Common Breastfeeding Problems: Mastitis, Latch Issues & Low Supply

Breastfeeding problems are extremely common — most breastfeeding parents hit at least one of these in the early weeks — and most are genuinely fixable with the right, specific help. The single most useful thing to know: almost every one of these issues is much easier to solve with someone trained watching an actual feed than by reading about it.

Mastitis

Mastitis is inflammation of the breast tissue, usually starting from a blocked duct that hasn't fully cleared. Signs include a red, hot, painful area of the breast, often wedge-shaped, sometimes with flu-like symptoms — fever, chills, aching, feeling generally unwell.

What helps:
- Keep feeding (or expressing) from the affected side — this doesn't harm your baby and is the most important thing you can do
- A warm compress or warm shower just before feeding can help milk flow
- Gentle massage toward the nipple while feeding, on the affected area
- A cold compress after feeding can ease pain and swelling
- Rest as much as you realistically can — mastitis often flares when you're run down

When to see a GP: if symptoms don't improve within 24 hours, or you have a high fever or feel very unwell, since some cases need antibiotics — which are safe to take while breastfeeding. Left untreated, mastitis can occasionally progress to a breast abscess, which needs specific treatment.

Painful or shallow latch

Pain that continues throughout a feed, cracked nipples, or a clicking sound while feeding usually point to a shallow latch — baby isn't taking in enough breast tissue, just the nipple. A good latch should feel like a strong tug, not sharp pain, after the first few seconds.

Signs of a good latch: more of the areola visible above baby's top lip than below their bottom lip, baby's chin touching the breast, and a rhythmic suck-swallow-pause pattern rather than rapid fluttery sucking.

Latch problems are genuinely one of the hardest things to fix from a written description — ask your midwife, health visitor, or a breastfeeding counsellor to watch an actual feed. This alone resolves a huge proportion of ongoing pain.

Perceived vs. genuine low milk supply

Worrying about supply is extremely common, but true low supply is less common than it feels — milk production works on demand, and cluster feeding, growth spurts and normal fussy evenings are very often mistaken for a supply problem.

Genuine signs of low supply: poor weight gain, fewer than 6 heavy wet nappies a day after the first week, or a baby who seems constantly unsettled after feeds and isn't gaining weight as expected — these are worth checking with your health visitor via a weight check, the definitive answer.

What helps if supply genuinely needs a boost: feed or express frequently (supply responds to removal, not rest), try breast compression during feeds, double-check the latch, and get skin-to-skin time in. Herbal supplements marketed for supply have limited evidence — a feeding specialist is a better first call than a supplement.

Tongue tie

A tongue tie (ankyloglossia) is when the strip of tissue under the tongue restricts its movement, which can sometimes cause a shallow latch, pain, or poor milk transfer. Not every tongue tie causes a problem — many babies with a tongue tie feed perfectly well, so it's only worth addressing if it's genuinely affecting feeding.

If feeding problems continue despite latch support, ask for an assessment by a trained professional (midwife, health visitor, or a specialist tongue-tie clinic). Where treatment is needed, the procedure (frenotomy) is quick, and many babies feed more comfortably straight after.

Sore or cracked nipples

Usually a sign of a latch issue, so that's the first thing to check and fix. A little expressed milk rubbed in and air-dried, or a pure lanolin cream, can soothe soreness while you work on the latch.

Watch for thrush, a possible cause if soreness continues despite a good latch — signs include shooting pain deep in the breast during or after feeds, and sometimes white patches in your baby's mouth. Thrush needs treating for both of you at the same time, so see your GP or health visitor rather than just treating the nipples alone.

Where to get real, hands-on help

• Your midwife or health visitor — the first call in the early weeks
• NHS infant feeding teams and breastfeeding drop-ins — many hospitals and children's centres run these, often free and walk-in
• National Breastfeeding Helpline (0300 100 0212) — free, run jointly by several UK breastfeeding charities
• An IBCLC lactation consultant — for persistent problems, a private consultant with this qualification can offer a longer, more in-depth session than an NHS appointment usually allows

None of this means you're doing it wrong — breastfeeding is a skill both of you are learning together, and getting stuck is normal, not a sign to give up before you've had the right support.