Almost half of breastfeeding mums quit before their baby is six weeks old and often it’s because they’ve run into problems that are actually easily solved. If you’re thinking of stopping, read on for quick solutions to common problems…

Yes you can breastfeed!

My baby is due and I want to breastfeed but I have very small nipples that don’t stick out like normal ones. Will this make it difficult?

Many women have nipples that are ‘inverted’ but this shouldn’t prevent your baby from nursing because it’s not actually your nipple she suckles on – it’s the areola (the darker area immediately surrounding it). The most important thing is to make sure your baby is properly latched on – you’ll probably feed him for the first time within 30 minutes of the delivery and there will be lactation consultants of nurses close by to help you. Some women find that breast shells can encourage inverted nipples to protrude more – a lactation consultant can advise you.

My baby is just over a week old and my nipples are really suffering – they’re cracked and bleeding and nursing is painful. Should I give up and switch her to the bottle?

It’s not unusual to feel some discomfort when you first start breastfeeding but you shouldn’t still be getting it a week on and certainly not to the extent you describe. Most cases of sore and cracked nipples are caused by incorrect latching on. If your physician isn’t qualified to check your technique it’s worth contacting a lactation consultant who can visit you at home – if it solves the problem it’s money well-spent. Other reasons your nipples may be sore include overdrying or excessive moisture; it’s also possible that your baby has passed on a yeast infection if she has one in her mouth (if your physician thinks this is the problem she can prescribe an anti-fungal medication).

Once you’ve perfected your latching-on technique, keep feeding but nurse your baby on the least-sore side first so that when you transfer her to the other breast she’ll be less hungry and will suckle less vigorously. If your nipples become so sore you can’t bear to nurse, gently express milk by hand.

My breasts are constantly leaking milk! I wake up with my T-shirt and sheets soaked and go through several boxes of nursing pads a week. Every time I go to latch on my baby she gets a face full of milk! Is this normal?

When your breast milk comes in, around four days after your baby’s birth, it’s common to have an overabundant supply and for your let-down reflex to be so powerful that milk sprays out when you start to nurse. It can cause problems, with your breasts becoming engorged (literally too full), and your baby finding it hard to latch on because the skin on your breasts is stretched so tight there’s no ‘give’. If this happens you may have to express a little milk before feeds, to help her grab hold! Thankfully this oversupply will diminish by the time your baby is around six to eight weeks old – breast milk is produced on a supply and demand basis, and as soon as  your body becomes accustomed to your baby’s needs your milk supply will balance out.

I’ve discovered a hard, tender patch on one of my breasts near my armpit – is it anything to do with nursing my baby?

This sounds like a blocked milk duct – these are pretty common near the armpits because milk glands are concentrated in those areas. Ducts can become blocked if you leave it too long between feeds or don’t feed for long enough, and women who tend to produce a lot of milk are more likely to get them.

There is a risk that a blocked duct can develop into mastitis but the solution is simple: feed your baby as often as you can and offer her the affected side first – the hungrier she is the more vigorous her sucking, and this alone may help dislodge the blockage. Positioning her so her chin points towards the blockage will also help, so latch her on in the underarm position with her body lying on a pillow placed at your side, and gently massage the tender area as she feeds. If she doesn’t feed for very long, hand express to fully drain the milk and mention the problem to your lactation consultant. If these measures don’t clear the lump, have your physician check it as a precaution.

My physician wants to put me on anti-depressants to help me cope with post-partum depression. Could the medication harm my baby if I continue to breastfeed?

Many new mums suffer from depression after the birth but rest assured that there are a number of anti-depressants that have no adverse effect on a nursing baby. As a precaution, and to set your mind at rest, inform your physician that you’re breastfeeding and ask him to prescribe a drug that is known to be safe. Let your baby’s paediatrician know you’re taking it, and watch out for any possible side-effects, which could include your baby seeming excessively drowsy or difficult to settle, or colicky. Keep in mind that your baby’s health and wellbeing depends on yours – and you’re likely to be happier if your depression is treated.

My sister had mastitis when she was breastfeeding. How can I avoid it?  

Mastitis is an infection that often develops out of a blocked milk duct. It causes flu-like symptoms including a fever, chills, and aches and pains; you’ll also notice a hard red patch of skin on your breast. The infection needs to be treated with antibiotics and you should continue to nurse your baby throughout, starting feeds on the unaffected side, to keep up your milk flow. Hot or coolpacks can help relieve soreness but if you find feeds too painful, hand-express your milk and ask your lactation consultant for guidance.

Many mums develop mastitis when they return to work and are not feeding their baby as regularly. If you’re expressing milk at work, try to schedule it when you would normally have nursed your baby or do it at least every four hours.

Help! I recently returned to work and my baby is getting expressed breast milk from a bottle during the day. But when I try to nurse her in the evening, she refuses the breast. Could it be she prefers to bottlefeed?

If you’re pumping milk at work this should keep up your milk supply but it’s best to try and do this at the times you would have nursed your baby. Many working mums cut down to just once a day, during their lunch hour and since milk is produced on a supply and demand basis, your flow will reduce if you’re not feeding your baby or expressing to the usual schedule. This means that when you latch your baby on after work, there may not be as much milk as she’s used to and she may get frustrated – especially if she has worked out that she doesn’t have to work so hard to get milk from a bottle! Try to get past the problem by latching your baby on as soon as you get in instead of waiting until she’s really hungry, when she’ll get particularly irate at having to suckle hard in order to feed. Try waiting until she’s drowsy too, as many babies will feed while they snooze.