Below is information on the most common breastfeeding challenges.

Engorged breasts

The signs of engorged breasts are:

Breastfeeding Problems

  • Larger, heavier and tender breasts.
  • Breasts hard and painful and warm to touch.
  • Swelling of breasts.
  • Firm nipples and areola.

What can be done about it?

  • Feed your baby frequently at least eight to 12 times per day.
  • Wear a support bra 24 hours per day while breasts heavy.
  • Apply a warm washer over each breast three to five minutes before a feed.
  • Warm showers and express milk in the shower.
  • A breast pump can help
  • Apply a cold compress for 20 minutes after feeding.


Sore nipples & cracked nipples

Breastfeeding Problems - Sore and Cracked NipplesThe impact of sore nipples and cracked nipples is painful feeding resulting in you deciding to cease breastfeeding sooner than planned and mastitis.

What can be done about it?

  • Check your baby’s positioning and attachment.
  • Air drying your nipples after each feed can help.
  • Apply colostrum or milk over your nipple after air-drying.
  • Avoid soap, alcohol and extra water on your nipples.
  • Clean your nipples with water flowing over them in the shower.
  • Nipples shields can be a great help.


Flat nipples

Breastfeeding Problems - Nipple ShieldsFlat nipples are a common problem. In my experience, it is more common in Caucasian than Asian women and more common in women with very large breasts. It is uncommon in small breasted


What can be done about it?

  • Nipples shields are helpful until your baby’s suck is strong enough to draw them out.


Poor milk supply

Breastfeeding Problems - MotiliumPoor milk supply is a huge challenge when you want to breastfeed.

What can be done about it?

  • Motilium (Domperidone) stimulates prolactin production. You will need a script for this. The recommended dose is two tablets (20mg) every eight hours until there is a good response, then one tablet twice daily for one week then one tablet daily for one week
  • Increase your fluid intake.
  • Check attachment and positioning.
  • Avoid using a dummy.
  • Rest and avoid stress. Stress can result in a reduction or even loss of your milk supply.
  • Increase the number of feeds per day.
  • Express five to 10 minutes after feeding. A breast pump can help. Fully emptying your breast stimulates more milk production.



Breastfeeding Problems - MastitisMastitis is a breast infection. It is usually related to a cracked nipple and incomplete emptying of breasts with breastfeeding.

What can be done about it?

  • You will need to contact me or see your doctor as you will need appropriate antibiotics. Dicloxacillin at 500mg each six hours for 10 to 14 days is the preferred antibiotic for treating mastitis.
  • Empty your breast as much as possible. A warm washer can help.
  • You may need a breast ultrasound scan to an exclude abscess.
  • Hospital admission may be needed for intravenous antibiotics and abscess drainage (if present).

I have had two women where the “mastitis” was due to underlying breast cancer. So careful assessment is very important.

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