A mother gently and blissfully smiling while breastfeeding her content baby—this is how breastfeeding is often portrayed. However, this image doesn’t always reflect reality: especially at the beginning, breastfeeding often doesn’t go smoothly right away, and many women experience challenges such as engorgement at least once during their breastfeeding journey. Some breastfeeding issues simply require a bit of time and calm, while for many others, a solution can usually be found with the right support. We’ve compiled the symptoms, causes, and treatment options for the 8 most common breastfeeding problems for you.

1. Pain during breastfeeding

Symptoms:

• Swelling and tightness of the breasts in the first days after birth

• Pain-sensitive nipples

Possible causes:

• After birth, the body releases oxytocin. This so-called “milk hormone” supports the uterus returning to its normal size and triggers the milk let-down about three to five days after birth ( initial breast swelling ).

• Increased blood circulation and the start of milk production can feel uncomfortable or painful at first

• The nipples need time to adjust to sucking

Treatment:

• Initial pain during breastfeeding usually goes away on its own within the first few days

• Continue breastfeeding: Frequent nursing triggers the Milk Ejection Reflex , helping breast milk flow more easily and reducing pressure. A breast massage can have the same effect

• Warm the breasts before breastfeeding to help the milk flow more easily. Warm cloths or a hot shower can help.

• Cool the breasts after breastfeeding. You can use a gel pack wrapped in a cloth, a quark compress, or white cabbage leaves placed directly in your bra.

2. Sore nipples

Symptoms:

• Cracks, skin abrasions, scab formation, and signs of inflammation such as pain, redness, swelling, or warmth of the nipples

• Rare cases of nipple bleeding

Possible causes:

• Incorrect latch: If your baby doesn’t take the nipple and areola with a wide-open mouth and can’t work the breast with their jaw, tongue, and lips to start milk flow, a strong vacuum can develop and injure the nipple.

• Anatomical factors that encourage ineffective sucking, such as a shortened frenulum, can make it difficult for your baby to latch properly

• Sucking confusion: If your little explorer is bottle-fed alongside breastfeeding, which requires less active effort, they may “forget” their innate sucking reflex and no longer latch onto the nipple properly.

• Increased need for security: Your baby may suck strongly and frequently not for nourishment, but because breastfeeding provides closeness and comfort ( non-nutritive sucking )

Treatment:

• Correct the breastfeeding position and latch: You can find an overview of what to consider when latching in our article "Proper Latching: 7 Basic Rules for Breastfeeding". If you’re unsure how your baby should be positioned at the breast, it’s best to ask your breastfeeding counselor or midwife for guidance.

• Use nursing pads and change them regularly to prevent bacteria from spreading in the warm, moist environment

• Massages and warm breast compresses stimulate milk flow and make sucking easier

• Use silver caps: The small caps made of antibacterial silver can be placed on your nipples between breastfeeding sessions under your clothing. Silver caps support the healing of acutely inflamed nipples and can also be used preventively.

• Low Level Laser Therapy to support wound healing: Some breastfeeding consultations offer laser therapy to support wound healing. Ask your midwife or doctor whether this therapy is suitable for you.

• If you have persistent discomfort and severe pain, you can pump breast milk and feed your baby with a bottle.

3. Milk Stasis

Symptoms:

• Hard, painful areas on the breast that don’t soften even with breastfeeding and are sensitive to touch

Possible causes:

• Blockage of one or more milk ducts, preventing the breast from being emptied properly and causing pain due to milk buildup

• Incorrect latch

• Psychological factors such as stress or exhaustion

Treatment:

• Pain relief through heat: A warm washcloth, a relaxing bath, or five minutes under an infrared lamp can work wonders

• Continue breastfeeding: A gentle breast massage during breastfeeding or pumping can help relieve congestion and stimulate milk flow. Tip: You can also use a vibrator or an electric toothbrush for the massage by placing it directly on the hardened area.

• Breastfeeding in the all-fours position: Milk can flow with gravity, and you can also position your baby so their jaw presses against the hardened area. To learn exactly how breastfeeding in the all-fours position works, read our article “ The ABCs of Breastfeeding Positions “

• If needed, pump additional milk after breastfeeding sessions to fully empty the breast and keep the milk ducts clear. However, consult your breastfeeding counselor or midwife first to determine whether pumping is appropriate for you.

• If your breast is red and painful and you have a fever, body aches, or headaches—or if you suspect the lump in your breast isn’t related to breastfeeding—consult your doctor in any case. For example, mastitis could be causing your symptoms. They can also prescribe medication for pain relief if needed.

• Give yourself and your baby rest and relaxation

4. Mastitis

Symptoms:

• The breast is red, hot, and tender

• Flu-like symptoms such as alternating hot and cold sensations and joint pain

• Body temperature above 38.5° Celsius

• The taste of your breast milk has changed and is salty

Causes:

• Inflammation of the breast tissue caused by bacteria entering the breast through the milk ducts in the nipples

• Triggered by an incorrect latch, overly long intervals between breastfeeding sessions, or psychological factors such as stress or exhaustion

• Sore nipples, milk stasis, or an oversupply of milk can lead to mastitis if left untreated

Treatment:

• Contact your doctor in any case. They can prescribe a suitable pain reliever and, if necessary, an antibiotic.

• Continue breastfeeding. The milk is harmless to your baby, and milk flow and gentle massages can help relieve blockages. Offer the affected breast first, and cool it after breastfeeding to reduce inflammation.

• Be kind to yourself: Rest, warmth, adequate fluids, and a healthy diet help your body fight the inflammation

5. (Supposedly) too little milk

Symptoms:

• Your baby is often restless while feeding, quickly lets go of the breast, or asks for it more frequently

Causes:

• Medical causes such as retained placental tissue in the uterus, anemia, diabetes, hormonal imbalances, certain medications, or injury to the mammary gland tissue, for example through surgery

Many nursing mothers mistakenly believe they aren’t producing enough milk. However, most women produce enough milk to breastfeed their baby. Often, other reasons are behind this:

• Incorrect latch

• Anatomical reasons such as a shortened frenulum

• Your baby is going through a growth spurt and is therefore feeding more often

• Non-nutritive sucking: Your baby seeks the breast more often for comfort

Treatment:

• If you have low milk production due to medical issues, contact your doctor or a breastfeeding consultant

• Your baby’s increased thirst may make it seem as though you aren’t producing enough milk

• Do not supplement with infant formula right away: As long as your little explorer is thriving and their digestion remains regular, keep offering the breast to stimulate milk production

• Feed your baby on demand rather than on a schedule to ensure they are full

• Get support from your midwife or breastfeeding consultant if you have questions or concerns

• Your body needs energy to produce milk. Pay attention to a healthy, balanced diet, drink enough fluids, and aim for at least one warm meal a day.

• Switch between breasts more often during feeds to stimulate milk production evenly on both sides

• Bonding with your baby: Spend a day skin-to-skin with your baby in bed. Close contact releases the breastfeeding hormone oxytocin, which stimulates milk production.

6. Too much milk (hyperlactation)

Symptoms:

• Swollen, tense breasts; excess milk leaks out easily; the milk ejection reflex is painful

• Mastitis and breast infections occur frequently

• Your baby is restless or passive while breastfeeding

• Has difficulty latching properly

• Frequently chokes, spits out, and gags

Causes:

• You produce more milk than your child can drink

• In some cases, increased milk production is hereditary, but usually your body adjusts to your child’s needs within the first few weeks.

Treatment:

• Express or pump a small amount of milk before breastfeeding to ease the milk ejection reflex during latch-on

• Choose the right breastfeeding position : With Laid-Back Nursing, not too much milk flows at once, allowing your baby to drink calmly

• Be patient: In most cases, milk production stabilizes on its own after a few weeks

• Tandem breastfeeding: Don’t switch breasts with every feeding; instead, offer the other breast only every three hours. This helps prevent additional stimulation of milk production.

7. White bubbles on the nipple

Symptoms:

• One or more white blisters on the nipples

• Occurs frequently in the first days of breastfeeding

• In some cases, causes pain during breastfeeding, but it can also be painless

Causes:

• Incorrect latch: If there is no pain, the blisters are likely caused by too much suction during sucking

• A milk duct opening is blocked: A thin membrane (milk blister) prevents milk flow and causes pain

Treatment:

• For painless blisters:

  • no treatment is necessary; they usually disappear on their own

• In case of painful blockage:

  • Place a warm washcloth on the nipple immediately before breastfeeding or pumping to help open the blocked milk duct. The painful plug may dissolve on its own during breastfeeding or can be gently opened by carefully wiping with your hand.

  • If it doesn’t open on its own, your doctor can carefully remove the plug with a sterile needle. Afterwards, you should empty the breast promptly.

8. Yeast infection (thrush) or bacterial infection

Mother's symptoms:

• The nipples are sensitive to touch, with burning, itching, and pain

• The pain persists during and after breastfeeding

• The nipples and areolas are pink or dark and may be dry and flaky in some cases, or may have a white rash

Symptoms Baby:

• White coating on the tongue

• White spots on the cheeks

• Bright red pimples and rash on the buttocks

Causes:

A yeast infection (thrush) or a bacterial infection can occur during the course of breastfeeding and, unlike many other complaints, often doesn’t appear right at the beginning.

Treatment:

• Weaning is not necessary, but the infection should definitely be treated

• Your doctor can determine, with a swab of the nipples, whether it is a yeast infection or another infection and prescribe the appropriate medication.

• Pay attention to hygiene: Wash your hands before and after breastfeeding and diapering, let your nipples air-dry after breastfeeding, change your nursing pads regularly, and wash your and your baby’s laundry at a high temperature

It’s completely normal for the start not to go perfectly smoothly and for challenges to come up from time to time during your breastfeeding journey. So don’t put yourself under pressure if it doesn’t work right away. Together with your baby, you’ll soon discover what works best for both of you. You don’t have to grit your teeth and endure pain while breastfeeding—a breastfeeding consultation or your midwife is always there to support you with experience and advice. Many breastfeeding problems can be resolved quickly with the right guidance, so nothing stands in the way of a loving breastfeeding experience that you and your baby can both enjoy.