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    Problem-Solving Guide

    The following recommendations are general guidelines. If you are still having problems after trying some of these suggestions, contact a lactation consultant or your health care provider. Remember:

    • If your baby is gaining weight, then your milk supply is fine.
    • If your baby is having at least six to eight wet diapers and frequent stools per 24 hour day, your baby is getting enough milk.
    • Burp your baby whenever suckling slows down. This will encourage your baby to wake up and complete the feeding on the other breast.
    • Many babies are content after feeding from one breast.

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    After 10 to 15 minutes of nursing, he cries as though he is still hungry. Is he getting enough?

    Although babies get most of the milk in the first 10 to 15 minutes, some take 15 to 45 minutes to finish nursing on both breasts, depending on the strength of their suckling.

    • On average, babies take 15-45 minutes to feed, depending on the strength of their suckle. Some babies nurse from only one side per feeding, and are quite content and gaining weight.
    • Try to listen for swallows during feeding which indicate that your baby is still actively nursing.
    • Consult a lactation consultant or your health care provider for support and advice.

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    When I give my baby a bottle after a feeding, he takes one to two ounces and finally goes to sleep. Is he getting enough milk from me?

    Are you offering both breasts at each feeding? Are you nursing for fewer than 10 minutes per breast? Using both breasts stimulates a second and third let-down and creates more milk for your baby to drink. Your baby’s primary motivation is to suckle, and it is not always out of hunger. Your baby will usually suckle if a nipple is put in your baby’s mouth.

    • Use both breasts at each feeding. Consider switching your baby back to the first breast when done nursing on the second breast. Remember, many babies are content after nursing from one breast.
    • Give longer feeding at breast until your baby falls asleep.
    • Feed more often.
    • Avoid formula supplementation. This will decrease your milk supply, because your baby will not nurse as often.
    • A baby will usually take from a bottle after nursing, just as you eat dessert even though you may be full. Therefore, just because your baby takes the bottle doesn’t mean that your baby is still hungry.
    • Contact a lactation consultant or your health care provider if these steps do not increase your milk supply within 48 to 72 hours.

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    When I try to squeeze milk from my breasts, only a few drops come out, and I get very little milk when I first start to pump. Does this mean I don't have enough milk?

    Hand expression and pumping are learned techniques and not as effective as your baby’s suckling. What you get when you first start pumping or hand expression does not necessarily reflect your milk supply.

    • Hand expression and pumping take practice.
    • Take a shower or apply warm, wet cloths to your breasts for 10 minutes before hand expressing.
    • Massage your breast down and out toward your nipple while expressing and pumping your milk.
    • Use a high-quality breast pump (preferably a double electric pump).

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    I've been giving a bottle and breastfeeding and now my baby fusses at the breast and doesn't want it. What's wrong?

    Bottle nipples allow milk to flow faster with less effort by your baby, and your baby may prefer the easier way. By giving bottles, you may have also lessened your milk supply.

    • Stop using the bottle and increase the number of times you breastfeed to get your milk supply going again.
    • Stop using all artificial nipples including pacifiers.
    • Contact a lactation consultant or your health care provider if the problem lasts 48 hours.
  • Your baby should suckle better with time. Be patient.

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    My nipples are sore all the way through the feeding. What can I do?

    Nipple-chewing due to incorrect positioning of the baby can cause nipple pain throughout the feeding.

    • Reposition your baby.
    • Make sure your baby is facing your breast, with your baby’s tummy facing your tummy during the initial latch-on, and that baby’s chin touches the breast first.
    • Be certain you are holding your breast behind the areola.
    • Wait for your baby to open the mouth wide then quickly pull your baby in close.
    • If the pain continues, remove your baby from your breast and reposition.
    • Contact a lactation consultant or your health care provider for support and advice.

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    Why are my nipples sore only when the baby first latches-on?

    Is your baby grabbing the nipple and using it to get into the proper position on the breast?

    • Be certain your baby’s mouth is wide open during the initial latch-on.
    • Position your baby so that your nipple is pointing down during latch-on.
    • This situation will work itself out as your baby learns that he/she will receive more milk in the proper position.

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    I'm feeding less often to give my nipples a rest. Will this create a problem?

    Your baby may become so hungry that he/she grabs the breast and sucks more vigorously, causing more nipple soreness. Your breasts may become engorged, making it harder for your baby to latch-on properly.

    • Return to your normal schedule of feeding, about 8 to 12 times per 24 hour period.
    • Sore nipples are usually caused by incorrect latch-on.
    • Be sure you break the suction when removing your baby from your breast.
    • Make an appointment with a lactation consultant or your health care provider to determine why your nipples are sore.

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    Should I wash my breasts before each nursing?

    • No, a daily shower is enough. Don’t use soap on your breasts.
    • Always wash your hands before feeding and before expressing your milk, whether by hand or with a breast pump.

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    No one in my family has ever had enough milk. Is it hereditary?

    Very few women truly do not make enough milk. Family members may have had dietary problems, misinformation and/or lack of support in the past. You can be the first to succeed!

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    Why doesn't my three week old baby sleep through the night?

    This is an unrealistic expectation for a newborn. Most babies do not sleep a six-hour stretch until they are at least six to eight weeks old.

    • This is normal.
    • Try to nap when the baby naps during the day.

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    He was doing fine, but all of a sudden he started nursing all the time. Is something wrong?

    Growth spurts usually occur at seven to 10 days, three weeks, six weeks and 12 weeks and will increase your baby’s appetite. Your baby’s increased suckling increases your supply to meet your baby’s new needs.

    • The increase in demand will typically last three to five days.
    • Your baby will return to a reasonable schedule.
    • Try to rest and drink liquids.

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    I am going back to work. Do I need to wean my baby?

    No! Working mothers have many options. New battery-operated and electric breast pumps allow for fast and efficient breast milk expression. Many mothers continue to breastfeed after returning to work. (See section on Expressing breast milk)

    For more information consider attending class before you return to work. Another helpful source for suggestions about breastfeeding and returning to work is the book, Nursing Mother, Working Mother by Gale Pryor.
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    I feel like I have a cold or the flu, can I still breastfeed?

    Yes. When you are exposed to an illness, your body begins producing antibodies that protect your baby. Continuing to breastfeed will help the baby fend off your cold. If your baby does get sick, it will almost always be a milder case. Good and frequent hand washing can help prevent transmission. Many mothers find it easier to conserve their strength by taking the baby to bed with them and getting plenty of rest and drinking plenty of liquids. Check with your health care provider before taking any medications.
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    Can I breastfeed my toddler and my new baby?

    Yes. You can breastfeed through a pregnancy, but you may need to eat a few more nutritious foods and get more rest. Some children wean during pregnancy, possibly due to a decrease in milk or a change in flavor. When the new baby is born, you generally want to feed the newborn first and then the toddler. For more information contact your local lactation consultant or your health care provider.
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    Other breast feeding resources

    From the Health Library
    Breastfeeding - an overview
    Breastfeeding - common concerns
    Making the decision to breastfeed
    Routine checkups
    When to call the doctor
    Activity, rest and breastfeeding
    Other places to get help
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