Common Breastfeeding Complications

Common breastfeeding issues

Clogged/plugged ducts

  • Breastmilk flows through a series of "pipes" called milk ducts inside your breasts and then out through pores in your nipples. Clogged ducts are just a blockage in these "pipes" which can cause hard lumps or nodules to form in a localized area of your breast.
    • These can be painful and give you an achy sensation
  • Usually do not cause a fever
  • Most times unilateral, or only on one side
  • Can lead to mastitis if no intervention, so contact IBCLC to be sure you have the correct treatment plan
  • Typically can be resolved by
    • Breastfeeding or pumping frequently, especially on affected breast
    • Massage breast during feeding/pumping toward the nipple
    • Warm compresses, warm gel packs, shower, etc.
    • Sunflower lecithin - a supplement that helps make milk less "sticky" and can help prevent reoccurrence
    • You can also use warm water with epsom salt in a haakaa with suction to gently pull the clog out
      • Click here for a step-by-step guide on how to do this


  • Mastitis is an infection in the breast tissue. It causes flu like symptoms (fever >101, chills, aches), along with localized pain, swelling and redness in the breast. 
  • May notice decreased milk supply or a fussy baby on the breast
  • Contact your OBGYN if you suspect mastitis, as it MUST be treated with antibiotics.
  • Other ways to help treat mastitis at home include:
    • Expressing milk or breastfeeding about every two hours on the affected side
      • It is safe to give your infant breastmilk when you have mastitis- you cannot pass a breast infection to your infant via the breastmilk
    • Use NSAIDs for pain/fever management
    • Use warm, moist compresses on the affected breast, warm showers and breast massage
    • Wash hands often
    • Rest and drink plenty of fluids
    • Wear a supportive, but not tight/restrictive bra

Fungal Infection (Thrush)

  • New onset severe nipple pain while breastfeeding after previously breastfeeding without discomfort
  • Typically described as itching, burning, shooting, stabbing pain that extends back to the chest wall
  • Breasts can look shiny, inflamed, irritated, or even get small blisters
  • Baby may also have symptoms such as thick, white spots or patches on their tongue, inner cheeks and upper palate, or a red, spotted, "angry" looking diaper rash. 
  • Contact IBCLC if you suspect a fungal infection because they can prescribe a treatment for you and baby.
    • In the meantime, air dry the nipples as much as possible. Yeast thrives in a warm, moist environment.
    • If you're using breast pads because of leakage, make sure you change them immediately once they become wet
    • Wear 100% cotton bras and underwear that "breathe" and can be washed frequently

Nipple Vasospasm

  • Caused by constriction in the arterioles of the breast which limits blood flow to the nipple causing intermittent, but severe pain and discoloration of the nipples
  • This can feel like a deep shooting or stinging pain and typically occurs after baby comes off the breast
  • Will notice a discoloration of the tip of the nipple - starts as white (blanching), then progresses to a deep purple/blue, then back to normal.
  • To combat this, make sure that you have a warm towel or heat pack ready so that you can apply that to your breast immediately after baby un-latches from the breast
    • You don't want the cold air to touch your nipples and make the constriction of blood worse
    • Avoid cold temperatures in general
    • Have warm towels ready for after showers
    • Sometimes may need a prescription medication to help dilate the blood vessels
  • Always contact IBCLC if you suspect this, because it can feel similar to a fungal infection

Milk Bleb/Blister

  • These can occur on the nipple itself or on the areola, and are typically caused by plugged ducts.
  • It happens when skin forms over the pores of the nipple which doesn't allow for milk to flow out as it normally should.
  • You'll want to treat it similarly to a plugged duct by applying warm, moist compresses to the affected nipple, warm saline soaks, and extra pumping to help pull the milk through the thin layer of skin.
  • Also try exfoliation with a dry or rough washcloth, a loofah or other material that can help rub that thin layer of skin off so the milk can flow.
    • If these strategies don't work, the last resort is popping or lancing the bleb with a sterile needle. This can be done at home or with the help of an IBCLC or other trained professional.
    • Click here for a nice article on how to treat these at home

Oversupply / Overproduction

  • Sometimes your breasts will produce more milk than your baby needs. 
  • Mom's symptoms may include: 
    • Frequent clogged milk ducts or mastitis, pumping >2 oz per hour in addition to breastfeeding, excessive leakage of milk, painful fullness of breasts even after breastfeeding.
  • Baby's symptoms may include:
    • Gagging or choking frequently during feedings, requiring them to unlatch
    • Spray of milk coming from breasts whenever baby pulls off
    • Frequent spit up, or reflux-like symptoms
    • Gassy, fussy, restless at the breast, or having explosive green, frothy stools (although we don't recommend basing too much on baby's poop!)
  • You can try to manage this supply issue by fully emptying the breasts once a day using a double pump, then restricting breastfeeding at one breast for a set number of feedings or a set amount of hours (aka- "block feeding").
    • Empty breasts = signal to the body to make more milk. Full breasts = NO signal to make more milk
    • For example: fully empty breasts by pumping both breasts once in the morning. Then offer ONLY left breast for 2 feedings in a row (or 4 hours), then switch and ONLY offer right breast for the following 2 feedings in a row. 
    • You can increase the time/feeding interval as needed based on severity of oversupply, but do not exceed 12 hour blocks.
  • Try not to pump the other breast unless it's extremely painful
    • If you need to pump, express just enough to reduce the pain (typically 15-30 ml. 
  • Milk stasis in the breast can lead to plugged ducts or mastitis, so always contact IBCLC with questions or concerns about supply.

Nipple Pain

  • There are a number of reasons for nipple pain so it's always helpful to speak with an IBCLC if you're experiencing symptoms.
  • It is important to note that nipple tenderness without any trauma to the nipple (cracks, blisters, bleeding) is normal in the first week of breastfeeding.
    • Nipples will toughen up naturally over time.
  • If you're having nipple soreness, there's a few things you can do at home to try and help
    • Try to change baby's position or switch your hold during a feeding
    • Saline nipple soaks - dissolve 1 tsp of table salt in 8 oz of warm water in a bowl, then "dip the nip" for a few minutes in the salt water.
    • Use a balm like lanolin or motherlove nipple cream after nursing.
    • Can also hand express a little breastmilk and rub it on the nipple and let it air dry after a feeding to help with soreness.