Problems & solutions

You may experience problems during breastfeeding. Read the information below to help with some of these issues. To help prevent blocked milk ducts, wear loose clothing and a well-fitted bra.

Sore and cracked nipples

Nipples shouldn’t be sore during the feed. Sore nipples are usually caused by the baby being in the wrong position at the breast. 

Thrush infections can also cause sore nipples. Thrush can feel like a burning pain, and you may feel it throughout and after the feed. This is caused by a spasm of blood vessels.

The spasm causes a burning pain, and the nipple looks white, then a throbbing pain occurs as the nipple turns back to its normal colour. This may be caused by a condition of the blood vessels, called Raynaud’s phenomenon. Talk to your Plunket nurse if this happens to you.

To help heal sore and cracked nipples

  • Express a few drops of breast milk, gently massage it on your nipples, and allow it to dry.

  • Leave your nipples uncovered or loosely covered between feeds to help them heal.

  • Avoid using soap on them, because it can irritate the skin.

  • You can reduce the pain of cracked nipples by taking paracetamol.

  • Be careful to take paracetamol as directed on the packet; taking it for more than a couple of days or too often may be harmful.

See your health provider if the pain continues. If you can’t improve your baby’s position on the breast, and your nipples are not healing or are still painful, get help from PlunketLine on 0800 933 922, your midwife or doctor, Plunket nurse, or the La Leche League.

Engorgement or breast fullness

Breast fullness usually occurs 2–4 days after birth. The breasts become swollen, hot and painful to touch.

To relieve breast fullness and engorgement try to:

  • feed frequently, making sure your baby is attached well to avoid sore, cracked nipples

  • gently express milk to soften the areola (darker area around the nipple). If it’s swollen, the baby can’t get onto the breast easily

  • use different feeding positions or trying to feed lying down

  • have a warm shower before feeding

  • apply cool face cloths (flannels) on the breasts between feeds

  • wear a comfortable, non-restrictive, supportive bra

  • take paracetamol as directed on the packet for pain (see your health professional if pain continues for more than a couple of days).

Blocked milk ducts

Breastfeeding mothers may experience breast lumps, which can be caused by a blocked milk duct.

Feeding more frequently from the affected breast may help to clear a blocked milk duct, but do continue to feed from both breasts. Changing the position you use for feeding might help too. If possible, try feeding baby in a position where their chin is near the blocked duct. This will help clear the blockage. 

You can also:

  • Have a hot shower, or apply warm facecloths to the affected breast.

  • Gently massage any lumpy areas towards the nipple.

  • Get any painless lumps that won’t go away checked by your doctor.

Breast infection (mastitis)

Symptoms of a breast infection are:

  • aches and pains

  • fever

  • feeling shivery like the flu

  • or a painful pink or red area on the breast.

If any of these symptoms are present, contact your midwife or doctor, or phone PlunketLine on 0800 933 922 as soon as possible. You may need antibiotics to clear the infection.

If you are suffering from a breast infection:

  • Keep feeding your baby. The symptoms clear more quickly if the breasts don’t get too full. The milk is not harmful for your baby to drink.

  • Get plenty of rest and try to sleep when your baby sleeps, and drink extra fluids.

  • Take paracetamol as directed on the packet for pain.

  • See a doctor if you’re still taking painkillers after two days.

If you are worried about anything to do with breastfeeding, talk to your midwife, Plunket nurse, PlunketLine, La Leche League, or lactation consultant.

Drugs and breastfeeding

Before taking any medicine, ask your midwife, Plunket nurse, doctor or pharmacist about the effect of the drug on your baby through breast milk.

Most medicines and herbal remedies pass through breast milk.

Alcohol and breastfeeding

It’s safest for breastfeeding mothers not to drink alcohol, because the long-term effects on the baby are unknown.

Smoking, marijuana, P, & breastfeeding

Smoking reduces the amount of milk produced and babies may gain weight more slowly. Smoking also increases the risk of SUDI (SIDS or cot death).

Marijuana and the drug P pass through to the breast milk and are known to affect babies. It’s safest for breastfeeding mothers to avoid smoking and taking drugs, because the long-term effects on the baby are unknown.


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