the type of birth you've had. Your baby should feed within the first hour after birth to get off to a good start. Babies then sometimes have a sleep and will start to give you signs that they're ready for the next feed. These signs include:

  • starting to move about as they wake up
  • moving their head around
  • finding something to suck, usually their fingers

If your baby doesn’t have a feed in the first hour, try skin-to-skin again, putting them to your breast as soon as possible so that they're not left without a feed in the first six hours.

Why is baby-led feeding so important?

A newborn baby’s stomach is only the size of a walnut, therefore they will need to feed ‘little and often’. This is why baby-led feeding, or ‘on-demand feeding’ is so important. Your baby can have a good feed and be hungry again quite quickly. Babies go through patterns of feeding more and less as they grow. Letting them feed when they need to will ensure that they're content and getting the milk they need, when they need it.

How long should each breastfeed last?

Every baby is different. Some babies want frequent short feeds, and others prefer feeding for longer. Let your baby finish the first breast, then offer the second. If your baby feeds all the time and you're worried, call the National Breastfeeding Helpline on 0300 100 0212 to discuss help with positioning and attachment.

Can I still breastfeed if I have more than one baby?

Twins, triplets and other multiples can be breastfed. Because multiple babies are more likely to be born prematurely and have a low birth weight, breast milk is especially important for their wellbeing. When you start breastfeeding you may find it easier to feed each of your babies separately until feeding is well established and you feel confident about handling them at the same time. This may take a few weeks.

It can be really helpful to talk to other mothers who have breastfed twins, either at an antenatal session or meeting at a twins group in your area. Triplets can be breastfed either two together and then one after, or all three rotated at each feed.

Read more about Feeding twins and multiples.

Can I breastfeed after a caesarean?

Yes, you can. Make sure you get a skin-to-skin cuddle with your baby as soon as you're able to. Your midwife may help you have a skin-to-skin cuddle in theatre, or in the recovery room. If you keep your baby close to you and maintain lots of skin-to-skin contact, you’ll be able to put them to the breast often, and this will stimulate your milk supply.

Breastfeeding counsellor Ruthie suggests that “after a caesarean you might find that the ‘rugby hold’ [baby’s body is around to the side of your body supported by the arm on the same side] is preferable to having the baby lying on your stomach”. Ask your midwife for pain relief before you're likely to feed your baby so that you can feed comfortably.

If you have a planned caesarean, talk to your midwife about expressing some breast milk before you have the baby. This can be available for use afterwards if necessary, either by cup or by syringe.

How long should I breastfeed for?

Exclusive breastfeeding (with no other food or drink) is recommended for around the first six months of a baby's life. After this, breastfeed alongside other foods for as long as you and your baby wish. This might be into their second year or beyond. Find information about introducing your baby to solid foods.

Every day you breastfeed makes a difference to you and your baby. There’s no need to decide at the beginning how long you'll breastfeed for. Many mothers continue to breastfeed when they return to work or college. Read about breastfeeding after returning to work.

How do I know if my baby's getting enough milk from breastfeeding?

All mums want to know that their baby is feeding well. When you first start breastfeeding, you may wonder if your baby is getting enough milk. There are clear signs that you can look out for. 

Signs that your baby is feeding well:

  • Your baby has a large mouthful of breast.
  • Your baby's chin is touching your breast.
  • It doesn't hurt you to feed (although the first few sucks may feel strong).
  • If you can see the dark skin around your nipple, you should see more dark skin above your baby's top lip than below their bottom lip.
  • Your baby's cheeks stay rounded during sucking.
  • Your baby takes rhythmic, long sucks and swallows. It's normal for them to pause sometimes.
  • Your baby finishes the feed and comes off the breast on their own.

Signs that your baby is getting enough milk:

  • Your baby will appear content and satisfied after most feeds.
  • They should be gaining weight after the first two weeks.
  • Your breasts and nipples should not be sore.
  • In the first 48 hours, your baby is likely to have only two or three wet nappies.
  • From day five onwards, wet nappies should start to become more frequent, with at least six wet nappies every 24 hours.
  • They should appear healthy and alert when they're awake.  

Breastfeeding help and support

If you have any questions or concerns about breastfeeding, a lot of help and support is available.

  • You can ask a friend or family member who has breastfed.
  • Ask your GP, midwife or health visitor.
  • You can call a helpline, for example, the National Breastfeeding Helpline on 0300 100 0212.
  • You can look at reliable web based resources.
  • You can join a local support drop in, Children’s Centre or group.  

Page last reviewed: 02/10/2012

Next review due: 02/10/2014

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

20twenty said on 08 February 2014

Probably a good page for breast feeding mums, but there is a lack of info for pregnant women with blocked ducts. Breastfeeding is not an option for me as I am only 11 weeks pregnant with 1st baby. But since my duct was infected (now nearly finished antibiotics) and still blocked (there is still a white blob) I would like to know how to clear it so the infection doesn't return once antibiotics stop. GP gave no advice on this. I will prob have to see GP again in all reality, but if could safely clear the duct and the lump goes, I could not waste their time.

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amanda34 said on 11 March 2013

Really good article.Never knew breast feeding was such a complicated task! I had major leaking-breasts issue right after i gave birth.Used to be embarrassing to get out in public,i would mostly return home with a patch work on my tees.Then i got some nursing bras and tops and they saved me.All their tops are padded and leak proof.Their nursing bras made feeding easier for me.

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Media last reviewed: 10/09/2013

Next review due: 10/09/2015