Dealing with difficult times

Many of the women we spoke to breastfed without any difficulty at all but some did have problems and they usually sought help from a breastfeeding counsellor or a health professional. Once they had overcome the problem, most women went on to breastfeed happily. They said that breastfeeding was one of the most rewarding experiences of their life and they were extremely glad that they had persevered through the difficult times. Some women, however, were unable to solve their problem and reluctantly gave up breastfeeding, sometimes resulting in later regret, but felt that they'd done the best they could under the circumstances at the time.

Difficult birth
Many women said that their birth experience was difficult or traumatic, sometimes resulting in an emergency caesarean section, and that it affected their later breastfeeding experience (see 'Sore nipples'). Some found that they were tired or medicated or too ill after the birth and unable to concentrate on breastfeeding in the beginning (see 'The first breastfeed' and 'When extra care is needed for mother and/or baby'). Some said that their baby was sleepy or uncomfortable after a difficult birth and not interested in feeding for several days. One baby took several weeks to learn to breastfeed (see 'Support from hospital staff'). Some were separated from their baby at birth and this caused them a great deal of anxiety, especially when they had expected to have skin-to-skin contact with their baby and breastfeed within the first hour.

Breast Pain
One of the most common difficulties that the women faced was breast pain caused by blocked ducts or infections such as mastitis, thrush (see 'Sore nipples') or, in one case, a superficial bacterial infection. They said that a blocked duct came on gradually, was mildly painful and localised. They said that the pain of mastitis came on quickly and was accompanied by heat, redness and swelling in their breast and sometimes they felt 'flu-like. They thought that the causes included poor attachment, engorgement, stress and tiredness, missed feeds, dropped feeds during hasty weaning, too much milk, and clothing or straps restricting the breast. A few women said that they thought expressing breastmilk had increased their supply and possibly caused their problems. To treat the problem, most went to bed with their baby and continued to breastfeed from the affected breast. One woman, who was tandem feeding, asked her older baby to feed from that breast to clear the blockage. Some used massage, expression, cabbage leaves*1, heat (compresses or a warm bath), painkillers, homeopathic remedies or antibiotics*2.

It is fairly common for babies to develop jaundice*3 a few days after birth as excess bilirubin (see Footnote 3) accumulates in their blood and makes them appear yellow. Of the few women whose baby did develop jaundice, some said that all they had to do was to be sure to wake their sleepy baby and breastfeed him/her frequently until the jaundice passed. Feeding near a window so that the sunlight could get onto the baby's skin was said to be helpful. One woman spoke about taking her sleepy baby to the hospital for daily blood tests. Eventually, the baby was covered with bruises at which point she decided to spend the whole night waking and feeding her baby to get breastmilk into her. Other women had babies under UV lights in the hospital and removed them from their crib for feeding, not always with the approval of medical staff. One woman said that her baby was:

 “Stripped so she was totally naked, she was just lying there with little goggles and a little yellow body in the incubator with the lights on”.

A few women found that, for a variety of reasons, their breastmilk supply had dwindled and that they had to relactate (bring up their milk supply again), usually by frequent feeding and expressing using a breast pump.

Postnatal Depression
A few women talked about a period of real depression (not just the third or fourth day post-birth 'baby blues') sometime after the birth of their baby*4. At their lowest point, they felt that they had no love for their baby. They connected their depression to unrealised expectations, disappointment, frustration that things were not going according to plan and adjustment to motherhood. One woman was prescribed antidepressants but felt that they didn't work because the root cause of the problem had not been addressed (see 'Emotional and psychological aspects of breastfeeding').

Tongue Tie
Tongue tie is the term used to describe the condition where the frenulum - the ligament that joins the baby's tongue to the floor of the mouth - is short and tight. It may affect breastfeeding. Research has shown that most babies with tongue tie have their problems resolved by clipping of the frenulum, but it is controversial. 

In the normal course of breastfeeding, teething is not a problem or a cause for weaning as the baby's teeth are covered by his/her tongue and not involved in sucking. If a baby is biting he/she is not actively breastfeeding. The women who spoke about biting said that it didn't usually last long. Several said that it was important not to jump, shout or otherwise react so that their baby did not get the idea that it was a game. One woman kept carefully and calmly taking her baby off the breast when she bit until she learned not to do it.

Dairy intolerance
Dairy products, such as cow's milk and cheese, are common causes of allergies and, when included in a mother's diet, may pass to her breastfed baby and cause fussiness and colicky symptoms. A few women talked about their baby being dairy intolerant. After these women went on a diet free from all dairy products, their baby became more settled*5. One woman spoke of her baby being extremely constipated with painful bowel movements (see 'When mother and/or baby need extra care') while another said that her baby screamed every night and had loose infrequent stools. Diagnosis was always difficult and took a long time.

Nursing strike
Nursing strike is the term used to describe times when a baby refuses to breastfeed for no 'apparent' reason. It is most unlikely that a baby under one year of age, who refuses to breastfeed, is weaning naturally. Some women talked about their babies going on a nursing strike, usually at holiday or Christmas time. The women were very worried and required counselling help to encourage their baby back to their breast. One woman received calming reassurance from a breastfeeding counsellor and lots of suggestions such as trying to latch her baby on while he was asleep, feeding him in the dark, using a dummy and then substituting it for the breast. One woman said that she was disappointed and frustrated when her babies refused the breast, one at four months and the other at ten months of age. She wondered what she had done wrong.

*Footnote 1: Cabbage leaves, kept cool and applied to the breast, are sometimes recommended as a home treatment for engorgement. Their effectiveness has not been scientifically proven.

*Footnote 2: Antibiotics may be needed to treat mastitis if the woman's temperature has not gone down after 24 hours of home treatments or if it increases suddenly. The antibiotics used must be compatible with breastfeeding as the mother should continue to breastfeed, especially from the affected breast. Information on medications and breastfeeding can be obtained from LactMed – an online Drugs and Lactation Database geared to health professionals and lactating mothers. A resource that is part of the US National Library of Medicine (See Resources section).

*Footnote 3: Jaundice is the term used to describe the yellowish colour that some babies develop in the first week of life as bilirubin (the yellow pigment resulting from the breakdown of red blood cells) is deposited in their skin because their immature liver cannot yet deal with it. It is very common, is considered normal and resolves itself. Normal newborn jaundice in a breastfed baby is usually associated with inadequate feeding in the first few days and usually requires no treatment other than to sort out the breastfeeding problem. However, high or rapidly rising levels of bilirubin, especially in the first two days of life, may indicate an underlying disease or condition that needs investigating. High bilirubin levels may require treatment (UV light or blood transfusion) as they can cause brain damage.

*Footnote 4: It is important that postnatal depression is recognised and appropriately treated as it can affect the baby. Breastfeeding is not a physiological contributor to postnatal depression but a lactation consultant or breastfeeding counsellor may be able to help and will know when to refer to another specialist.

*Footnote 5: It is recommended that exclusion of a whole food group from your diet be done in consultation with a dietician.

Last reviewed November 2018.
Last updated September 2015



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