Breast milk is free, sterile and always available on tap. However, breastfeeding can be a challenge, especially at the beginning. Like any new skill, it can take time, support and perseverance to establish feeding-but it’s worth it because breast milk is designed to meet your baby’s needs and provide the perfect balanced nutrition.

You’re not alone in dealing with the difficulties; on the post-natal ward your midwife should be on hand to help you get started. Many hospitals have breastfeeding counsellors to offer support and advice and the NCT, the new parent support charity, can be a great source of information and help for new mums.

Problems latching on

You’re not the only beginner at breastfeeding, it’s new to your baby too. However, they have a natural rooting reflex to help them find your nipple. Make use of this by brushing the nipple against their top lip. They should open their mouth wide, you can then bring the open mouth towards the breast so that they can latch on.

If latching on continues to be a problem, it can be worth checking if your little one has tongue-tie or ankyloglossia. It’s a structural abnormality that affects between 3 and 10% of newborn babies. The piece of skin joining the tongue and the floor of their mouth is too short which can restrict tongue movement and impair feeding. If it’s causing problems, see your doctor. Tongue-tie can be divided in a simple procedure, which usually resolves any feeding difficulties.

Sore or cracked nipples

Many mothers struggle with sore and cracked nipples, especially in the first week of breastfeeding. You can help prevent this by making sure your little one gets a big mouthful of your breast. It’s no good if they’re only sucking the nipple, it’s inefficient, uncomfortable and increases the risk of suffering nipple pain and inflammation.

If your nipples are cracked, applying an emollient may help. AproDerm^® creams can be used before and after feeding on sore nipples to help soothe discomfort without affecting your baby.

Breast engorgement and mastitis

Your breasts can become very swollen, tender and engorged when you breastfeed. It can be a problem particularly when your milk first comes in if your baby isn’t latching on properly, if they drop a feed or if you’re not evenly using both breasts to feed from.

Mastitis is inflammation in the breast that can happen when there is breast engorgement. This will make the area firm, red, hot and tender to the touch. As well as the breast swelling and soreness, you’ll also feel generally unwell if you’ve got an infection. You may feel achy, feverish, shivery and get chills, a bit like the flu.

Although mastitis can be unpleasant, you can usually clear it yourself without medication.

• Carry on feeding often and on demand to get the milk flowing.
• If your breast is so sore that you can’t manage to feed, then use a pump or hand to express milk.
• Apply a warm flannel before starting to feed, it helps stimulate the let-down reflex.
• Make sure your bra fits well, is supportive and doesn’t dig in.
• Gently massage the area during feeding to help the congested milk to flow.
• If your breasts are uncomfortable, a cool cabbage leaf has been used by mums for centuries to provide relief, don’t eat it-just pop it in your bra.
• Rest, have plenty of fluids and look after yourself as you recover.
• If you’re feverish, unwell or the inflammation is not settling see your doctor. You may need antibiotics or there could be an abscess that requires surgical drainage.

Thrush

Ongoing nipple pain and soreness could indicate a thrush or candida infection of the nipple. You’re more at risk if your nipples have been cracked and sore, if your baby has oral thrush or if you or your little one has been treated with antibiotics. See your doctor if both nipples are sore, especially if the pain is severe and lasts a long time after feeding.

It’s safe to continue breastfeeding with thrush, but you should see your doctor. It can be treated with antifungal creams and oral drops for your baby.

Not enough milk?

Your breasts should respond to your baby’s needs and increase the supply according to their demands. You can’t see how much milk they’re taking, but if they’re gaining weight and having regular wet nappies, they’re probably getting the nutrition they need.

If you’re worried or struggling, you may need a little advice and support. Correct positioning and latching on can make a big difference. Chat to your midwife, health visitor or ask if the NCT have someone in your area. The National Breastfeeding Helpline on 0300 100 0212 or the NCT Breastfeeding Helpline on 0300 330 0771 are both staffed with experts who can offer a listening ear and useful advice.