What to Do If You’re Experiencing Low Milk Supply, Engorgement, or Pain?

Breastfeeding may be natural, but that doesn't always mean it comes naturally. Many nursing parents are surprised when they encounter hurdles like dwindling milk supply, uncomfortably full breasts, or pain that makes each feeding session a challenge. These common issues affect countless parents worldwide, often leading to frustration, worry, and sometimes even early weaning.

The reality is that almost every breastfeeding journey includes some bumps in the road. The good news? Most breastfeeding challenges have solutions. With the right information and support, these temporary obstacles can be overcome, allowing both parent and baby to enjoy the numerous benefits of breastfeeding.

Low Milk Supply: Understanding the Causes

It's completely normal to worry about whether your baby is getting enough milk. Around 3-4 weeks after birth, many nursing parents notice their breasts feeling softer and smaller than before. This doesn't necessarily mean there's a problem with milk production - it's just your body adjusting to your baby's needs.

Several factors can contribute to a truly low milk supply:

Delivery complications such as C-sections, premature births, or stressful deliveries
Excessive bleeding after childbirth
Retained placental fragments
Health conditions like thyroid disorders, PCOS, diabetes, or obesity
Previous breast surgeries that affected nerves or milk ducts
Insufficient glandular breast tissue

Other potential causes include:

Smoking or alcohol consumption
Certain medications and herbs
Hormonal birth control (especially those containing estrogen)
Infrequent nursing or pumping
Illness
Stress
Pregnancy

How to Boost Your Milk Supply?

If you're concerned about low milk supply, try these strategies:

Check your baby's latch and positioning - getting help from a lactation consultant makes a huge difference
Offer both breasts at each feeding, letting your baby drain the first breast completely before switching
Increase feeding frequency to 10-12 times in 24 hours
Maximize skin-to-skin contact by cuddling with your baby, both of you shirtless with a blanket over you
Pump for a few minutes after nursing to stimulate additional production
Consider renting a hospital-grade pump for ongoing supply issues
Talk to your healthcare provider about galactagogues (medicines or herbs that boost milk production)
Avoid supplementing with formula if possible, as this can reduce your baby's demand for breast milk

Remember, even small amounts of breast milk provide valuable benefits to your baby, and many supply issues can be resolved with patience and support.

For more information on maintaining a healthy milk supply, consider reading "Is My Milk Supply Low? Signs and What to Do About It."

Breast Engorgement: When Your Breasts Are Too Full

Engorgement happens when your breasts become overfilled with milk, usually during the first few days after birth when your milk comes in or when feedings are missed or delayed.

Signs of Engorgement Include:

Hard, swollen breasts that feel tender and heavy
More noticeable veins under the skin
Flattened nipples and hardened areolas (making it difficult for the baby to latch)
Slight fever (around 38°C)
Reddish, warm areas on the breast

Managing Engorgement:

Nurse frequently, every 1-2 hours if possible
Express a small amount of milk by hand or with a manual pump to soften the breast before feeding.
Apply cold compresses after feeding to reduce swelling and pain.
Try reverse pressure softening - gently press on the edge of your areola inward toward your chest wall for about 50 seconds to help your baby latch.
Wear a supportive (but not tight) bra.

Preventing Engorgement:

Breastfeed regularly, every 2-3 hours.
Let your baby completely drain one breast before switching to the other.
Ensure proper latch technique.
Pump if you're away from your baby.
Wean gradually when the time comes

For a deeper dive into managing engorgement, check out "Dealing with Engorgement: How to Relieve Pain and Unclog Ducts?"

Breast and Nipple Pain: Finding Relief

Pain during breastfeeding usually signals that something needs adjustment. While some discomfort in the first few seconds of latching is normal in the early days, ongoing pain requires attention.

Common Causes of Pain:

Improper Latch

Signs of a poor latch include:

Pain that lasts beyond the first few seconds of feeding
Slurping sounds when baby attaches
Nipples that are misshapen, flattened, or lipstick-shaped after feeding
Cracked or bleeding nipples

Strong Let-Down Reflex

This causes:

Sharp, intense pain at the beginning of feeds
Squeezing sensations in the breast
The baby may choke or pull away from the breast

Vasospasm and Raynaud's Phenomenon

When blood flow to the nipple is temporarily restricted:

Pain after feeding
Nipple whitening or color changes (white to purple, then red)
Pain that radiates through the breast
Symptoms triggered by cold

Skin Conditions

Eczema or dermatitis causing redness, itching, flaking, or crusting
It could be triggered by nipple creams, soaps, breast pads, or damp conditions

Blocked Ducts and White Spots

Discrete painful spot on the nipple (often white, yellow, or pale pink)
Recurring pain in the same location

Compressed Ducts and Mastitis

Sore, lumpy areas on the breast
Warm or hot spots
Redness (on lighter skin tones)
Flu-like symptoms if mastitis develops

Relief Strategies:

Get help with positioning and latch from a lactation consultant
Apply warm compresses before feeding to encourage milk flow
Use cold compresses after feeding to reduce swelling and pain
Take appropriate pain relievers like ibuprofen or paracetamol
For skin conditions, eliminate irritants and keep nipples dry
For vasospasm, keep breasts warm and avoid cold exposure
For blocked ducts, continue nursing frequently and use gentle massage
For mastitis, continue breastfeeding, rest, and seek medical attention if symptoms persist

If you’re experiencing persistent pain, it’s essential to understand when to seek help. Articles like "When to Seek Help: Understanding Breast Pain in New Moms" can guide you on recognizing signs that require medical attention and how to address them effectively.

Conclusion

Remember that lactation consultants, midwives, and healthcare providers are there to help you navigate these challenges. Many breastfeeding difficulties can be resolved with proper support and guidance. Every drop of breast milk is valuable, and overcoming these obstacles is worth the effort.

What to Do If You’re Experiencing Low Milk Supply, Engorgement, or Pain?