Common Problems

Main Menu:

• Inadequate Milk Supply
• Blocked Milk Duct
• Breast Engorgement
• Breast Mastitis (infection)
• Nipple Discharge
• Nipple Confusion
• Breast Pain
• Nipple Soreness
• Inverted or Flat Nipples
• Thrush
• Jaundice
• Additional Resources and References

Inadequate Milk Supply

The amount of milk produced is directly related to how often and how long the baby is breast-fed.  When an infant suckles at the mother’s breast, milk is brought out from the nipples.   This suction signals the mother’s body to make more milk.  Therefore, the less a mother breast-feeds (or manually pumps milk from her breast), the less milk her body produces.  This supply/demand relationship is established so that the baby can be weaned successfully.  The most common way to increase milk supply is simply to breast-feed more often (or pump the breasts manually). 

Less commonly, an inadequate milk supply may be due to other complications, such as a problem with the baby’s sucking or a physical problem with the mother.  Mothers who continue to have inadequate milk supplies even if they have tried emptying their breasts often should consult a physician or certified lactation consultant.

Blocked Milk Duct

If the breasts are not emptied often, the milk ducts may become blocked or plugged.   A tender breast lump or spot may occur when a milk duct becomes blocked.  To treat a blocked milk duct, experts recommend breast-feeding often and changing positions to help drain the milk from all parts of the breast.  Applying warm heat, massaging the breast before nursing to increase the flow of milk, and getting plenty of rest are also helpful. 

Blocked milk ducts can lead to breast engorgement (swelling) and mastitis (infection).   See below for an explanation of these conditions.

Breast Engorgement

Breast engorgement (swelling) occurs when the breasts produce more milk than the amount that is being expelled by breast-feeding, pumping, or manual (hand) expression.  The milk overflows from the glands and engorges the breasts.   Breast engorgement is common during the first two to five days after childbirth when breast-feeding begins but can also develop any time the baby’s demand for breast milk decreases or stops or the mother is unable to empty her breasts.  

When breast engorgement occurs, the entire breast, nipple, and areola (pigmented region surrounding the nipple) swell and usually cause discomfort or pain.  The baby may suck from the nipples but will not receive much milk.  However, the baby's sucking will cause the breasts to produce more milk, further overfilling the milk glands and increasing engorgement.

Other symptoms of breast engorgement include:

• Hard, warm, throbbing, or slightly lumps breasts
• Flattened nipples (difficult for the baby to latch on)
• A slight increase in body temperature (around 100 degrees Fahrenheit or 37.78 degrees Celsius)
• Slightly swollen axillary (underarm) lymph nodes

Severe breast engorgement should not last more than 12 to 48 hours.  The best way to prevent breast engorgement is to breast-feeding, pump, or manually (hand) express milk often.  The treatment of breast engorgement usually focuses on relieving symptoms.  Click here to learn more about breast engorgement and other treatment suggestions.

Breast Mastitis

Mastitis is a benign (non-cancerous) infection that can usually be treated successfully with antibiotics.   Signs of mastitis include red, hot, painful, or inflamed breasts and other flu-like symptoms such as headache, nausea, temperature (101 degrees Fahrenheit, 38.4 degrees Celsius or greater), or chills.  Women with symptoms of mastitis should see a physician.  Breast-feeding with mastitis is generally not harmful to the baby and may actually help speed up recovery.    

Mastitis during breast-feeding can be caused by:

• Breast engorgement (swelling)
• Blocked milk duct/s
• Cracked or damaged skin or tissue around the nipple

Approximately 10% of women with mastitis develop pus-filled abscesses in the affected breast area.  An abscess is benign (non-cancerous) and will usually need to be drained with a needle by a physician.   A particularly large abscess may need to be cut open by a physician to drain.  Usually, the area is numbed with a local anesthesia and covered with gauze after the procedure.  Click here to learn more about breast mastitis and other treatment suggestions.    

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