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Problem-Solving Guide for Breastfeeding Moms

Many breastfeeding women experience complications and difficulties. However, many of these are easily treatable at home.

Sore Nipples

Sore nipples are common for many women during the first few days as they pump for their hospitalized baby. The following measures may be helpful:

Before Pumping

  • Place a clean, warm, wet washcloth on the breasts just before pumping. This will help stimulate your milk flow.
  • Massage both breasts and gently roll the nipples between your fingertips just before you pump. This will help your milk flow more readily, hopefully allowing you to use a lower suction setting.
  • Gently hand-express a small amount of milk just before you pump. This will stimulate milk to flow more easily.

During Pumping

  • Try a different size flange or a different brand of pump if your nipples do not fit comfortably within the flange.
  • Use the lowest suction setting that removes milk.
  • Place a clean, warm, wet washcloth on your nipples for a few minutes after pumping sessions to soothe sore nipples.

After Pumping

  • Massage breast milk into your nipples and allow them to air-dry. Apply a small amount of hydrous lanolin (a pure lanolin such as Lansinoh® or PurLan) onto your nipples after they are dry.
  • Wear breast shells between pumping sessions during the day to keep clothing from rubbing your nipples and irritating them. Do not wear the breast shells while sleeping because the shell may shift and cause pressure on tender breast tissue.


Thrush is a type of yeast infection that causes nipple or breast pain that lasts throughout the feeding and does not improve after baby has a better latch or changes position. Your nipples may itch or burn, appear pink or red, and may have a rash.

If your baby has thrush, creamy white patches may appear inside your baby's mouth or on your baby¹s tongue. Babies often also get a red, bumpy diaper rash.

If you suspect thrush, contact your doctor and your baby's doctor. This condition requires medication to treat both you and your baby.


About 2 or 3 days after giving birth, your breasts will increase in size and feel full and heavy. This engorgement is normal, and is caused not only by an increase in the volume of milk in your breasts but also by increased blood flow and tissue swelling. The breasts may feel slightly warm to the touch and may be slightly reddened. This signals the beginning of milk production. If you manage engorgement correctly, it should end within 2 to 3 days:

  • Before pumping, apply a clean, warm, moist washcloth to the breasts for 10 to 15 minutes, or take a warm shower. Heat will help your milk to flow more easily.
  • Before pumping, massage your breasts and gently roll your nipples between your fingertips to stimulate milk flow.
  • Pump often, at least every 2-1/2 to 3 hours. Pump for at least 2 full minutes after your milk stops flowing. Pumping often will help relieve your engorgement, not make it worse.
  • Massage both breasts during the pumping session. This will also help the milk flow.
  • Be sure not to skip any pumping sessions, even at night.
  • Cold compresses or "icy diapers" applied to the breasts between pumping sessions will soothe and may help reduce swelling. To make "icy diapers," fill disposable diapers with water and place the diapers in your refrigerator or freezer for 20 to 30 minutes. These cold, wet diapers can be tucked and worn inside your bra until they lose their chill.

Plugged Ducts and Mastitis

Occasionally, women develop a hard, painful knot inside a breast. This is usually caused by a milk duct that is not draining well or is plugged. The area may be slightly reddened and warm to the touch. These symptoms likely indicate a plugged duct.

It is important to unblock a plugged duct as soon as you become aware of it. If a plugged duct is not corrected, it can lead to an infection called mastitis.

Symptoms of mastitis include headache, fever, chills, backache, body aches and a flu-like feeling in addition to symptoms experienced with a plugged duct. If you have the symptoms of mastitis, call your obstetrician. He or she will likely prescribe antibiotics.

If you have mastitis, it is important that you rest in bed, drink plenty of fluids, take your prescribed medicine and follow the suggestions listed for relieving a plugged duct.

Relieving a Plugged Duct

  • Apply a clean, warm, wet washcloth to the sore breast or take a warm bath or shower just before pumping.
  • Massage the breasts gently, especially over the sore, hardened area, stroking gently toward the nipple.
  • Massage the breast during the pumping session, gently stroking down toward the nipple.
  • Pump more often during the day and at night until you can no longer feel the knot.
  • Position the baby's chin toward the plugged duct if feeding at the breast.
  • Begin feeding on the affected breast until resolved.
  • Inform your nurse if you have mastitis and are taking antibiotics for this condition.
  • Continue to pump or nurse frequently.

Related Article:
Common Breastfeeding Challenges