A good latch will be comfortable and pain-free. You should see signs of swallowing. If you can’t get a good latch, try doing skin-to-skin contact and then letting your baby find your nipple with their mouth. If you continue having trouble, talk to your healthcare provider or a lactation consultant. They’re there to support you!
Making Sure Your Baby is Getting Enough Milk
If only newborns could talk… but since they can’t, here’s what to look out for to ensure they’re getting enough milk (8):
• They lose less than 7% of their birth weight before putting weight back on. (Losing weight is common in the first five days after birth.) (9)
• They have 1-2 blackish, tarry bowel movements on days 1-2, at least two more greenish or yellowish stools on days 3-4, and 3-4 yellow and loose stools on days 5-7. After that and through the first month, there should be one stool per feed.
• They have six or more wet diapers every day with pale yellow urine by days 5-7.
• They seem satisfied for 1-3 hours between feedings.
• They nurse 8-12 or more times every 24 hours.
Common Breastfeeding Challenges
If you find nursing to be a challenging experience, you’re in very good company. These are some of the more common issues you may encounter. (10)
“The most common nursing issues I've encountered while working at Aloha Nutrition are nipple pain and worries about not having enough milk,” Mari says. “Working with an international board certified lactation consultant (IBCLC) can help families learn latching and positioning techniques. If you're stressed about not making enough milk, an IBCLC will help identify the root cause of the low milk supply.”
Sore Nipples or Breastfeeding Pain
Once you and your baby have gotten into a good rhythm, nursing should be comfortable and pain-free. If you have continued discomfort:
• Make sure your baby has more than just the nipple in their mouth.
• Check in with the latch.
• Try switching positions each time you nurse.
• Moisturize cracked nipples using a few drops of your milk, nursing ointment (lanolin), and letting your nipples air dry or wearing a soft cotton shirt after nursing.
• Wear well-fitting bras and clothing that aren’t too tight around the breasts/chest.
• Frequently change nursing pads.
• Only wash your breasts/chest with water.
• Talk to your healthcare provider about non-aspirin pain medication if you need it.
• Reach out to your healthcare provider or lactation consultant for support.
Low Milk Supply
Many nursing parents have concerns about low milk supply. But if your baby is gaining weight as expected, they’re getting enough milk.
If you don't think you're producing enough milk:
• Check in with your baby’s latching and positioning.
• Nurse frequently and follow your baby’s lead on when to end.
• Offer both of your breasts/sides of your chest every time you nurse.
• Avoid introducing other ways of feeding your baby (unless you’ve decided to do combination feeding). When possible, you can try pumping extra milk to supplement.
• If the issue continues, talk to your healthcare provider about possible underlying causes.
Milk Oversupply
On the flip-side, producing too much milk can also be distressing and uncomfortable.
If you have this issue, try:
• Nurse on one side each time you feed your baby. Offer that same side for at least two hours. Then, gradually increase the length of time you nurse each time you nurse.
• Hand express your breast/chest for a few moments if it’s uncomfortably full between nursing times.
• Use a cold compress or washcloth to help with discomfort.
• Nurse your baby before they get too hungry so you can avoid more intensive sucking.
• Burp your baby as often as you need. Doing that has the added benefit of leaving more space for milk.
Engorgement
Breasts/chests become fuller and tender when milk production starts. Sometimes, though, this can lead to engorgement. Engorgement is caused by a build-up of milk, and it’s common around 3-5 days after childbirth.
Signs of engorgement include swelling, tenderness, warmth, redness, throbbing, flattened nipples, and a low-grade fever. Engorgement can also lead to clogged ducts.
You can try to prevent engorgement by:
• Nursing frequently and letting your baby feed for as long as they want to.
• Working with a lactation consultant to address any issues.
• Nursing on the engorged side to relieve the buildup.
• Avoiding pacifiers or bottles until about 3-4 weeks.
• Hand expressing or pumping to soften the breast/chest before nursing.
• Doing reverse pressure softening to soften the areola around the base of the nipple and help your baby latch.
• Massaging the breast/chest.
• Using a cold compress between feedings to help with discomfort.
• Pumping when you would be nursing if you’re at work or otherwise away from your baby more often.
• Wearing a supportive bra that isn’t too tight.
• Eating, hydrating, and sleeping well (or, as well as you can.)
Plugged or Clogged Ducts
Plugged or clogged ducts are common. They’re caused by milk ducts not fully draining. Pressure can build up and the area can become irritated. You might notice a tender and sore lump in your breast/chest.
If you think you might have a plugged or clogged duct, try:
• Nursing on the side with the clogged duct every two hours.
• Aiming your baby’s chin toward the clog.
• Massaging the area in a circular motion, starting from the sore spot and moving toward the nipple.
• Using a warm compress on the sore spot.
• Relaxing and getting more rest.
• Wearing a supportive bra that isn’t too tight.
• Reach out to a lactation consultant if clogged ducts keep coming back.
Nipple Size and Shape
Everyone’s nipples are different! But sometimes nipples temporarily flatten with engorgement. Having flat, inverted, or very large nipples can make it harder to nurse. Flat and inverted nipples may begin to stick out more over time.
If your nipples are making it difficult to nurse, try:
• Reaching out to your healthcare provider or a lactation consultant.
• Pulling out your nipples with your fingers or using a helpful device.
• Giving it time. Latch can improve the more you nurse. As long as you have enough milk production, the latch doesn’t have to be perfect to ensure your baby’s eating enough.
Nursing Strike
Sometimes, for a variety of reasons, babies may stop or get fussy around nursing. This could mean they’re trying to communicate an issue like pain, illness, or infection.
If getting your baby to nurse becomes really difficult, try:
• Hand expressing or pumping at the same cadence you were nursing to reduce the chances of engorgement and clogged ducts.
• Temporarily using another feeding method, like a cup, dropper, or spoon.
• Track wet and dirty diapers to confirm your baby’s eating enough.
• Continuing to offer your breast/chest. Stop if they get frustrated and try again later, like when they’re sleepy.
• Nursing in positions that allow for skin-to-skin contact.
• Nursing while rocking your baby in a quiet and distraction-free space.
• Giving your baby extra comfort and cuddles.
Exhaustion
New parenthood can be overwhelming. It’s also not a time that is exactly known for quality sleep. But being exhausted can contribute to a lot of the challenges you may face when nursing. Remember to take care of yourself in addition to your baby. Sleep when your baby sleeps, and lean on loved ones when you need support.