Common breastfeeding issues
Common problems and solutions
Many mums will at some time experience difficulties with breastfeeding. Your midwife or a lactation consultant will be happy to help and you can always call 13 HEALTH (13 43 25 84) for advice.
How often should I feed my baby?
The simple answer is whenever your baby is hungry or seeking comfort. It's normal for newborns to feed 8–12 times in 24 hours, including several times during the night. As your baby gets bigger, they will need fewer feeds. However, during your baby’s growth and development, there will be times when your baby will want to feed a lot more than usual.
How long does a feed take?
Your baby will determine this. Some will gulp a full feed down in just 10 minutes. Others may take 50 minutes a feed. When your baby has had enough, they will stop sucking and come off the breast or simply fall asleep. If you notice that baby's jaw isn't really moving anymore, you can detach baby by inserting a finger into the side of the baby's mouth to break the seal.
How much should I feed my baby?
That depends on how hungry your baby is. It is important that you allow the baby to feed for as long as the baby wants on one side, if after feeding well the baby becomes fussy then you may offer the other side. For some feeds, one breast may be enough. Don't time the feed or swap sides unless the baby seems to have finished one side. This will ensure that your baby feeds well and helps with your breastmilk supply. If the baby takes only one breast, remember to offer the other breast at the next feed.
I don't think I'm producing enough milk
Your body is amazing and produces as much milk as your baby needs. It is very rare for a woman not to produce enough milk. Your baby is getting enough milk if they:
- have 6-8 heavily wet nappies of pale, inoffensive-smelling urine a day
- are passing soft, mustard-coloured poo
- look bright-eyed, alert, healthy and have good skin colour
- are reasonably content for some time between feeds
- are feeding around 8–12 times a day, depending on their age and storage capacity of your breasts
- are gaining weight over time. Your baby should be back to their birth weight by 2 weeks of age.
If you want to increase your milk supply you can:
- check the positioning and attachment of your baby on the breast is correct
- increase the frequency of feeds. The more the baby feeds, the more milk you will make
- allow your baby to finish the first breast before offering the second breast—always feed from each breast more than once each feed
- express milk between feeds
- eat a variety of healthy foods during the day and stay hydrated (water is best)
- avoid supplementing baby’s feeds with formula (unless there is a medical reason), as the less baby drinks from you, the less milk you will produce.
- try not to use a dummy, they can reduce breastfeeds and breastmilk production
- relax when you breastfeed. Find a quiet spot and turn the phone off
- get more sleep. Have a nap when baby naps, or just relax with a book or walk in the garden
- try frequent skin-to-skin contact, breast massage and nipple stimulation.
My breasts are swollen
In that first week when your milk comes in, your breasts can feel as hard as rocks. Don't worry, the swelling and tenderness usually go away in a day or two. In the meantime:
- wear a supportive, well-fitting bra (no underwire). If you want to wear an underwire bra it is important that you at least sleep without it on and that after feeds you massage under your breasts to ensure there are no blocked ducts
- breastfeed often—8–12 times in 24 hours—if you are separated from your baby, express as often as your baby would breastfeed
- apply heat (try heat packs or a warm shower) to your breasts before you feed, then apply cold packs to your breasts after each feed
- hand express a small amount of milk for your comfort before or after a feed so that the breast is soft enough for your baby to attach
If your breasts are hard and the baby cannot attach, you may be engorged and need to seek help.
Contact your midwife, a lactation consultant or call 13 HEALTH (13 43 25 84) for advice.
My nipples are sore
- See a midwife, lactation consultant, child health nurse or a doctor straight away. They will make sure baby is latching on correctly.
- If your nipples become shiny, very red and you develop flu-like symptoms, you may have an infection. See your doctor.
- Try different feeding positions.
- Don't pull the baby off your breast or you'll stretch your nipples. Insert your finger into the side of your baby’s mouth to break the suction seal.
- Try smearing expressed breastmilk on your nipples after each feed and allow to air dry. Your breastmilk contains healing properties that you can't buy in a shop.
- Avoid using shampoos and soaps on the nipples—generally avoid applying ointments, sprays, tinctures and powders
- Wear breathable, natural fabrics.
- Change your breast pads often and avoid plastic liners.
- Nipple shields are used occasionally to help with breastfeeding problems, but only under the guidance of a health professional.
Should I breastfeed with sore nipples?
If your nipples are sore and you are afraid of breastfeeding, try gently hand expressing for a few feeds to allow your nipples to heal. Usually this is not needed as sore nipples can often be helped by changing the baby's feeding position and checking the baby's attachment.
I think I have mastitis, what should I do?
If your breasts feel swollen, red, lumpy and you feel like you have flu-like symptoms, you may have mastitis. Mastitis occurs when blocked milk ducts in your breast become inflamed or infected. See your doctor immediately so they can check if you need antibiotics and pain relief.
If you ignore the symptoms, it can lead to an abscess in your breast. It is safe and important to feed your baby when you have mastitis. It will hurt, but it will actually help your breasts heal, and don't worry, the milk is safe for baby.
How can I avoid getting mastitis?
The more run-down you are, the more you become prone to infection. Being a new mum is exhausting, so try to get plenty of rest and eat healthy food to keep your body strong. Blocked milk ducts feel like a lump in your breast. They can also feel hot and achy to touch, and may look a little red. If you think you notice some lumps, try and get rid of them before they become infected by:
- continuing breastfeeding—if breastfeeding is very painful, remove milk by expressing to prevent progression of mastitis
- applying heat to your breasts (a heat pack or a warm shower will do the trick) before you feed
- applying a cold pack to your breasts after a feed
- gently massaging the affected area towards the nipple while you are feeding or expressing
- checking your baby’s positioning and attachment
- feeding your baby frequently, starting with the affected side. If pain inhibits milk ejection, begin feeding on the unaffected side, and switch breasts as soon as milk ejection occurs
- taking pain relief (paracetamol or ibuprofen) as needed
When treated promptly, a blocked duct should clear in 24-48 hours.
