Dr. Rujuta Puranik OB – GYN Resident
If there’s one thing I’ve learned across hundreds of postnatal consultations, it’s this: almost every new mother believes she’s the only one struggling with breastfeeding. She isn’t. In the OPD, I see the same handful of problems walk in on repeat, usually accompanied by guilt, exhaustion, and a lot of unsolicited advice from well-meaning relatives that often makes things worse, not better.
Breastfeeding is natural, yes. But natural doesn’t mean easy. It’s a skill both mother and baby are learning together, often at 3 AM, often in tears. So let’s talk honestly about the ten challenges I see most often, and what actually helps.
- Painful Latch and Sore Nipples
This is, without doubt, the number one complaint in the first week. A shallow or incorrect latch is almost always the culprit, not “sensitive skin” as many mothers assume.
What helps: Aim for an asymmetric latch, where the baby takes in more of the areola from below than above, with the chin digging into the breast first. Lanolin cream or even a few drops of your own hind milk applied after a feed can soothe cracked nipples. If pain persists beyond the first two weeks, please get a lactation consultation done. It’s not something you should just “push through.”
- Engorgement During Breastfeeding
Around day 3 to 5, many mothers wake up to breasts that feel like rocks, hot, tight, and painful. This happens when milk supply is establishing faster than the baby is removing it.
What helps: Feed frequently, roughly every 2 to 3 hours, and don’t skip night feeds during this phase or cold compresses between feeds reduce swelling. Warm compresses just before a feed can help with let-down. If the areola is too firm for the baby to latch, try reverse pressure softening before you begin.
3. Low Milk Supply (Real or Perceived)
Here’s something I tell every mother in my clinic: true low supply is rare. What’s common is perceived low supply, mothers assume they don’t have enough milk because the baby cries often or feeds frequently.
What helps: Track wet and soiled diapers instead of going by how “empty” your breasts feel. Six or more wet diapers a day past the first week is usually reassuring. Frequent feeding actually builds supply through demand; it doesn’t indicate insufficiency. If weight gain on the growth chart is poor despite good feeding frequency, that’s when we investigate further, not before.
- Oversupply and Forceful Let-Down
Less talked about, but just as distressing. Some mothers produce milk faster than the baby can manage, leading to choking, gulping, gas, and a baby who pulls off crying at the breast.
What helps: Try leaning back while feeding so gravity works against the flow rather than with it (this is sometimes called laid-back or biological nursing). Feeding from one side per session for a few sessions in a row can also help balance supply gradually. Avoid excessive pumping “just to be safe,” as this often worsens oversupply.
5. Blocked Ducts and Mastitis During Breastfeeding
A tender lump, sometimes with redness, occasionally with fever, this is one of the more frightening breastfeeding challenges, and I understand why. Many mothers panic and stop feeding on that side, which is exactly the wrong move.
What helps: Continue feeding or expressing from the affected side; stopping causes further stasis. Gentle massage toward the nipple during a feed, along with warm compresses beforehand, helps clear the blockage. If fever, chills, or flu-like symptoms develop, this may be mastitis, and you’ll likely need antibiotics. Don’t self-medicate; call your doctor.
6. Tongue-Tie and Poor Weight Gain
Sometimes the latch looks fine externally, but the baby still isn’t transferring milk well, and weight gain lags behind expectations. Tongue-tie (ankyloglossia) is an underdiagnosed cause of this.
What helps: If feeds are consistently painful despite a correct-looking latch, or if the baby clicks while feeding or tires quickly without gaining weight, ask your paediatrician to specifically assess for tongue-tie. A simple frenotomy, when indicated, can make a dramatic difference. This isn’t something to diagnose off an Instagram reel; get it examined properly.
7. Returning to Work and Maintaining Supply
For many of my patients, especially working professionals, this is where breastfeeding confidence takes its biggest hit. The fear of supply dropping once regular pumping replaces direct feeds is very real.
What helps: Start building a small freezer stash a couple of weeks before returning to work, but don’t stress over hitting a specific number. Pump on the same schedule your baby would normally feed, this keeps supply steady. Power pumping (short bursts of pumping mimicking cluster feeding) for a few days before rejoining work can also give supply a boost. And remember, combination feeding is not failure. Fed is what matters most.
8. Cracked, Bleeding, or Infected Nipples
An extension of the latch problem, but severe enough to deserve its own mention. Some mothers develop deep cracks or even fungal infections (thrush) that make every feed feel unbearable.
What helps: Air-dry nipples after every feed rather than immediately covering them. Change breast pads frequently if they’re getting damp. If you notice shiny, flaky skin with shooting pain even between feeds, this might be thrush, and both mother and baby usually need treatment together, not just one of you.
9. Baby Refusing the Breast (Nursing Strike)
This one catches mothers off guard emotionally. A baby who was feeding well suddenly arches away, cries, or refuses to latch, often around 3 to 8 months.
What helps: Rule out simple causes first: a blocked nose, teething discomfort, an ear infection, or even a change in your soap or deodorant altering your smell. Try feeding in a quiet, dim room away from distractions, and offer the breast when the baby is sleepy rather than fully alert and irritable. A nursing strike is almost never a sign the baby wants to wean; it usually resolves within a few days with patience.
10. Emotional Overwhelm and Guilt
I’ve kept this for last, but it’s not the least important, if anything, it’s the challenge I wish more people spoke about. The pressure to “give only breast milk,” the comparisons with other mothers, the 2 AM tears when nothing seems to be working, this takes a real toll.
What helps: Please hear this clearly: your worth as a mother is not measured by your milk supply. Breastfeeding difficulties are common, they are fixable in most cases, and asking for help, from a lactation consultant, your doctor, or even just another mother who’s been through it, is a sign of strength, not failure. If you notice persistent low mood, anxiety, or feeling disconnected from your baby beyond what feels like normal new-parent tiredness, please talk to your doctor. Postpartum mental health deserves the same seriousness as physical recovery.
A Final Word
Breastfeeding is a journey, not a test you either pass or fail. Every mother-baby pair figures out their own rhythm, and it rarely looks like the picture-perfect version we see online. My advice to every new mother who walks into my clinic worried and overwhelmed is the same: give yourself grace, seek help early rather than late, and remember that a fed, loved baby and a mother who is coping well is always the actual goal.
If you’re struggling with any of these Breastfeeding challenges right now, please don’t suffer in silence. Reach out to your obstetrician, a certified lactation consultant, or your paediatrician. You don’t have to figure this out alone.
