Here is a list of common questions and answers about breastfeeding. If you don’t find your answer below, please feel free to check out the support section of our site and find supports in your community.

Engorged breasts

Breasts are engorged when they become swollen with milk and feel warm or hot. They also feel heavy and firm or hard. The areola may become swollen and tight, making the nipple “flatten out.” This may make it difficult for your baby to latch onto your breast properly.

Some fullness is normal in the first few days of breastfeeding as the breasts start to produce milk and fill. If your breasts become heavy, firm, and hard (engorged), some of the suggestions below may help you latch your baby correctly. Engorgement that continues after the first week with painful, uncomfortable breasts is usually caused by not “emptying” the breasts at each feeding.

What can I do?

Continue to breastfeed your baby. Feed your baby frequently to keep your milk flowing regularly—every 2 to 3 hours is best. Wake baby to feed, if necessary. Your baby may have trouble latching on when your breasts are full and hard. To make this easier for your baby, soften the areola first. The best way to do this is to express some milk by hand.

You can also gently squeeze or compress the areola between your thumb and index finger to make it easier for your baby to grasp. Before you breastfeed, use a warm moist cloth on your breasts to help your milk flow. You could also take a warm shower or soak in warm water.

After you breastfeed: use cold packs on your breasts to help reduce swelling. If your baby is over one week old and you are still experiencing excess milk flow or engorgement, call your public health nurse, lactation consultant, or doctor.

Flat and inverted nipples

Flat nipples are those that do not stick out at all or do not stick out when stimulated or cold. Inverted nipples sink into the breast rather than stick out when the areola is squeezed.

What can I do?

If the baby is positioned and latched on well, most types of flat or inverted nipples will not cause breastfeeding problems. Some types of nipples may be more difficult for baby to latch on to, especially at first, but patience and persistence will pay off. Remember that babies breastfeed, not nipple feed. Contact your public health nurse or lactation consultant in the early days of breastfeeding for help with latching on.

Cracked or bleeding nipples

The most common causes of cracked or bleeding nipples are incorrect positioning or latch-on of the baby or both. Generally, a cracked nipple indicates that the baby was not latched on to enough of your breast.

What can I do?

Continue to breastfeed your baby. It will not harm your baby to swallow a little blood in your breast milk. Your breast milk is still the very best food for your baby. Get help immediately from your public health nurse, lactation consultant, or doctor. The longer you wait, the worse it will get. You need help to get baby positioned and latched on properly.

You can also gently rub a few drops of your breast milk into the nipple area after your baby has finished feeding and allow your nipple to air dry.

Blocked milk ducts

A milk duct that does not drain properly can become blocked. This causes a swollen, tender spot or lump in the breast. If you have a blocked milk duct, you feel generally well and have a normal temperature.

What can I do?

Continue to breastfeed your baby often and use different positions. Begin feeding on the affected breast. Gently massage the affected area before and during a feeding. Rest and watch for signs of infection. Talk with your public health nurse, lactation consultant, or doctor if the duct continues to remain blocked or if you develop a fever and flu-like symptoms.

Mastitis

Mastitis, or breast infection, is a bacterial infection that comes on quickly, usually in only one breast. The infected breast is red, hot, and swollen, and may be painful. You may notice a lump. If you think that you have a breast infection, check your temperature. Mastitis usually causes a high temperature and flu-like symptoms, which include aches, nausea, vomiting, and chills.

What can I do?

Continue to breastfeed your baby often. The breast infection will not harm your baby. Get help right away from your public health nurse, doctor, or lactation consultant. If it is truly mastitis, then you will need an antibiotic. If it is not mastitis, then you can get help to clear up the problem before mastitis can develop. Get extra rest. Your body will need it while fighting the infection.

Thrush

Thrush is a yeast infection that can affect both mother and baby. Mothers may have itchy, red, sore nipples and a shooting, deep pain in the breasts during feedings and possibly between feedings. Babies may have white patches inside the mouth. They may also have a persistent diaper rash.

The overgrowth of the yeast: Candida albicans. This yeast is normally present in warm, moist places, such as in baby's mouth, in mother's milk ducts, or on mother's nipples or genital area. Yeast feeds on sugars, including milk sugars. It is common for this yeast to overgrow when your resistance is low or after you have taken antibiotics. Antibiotics destroy the good bacteria that normally keep this yeast in check. Thrush is also common in women with diabetes.

What can I do?

Continue to breastfeed your baby. Get help right away to discuss the many options for treating thrush. If you need to take medicine, you and your baby will need to take it. The infection can pass back and forth between mother and baby. Your partner may also need medicine. Thrush can be passed between you and your partner during sexual activity.

Understanding your let-down reflex

Besides having full, heavy breasts, you will know that your milk has come in when you feel your milk let down. Your breasts may leak milk. You may have a tingly feeling, like pins and needles, or a feeling of warmth or pressure in your breast. Some women experience it as pain. Some other women don't feel the let down at all, but still have plenty of milk. If you don't feel the let down, then you will know it has happened when you hear your baby swallowing.

The hormones prolactin and oxytocin work together to get your milk flowing. Prolactin, the “mothering hormone” triggers the letdown, while oxytocin causes the contractions that move the milk along. Your body produces these hormones when your baby suckles, or maybe even when you just think of your baby or hear any baby cry. Oxytocin, called the “hormone of love,” also causes contractions during childbirth and during orgasm. You may notice that you have sexual feelings during breastfeeding and milk let-down during sex.

Both are completely normal. It's oxytocin at work.

“I tried to breastfeed my first baby, but it just didn't work. It was so frustrating. I felt like a failure. I thought something must be wrong with me. But, you know, I tried again when the second one came along, and it worked! I was much more relaxed, because I knew how to care for the baby and all that. There was nothing physical wrong with me. I must have been too uptight the first time. Too nervous.” ~a nursing mother

Milk let-down is controlled by hormones, and hormones are affected by your emotions. Therefore, if you feel embarrassed or uncomfortable, your milk might not flow as easily. It is important to understand the connection. Your milk is in there, but you must relax enough to let it flow.

If your breasts leak

Your breasts might leak at times after your milk comes in. This happens more often in the early weeks or months. Something has triggered your let-down reflex, like the cry of a baby or simply bending over. Your breasts will leak less often the longer you breastfeed. If leaking breasts bother you, use breast pads or cotton handkerchiefs inside your bra. Breast pads can be bought or made from circles of cotton. Change your breast pads whenever they are moist and avoid nursing pads with plastic liners--they trap moisture against your skin.

You can also wear clothing that disguises leaks. Try loose, printed clothing or dressing in layers.

Teething and breastfeeding

When baby's teeth start to come in, you may be concerned that baby may bite while you are breastfeeding. This is usually not a problem.

Normally, your child's tongue will lie over the lower teeth while breastfeeding. If you do find that your child bites down on your breast while feeding, pull your baby closer into your breast. Baby will release your breast to breathe. Your child may also bite down on your breast while sleeping or being playful. Deal with any biting firmly, but gently. Take your breast away for a moment. Your child will get the message. If your child seems to be bothered by teething pain, then offer a chilled teething toy or cold cloth before breastfeeding.

How long do I breastfeed?

You can breastfeed for as long as both you and your baby are enjoying it. The World Health Organization and UNICEF recommend breastfeeding until at least age two. In cultures where breastfeeding is the norm, most children breastfeed past age two. When this works for you and your child, great! Your child will continue to benefit from antibodies in your milk for as long as he or she breastfeeds. But, more importantly, your child will benefit emotionally. Children who breastfeed long-term tend to be more secure. Breast milk provides perfect and complete nutrition for the first six months of your baby's life. It is all the food your baby needs.

At six months you can begin to introduce your baby to complementary foods while continuing to breastfeed. You can continue to breastfeed for two years and beyond—long after your baby has been eating solid foods.

Breastfeeding and special situations

Most babies can be breastfed. This includes babies born early, babies born as twins or triplets, and babies born with special physical conditions. In these cases, though, you will need more help and information to get breastfeeding going well. You may need help to find a comfortable feeding position or to get baby well latched. Ask your nurse, doctor, midwife, or lactation consultant for help.

Your breasts may produce milk even if you have never been pregnant, making it possible to breastfeed an adopted baby. Some adoptive mothers have done this successfully. Your breasts might even produce milk if you have had surgery to reduce or enlarge your breasts. In these cases, get help from a lactation consultant. There is a good chance that you can at least partially breastfeed.