Breastfeeding challenges healthcare professionals should be prepared to address
A neonatal nurse and lactation consultant sets out what she sees as the most common breastfeeding challenges healthcare professionals should be prepared to address.
Across more than a decade working in the Neonatal Intensive Care Unit, I’ve supported hundreds of families through those first fragile days of feeding. While every journey is unique, the challenges mothers face often follow familiar patterns. When we, as healthcare professionals, can anticipate and respond with evidence-based guidance and empathy, we set mothers up for success — not just in breastfeeding, but in confidence, connection and overall wellbeing.
The early postpartum period is an emotional and physical crossroad. Hormones are fluctuating, recovery is ongoing and even the smallest challenge can feel monumental. Every word, touch and piece of advice from a clinician has the power to build confidence or unintentionally create doubt.
Below are the most common breastfeeding challenges I see in practice and how healthcare teams can better support mothers through them.
1. Getting the right latch and positioning
A good latch is the cornerstone of successful breastfeeding, yet it’s one of the hardest things to master. Pain, shallow attachment, clicking sounds or flattened nipples post-feed all point to latch or positioning issues.
Encourage the semi laid-back (biological nurturing) position early on. This allows babies to use instinctive reflexes to find the breast while keeping the mother comfortable — ideal after birth when upright sitting can be uncomfortable. Correcting latching issues early prevents nipple trauma, ensures efficient milk transfer and boosts maternal confidence.
2. Managing engorgement when milk comes in
Around days three to five after giving birth, many women experience a sudden surge of fullness, warmth and discomfort. Engorgement can flatten the nipple, making attachment harder.
Suggest laid-back or side-lying feeding positions for comfort, alongside gentle breast massage or expressing just enough milk to soften the areola before a feed.
During this phase, leakage is common — and frustrating. Tools like silicone breast milk collectors can help relieve surface pressure and collect milk passively, offering comfort while allowing mothers the chance to begin building their ‘milk stash’ without needing to pump — something many appreciate when everything feels overwhelming.
3. Healing sore, cracked or damaged nipples
Nipple trauma is one of the top reasons women stop breastfeeding prematurely — and it often stems from poor attachment or frequent unlatching. Once damage occurs, feeding can become excruciating.
Reassess positioning, then support healing with topical treatments such as lanolin, coconut oil or nipple ointment. If severe, a short break from direct feeding may be needed. During that time, mothers can hand express or pump as appropriate to maintain supply — but be mindful that overuse of silicone pumps in the early weeks may contribute to oversupply and engorgement.
If bottle feeding temporarily, teach paced feeding using a slow-flow teat to help protect the breastfeeding rhythm and prevent flow confusion.
4. Recognising and managing nipple thrush
Nipple thrush is an invisible but intensely painful condition, often triggered by antibiotic exposure during birth or excessive moisture from soaked breast pads.
Encourage mothers to describe symptoms in their own words; many report a ‘stabbing’ or ‘burning’ pain deep behind the nipple, even without visible signs.
Remind them to keep nipples dry and change pads frequently. Reusable silicone shells can help by keeping milk off the skin, allowing airflow and reducing the damp environment thrush thrives in.
If infection is suspected, coordinate treatment for both mother and baby to prevent reinfection and prolonged pain.
5. Supporting mothers with perceived low milk supply
Few concerns cause more anxiety than “I don’t think I have enough milk”. In most cases, this fear stems from misunderstanding normal newborn behaviour.
Frequent feeding, cluster feeding and unsettled evenings are developmentally normal, not indicators of low supply.
Educate mothers on the true markers of adequate intake — swallowing sounds during feeds, softening of the breasts, steady weight gain and healthy nappy output.
Encouragement and reassurance at this stage are invaluable. Confidence alone can influence supply by reducing stress hormones that inhibit milk letdown.
6. Preventing and managing blocked ducts and mastitis
Blocked ducts and mastitis often arise in the first few weeks when feeds are skipped, bras are too tight or latch is suboptimal.
Teach mothers to recognise early warning signs — localised tenderness, warmth or a firm lump.
Encourage continued feeding with the baby’s chin pointing towards the blockage, warm compresses and gentle massage towards the nipple.
If systemic symptoms develop — fever, chills, body aches — refer promptly for antibiotic therapy. Early intervention reduces the risk of abscess and supports ongoing breastfeeding.
7. Prioritising emotional and mental health support
Amid the physical challenges, emotional wellbeing is often the deciding factor in breastfeeding continuation.
Mothers who feel supported and seen are more likely to persevere through setbacks. Words matter: “You’re doing beautifully” can mean more than any technical correction.
Approach every consult with compassion. Offer plans, not ultimatums. Validate her efforts. When mothers feel safe and empowered, their feeding outcomes and mental health improve dramatically.
Final thoughts
Breastfeeding support is not just a clinical skill — it’s a blend of evidence, empathy and presence.
When healthcare professionals are equipped to identify and respond to the most common challenges early, we protect more than breastfeeding rates: we protect confidence, connection and mental health.
A mother may forget the exact advice you gave, but she’ll always remember how you made her feel. That’s the kind of care that changes outcomes and lives.
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