Birth & Delivery

From thrush to mastitis – 4 common breastfeeding problems & the latest guidance for supporting each one

Emma Harpham, Editor  |   29 Apr 2024


If there’s one thing that can be said about breastfeeding, it’s that the journey can so often come with bumps in the road. 

We’ve had our fair share of breastfeeding problems on team TRB. From struggling to adjust and relax into the process, to difficulty latching and the external pressure to get everything right the first time – we’ve been there, and we really get it. 

Senior Editor Jessie has shared candid insights into her early breastfeeding journey before, and Founder Eloise has also documented her experience, from all things colostrum harvesting (more on this to come) to dealing with her second hit of mastitis. Hop over to our Instagram to follow the latest in her newborn journey, with babies four and five.

Common breastfeeding problems and solutions, summarised  

The good news is that with so many of these breastfeeding challenges, there are things you can do, at home, to help ease discomfort and support yourself.

Here are four common breastfeeding problems and solutions, with signposting to the latest guidance.

1. Sore or cracked nipples

Sore or fissured nipples when breastfeeding usually happen when your baby isn’t positioned properly at the breast, and can’t latch correctly.

If your baby isn’t latched on well, your nipple might end up sitting closer to the front of their mouth, which can lead to discomfort as it pinches against their hard palate.

Ways to treat sore or cracked nipples

The NHS says: Don’t wait to get help from your midwife, health team, or lactation specialist. They’ll be able to support you with getting your baby into the right position during feeding, and properly attach to your breast.

Keep feeding your baby for as long as they need, as limiting feeds to ‘rest’ your nipples won’t alleviate pain and could impact your milk production.

Instead, focus on creating comfort alongside feeds. This could look like swapping out breast pads at every feeding session and opting for ones without a plastic backing if possible. Choosing a breathable cotton bra to allow air circulation is a good idea, too.

If your nipples become cracked, consider applying a small amount of expressed breast milk after each feeding, and topping up with a really good nipple balm in between feeds. TRB Founder Eloise is using the Wren Go-to Balm – Nipple Salve, and it’s an absolute wonder-worker.

common-breastfeeding-problems-and-solutions-lactation-consultant

2. Thrush 

If you’re dealing with breast and nipple pain, thrush (also known as a candida infection) can sometimes be a possible cause. It’s not just mums who can get it – breastfed babies can develop it in their mouths too.

Senior Editor Jessie dealt with painful fissures and a bout of thrush with her second baby. The two problems are so often linked, as cracked nipples can provide an entry point for candida.

In mums, thrush can cause pain in both nipples or breasts after feeds, and can last for up to an hour after each one.

In babies, watch out for:

  • Creamy white spots or patches on the tongue, gums, roof of the mouth, or inside the cheeks that won’t budge when you wipe them with a cloth.
  • Fussiness in your baby during feedings
  • A layer of white film on the lips
  • Persistent nappy rash

Ways to treat thrush while breastfeeding

The NHS says: Book in with your health team, and they’ll be able to help you confirm that you have thrush. 

If either you or your baby has it, you’ll treat both at the same time to prevent spread. You can continue breastfeeding during treatment. 

Babies usually get oral thrush treatment in the form of a safe anti-fungal gel. For mums, an anti-fungal cream to be used on the nipples is usually prescribed.

You should usually see improvement within a couple of days, but complete clearance can usually take a bit longer.

3. Breast engorgement

Breast engorgement happens when your breasts become too full of milk. They might feel hard, tight, or just downright uncomfortable

This can occur during the initial days of breastfeeding as both you and your baby adjust, your colostrum transitions to breast milk, and your supply syncs with your little one’s needs. 

Additionally, engorgement may crop up later on when your baby begins eating solid foods and you aren’t feeding them as frequently.

Ways to treat breast engorgement

The NHS says: Your best bet is to keep feeding your baby or use a breast pump. If you’re experiencing discomfort, you could try hand-expressing a small amount of milk to alleviate the pressure – expressing too much could lead to increased milk production, though. 

Get guidance from your midwife, health visitor, or breastfeeding specialist. 

Plus, wearing a well-fitted breastfeeding bra, and applying warm flannels before expressing can help relieve discomfort.

common-breastfeeding-problems-and-solutions-demonstration

4. Mastitis

Mastitis is when your breast gets swollen, hot, and painful – not fun, we know. 

It’s been a part of TRB Founder Eloise’s breastfeeding journey twice, with both sets of twins, and along with all the textbook signs, she experienced flu-like symptoms that came on out of nowhere, within minutes.

Wondering if you have mastitis? Look out for: 

  • warmth, pain and swelling that affects just one breast, with symptoms that show up pretty quickly and continue when feeding
  • redness on your breast, though this can be tricky to spot if you have darker skin 
  • lumps or a hard spot in the breast
  • feelings of tiredness, muscle aches, a fever, and chills

You might also experience nipple discharge, which can be white or have streaks of blood. This can sound alarming, but it’s often par for the course with mastitis.

How to treat mastitis

The NHS says: Continuing to breastfeed is often the best course of action as it can actually help prevent the condition from getting worse. Try to stick to your feeding schedule and avoid suddenly stretching out the time between sessions. This is to prevent milk from building up and causing trouble down the line. 

A cloth soaked in warm water and applied to the breast (or a shower or bath) may improve your milk flow, and breast pain can also be soothed using a cold cloth or compress.

If things don’t improve at home, you’ll typically be prescribed oral antibiotics.

It’s a good idea to get medical advice if your symptoms do not get better 12 to 24 hours, or if your symptoms do not get better 48 hours after taking antibiotics.

That’s it! Some of the most common breastfeeding problems, and ways you can support yourself through them.

Remember, sometimes these things can just happen, despite our best efforts, so don’t sweat it too much if you’re struggling right now. We see you, and we think you’re doing great.

Bookmark this one for later: Sick and breastfeeding? Here’s (almost) all the advice worth knowing

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