Breastfeeding may be entirely natural, but it is still a learned art, and it is understandable if things don't go perfectly smoothly at first. Below you can find the most common problems faced by newly breastfeeding mothers and some suggestions for dealing with those problems. If following these suggestions doesn't provide relief, call our hotline number and a counselor will call you back.


When your milk comes in two to four days after you give birth, and any time you have delayed a feeding, you are likely to experience engorgement. Engorgement is defined as swollen, hard breasts, with no other symptoms. If baby feeds frequently, engorgement will probably be relieved within 48 hours. To keep the areola soft so the baby can latch on to feed, try the following:

  • Apply moist heat to the breast before feeding. Hand-express enough colostrum or milk to soften the areola, which can become so firm as to be difficult for the baby to properly latch on to.
  • Stand in a hot shower with the water at your back, allowing the water to run over your shoulders and breasts. Hand-express or pump milk while in the shower to soften the areola.
  • You might need to limit the time the baby feeds on the first breast to make sure the baby will take the second breast during the feeding.
  • Use cold packs to relieve pain and swelling after feeding.

sore nipples

Some soreness of nipples is to be expected, but severe cases usually result from improper positioning. If sore, review positioning and also follow these steps:

  • Feed baby first on the less-sore side.
  • Provide short, frequent feedings rather than long, infrequent feedings.
  • Change feeding position to allow baby's jaws to exert pressure on less sore areas.
  • Remember to remove baby from the breast by breaking the suction with your finger.
  • After each feeding, wipe baby's saliva from the nipple, express a few drops of breast milk on the nipple area to promote healing, and air-dry breasts for 15 to 20 minutes.
  • Click on the link to see proper latch on.


“Thrush” is not a contagious disease or infection. Rather, it is an overgrowth of a common yeast-like fungus (Candida albicans) that normally lives on various parts of the body and ordinarily does not cause any symptoms. There is no clear reason why overgrowths of Candida sometimes occur. However, there does seem to be some correlation between the incidence of thrush and exposure to antibiotics or steroids, use of contraceptives that contain estrogen, warm/moist environment (i.e. allowing damp bras or nursing pads to remain against nipples), a diet high in sugars, fruits, as well as a previous history of yeast infections.

Thrush can occur in either the mother, or the baby, or both at the same time. Typical symptoms of thrush in baby may include:

  • Diaper rash with a raised, very red area with a sharply defined border
  • Cheesy, white vaginal discharge, or bright red, tender genitalia
  • White patches on the sides of the mouth or tongue that look like cheese curds and are DIFFICULT to wipe off. 

Typical symptoms for mom may include:

  • Bright pink or red nipples
  • Shiny, red or flakey skin on the areola
  • Burning, itching pain on the nipples

Current research shows that thrush in mothers is not as common as was once thought.  Many of the symptoms previously attributed to thrush (i.e. deep, shooting pain when breastfeeding, flakey skin, nipple cracks) are just as likely to be caused by poor latch, sucking problems, tongue tie, vasospasm in the nipple (Reynaud’s phenomenon), allergic dermatitis, eczema/psoriasis, damage from pumping or bacterial infection.

If you suspect you have thrush, try some of the following self-care tips. Diagnosis and treatment should be reevaluated with the help of a healthcare provider if you do not see significant improvement after 5 days.

Tips for Mom:

    • Rinse nipples/areolas in a solution of 1cup water plus 1–2 Tablespoons apple cider vinegar, 2–3 times per day.
    • Expose your nipples to sunlight 3-5 minutes, 2–3 times per day.
    • Careful not to let bras/nursing pads become damp with milk. May want to boil/sterilize after use.
    • Take ibuprofin for pain.
    • Take a broad spectrum probiotic (20 billion cfu per day).
    • Decrease or eliminate sugars, fruits and refined carbohydrates.
    • Apply coconut oil (food grade, found in healthfood stores and Trader Joes) to nipples after breastfeeding.
    • Apply miconazole (2%)....this is an antifungal cream available at drugstores; brand names include Monostat 7, Lotrimin AF, Gynelotrimin.  Apply to nipples 4–6 times per day after breastfeeding.  Wipe off before breastfeeding.
    • Sterilize all pump and bottle parts after using.  Discard pacifiers

Tips for Baby:

    • Administer probiotic orally (10 billion cfu per day; you can put the powder on your finger or nipple and let baby suck it off).
    • Apply gentian violet to mouth (be sure to follow directions for appropriate dilution).
    • Apply a sprinkling of probiotic topically onto diaper rash.
    • Expose diaper rash to sunlight 3-5 minutes, 2–3 times per day.