Common Breastfeeding Challenges

Breastfeeding, like anything worth doing, can come with its share of challenges. If this is your story, it's important to know that you are not alone. The Andrew County Health Department offers many services to breastfeeding moms to help them overcome any challenges they might be facing.

1.) Sore Nipples

Many moms say that their nipples feel tender when they first start breastfeeding. Breastfeeding should feel comfortable once you and your baby have found a good latch and some positions that work.

What you can do

  • A good latch is the key to preventing sore nipples. If your baby sucks only on the nipple, gently break your baby's suction to your breast by placing a clean finger in the corner of your baby's mouth. Then try again to get your baby to latch on. (Your nipple should not look flat or compressed when it comes out of your baby's mouth. It should look round and long or the same shape as it was before the feeding.)
  • If you find yourself delaying feedings because breastfeeding is painful, call the Breastfeeding Help Hotline or our office to get help from our Breastfeeding Peer Counselor.Delaying feedings can cause more pain and harm your milk supply.
  • Help cracked nipples stay moist so you can continue breastfeeding. Try one or all of these tips:
    • After breastfeeding, express a few drops of milk and gently rub the milk on your nipples with clean hands. Human milk has natural healing properties and oils that soothe.
    • Use purified lanolin cream or ointment that is especially made for breastfeeding.
    • Let your nipples air dry after feeding, or wear a soft cotton shirt.
  • Don't wear bras or clothes that are too tight and put pressure on your nipples.
  • Change nursing pads (washable or disposable pads you can place in your bra or absorb leaks) often to avoid trapping in moisture.
  • Avoid harsh soaps or ointments that contain astringents (like a toner) on your nipples. Look for labels on products that instruct you to remove them or was the area before breastfeeding. Washing with clean water is all that is needed to keep your nipples and breasts clean.
  • If you have very sore nipple, you can ask your doctor about using non-aspirin pain relievers.

 2.) Questions About Milk Supply

Most mothers can make plenty of milk for their babies. But many mothers worry about having enough milk. There may be times when you think your supply is low, but it is actually just fine.

When your baby is around 6 weeks to 2 months old, your breasts may no longer feel full. This is normal. At the same time, your baby may nurse for only five minutes at a time. This can mean that you and your baby are just getting used to breastfeeding - and getting good at it!

Growth spurts can cause your baby to want to nurse longer and more often. These growth spurts can happen when your baby is around 2 to 3 weeks, 6 weeks, and 3 months of age. Growth spurts can also happen at any time. Don't be worried that your supply is too low to satisfy your baby. Follow your baby's lead. nursing more and more often will help build up your milk supply. Once your supply increases, you will likely be back to your usual routine.

What you can do


  • Make sure your baby is latched on and positioned well.
  • Breastfeed often and let your baby decide when to end the feeding.
  • Offer both breasts at each feeding. have your baby stay at the first breast as long as he or she is still sucking and swallowing. Offer the second breast when the baby slows down or stops.
  • Avoid giving your baby formula or cereal in addition to your breastmilk, especially in the first six months of life. Your baby may lose interest in your breastmilk, and your milk supply will decrease. If you need to supplement your baby's feedings, try using a spoon, cup, or a dropper filled with breastmilk.
  • Check with your doctor for health issues, such as hormonal issues or primary breast insufficiency, if the above steps don't help.


3.) Engorgement

It is normal for your breasts to become larger, heavier, and a little tender when they begin making milk. Sometimes, this fullness may turn into engorgement, when your breasts feel very hard and painful. Engorgement is the result of the milk building up. It usually happens during the third to fifth day after giving birth. But it can happen at any time, especially if you have an oversupply of milk or are not feeding your baby or expressing your milk often.

Engorgement can also cause:


  • Breast swelling
  • Breast tenderness
  • Warmth
  • Redness
  • Throbbing
  • Flattening of the nipple
  • Low-grade fever


Engorgement can lead to plugged ducts or a breast infection, so it is important ot try to prevent it before this happens. If treated right engorgement should fix itself.

What you can do

  • Breastfeed often after giving birth. As long as your baby is latched on and sucking well, allow your baby to feed for as long as he or she likes.
  • Call the Breastfeeding Help Hotline or call the Health Department to meet with the Breastfeeding Peer Counselor and help improve your baby's latch.
  • Breastfeed often on the affected side to remove the milk, keep the milk moving freely, and prevent your breast from becoming overly full.
  • Avoid using pacifiers or bottles to supplement feedings in the beginning. Try to wait to introduce pacifiers until your baby is 3 or 4 weeks old.
  • Hand express or pump a little milk to soften the breast, areola, and nipple before breastfeeding.
  • Massage the breast.
  • Use cold compresses on your breast in between feedings to help ease the pain.
  • If you are returning to work, try to pump your milk on the same schedule that your baby breastfed at home. Be sure to not let more than four hours pass between pumping sessions.
  • Get enough rest, proper nutrition, and fluids.
  • Wear a well-fitting, supportive bra that is not too tight. 
  • Try reverse pressure softening to make the areola soft around the base of the nipple and help your baby latch. Try one of the holds in the illustrations below. Press inward toward the chest wall and count slowly to 50. Use steady and firm pressure, but gentle enough to avoid pain. You may need to repeat each time you breastfeed for a few days.


4.) Mastitis

Mastitis (mast-EYE-tiss) is soreness or a lump in the breast. It can cause symptoms such as:


  • Fever and/or flu-like symptoms, such as feeling run down or very achy
  • Nausea
  • Vomiting
  • Yellowish discharge from the nipple that looks like colostrum
  • Breasts that feel warm or hot to the touch and appear pink or red


A breast infection can occur when other family members have a cold or the flu. It usually only occurs in one breast. It is not always easy to tell the difference between a breast infection and a plugged duct because both have similar symptoms and can improve within 24-48 hours. Some breast infections that do not improve on their own within this time period need to be treated with medicine given by a doctor.

What you can do


  • Breastfeed on the affected side every two hours or more often. This will keep the milk moving freely and our breast from becoming overly full.
  • Massage the area, starting behind the sore spot. Move your fingers in a circular motion and massage toward the nipple.
  • Apply heat to the sore area with a warm compress.
  • Get extra sleep, or relax with your feet up to help speed healing. Often a breast infection is a sign that ta mother is doing too much and becoming overly tired.
  • Wear a well-fitting, supportive bra that is not too tight, since this can constrict milk ducts.


Ask your doctor for help if you do not feel better within 24 hours of trying these tips, if you have a fever, or if your symptoms worsen. You might need medicine. See your doctor right away if:


  • You have a breast infection in which both breasts look affected
  • There is pus or blood in your breastmilk
  • You have red streaks near the affected area of the breast
  • Your symptoms came on severely and suddenly


5.) Fungal Infections

A fungal infection, also called a yeast infection or thrush, can form on your nipples or in your breast. This type of infection thrives on milk and forms from an overgrowth of the Candida organism. Candida lives in our bodies and is kept healthy by the natural bacteria in our bodies. When the natural balance of bacteria is upset, Candida can overgrow, causing an infection.

A key sign of a fungal infection is sore nipples that last more than a few days, even after your baby has a good latch. Or you may suddenly get sore nipples after several weeks of pain-free breastfeeding. Other signs are pink, flaky, shiny, itchy, or cracked nipples or deep pink and blistered nipples. You also could have achy breasts or shooting pains deep in the breast during or after feedings.

Causes of fungal infection include:


  • Thrush in your baby's mouth, which can pass to you
  • An overly moist environment on your skin or nipples that are sore or cracked
  • use of antibiotics or steroids, perhaps during labor
  • A chronic illness like HIV, diabetes, or anemia


What you can do

Funal infections may take several weeks to clear up , so it is important to follow these tips to avoid spreading the infection:


  • Change disposable nursing pads often
  • Wash any towels or clothing that comes in contact with the yeast in very hot water (above 122 F).
  • Wear a clean bra every day.
  • Wash your hands often.
  • Wash your baby's hands often, especially if he or she sucks on his or her fingers.
  • Boil every day all pacifiers, bottle nipples, or toys your baby puts in his or her mouth. (To boil them, place them in a pot of water and heat the water to a rolling boil.)
  • After one week of treatment, throw away all pacifiers and nipples and buy new ones.
  • Boil every day all breast pump parts that touch your milk.
  • Make sure other family members are free of thrush or other fungal infections. If they have symptoms, make sure they get treated.


Office on Women's Health, Department of Health and Human Service (2014, July 21). Common Breastfeeding Challenges. Retrieved February 15, 2017 from

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Certified Lactation Specialist

Certified Lactation Specialist

Jessica Bowman



Nicole Parson

Breastfeeding Peer Counselor


Monday and Wednesday

8 am to 4 pm

Breastfeeding Help Hotline


every day 7 am to 10 pm

Other Local Resources

St. Joseph, MO

Mama's Milk Café

Every Monday
4:30 pm - 6:00 pm
Mosaic Life Care
Exploratorium Room in Plaza 2

La Leche League

3rd Tuesday of Every Month
6:00 pm - 7:00 pm
Paradox Coffee in Downtown St. Joseph
Meet in the Nursery


Mothering Monday's

Every Monday
4:30 pm - 6:30 pm
St. Francis Hospital
Meet in the Hospital's Board Room

Lactation Consulting

House Calls Available
Call to make an appointment
(660) 562-2600
Absolutely Free

Andrew County

Breast-Friends Support Group

1st Tuesday of Every month
4:30 pm - 6:00 pm
Andrew County Health Department
Use Back Entrance

Breastfeeding Peer Counseling

Mondays and Wednesdays
8:00 am - 4:00 pm
Andrew County Health Department
Call to make an appointment
(816) 324-3139
Absolutely Free

WIC Participant Breastfeeding Hotline

Available every day of the week
Anytime before 10:00 pm
(816) 273-2278