Sore, cracked or bleeding nipples
Sore, cracked or bleeding nipples are usually a sign that your baby is not latched on properly, not feeding in the right position, or you could be using a breast pump incorrectly. Your midwife or health visitor can help with your breastfeeding technique.
There are two types of blocked duct.
- A small white spot at the end of your nipple: you can normally remove it with a clean fingernail when your skin is soft after feeding.
- A painful lump in your breast with inflamed skin around it. This kind of blockage could be an early sign of mastitis but could simply be a blocked duct.
If you have inflammation in your breast it’s important to speak to your midwife or doctor as soon as possible to prevent mastitis from fully developing.
In the meantime:
- Feed as often as you can to drain the excess milk.
- Make sure your baby is latching onto your breast correctly.
- Try using a breast pump to drain your breasts fully after a feed and take ibuprofen to help relieve the pain. Gently massaging your breasts and applying warm flannels can help too.
Thrush is a fungal infection that babies often get on their genitals and in their mouths. It can also spread to your breasts during feeding. If your baby has thrush you’ll notice white spots in their mouth and on your breasts. The spots may be flaky and itchy and your breasts might feel sore.
If you think you or your baby has thrush, see your doctor. They may prescribe an oral fungal cream for your baby. Mum and baby need to be treated at the same time to prevent re-infection. You can still carry on breastfeeding, though it may be a little sore!
Three to four days after you give birth, your breasts may become full, tender and lumpy, with flattened nipples. The swelling may even spread to your underarms and you might get a small fever. This happens when your milk ‘comes in’. It can be painful, but it’s quite harmless and usually goes away quickly.
To soothe the symptoms, express some milk before you feed, using a pump or your hands. And use warm flannels, baths and showers to help soothe and relax your breasts between feeds.
Your breasts may leak if they are too full of milk, or your ‘let down reflex’ is triggered. Usually your breasts only release milk when your baby suckles, but sometimes just hearing a baby cry can trigger your breasts to ‘let down’ their milk!
The more regularly you feed, the less likely your breasts are to leak. Most mums wear breast pads inside their bras in case of any leaks. You’ll probably find that the problem disappears almost completely after about seven to ten weeks of breastfeeding.
Problems with your milk
Too little milk
The less milk your baby consumes the less your body will produce, so if your baby isn't latching on properly and not taking in enough milk, your body may produce less milk than they need. If you’re worried your baby may not be getting enough milk, speak to your midwife or health visitor.
Too much milk
Producing too much milk is common in the first few days. Initially your body produces lots of milk to allow for a high volume of feeding, this settles down once your baby is feeding effectively and milk production should begin to regulate, to provide your baby with the amount they need. Usually, overabundant milk production will correct itself in a few weeks, once breastfeeding is established, but some mums find that the problems continue if their baby isn't latching on properly. Expressing some breastmilk before feeding may help. Speak to your midwife or health visitor if you aren’t sure your baby is latching on properly.
Problems feeding later on are often caused by an overactive let down reflex (milk coming out too quickly) combined with an imbalance between the amount of foremilk and hindmilk you’re producing. If you’re still producing too much milk after your baby’s pattern has settled, you can express some and store it for later. Try not to express too much or in-between feeds though, as this will cause your body to produce more milk to fill the extra demand.
Some mums can produce a strong spray of milk either as a side effect of being full of milk or as a problem on its own, which can put off some babies.
If this happens, it helps if you can express some milk before you let your baby feed. Or you can try letting them suckle to bring the milk down, and then capture the initial spray in a towel. When the flow has calmed a little let your baby latch on again.
Problems with your baby’s feeding habits
If your baby is refusing your breast, it’s usually their way of telling you there’s something wrong. It might just be teething pain, or difficulty breathing from a cold.
If your baby’s gone on breast strike, try feeding them when they’re very sleepy, and keep the room quiet and distraction-free. You could also try different feeding positions, or even try feeding on the move as the rocking motion can be comforting to your baby.
It’s also a good idea to see your doctor to make sure there’s nothing wrong, such as an ear-infection or thrush.
Feeding from one breast only
Sometimes babies develop a preference for one breast. It won’t harm them, but you want to give both your breasts the chance to produce equal amounts of milk.
If your baby’s being choosy, try feeding them on the breast they don’t favour in the same position as the one they do. So if you’re cradling your baby on your left breast, just move them across to the right one, instead of turning them around. You’ll find it more comfy if you put a pillow under your supporting arm.
A biting baby is not much fun! If your baby is teething, let them have a good chew on a cold teething toy to get it out of their system and numb their gums. And if they do bite, draw them close. This makes it difficult for your baby to breathe through their nose, forcing them to open their mouth and let go!
If your baby is biting because they think making mum yell is a great game, be firm, say ‘no!’ and take them away from the breast for a minute.