By Lactation Lab

There’s nothing in a book, online, or chat with a friend that will fully prepare you for breastfeeding—every journey is unique. But that doesn’t mean common issues won’t come up. If you’re wondering, “Is this normal?” for any part of breastfeeding, chances are there’s tons of women who have gone through the same thing.  

We’ve rounded up some of the most common breastfeeding concerns, with IBCLC’s (including our own Ashley!) weighing in on ways to fix, soothe, and prevent any hiccups for a smoother breastfeeding experience.

Is my baby getting enough milk?

Babies who were carried for a full term should nurse around 8-12 times in a 24-hour period for the first 4 weeks. After that, they should nurse around 7-9 times every 24 hours.

A great way to tell if they’re getting enough milk is to check their diaper! At five or more days, babies should pee around 6-8 times and poop 3 or more times a day. Their pee should be pale yellow, and their poop should be loose, seed-like, and yellow or tan.

It’s totally normal for babies to lose 7% of their body weight a few days after being born. They’ll usually regain it 1-2 weeks later. After that, babies should generally gain about 5.5-8.5 ounces per week until they’re 4 months old. 

There’s only reason to worry if babies lose 10% or more of their birth weight and don’t return to their starting weight. Scales we have at home aren’t precise enough. Babies need to be weighed on a medical scale. 

Tip: Always weigh your baby both before and after a feed and always in the same clothes.

If things aren’t matching up with these guidelines, your baby might not be getting enough milk. This may be because:

• Your newborn is so sleepy they don’t wake up and cry to feed. You’ll have to wake them up to feed if it’s been 3-4 hours since they last nursed.
• They need more nighttime feedings. That’s when your prolactin spikes and they’re often hungry.
• They’re going through a growth spurt and need to cluster feed. Look out for the hunger cues below. 
• There’s a latching issue and enough milk isn’t actually transferring.
• Your milk supply is too low.

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Is my baby latching properly?

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Some other signs of a bad latch are:

• Your nipples are cracked, bleeding, or in pain. Beyond a little tenderness in the first few days, breastfeeding shouldn’t be painful!
• Your baby isn’t gaining enough weight.
• They don’t have enough wet or soiled diapers. 

Any latching issues should be dealt with ASAP for both a mom and baby’s health and to stop more issues from happening.

• Try different breastfeeding positions

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• Check if your baby has tongue-tie and get it treated.
• Nipple shields can be really handy if you have flat, inverted, or damaged nipples.
• Don’t use a pacifier until you're well into a routine with breastfeeding and then only use a breastfeeding-friendly pacifier.

We strongly recommend seeing a qualified lactation consultant for any latch issues—these tips shouldn’t replace professional advice.

Why are my nipples cracked, bleeding, or painful?

Like we talked about, nipple pain isn’t normal and usually a sign of a poor latch or position. But there might be another culprit like:

• The setting on your pump suction is too high or the flange size is wrong. Use a nipple ruler to find the right size. There shouldn't be air gaps between your nipples and the tunnel, but your nipples shouldn’t rub on the sides of the tunnel, nor should any of your areola be pulled into it. Breasts should be fully drained without bruising or a lot of redness after a 10-15 minute session.
• Irritating cosmetics. Only use cleansers that are fragrance-free with gentle ingredients. 
• Eczema. Even if you didn’t have it before, you can get eczema while pregnant or breastfeeding. If you need to use a steroid cream from your doctor to manage it, make sure you apply it at least an hour before breastfeeding, and wipe away any left over before nursing.
• Thrush (yeast infection). Thrush is sometimes diagnosed wrongly. Be sure to see a lactation consultant to rule out other possibilities. 

Icing your breasts before pumping or breastfeeding, taking ibuprofen (if okayed by your doctor) and using a balm like this Nip Gloss from kozēkozē

can help with discomfort as you heal. 

Why is my supply low?

There’s a bunch of reasons why your milk supply is low, or has suddenly dropped. Some of the most common reasons are:

• Stress.
• Not eating or drinking enough.
• Illness.
• Your periods have started again and supply may drop a few days before your period and return to normal soon. 
• Not fully emptying your breasts every time you breastfeed or pump.
• A change in your schedule, such as returning to work or school.

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Breastfeeding works via supply and demand so the more often and thorough you are with removing milk, the more you’ll make. You should also focus on resting well, eating and drinking more, and giving yourself breast massages to get that milk flowing. 

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Am I engorged?

Engorgement is when you have too much milk in your breasts a few days after giving birth making them swollen, warm, and tender. Here’s what you should do:

• Avoid heat, vigorous massages, or electric pumps—that will just add to the swelling. 
• Apply ice wrapped in a towel for 20 minutes between feedings.
• Gently give yourself a lymphatic drainage massage. Put a finger above your collarbone, messaging ten, tiny circles. Repeat where your armpit meets your breast.
• Take ibuprofen if okayed by your doctor.
• Nurse on demand. 
• Hand express milk if your baby didn’t empty your breast. 

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Do I have mastitis? 

Mastitis is when a clogged duct turns into an infection. 

Symptoms of mastitis are:

• Breast pain, heat, swelling, or red streaks.
• Fever, chills, body aches, and fatigue.

If you have these symptoms contact your doctor right away.

To treat mastitis, you’ll need lots of rest, breastfeeding or pumping frequently, and warm compresses before and cold compresses after nursing to treat mastitis. Antibiotics are often given as well. 

Mastitis is not fun, plus a lot of moms want to avoid antibiotics as much as possible, so what can you do to limit clogged ducts? 

• Breastfeed on demand as much as possible. 
• Empty your breasts completely, even if that means hand expressing or pumping after nursing.
• Avoid wearing tight and restrictive clothing.
• Give yourself, (or let a partner give you) a breast massage. 

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Is my milk nutritious enough?

And lastly, it’s very normal to worry if your breast milk is giving your little one enough nutrition. If your baby is showing signs that they’re getting enough milk, it’s very likely your milk is more than enough. 

You can also have your milk tested to receive a unique nutrition label with exactly what’s in your milk plus personalized dietary recommendations to optimize it even more.  

As you can see, we answer these questions regularly on our Instagram. So head over there to get answers to all your breastfeeding questions @lactationlab.