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Ages & Stages

Warning Signs of Breastfeeding Problems

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Natural as the breastfeeding process is, challenges can sometimes arise. When problems do surface, they may grow worse very quickly. They can even interfere with your milk production or your baby's ability to get the nutrition they need.

That's why it's vital to get help right away if you experience difficulty with breastfeeding at home.

Don't hesitate to ask for guidance

Contact your baby's pediatrician, and don't stop asking for one-on-one guidance until you get the help you need. Reaching out to solve problems promptly helps ensure that you and your baby can continue to enjoy the many benefits of breastfeeding.

Here are 11 signs of breastfeeding problems:

1. Your baby's nursing sessions are either very short or extremely long.

Breastfeeding sessions that are consistently shorter than about 10 minutes during the first few months could mean that your baby isn't getting enough milk. Another potential problem: not enough milk is being removed to stimulate your ongoing milk production.

Sessions that are consistently longer than about 50 minutes are also cause for concern. It could mean your baby is not getting enough to eat due to ineffective suckling or low milk production.

2. Your baby still seems hungry after most feedings.
Your baby may not be ingesting enough milk. Consult your pediatrician and have them weighed right away. Meanwhile, double-check their latch-on and position at the breast to try to increase the amount of milk they are getting.

3. Your newborn frequently misses nursing sessions or sleeps through the night. Frequent, around-the-clock feedings are a necessary part of breastfeeding a new baby. Your baby needs a feeding every few hours to gain enough weight to thrive. If your newborn sleeps longer than 4 hours a night, wake them up and encourage them to nurse.

4. You don't hear frequent swallowing when your baby nurses once your milk supply has come in. Your baby will likely swallow occasionally as they begin to nurse, then swallow more frequently as they continue a session and less frequently again near the end. Swallowing is an excellent sign that they are actually ingesting milk. If they don't seem to be swallowing, call their pediatrician right away. (Keep in mind that you may not be able to hear your baby swallowing when they are taking small sips of colostrum in the early days, though.)

5. By two weeks of age, your baby is under their birth weight or hasn't started gaining at least 5 to 7 ounces per week since your milk came in. Inadequate weight gain is one of the strongest signs that a baby is not getting enough milk.

6. After 7 days, your baby has fewer than 6 wet diapers and 4 stools per day, their urine is dark yellow or specked with red, or their stool color is still dark rather than yellow and loose. If you or your pediatrician is concerned about your child's milk intake, you might want to keep a written record of your baby's wet diapers and bowel movements during the early days. This can help to be sure they are progressing properly. Most hospitals and lactation specialists can provide you with a special diary for recording your newborn's feedings and diaper changes.

7. After 5 days, your milk hasn't come in or your breasts don't feel as though they're filling with milk. If you feel this way, have your baby weighed by their pediatrician immediately. This is the most precise way to tell whether they are ingesting enough milk. You may also want to have your breasts examined.

8. You experience severe breast engorgement. Hard, painful breasts may prevent your baby from latching on correctly and discourage both of you from nursing. You may need to express milk manually or with an electric breast pump until your breasts have softened somewhat. Severe, unrelieved engorgement can decrease your milk supply.

9. The fullness and hardness of your breasts don't decrease by the end of a feeding. Your baby may not be drinking enough milk or may be suckling ineffectively.

10. Severe pain interferes with breastfeeding. Your baby is probably not latching on correctly. If you have severe nipple pain or significant cracking of the nipples that makes it too painful to nurse, consult your physician or lactation specialist. They can check for a nipple or breast infection, such as mastitis, and help you with any problems with latching on. You may need to start breastfeeding on the less sore side or even use an electric breast pump until your nipples have healed. Your lactation specialist or La Leche volunteer can show you how to do this.

11. After a week or two, you don't notice the sensations associated with your milk let-down reflex. Though this may not signal a problem at all, it could mean that your milk production is low. Ask your baby's pediatrician to evaluate your baby and observe your breastfeeding technique. Your local La Leche League volunteer or lactation specialist can help assess the situation, too.

More information

Last Updated
American Academy of Pediatrics Section on Breastfeeding (Copyright © 2024)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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