How to Solve Common Breastfeeding Problems

Note: This page is for educational purposes only. Receiving a link to this page should not be considered marketing of my services. 

(For more help with breastfeeding, please go back to Common Problems and follow the links there.)

Low Milk Supply

Sleepy or Unsatisfied Baby, Weight Loss, or Poor Weight Gain

Note: the following is a 3-5 day plan. If you do not see any increase in your milk supply in 3-5 days, see a lactation consultant (IBCLC).

Step 1: 

Feed your baby their full calorie needs at every feeding

How Much Milk Does My Baby Need?

Important note: these numbers are average feeding amounts. Always follow your baby’s hunger and fullness cues. 

Average Amount of Milk

Per Feeding 

(more is fine)

Day One: 0.5 oz (15 ml)

Day Two: 0.5–1 oz (15–30 ml)

Day Three: 1–1.5 oz (30–45 ml)

Day Four: 1.5–2 oz (45–60 ml)

Day Five to Six Months: see milk calculator

Step 2: 

Keep your breasts emptied by frequent & thorough pumping in addition to (or in place of) breastfeeding.

Sample pumping schedule (customize as needed):

  • 15 min pumping at 8 am, 10 am, 1 pm, 4 pm, 7 pm, 10 pm, 12 am (sleep for 5 hours*). When you wake up, power pump (see next bullet point).
  • 5 am power pump (20 min pumping, 10 min rest, 10 min pumping, 10 min rest, 10 min pumping.

*If you wake up with very hard breasts (engorgement), you may need to cut the 5-hour sleep to 4 or even 3 hours if your goal is a full milk supply. More here

Note: if you are in the first 3-4 days of your baby's life, a low supply is normal, especially for first time moms and/or c-section deliveries. Your body is working on it! Emptying your breasts every 3 hours is usually all that's needed. You will know if your breast is empty enough if it is soft after feeding or pumping. You do not need to power pump. 

Step 3: 

Breastfeed whenever you and your baby are both up to it

(if you’re pressed for time or exhausted, just keep baby at breast when they’re actively swallowing.) Swallowing sounds like little puffs of air: "kuh...kuh...kuh"

Sleep deprivation is bad for milk production! Your needs matter!

Sore or Injured Nipples, Shallow Latch, Tongue/Lip Tie

The three principles of comfortable latching:

1. Smush baby’s body firmly  against yours (baby wiggling? not close enough). If your baby feels like they're falling, latching will be harder.

2. Baby’s nose lines up with your nipple, their chest snuggles into your breast, their hips are against your rib cage. Baby must be positioned so that they can tilt their head back  in order to open their mouth as wide as possible. (Try opening your mouth with your head tipped forward; it doesn’t work well.) Do not put pressure on the back of their head; put your finger and thumb behind their ears for head support.

Positioning and Latching (note that there is no sound):

3. The nipple goes far  back in the baby’s mouth. Run your tongue along the roof of your mouth (from your teeth towards your throat)—your palate is hard, smooth, and there is plenty of room up there; as you move your tongue back, there is a softer area. Right between the hard and soft area is where your nipple needs to be, both for its protection and for your baby to get more milk more easily.

There are other causes of nipple pain besides shallow latching, but this is the most common.

Baby Won’t or Can’t Latch

Until you can get the help you need, there are three things you should do:

  • Make sure your baby is well-fed (milk drunk after every feeding; see milk calculator if you're not sure how much your baby should eat) 
  • Keep your breasts emptied frequently and thoroughly (sample pumping schedule in this section)
  • Ensure that your baby’s only  time near the breast is comfortable and enjoyable—no trying to force or pressure baby to latch.

If you have not already tried it, a nipple shield can help.

Good, deep latch on nipple shield

*be sure to follow up with a lactation consultant to make sure it fits well, you're putting it on correctly, and to plan how and when to stop using it. More about nipple shields.

Applying a nipple shield

Photo credit: La Leche League UK

Engorgement, Plugged Ducts, & Mastitis

Note: If you have a fever over 100.5, unbearable pain, or your skin looks reddened or darkened, call your OB or go to the nearest emergency room.

These conditions are largely the result of swelling and pain (inflammation), or a bacterial infection. They have different causes, but similar treatments. The swelling must be reduced to allow the breasts to provide optimal milk flow. Do the following:

(1) Lie on your back with cold compresses around your breasts for about 10 minutes
(2) Perform gentle massage called lymphatic drainage on your breasts (shown below)
(3) Breastfeed your baby or pump (only as much milk as you expect baby to eat)

If your milk isn't flowing, do this:

  • Reverse pressure softening (shown below)
  • Short (5 min) frequent (every 10-15 min for no more than an hour) pumping sessions (make sure the suction strength is comfortable, not too high).
  • Repeat the 3 steps above (cold, lymphatic drainage, breastfeed/pump)

Source: Maya Bolman, IBCLC; see also "breast gymnastics" video for more tips on relieving full breasts

Reverse Pressure Softening:

 Video by Newman Breastfeeding Clinic