Breastfeeding

Overview

Breastfeeding is the natural way to feed your baby with milk from your breasts. It gives your baby the nutrients they need and helps you and your baby build a close bond.

Breastfeeding is very common. Most women make enough milk for their baby, but many face challenges along the way and need support.

Breastfeeding affects mothers and babies in the first months after birth. Partners and wider family may also be involved in supporting a new mother.

Symptoms

Common symptoms

• Sore, cracked or painful nipples
• Swollen, hard or tender breasts (engorgement)
• A red, painful patch on the breast, sometimes with a fever (possible mastitis)
• A feeling that your milk supply is low or your baby is not satisfied after feeds
• Pain or a burning feeling during or after feeding

Symptoms in children

• Your baby is feeding less than usual or seems unusually sleepy
• Fewer wet or dirty nappies than expected for your baby’s age
• Your baby is losing weight or not gaining as expected
• Signs of dehydration, such as fewer tears or a sunken soft spot on your baby’s head

Symptoms in older adults

• Not applicable. Breastfeeding is a stage in the early life of a mother and baby.

Causes

Main causes

• Many breastfeeding difficulties are caused by a poor latch or positioning of the baby
• Feeding on a strict schedule rather than when your baby is hungry can reduce milk supply
• A short frenulum (tongue-tie) in the baby can make it harder to latch on
• Engorgement happens when milk builds up and the breasts become overfull
• Damaged nipples can become infected, which may lead to deeper breast pain

Risk factors

• First-time breastfeeding
• Delivery by caesarean section or a difficult birth
• Premature birth or a baby with health problems
• Flat or inverted nipples (though this does not mean breastfeeding is impossible)
• Lack of practical support at home

When to see a doctor

See a doctor urgently if:

• If you have a red, painful breast with a high fever, you need same-day medical advice
• If your baby is very sleepy, feeding poorly, or has fewer wet nappies, see a doctor or midwife urgently

Book a routine appointment if:

• If you have nipple pain, cracked nipples, or worry about your milk supply, ask your midwife, health visitor, or lactation consultant
• If your baby is not gaining weight or you have concerns about feeding, mention it at your baby’s routine check-up

Diagnosis

Breastfeeding issues are usually diagnosed through talking with you, observing a feed, and doing a physical check of your breasts and your baby’s mouth.

Tests that may be done

• A careful discussion of your symptoms and feeding pattern
• Watching a full breastfeed to check your baby’s latch and positioning
• Weighing your baby before and after a feed to estimate how much milk they are getting
• Checking your breasts for signs of engorgement, infection, or nipple damage

What to expect at your appointment

A midwife, lactation consultant, or doctor will ask about your feeding pattern, examine you and your baby, and watch you feed. They will then give practical advice and follow up to make sure things are improving.

Treatment

Treatment focuses on correcting the baby’s latch and your feeding position, feeding your baby frequently, and supporting you while any infection is treated.

Self-care at home

• Feed your baby whenever they show hunger signs – at least 8 to 12 times in 24 hours
• Offer the breast that feels fuller first, and let your baby feed until they come off on their own
• Use a comfortable feeding position – bring your baby to the breast rather than leaning over them
• Apply a cold compress after feeding if your breasts feel sore or swollen (always wrap it in a cloth)
• Rest, drink plenty of water, and eat a balanced diet to support your energy levels

Medical treatments

If there is an infection such as mastitis, a healthcare provider may prescribe antibiotics that are safe to take while breastfeeding. If your baby has tongue-tie, a healthcare professional may suggest a simple procedure to release it. Always discuss any treatment with your healthcare provider.

When is surgery considered?

Surgery is rarely needed. Very occasionally, an untreated breast abscess may require a drainage procedure by a healthcare professional.

Living with this condition

Breastfeeding is a learned skill for both you and your baby. It can take time, but most mothers find it becomes easier with practice and support. Allow yourself time to learn and ask for help whenever you need it.

Lifestyle tips

• Keep yourself hydrated and eat regularly – making breast milk uses energy
• Have your partner or a family member bring the baby to you at night so you can feed while lying down
• Use a feeding diary or app to track feeds and wet nappies in the early days
• Rest when the baby sleeps, and accept offers of help around the house

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and whole grains. You do not need a special diet, but you may need extra calories and fluids. Light exercise is safe and can boost your mood.

Mental health and emotional wellbeing

Mothers can feel pressure, guilt, worry, or sadness if breastfeeding is harder than expected. These feelings are normal. If you feel low, overwhelmed, or anxious, talk to your healthcare provider. They can support you with both breastfeeding and your mental health.

Prevention

Many breastfeeding difficulties can be prevented or reduced by having skin-to-skin contact with your baby early on, feeding on demand, and getting help with positioning as soon as you need it.

Vaccines

Vaccines are not used to prevent breastfeeding problems, but some vaccines are safe during breastfeeding – ask your healthcare provider for advice.

Screening programmes

Screening does not apply to breastfeeding itself, but your baby’s weight and health will be monitored regularly.

Complications

If left untreated

• Untreated mastitis may develop into a breast abscess that needs medical drainage
• If a baby does not feed well, they may become dehydrated or fail to gain weight
• Severe nipple damage can make breastfeeding very painful and increase the risk of infection
• Without support, low milk supply can lead to early weaning, and the baby may miss out on the benefits of breast milk

Long-term outlook

With the right support, most breastfeeding challenges can be overcome. Many mothers who struggle at first go on to breastfeed for several months or longer. If you decide to stop, that is okay too – what matters is that your baby is fed and you feel supported.

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