Top 3 breastfeeding challenges (and how to overcome them)


Top 3 breastfeeding challenges (and how to overcome them)

It’s no secret that breastfeeding is good for baby and mom, but many women experience difficulty sticking with it.
According to the Centers for Disease Control and Prevention, 84 percent of newborns born in 2017 started breastfeeding, but by the time they were six months old, only 58 percent of babies were still breastfed. By a year old, only 35 percent were breastfed.
Those statistics don’t surprise Ashley Pritchett, a registered nurse and lactation consultant at Tidelands Health. She says it’s common for mothers to stop nursing as challenges arise.
“The most common challenges to continuing breastfeeding, in my opinion, are sore nipples, engorgement and the difficulty of continuing after going back to work,” Pritchett says.
So how can you overcome these common breastfeeding problems? Here’s Pritchett’s advice:

Sore Nipples

To prevent sore nipples, ensure baby has a good latch at each feeding. Baby’s mouth should be wide open and at a 140-degree angle on the breast. More of the bottom of the areola should be in the mouth than the top. The baby’s cheeks should be round and puffy, not sucked in. The lips should be flanged outward and you should be able to hear audible swallows.
Pritchett says a good latch keeps baby from pinching and bruising the nipple.

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“Most women, even with a good latch, are tender in the beginning from the baby nursing and pulling their nipples eight to 12 times a day,” she says. “I encourage mom to change positions frequently and express drops of colostrum and/or breast milk, gently rubbing the liquid into the nipple. Allow your nipples to air dry after each feeding and use lanolin or other creams that are made for breastfeeding.”
Cool hydrogel pads can also ease soreness, Pritchett says. If your nipples are cracked, bleeding or continue to hurt, seek help from a lactation consultant, physician or midwife.


It’s normal for mothers’ breasts to become larger, heavier and tender when mature milk comes in. This fullness can sometimes lead to engorgement. Engorgement is the rapid filling of the breast with milk. If not emptied often enough, milk can build up and get blocked by the swelling of breast tissue.
Engorgement causes breasts to feel very firm and painful. Mothers may also notice warmth, redness, flattening of the nipple and a low-grade fever. If not addressed, engorgement can lead to plugged ducts, mastitis and supply issues. Engorgement can be prevented by:

  • Ensuring baby has a good latch at each feeding,
  • Massaging any areas that feel full or firm while baby is nursing.
  • Expressing milk by hand or with a pump if breasts are too full for the baby to latch on.
  • Using ice packs on the breast after feeding to lessen inflammation.

“If a mom does get engorged, I encourage her to take a warm shower, massage and hand express her milk. Once milk starts to flow, she should nurse her baby as much as she can get baby to feed,” Pritchett says. “If she can only get baby to feed on one side, then she can pump a enough from the other side to get comfortable.”
If these steps don’t work, Pritchett says to contact a lactation consultation for assistance. Every mother who gives birth at Tidelands Health can benefit from the help of a lactation consultant, one of the reasons why Tidelands Waccamaw Community Hospital has earned the prestigious designation of Baby Friendly, an initiative created by the World Health Organization and UNICEF to promote breastfeeding and mother-baby bonding.

Returning to Work

To prepare for going back to work, Pritchett says it’s important to plan ahead.
“If a mom has six to eight weeks off, I usually start them on a pumping plan at three weeks,” Pritchett says. A pumping plan entails feeding the baby normally in the morning, then pumping for 15 minutes using a double electric breast pump after baby is finished nursing. Repeat in the evenings. Store pumped milk in the refrigerator.

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“It is important for moms to know that she will not get very much when she does this because her supply should be regulated to the baby’s needs. Pumping after feeds will tell the mom’s body that she needs more milk for the feeds,” Pritchett says.
After about two days of the pumping plan, mom’s bodies will catch up to the increased demand.
Combine the refrigerated milk into breastmilk storage bags, write the date on the bags and put them in the freezer. This is how moms can stockpile milk to have on hand once she returns to work. Between four and six weeks, introduce a bottle containing mom’s breastmilk to baby. Someone other than mom should do this feeding, Pritchett says.
Although returning to work, sore nipples and engorgement are the most common obstacles a mother may face to breastfeeding, other issues can include:

  • Difficulty with latching
  • Supply problems
  • Strong let-down reflex,
  • Breast infections
  • Plugged ducts

If you encounter any of those challenges, Pritchett says to work with a lactation consultant, physician, certified nurse midwife or other qualified care provider.
“Don’t hesitate to reach out for help,” Pritchett says. “That’s what we’re here for.”

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