Breastfeeding difficulties — mother.

Sore nipples and injuries

Misshapen nipples (pointed or flattened) after nursing can indicate incorrect latch or non-ideal sucking by the baby.

In the first days, sensitive nipples are normal — strong pain and injuries are not. Common causes: incorrect care, wrong breastfeeding positions or latch techniques, abruptly breaking the latch, a short tongue-tie in the baby, or the use of pacifiers.

If injuries don't heal, a fungal or bacterial infection should be ruled out.

The most common reason for early weaning is sore, injured nipples. Finding the cause is therefore especially important. Pay attention to thorough hand hygiene — sore nipples are a risk factor for mastitis.

Vasospasm

The nipple tip turns white — usually after nursing — accompanied by very strong pain.

Blocked milk duct

Causes are often stress, mechanical obstruction (a backpack, a tight nursing bra), a clogged duct, or the baby suddenly sleeping longer. Rarely is the cause an oversupply. Symptoms: painful swelling, local redness, possibly fever and chills.

Here too: investigate the cause, especially with recurring blockages.

Mastitis (breast inflammation)

The transition from a blocked duct to mastitis is usually gradual. Symptoms as with a blocked duct, plus strong pain, usually high fever, fatigue and a strong feeling of illness.

Abscess after mastitis

An abscess is a rare complication. Often the history includes sore nipples, recurring blocked ducts or insufficiently treated mastitis. An abscess can be reliably diagnosed with ultrasound.

Low milk supply

Causes can be many: misinformation about breastfeeding, pacifiers or nipple shields, supplementing with formula. But also: difficult delivery, retained placenta, thyroid dysfunction, high blood loss, insecurity or little support around the mother. In very rare cases (3–7%) there are anatomical peculiarities.

This is where close contact with a lactation consultant matters most. Identifying causes comes first, then the mother's and partner's wishes and goals. Aids such as a supplemental nursing system, electric pump, finger feeding, cup, sucking training or galactagogues are weighed individually.