Why won’t she latch? Top 10 most common breastfeeding problems

The World Health Organization, the American Academy of Pediatrics and the Washington State Hospital Association agree: Breastfeeding is the ideal source of nutrition for your baby.

And, it’s a natural process, so it should be easy, right? Not necessarily. Just like learning how to ride a bike, you need to learn how to breastfeed — and so does baby, by the way.

In my work as a Board-Certified Lactation Consultant, I get a lot of questions from moms about challenges they’re having when it comes to breastfeeding. Here are the top 10 problems I hear, all of which can be helped with an in-person or virtual lactation support appointment.

Problem #1: Latching pain

It’s normal for your nipples to feel sore when you first start to breastfeed, especially if you’re a first-timer. But if baby has latched and the pain lasts longer than a minute into your feeding session, check the positioning.

Problem #2: Cracked nipples

Cracked nipples can be the result of many different things: thrush, dry skin, pumping improperly, or most likely, latching problems. During the first week of breastfeeding, you may have bloody discharge when your baby is just learning to latch or you are just beginning to pump. Even though it may look bad, a little blood won’t harm baby, and is normally nothing to be concerned about.

Problem #3: Clogged/plugged ducts

Ducts clog because your milk isn’t draining completely. You may notice a hard lump on your breast or soreness to the touch and even some redness. If you start feeling feverish and achy, that’s a sign of infection and you may need antibiotics.

Problem #4: Engorgement/high milk supply

Engorgement makes it difficult for baby to latch on to the breast because it’s hard and un-conforming to his mouth.

Problem #5: Mastitis

Mastitis is a bacterial infection in your breasts marked by flu-like symptoms such as fever and pain in your breasts. It’s common within the first few weeks after birth (though it can also happen during weaning) and is caused by cracked skin, clogged milk ducts or engorgement.

Problem #6: Thrush

Thrush is a yeast infection in your baby’s mouth, which can also spread to your breasts. It causes incessant itchiness, soreness and sometimes a rash.

Problem #7: Low milk supply

Breastfeeding is a supply-and-demand process. If your doctor is concerned about baby’s weight gain, and he is being plotted on the World Health Organization curves designed for breastfeeding babies, your body may not be producing enough breast milk for your baby.

Problem #8: Baby sleeping at breast

Baby is sleepy in the first couple of months after birth (hey, he’s been through a lot) so falling asleep while nursing is common.

Problem #9: Inverted/flat nipples

You can tell if you have flat or inverted nipples by doing a simple squeeze test:  Gently grab your areola with your thumb and index finger — if your nipple retracts rather than protrudes, breastfeeding will be more challenging.

Problem #10: Painful/overactive let down

Your breast is like a machine — when you let down, all the milk-producing engines constrict to move the milk forward and out of your nipple. Some mothers feel a prickly pins-and-needles sensation and others just get an achy feeling.

If you’re facing any of these challenges, you’re in good company. And all it might take to help you solve these problems is an appointment with a lactation consultant. Lactation consultants, like me, are specially trained to help breastfeeding moms learn the right techniques to feed their babies, and minimize the risk of issues such as clogged ducts and mastitis. A lot of women visit with a lactation consultant in the hospital after baby is born, but many may not know that support is available even after you go home.

MultiCare offers lactation consultations — both in-person and through “virtual” lactation support appointments. To connect with a virtual lactation specialist, you need a computer, webcam and speakers or a smartphone/tablet. The webcam allows us to see you and your baby and provide you with the same kind of guidance that’s available at our in-person appointments, without the hassle of having to drive to one of our hospitals.

Another benefit of virtual lactation support consultations is that they are available without a referral.

This story was originally published in December 2015 and updated in August 2017.