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Breastfeeding challenges

There may be times when breastfeeding is challenging. Never ignore any issues you may have – talk to your health visitor, midwife, GP or breastfeeding specialist as soon as possible, they will be able to help you sort it out quickly.

Here are some common breastfeeding issues, and tips on what to do.

Things that can affect your milk supply

Generally, the more your baby feeds, the more breast milk you'll produce. However, if you're worried that your baby isn't getting enough milk, talk to your midwife, health visitor or a breastfeeding specialist as soon as possible. With their help and advice, you'll be able to identify any issues and work out the best way to resolve it. Things that can affect your milk supply include:

Sore nipples

If breastfeeding hurts and you have sore nipples it's likely that your baby is not latching on well. When your baby latches, make sure they start with a wide mouth (like a yawn) to allow your breast to reach the back of the roof of the mouth. Have a look at our step-by-step guide to latching on.

Feeding by the clock

Let your baby guide you as to how often to feed, especially in the early days, rather than sticking to set times. This is known as 'feeding on demand' and will ensure you maintain a good milk supply.

Breast milk is produced on a supply and demand system, so if you're feeding hours apart, you may start producing less milk.
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Topping up with first infant formula

Your baby will want to feed less if you are topping up with first infant formula milk (as their tummy is fuller for longer), the less often you feed, the less breast milk you produce. If you are planning on topping up with formula, it's best to wait until breastfeeding is well established.

Dummies

If possible, avoid using a dummy until you and your baby are happy with breastfeeding (usually after your baby is at least one month old). If your baby gets used to having a dummy before breastfeeding is well established, it may interfere with learning how to properly latch on. This is because babies suck dummies in a different way to how they breastfeed. Also, if your baby has a dummy in between feeds, this may reduce how frequently your baby wants to feed (if your baby is feeding less often, you'll produce less milk).

Being apart from your baby

If you have to spend time apart from your baby, and you're unable to breastfeed, this will impact the amount of breastmilk you produce. Regularly expressing your milk will help maintain your milk supply.

Medication

Most medicine, including medication for postnatal depression, common painkillers and most antibiotics, can be taken while breastfeeding without harming your baby. But if you need to take medication that is not advised during breastfeeding, talk to your midwife, health visitor, pharmacist or GP. They will be able to best advise you.

Is my baby getting enough milk?

This is a very common question, especially when you first start breastfeeding. While you can't always tell exactly how much your baby is drinking, there are positive signs that they're feeding well, including:

  • feeds begin with a few rapid sucks followed by long, rhythmic sucks and swallows with occasional pauses. Your baby's cheeks stay rounded, not hollow, during sucking and you can hear and see them swallowing
  • your baby seems calm and relaxed during feeds, and comes off the breast by themselves when they've had enough, and appears content and satisfied after most feeds
  • after feeds your breasts feel softer and your nipples should look the same (not flattened, pinched or white)
  • you may feel sleepy and relaxed after feeds

In the first 48 hours, your baby is likely to have only 2 or 3 wet nappies. Wet nappies should then become more frequent, with at least 6 every 24 hours from the fifth day onwards. If your baby is feeding well, they should start gaining weight steadily after the first 2 weeks (it’s normal for babies to lose some of their birth weight in the first 2 weeks).

It can be hard to tell if disposable nappies are wet. To get an idea, add 2 to 4 tablespoons of water to a nappy – this'll give you a better idea of what to look and feel for.

In the beginning, your baby will produce a black tar-like poo called meconium. After about 5 or 6 days, they should pass at least 2 soft yellow poos. Breastfed babies' poo is runny and doesn’t smell.

Increasing your breast milk

If you feel you need to boost your milk supply, there are a few ways you can do this:

  • try not to give your baby anything other than breast milk. The more you breast feed your baby, the more you'll produce

  • if you want to give your baby a dummy, try to wait a few weeks – or until you are both comfortable and confident with breastfeeding

  • let your baby feed when they want to, for as long as they need to

  • when you're feeding, offer both breasts – remember to switch breasts each feed

  • holding your baby close, especially skin-to-skin, will help increase your milk supply

  • avoid weaning until your baby is ready – this is usually around six months

If you're doing all these things already but still concerned you have low milk supply, ask your midwife to refer you to a breastfeeding specialist. Feeding specialists are very understanding and can have a look at how your baby's feeding and offer practical advice, help and support.

If you feel like getting out and about, you could pop along to your local breastfeeding support group. You'll be very welcome and it's a great way to meet other mums.

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