Breastfeeding challenges

baby breastfeeding

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.

Mastitis

Mastitis makes your breast tissue inflamed and painful. You might notice a lump around the sore area, sometimes the inflammation turns into an infection. Mastitis can make you feel achy and run down, with flu-like symptoms or a fever.

Symptoms

Usually, mastitis affects one of your breasts, but can sometimes affect both. Signs and symptoms of mastitis often develop quickly and can include:

  • sore breasts that feel swollen, hot, painful to touch. You may also have red patches, but redness can be harder to see on brown and black skin
  • a lump or hard area on your breast
  • feeling tired, run down and feverish – you may have flu-like symptoms

What causes mastitis?

If you're breastfeeding, mastitis is usually caused when the milk in your breast builds up faster than it's being removed. This creates a blockage in your milk ducts (known as 'milk stasis') and can be brought on by:

  • your baby not latching on properly
  • missing feeds, or not feeding often enough
  • feeding from one breast more often than the other
  • an injury that damages a milk duct or gland

If you aren't breastfeeding, mastitis can be caused by infection. The infection could happen if your nipples are sore or cracked, or through a nipple piercing.

Did you know?

Mastitis mainly affects breastfeeding women, usually within the first 3 months of giving birth – but you can also get it if you are not breastfeeding (due to an infection in the breast).

How long does mastitis last?

If you catch the early signs of mastitis, it's quick and easy to treat. If the pain continues for more than a few days, it may be a sign that you've got an infection, and it's time to make a GP appointment. Your GP may prescribe a course of antibiotics, which should clear up the infection in a few days.

Treating mastitis

The main thing to do is carry on breastfeeding (even though it may be extremely painful). By stopping breastfeeding, the blockage will only get worse. Even if you have an infection, breastfeeding won't harm your baby (although your milk may taste a little salty).

Make sure your baby is latched on properly and aim to feed 8 to 12 times a day (including at night). Try putting a warm flannel over your breast before feeding, this will help ease the pain and encourage the let-down reflex.

After feeds, make sure any leftover breast milk is drained by expressing by hand or with a pump.

Don't leave it too long. If you feel that you're not improving and continuing to feed regularly isn't making a difference, see your doctor. They'll be able to assess whether your mastitis is caused by an infection. If it is, you may need antibiotics. It would also help to see a breastfeeding specialist who would be able to check your baby's attachment and positioning.

woman drinking a glass of water

Self-help methods

  • Remember to drink fluids when you are thirsty.
  • Get plenty of rest – take your baby to bed and feed frequently (8 to 12 times every day, including night time).
  • Express your milk in between and after feeds to make sure all your breast milk is removed.
  • Medication such as paracetamol and ibuprofen can reduce pain. Although some paracetamol can enter your breast milk, it's not enough to harm your baby.
  • Avoid wearing tight, restrictive clothes and bras which can restrict milk flow.
  • Ease the pain by putting a warm flannel over your breast – warm showers and baths may help.
  • Massage the affected area if it's not too painful, gently massage on and around the affected area.

Breastfeeding Friend from Start for Life

The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you – and because it's a digital tool, you can access it 24 / 7.

Preventing mastitis

Luckily, once it's diagnosed, mastitis is easy and quick to treat. But remember, prevention is better than cure.

Reducing the risk of mastitis

  • If possible, breastfeed exclusively (avoid using first infant formula to top up, or a dummy).
  • Feed frequently and responsively – long gaps in between feeds can create a build-up of breastmilk.
  • Encourage your baby to feed if you feel your breasts are getting full.
  • Make sure your baby latches on properly – try different breastfeeding positions to work out which is most comfortable.
  • Wait for your baby to finish feeding – usually, they'll release when they're finished.
  • When you want to stop breastfeeding, try cutting down your feeds gradually (don't suddenly go longer between feeds).
  • Avoid wearing a bra or clothing that is too tight and puts pressure on your breasts.
For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212. Lines are open 9:30am to 9:30pm every day.

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