Some breastfeeding problems and solutions

Sore and cracked nipples 

The main cause of sore nipples is incorrect positioning of the baby at the breast. If you cannot improve their position yourself, or your nipples are not healing you can get help from your LMC, a lactation consultant or the La Leche League. 

To help heal sore and cracked nipples:

• express a few drops of breastmilk, gently spread it on the nipples, and allow to dry. This helps prevent against infection and is soothing. Ointments may be soothing and it works as a moist healing method 
• leave nipples uncovered or loosely covered between feeds to help them heal 
• some people find silver nursing cups may help to relieve the discomfort of cracked and sore nipples 
• if your nipples stick to your bra, a helpful tip is to moisten with expressed breastmilk or warm water so that you do not cause more damage or pain 
• avoid using soap on the nipple 
• pain may be helped by taking paracetamol every four hours, up to four times a day. Prolonged (for more than a couple of days) or excessive use may be harmful. See your health professional if pain continues 
• breast pain may also be caused by blocked ducts and/or nipple and breast infections 
• seek professional help 

Engorgement/ breast fullness 

Breast fullness can occur usually 3-5 days after birth. This means that the breasts have become distended and are hot and painful to touch.

To relieve breast fullness and engorgement you can try 

• frequent feeding. Make sure baby is attached well to avoid sore, cracked nipples 
• if the areola is too swollen, gently express enough milk to enable your baby to get onto the breast correctly 
• using different feeding positions or feed lying down 
• light touch lymphatic drainage massage techniques can help. With gentle sweeping motions up into the armpit, applying cool face cloths or cooling packs on the breast between feeds 
• wearing a comfortable, non-restrictive, supportive bra 
• using non-steroidal anti-inflammatories every four - six hours, up to four times a day for pain (see your health professional if pain continues) 

Blocked ducts and breast infections (Mastitis) 

Breast lumps while breastfeeding may mean that you have a blocked duct 

To help clear blocked ducts try:

• continue to feed from both breasts as usual 
• changing breastfeeding positions 
• lymphatic drainage massage can help to remove excess fluid away from the breast. Use gentle sweeping motions towards the armpit 
• cool compress after feeds 
• a painless, persistent lump should be checked by your LMC, lactation consultant or GP 

You may have a breast infection if you have aches and pains, fever, feel shivery like you have the flu, or have a painful pink or red area on the breast. If you have any of these symptoms contact your LMC or doctor as soon as possible. 

To help recover from a breast infection:

• keep breastfeeding baby as advised. The breast heals more quickly if kept from getting too full. The milk is fine. It is the breast tissue that is infected, not the milk 
• take two paracetamol (500mg per/tablet) and two ibuprofen (200mg per/tablet) every four hours, up to four times a day as required for pain and to reduce inflammation. See your health professional if pain continues 
• drink extra fluids 
• get plenty of rest. Try to sleep when baby sleeps 
• to help prevent breast infections and blocked ducts, avoid wearing tight clothing or poorly fitting bras 

If you are having problems or concerns with breastfeeding, talk to your LMC, lactation consultant or La Leche League.