Breastfeeding: Common Issues and Support Services

During the first days and weeks of breastfeeding, you and your baby are learning to nurse. It is important to get help early to make sure you are comfortable and that your baby has a good latch and is feeding well.

If your baby is not feeding well, you may be having one of the common breastfeeding problems described below.

Common Issues

Sore Nipples

If your baby is not latching on well, your nipples may get sore. When you bring your baby onto your breast, make sure they have a wide-open mouth to get your breast and as much of your areola (the dark area around your nipple) into their mouth as possible. If your baby is sucking only on your nipple, break the suction by placing your pinky finger gently into the corner of their mouth and remove your breast from their mouth. Then, try to latch them on again.

Ask a lactation specialist for help in getting a good latch.

If you are experiencing sore nipples, you can also try the following:

  • Try a different breastfeeding position.
  • Nurse more frequently for shorter periods of time.
  • Start on the less sore side first.
  • After feedings, coat your nipples with breast milk and let them air dry.

Engorgement

Your breasts will swell when you start to make more milk. This is normal and will usually happen within the first few days after giving birth. If your breasts swell so much that they feel too full and painful, this is called engorgement.

To prevent engorgement, make sure your baby is latched on well and feeding frequently. Ask your lactation consultant for help in relieving engorgement and preventing it from happening again.

If you are engorged, try the following:

  • Continue to feed or express your milk frequently — eight or more times in a 24-hour period. Try not to go more than two hours without nursing or expressing breast milk.

  • Alternate which breast you use to start feeding and offer both breasts at each feeding, without time limits. Your breasts should feel softer (not hard or tight) after a good feeding.

  • Express some milk before you offer the breast to relieve discomfort and reduce swelling. This can also help your baby latch on if they are having trouble because of the swelling.

  • Shower or apply warm, moist washcloths to your breasts before you breastfeed. If you can, gently massage your breasts towards the nipples. After you feed, apply cold washcloths or compresses.

Clogged Ducts

Milk may clog the ducts and create blockages. This can feel as if you have a lump or marbles in your breasts, which can become red and painful to touch. The best way to clear a clogged duct is to continue to breastfeed, as babies are the best at moving milk.

To prevent clogged ducts:

  • Continue to feed frequently — eight or more times in a 24-hour period.

  • Drink plenty of fluids and get some rest.

  • Make sure your bra fits properly and is not too tight.

  • Avoid sleeping positions that put pressure on your breasts, such as sleeping on your stomach.

If you think you have a clogged duct, in addition to the tips above, try the following:

  • Try not to go more than two hours without nursing or expressing your breast milk.

  • Shower or apply warm, moist washcloths to your breasts before you breastfeed. You can also try soaking the breast in a bowl of warm water and massaging the clog.

  • Before and during nursing, gently massage the breast over the area of the blockage and toward the direction of your nipple.

  • Start feeding on the affected breast first, then offer the other breast. A baby will suck strongest when they start a feed and they can help clear a clogged duct. Try to keep the breast as empty as possible, but continue to offer both breasts.

If a clogged duct does not go away in a day or two, see your health care provider or lactation consultant.

Mastitis

Mastitis is a serious breast infection and should be addressed immediately. If you have a lumpy, painful red area on the breast and chills, aches or a fever, contact your health care provider or lactation consultant immediately. Your health care provider may prescribe antibiotics to treat the infection. Antibiotics commonly used to treat mastitis are safe for breastfeeding.

Start following the steps for resolving a clogged duct and contact your health care provider as soon as possible to discuss your treatment plan.

Local Support Services

Your health care provider or lactation consultant should be your first contact for information and support. You can also contact the hospital where you gave birth, or local organizations and groups.

Here are some local services for breastfeeding parents:

  • Lactation Rooms: You have the right to breastfeed anywhere you and your baby have the right to be. If you would like privacy, Community Lactation Rooms (PDF) are available in municipal buildings and public spaces.

  • WIC Program: If you get WIC services, contact your WIC clinic for help. Most WIC clinics in the city offer parent-to-parent breastfeeding support from peer counselors.

  • Baby Cafés: The Center for Health Equity and Community Wellness offers regular Baby Cafés at our Neighborhood Health Action Centers. You can also contact Baby Café USA to find a group near you.

  • Newborn Home Visiting Program: A health educator can visit you in your home to answer your questions and help you find services. This program is available to all parents who have recently given birth in certain hospitals, regardless of age or immigration status.

  • New York City Breastfeeding Hospital Collaborative: As part of this initiative, many hospitals in NYC have achieved or are on the way to achieving the Baby-Friendly Designation. Baby-Friendly hospitals and birthing centers provide support around infant feeding and bonding by upholding the 10 Steps to Successful Breastfeeding and the International Code of Marketing of Breast-milk Substitutes.

  • Latch On NYC: As part of this citywide initiative, participating hospitals have made a commitment to provide support to breastfeeding parents and refrain from infant formula marketing.

  • Mobile Milk: Mobile Milk is a text messaging campaign to encourage and support breastfeeding for people who are pregnant or have given birth. To sign up, text "MILK" to 877-877.

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