Most breastfeeding problems are solvable — but "solvable" usually requires skilled support, not just time and perseverance. A lactation consultant (IBCLC) is the most effective resource for most early breastfeeding difficulties. Here are the most common issues and what to do about them.
Painful latch
Pain during breastfeeding is common but not normal — it usually signals a latch problem. The baby should take a large mouthful of breast tissue, not just the nipple. Signs of a good latch: baby's lips are flanged outward, chin is touching the breast, and you can hear swallowing. If latch is consistently painful, seek help from a lactation consultant before nipple damage worsens.
Engorgement
Engorgement — painful fullness — is common in the first few days as milk comes in. The fix is feeding frequently (or expressing) to relieve pressure. Cold compresses between feeds reduce inflammation; warm compresses immediately before a feed encourage let-down. Engorgement that does not improve with feeding may signal a blocked duct or early mastitis.
Mastitis
Mastitis is a breast infection causing redness, warmth, flu-like symptoms, and severe pain in one breast. It requires prompt medical attention: continue feeding from the affected breast, rest, apply warm compresses, and see a doctor. Antibiotics may be needed — your doctor will assess and advise. Seek urgent care if you develop a high fever, worsening redness, or feel seriously unwell. Stopping breastfeeding during mastitis often makes it worse.
Tongue tie
Tongue tie (ankyloglossia) restricts the baby's tongue movement, which can affect latch and milk transfer. Diagnosis requires assessment by a qualified lactation consultant or paediatrician. A procedure (frenotomy) is sometimes recommended, but is not appropriate in every case — a healthcare professional can advise whether it is indicated for your baby.
Cluster feeding
Cluster feeding — when babies feed very frequently for several hours — is normal developmental behaviour, not a sign of low supply. It most commonly occurs in the evenings and during growth spurts. Feeding through it, rather than supplementing with formula, helps maintain supply.
Seek medical advice urgently if your baby:
• Has fewer wet diapers than expected or signs of dehydration
• Is losing weight or not regaining birth weight
• Appears jaundiced, very sleepy, or difficult to rouse for feeds
• Has blood in stool or persistent vomiting