Help with Breastfeeding Problems

Support for breastfeeding pain and other challenges

Support for breastfeeding pain and other challenges

Breastfeeding should be a relatively comfortable experience for you and your baby, but certain conditions such as chapped skin and engorgement can cause pain and make breastfeeding difficult. Talk to your physician about breastfeeding discomfort and challenges, and be sure to ask plenty of questions about breastfeeding while still in the hospital.


Engorgement is when your breasts become tender, firm and full as a result of milk production as well as extra blood and fluid in the breast tissue. Engorgement usually starts within 72 - 96 hours after birth. Because engorgement causes the breasts to be firmer, it may be hard for your baby to latch on.

To prevent engorgement discomfort:

Feed your baby as often and as long as your baby needs. This will keep up your milk supply and allow your breasts to be relieved of the pressure of too much milk.

Be sure your baby is properly latched so he or she can get enough milk.

Gently massage the breasts between sucks to improve milk flow.

Avoid pacifiers and bottles in the first few weeks and months so your baby can learn to breastfeed without nipple confusion.

Try to relax, which can help stimulate the hormones that allow the milk to flow from the milk glands to the milk ducts and out of the nipples (known as let-down).

Try using a warm compress for no more than five minutes before breastfeeding to start milk flow. Other women find a cold compress helps reduce pain and swelling.

Express a small amount of milk if the breasts are too full for the baby to latch so they are softer and it’s easier for the baby to breastfeed.

To treat engorgement discomfort:

If breasts are leaking or milk is easily hand-expressed, do the following between feedings to relieve discomfort as often as needed:

Take a shower and allow the water to spray your back and trickle down your breasts. Do not let the water spray directly on your breasts.

Get a basin of warm water and bathe your breasts in it.

  • In the basin or shower, massage breasts in a forward direction toward the nipple and let milk drip out.
  • After the shower or basin bath, place cool packs on the breasts for five to six minutes.

If breasts are not leaking or easily expressible:

  • Place ice on them, then massage, then ice again. 
  • Do this between feedings to help relieve the pressure.

Note: You can pump during engorgement but you must pump to comfort only, not to empty your breast.

  • Pump for two to five minutes between feedings to relieve pressure as necessary.
  • Do not pump for more than five minutes at a time as this will tell your body to produce more milk.

Contact your doctor if you are in severe pain or develop a fever over 100.4°F.

Preventing nipple soreness

Breastfeeding can sometimes cause pain or discomfort in the nipples, particularly if there is chapping or broken skin.

Below are some tips to prevent nipple soreness:

  • Make sure the baby is properly latched. A lactation specialist can assist you with making sure the baby is properly latched to the breast. Lactation specialists are available at all Scripps maternity units.
  • Keep your bras and any bra pads clean and dry.
  • Bra pads can prevent bras or clothing from chafing against the nipple during the day and allow air to circulate so the skin stays dry.
  • Avoid cleaning the nipple area with soap, which can be drying.
  • Rinse off your baby’s saliva after breastfeeding.
  • Ask your doctor about using a lanolin-based cream to soothe any chapped or tender skin.

Additional breastfeeding concerns

In addition, our certified lactation consultants can help new mothers with additional breastfeeding problems such as:

  • Mastitis: an infection of the breast tissue
  • Insufficient milk supply
  • Breastfeeding a premature baby
  • Slow weight gain in the infant
  • Breastfeeding an infant with a cleft lip/palate
  • Induced lactation for adopted infants