Breastfeeding is the natural way to feed your baby. In addition to providing nutrition, your breast milk gives your baby disease-fighting immunities, bonding time, and the loving touch of skin-on-skin. Nursing often comes with challenges in the early days. Working closely with an experienced and supportive International Board Certified Lactation Consultant (IBCLC) can help you meet your breastfeeding goals. We’re here to help! 

Pain while breastfeeding

You may have heard the saying “Breastfeeding shouldn’t hurt,” and it’s true that once a nursing relationship is well established—with a proper latch—you should not be in pain. It’s not uncommon to have some nipple soreness in the first days, especially during the initial latch as your body adjusts to this new experience. 

While pain is never good, it can be an important indicator to tell us that something is not right, and that you need help right away. When breastfeeding hurts, our bodies are telling us we need to correct a problem. Seeking a consultation with a lactation consultant is the best way solve these issues.

No one should be enduring excruciating pain throughout a nursing session. Cracked, bleeding, or sore nipples are sign of an improper latch. Shooting pains in the breast can be sign of an infection like thrush or mastitis. Painful lumps, which often indicate clogged or plugged milk ducts, need to be addressed immediately through breast massage and milk expression in order to avoid infection, as well as to maintain milk supply. 

Pain can sometimes be caused by anatomy issues such as a tongue tie or a lip tie. See below for more information about an oral anatomy exam. 

Latching issues

Painful latch, babies who won’t latch, and babies who can’t maintain a proper latch are all common reasons to seek out breastfeeding help. Sleepy babies can also be difficult to arouse long enough to complete a full feeding. 

An experienced IBCLC will perform an oral exam on your baby’s mouth to detect issues. Using a gloved finger, the lactation consultant will feel the shape and structure of your baby’s tongue, palate and inside cheeks. The lactation consultant will look and feel under the baby’s tongue and top lip to check for a tight frenulum (the small ridge of connective tissue) which may restrict proper motion of the tongue or lip. Sometimes babies have a posterior tongue tie that can be difficult for an untrained individual to see or feel. In the case of a tongue tie or a lip tie, babies may be unable to create a proper latch and compensate for the lack of suction by “biting” or chomping down on the breast, causing pain.

If the IBCLC suspects a tongue or lip tie is present, you may be referred to a pediatric dentist or ENT for further evaluation. When a dentist decides to do a revision—a release of the tight frenulum by scissors or laser—it is always important to see an IBCLC for follow up care. 

Flat or inverted nipples

It’s not uncommon for a baby to have difficulty latching onto a breast with flat or inverted nipples. Pumping a little before bringing baby to breast may help evert the nipple and make it easier to latch deeply. IBCLCs sometimes recommend a nipple shield as a temporary tool to help baby learn. It’s important to work with a trained healthcare provider who can fit you properly and explain the correct use of nipple shields. 

Engorgement and oversupply

Engorged breasts are normal in the first days of breastfeeding, after the milk has “come in,” meaning the body has progressed on from the colostrum stage. However, continued engorgement can be painful and could lead to a breast infection known as mastitis. Likewise, engorged breasts may make it hard for your baby to latch properly and deeply. 

Oversupply means your body is making more milk than your baby requires. Working with a lactation consultant to carefully regulate supply is important so that you maintain the proper milk supply for your baby and avoid infection due to milk stasis. 

Overactive letdown—meaning the milk releases too quickly for the baby to handle—may result in gulping or choking in your baby. It can also lead to a gassy, fussy baby or excessive spitting up. The “laid back positioning” may help. Working with your IBCLC to regulate your milk supply can also correct this issue.

Low milk supply

Anxiety about making enough milk is common. If you need to boost your supply while supplementing with expressed breast milk, donor milk or formula, creating a plan with your IBCLC is a great way to make the most of each pumping session. An experienced IBCLC can help you determine how baby is transferring milk at each feeding.

Laid Back Lactation consultants specialize in helping moms supplement at breast with a Supplemental Nursing System (SNS) which lets you stimulate the breast at the same time you’re offering the supplement. “How can I make more milk?” is one of the top reasons parents reach out to a lactation consultant.

Weight gain issues

Parents and doctors become concerned when a breastfed baby is not gaining enough weight or continues to lose weight after hospital discharge. Many parents ask, “HOW do I know if my baby is getting enough milk?!”

During all consultations with our IBCLCs, your baby will be weighted before and after feedings to help gauge roughly how much milk is being transferred at a feeding. Our lactation consultants also work closely with, and send reports to, your child’s pediatrician. 

If your baby is exclusively breastfeed, it’s important to make sure the weight is being checked on the WHO growth curve chart. Be sure to ask your pediatrician about this. Babies should also be weighted on the same scale, in just a clean, dry diaper each time to avoid misreadings. 

Breastfed babies who are determined to be “failure to thrive” by their doctors must see an experienced IBCLC.

Sleep issues in the breastfed baby

The first few weeks with a newborn can be one big blur of sleepless nights. It’s normal for a baby to need to eat around the clock. Their stomachs are still very tiny and breastmilk is digested very quickly. Newborns should be put to breast 8-12 times every day. 

As your baby grows, so will the stomach. Longer stretches of sleep become possible. Working with an IBCLC can help you better understand your baby’s needs. 

Milk blebs or blisters

Sometimes a small bit of skin can grow over a milk duct opening and milk backs up behind it. This may result in a small blister or “bleb” on the nipple or areola. They may be clear, white, or yellow in color. Pain may or may not be associated, and may be worse during feedings.

Moist heat on the area between feedings can help. Some blebs clear up on their own in a few days. Any open wounds on the nipple should be kept clean.  

In the case of a persistent bleb, an IBCLC can help treat the issue, as well as examine you for underlying causes. 

Returning to work and pumping

This is obviously not a problem! But it’s a cause for worry and anxiety for many parents while on parental leave. It’s important to be realistic and keep in mind that you don’t need to pump all the milk your baby will ever need on maternity leave. Right after your first morning feeding is usually the best time to pump, because the body has the most milk then. Adding just an ounce or two to your freezer each day can help you build that “stash” that will make transitioning to work and daycare doable.

Sitting down with an IBCLC to set up a plan that will work for you can make maternity leave and going back less stressful for you, your partner, and your baby. 

Need help with solving your breastfeeding issues?
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