Photo by Karin Pedersen Photography

Breastfeeding was not intuitive for me. I struggled with low milk supply early on and had difficulty getting Madi to latch correctly. Fortunately, with the help of a lactation consultant, after two weeks breastfeeding improved.

There are two main reasons why mothers and their infants may have breastfeeding difficulties.  The first reason is inadequate milk production from the mother. The second reason is inadequate milk extraction by the baby.  I have partnered with Enfamil to discuss ways to improve breastmilk production and extraction.

Frequency Of Feeding Contributing To Breastfeeding Difficulties

The breast and nipple are a complex system of tissues and nerves that help signal to our bodies when more milk needs to be produced. Milk supply is increased by the frequency of breastfeeding or pumping.  The more you pump or breastfeed, the more milk you will produce.  When the breasts become engorged with milk, a signal is sent to the body to slow down milk production. This then leads to milk undersupply.  

That Is Why It Is Best To Breastfeed More Frequently And On Demand To Avoid Overfilled Breasts And Maintain Consistent Milk Production.  

It may be tempting to stretch out feeds or give your baby a pacifier to prolong the time between feedings, however, this is not recommended as milk is produced when the breasts are emptied. So the more frequently the breasts are emptied, the more milk will be produced.  

Breastfeeding more frequently (and fully emptying the breasts with each feed or pump) will increase milk supply and reduce breastfeeding difficulties.

Inconsistent Feeding Routine May Contribute To Trouble Breastfeeding

After birth, both mother and baby are often very sleepy making establishing a consistent breastfeeding routine more difficult. The lack of frequency or consistency in feeding can lead to inadequate milk transfer to the baby. This may decrease milk supply and lead to breastfeeding difficulties.

Feeding your baby “on demand” and watching for your babies cues is a preferred method in the newborn period to establishing milk production. I nursed Madi on demand rather than on a schedule. Most newborns need to be breastfed 8 to 12 times per day. Sometimes even more.  

Supplementing With Formula Too Early May Lead To Trouble Breastfeeding

Sometimes mothers supplement with formula until their milk comes in which can take a few days. The important thing to remember is that if you are supplementing with formula, you still need to breastfeed or pump at the same frequency as providing formula.  This is because the breasts rely on frequent filling and emptying to produce milk.

Nipple Pain And Trouble Breastfeeding

Many women get sore nipples while breastfeeding.  This may reduce breastfeeding frequency which can lead to decreased milk supply and lead to trouble breastfeeding.  

Nipple pain can be caused by improper latching, abnormalities of the infants tongue or mouth, or abnormalities of the nipple (such as small, flat, or inverted nipples).  Sometimes tight bras, or reactions from lotions and soaps can irritate the nipples, which can result in pain while breastfeeding.  

It is normal to experience some nipple sensitivity and discomfort during the first few days postpartum. This should go away after a week or two.  If nipple pain becomes more severe after a week of breastfeeding, a physician or lactation consultant should evaluate both mother and infant.  

Some Breast Surgeries May Contribute To Breastfeeding Difficulties 

Breast augmentation, lift and reduction procedures have the potential to impact breastfeedingSurgeries where incisions are made through the nipple or disrupt the tissue within the breast may impact a woman’s breast sensation. Similarly, some breast biopsies may disrupt the anatomy of the breast. Any surgery where there has been disruption of the breast tissue can potentially alter the ability to breastfeed.

Breast reduction surgeries are associated with insufficient breast milk production.  Women with previous history of breast reduction surgeries may find it helpful to discuss with their doctor.

Medications And Their Impact On Breastfeeding

Some medications such as decongestants (egPseudoephedrine) and nicotine may impair the mother’s ability to have adequate milk supply

Poor Milk Extraction

Poor feeding can be caused by difficulty with the baby latching.  Other potential causes that may make it difficult for the baby to latch and extract milk from the breast include:

  • Malformations of the lip and palate – cleft palate, lip
  • Sucking and swallowing issues – due to possible tongue tie
  • Neuromotor delay
  • Premature infants

If the baby has experienced a prolonged separation from their mother, they may forget or fail to learn how to breastfeed.  Breastfeeding as early as possible after delivery, and keeping a consistent and frequent breastfeeding routine is vital to having a baby that can successfully breastfeed.  

Late Preterm Babies And Breastfeeding Challenges

Babies that are born in the late premature age (34 to 37 weeks gestation) may have more difficulty feeding compared to full-term infants.  This may lead to insufficient nursing, inadequate milk production, and trouble breastfeeding.

Milk production to a certain extent is a supply-demand situation. Frequent breastfeeding or pumping will help to increase your milk supply, but if it doesn’t, reach out to your healthcare team for support. There are many factors at play when it comes to a woman’s ability to succeed with breastfeeding. If breastfeeding is not an option for you, know that infant formula is an alternative source of complete nutrition for your baby.