Society labels breastfeeding as the natural choice. Therefore, many mothers feel like it should come naturally. They are often frustrated when they find that they are struggling to breastfeed. 

When breastfeeding doesn’t work, we can feel like there is something wrong with us as mothers.   Nothing could be further from the truth. 

Breastfeeding struggles are common.   According to a 2019 study, 70.3% of mothers experience difficulties of some sort and 80% stop breastfeeding earlier than they want to. (Gianni et al., 2019)

Are the benefits of breastfeeding worth the battles?  What can be done to overcome some of the most common difficulties?

Benefits formula feeding

Breastfeeding is pushed hard in the UK.  This is often to the extreme of shaming mothers who choose to formula feed.  No parent trying to feed their child should ever be shamed.  

Yes, breastfeeding has benefits.   So does formula milk.

• A baby fed with formula can be fed by anyone, anywhere.  This can mean more bonding opportunities for Daddy, or other family members, and more sleep for Mummy.
• It can be easier to establish a routine with formula-fed babies.  Partly because they don’t need to cluster feed to increase milk supply, and partly because formula milk takes longer to digest so the baby can wait longer between feeds.  (Shaw, 2012)
• If breastfeeding is causing stress, opting for an option that works can improve your mental health.  Some would call it noble to sacrifice your mental health to breastfeed. However, if you are mentally and emotionally well, it will be a huge asset to your little one. (Modak et al., 2023)
•   You can make eye contact with your baby while you feed them by bottle.  It is a beautiful thing, to feed your baby with your eyes locked in theirs. 

Benefits of breastfeeding

Despite my strong conviction that no mother should be forced to breastfeed, there is no denying that breastfeeding can have many physical and emotional benefits for both baby and mother.

• Breast milk can boost a baby’s immunity to infections and viruses.
• Breastfeeding has been shown to lower a mother’s risk of some medical conditions, such as breast cancer and osteoporosis. (NHS, 2023)
• Breastfed babies have been shown to have better academic and health outcomes later in life. (World Health Organization (WHO, 2023.)
• Breastfeeding releases oxytocin, a chemical linked with emotional bonding and well-being.   This means that a breastfeeding mother has a lower chance of postnatal depression.

When you are struggling to breastfeed

Different issues that can cause struggles with breastfeeding. Let’s look at the most common problems and how to tackle them.

If you are still struggling, check what breastfeeding support is available in your area. A lactation support team may be able to spend time alongside you, providing support.

Pain when breastfeeding

This is one of the most common issues.   It can be caused by:

Poor latch– A poor latch can cause pain and damage to the nipple.  If your baby is slurping during the feed, or your nipple is misshaped after a feed, this could be the cause.  (“Pain: If Breastfeeding Hurts”, 2024)

If you believe you are experiencing pain due to a poor latch, check out this guide on improving your baby’s latch.

Used correctly nipple shields can also support a healthy and comfortable latch.   We will look at nipple shields in more detail later.

Mastitis/ nipple thrush– Mastitis is when your breast becomes infected.  It can lead to swelling and redness.  When you have mastitis you may feel a burning in your breast and have flu symptoms. (NHS Choices, 2019) 

Thrush is caused by candida fungus.  If your nipples are cracked the fungus can enter your nipple or breast causing pain. 

For either mastitis or thrush, seek medical advice promptly.  You can continue breastfeeding, although it may be painful.   With thrush, your baby will also be treated.  The treatment is safe for your baby.  (NHS, “Breastfeeding and Thrush”, 2020)

Engorgement–  It is normal for a lot of milk to come on day three.  This will settle down in time.  At first, however, your breasts can become overly full, which can cause pain.  

It can be difficult for your baby to latch if you are engorged. Expressing till your breasts feel softer can help this.  A breast pump is useful, but you can also hand express.

You can place ice on your breasts for 20 minutes between feeds to reduce swelling.   A warm cloth before feeds can help encourage your letdown. 

Baby routes for the breast and then pulls away

This is a frustrating issue. Your baby is crying for food and showing all the hunger signs.  You put them to the breast. They suckle a second before pulling away and crying for milk again.  

There are three common causes of this.

Pain from trapped wind– If your baby has trapped wind, being in a reclined position to feed can hurt.  If you are unsure how to release trapped wind, here is a guide.

Too strong of a release– too much milk at once can be hard for a little mouth to handle.   This is a common issue in the first few weeks before your milk supply has settled down.  Try expressing a little excess milk, to reduce the flow and make it manageable for your baby. (https://www.facebook.com/parents, 2015)

Milk is coming too slowly– A hungry baby may not have the patience or understanding to keep suckling until your milk comes.

The hormone which controls the release of milk is oxytocin.  Oxytocin is released during times of bonding, which is perhaps why it is so integral to breastfeeding. (World Health Organization, 2009)

Oxytocin is also more likely to be released when you feel relaxed and calm, which is not always the case when you have a young baby.  This can mean that if you are feeling tired, stressed and a little bit edgy, then you might find your milk is a little slower coming.   Although common advice for this issue is to simply relax more, when you have a hungry baby screaming at you for food it can be difficult to soothe your nerves.   It may be more useful to try hand expressing until your milk begins to flow. Put your baby onto feed when the milk is comin.

Baby’s mouth slides off the breast

In the early days, your breast may be swollen from too much milk.  This swelling can make it difficult for your baby to latch properly.   This is often an issue that time will fix.  As your supply syncs to your baby’s needs swelling will stop and your baby will be able to latch and feed much more easily.  Until that happens, you may want to express a little excess milk before each feed to help. (Lois, 2016)

Low Milk Supply

Feeding on your baby’s cues rather than a schedule can help your milk production keep up with a babies growing needs.

Your body makes milk to demand.  Every breastfeed stimulates milk production.   If there is not enough milk, your baby will feed till there’s only a trickle.  Then your baby may become frustrated and stop feeding but want to feed again a few minutes later.   This is called cluster feeding and will pass.  Cluster feeding tells your body there wasn’t enough milk, please make more. 

It also works the other way.  If your baby takes less milk or misses a feed, milk supply will slow down to meet the decreasing demand.  (https://www.facebook.com/nhswebsite)

Anything that reduces the amount you feed can harm your milk supply.   If you are away from your baby or top up with formula, expressing can boost milk production.

As well as how much you feed, the time you feed is also important.

Night-time feeds are more effective at boosting supply than daytime ones.   The prolactin hormones which help your body to lactate are higher at night than they are during the day.  (“Prolactin | South Tees Hospitals NHS Foundation Trust”)  It is worth feeding at night if you are struggling with supply.   If your baby has started to sleep through the night, I would be loathe to stop a good thing.   You can express at night, which will still be beneficial for milk production, and doesn’t require settling a little one afterwards. 

Other things that can help with milk production are resting when you can, eating enough yourself and staying hydrated.

If you have a persistent issue with low milk supply or worry your baby is not feeding enough talk to a healthcare worker to get support.

Feeding stations

One thing that can help is to make a feeding station.   You will spend a lot of time feeding, so having somewhere that is comfortable to sit can be a boost.  Make it somewhere comfortable where you have a table or shelf near where you can store things next to you that you might want during feeds.  Stock the area with snacks, a full bottle of water and some sort of entertainment.   I was lucky with my second that the position she fed in meant I could read with a spare hand, with my first my feeding station was near a television as I didn’t have free hands.

Baby falls asleep during feeds

This is an issue that is more common during the first few weeks.  Sometimes little eyes just can’t stay open.   Often this isn’t a problem, but if it gets to the point where your baby isn’t getting enough food it can become a concern.

When should you worry?  Sleepy feeds are only an issue if your baby is not getting enough milk.  You can gauge how much your baby is feeding by looking at nappy output. You should be seeing between four and six wet nappies and three to four dirty nappies a day for a little one. (Wisner, 2021) 

One technique that you can use to help your baby stay awake for feeds is to switch them from one side to the other when they begin to look like they are nodding off.  This can give them the little nudge that they need to keep them awake.  

Other things like stripping your baby down to a nappy can help.  Sometimes a baby can sleep when milk flow slows down so hand expressing can increase the flow and keep your baby engaged in feeding. (“Keeping Baby Awake during Feeding | Happy Baby Organics”)

Baby gets distracted

This is an issue that you are more likely to come across with an older baby.  As our little ones begin to engage with the world around them, they can struggle to focus during feeds and rather become drawn into all the exciting things happening around them.

There are a few simple fixes to this.  The most obvious is to move somewhere quiet and with as few distractions as possible, though this isn’t always possible.  Another simple solution is to invest in a feeding cover.   Some women choose to wear feeding covers for modesty, but they can also be great for keeping babies focused on the task at hand if they are easily distracted.

Try not to worry too much.  A baby won’t starve themselves.  It may be that the quieter night feeds become more substantial, whilst the daytime feeds when there are more interesting things going on, become smaller.  That is okay.

Nipple shields

Nipple shields can be fantastic if used correctly.  A lot of the time you will find healthcare workers are nervous to recommend them.    This is because if they are used incorrectly, they can cause a baby to latch badly, and the poor latch can impact how well they stimulate milk production during feeds.

How to use nipple shields correctly

If you are using nipple shields, ensure that your baby is latched to the base, and is keeping a wide mouth.   Some babies may try to suckle from the tip like a bottle;  If you notice this, try putting a little pressure on babies head to move them lower down the shield and into a proper latch.

How you put on the shield can also have an impact on how well your baby feeds with it.  The medulla nipple shields are designed to be inverted before use to draw in more of the nipple and ensure your baby is latching to a larger area.   Here is a link that explains how to wear a nipple shield. (chris, 2015)

 I personally found the medela shields to be excellent.  They helped to reduce the pain of feeding a lot during both my breastfeeding journeys.

How to wean off using nipple shields

As your baby grows, feeding often becomes easier and you can start to move away from nipple shields.  

When you are ready to stop using your nipple shield, start by using it for the first part of each feed, then remove it.  Latch with the shield as usual. After a few minutes, when your baby is happily feeding, try to slide the shield off and relatch your baby.  It may take a few goes, but in time they will learn to relatch without the shield.  Once you have done a few feeds removing the shield part way through, you can try to start a feed without the shield.

Feeding out and about

Feeding in front of other people is different for every person.  Some people are perfectly comfortable with it, but for others, it can be a cause of great anxiety.   At the end of the day, you need to be happy.  Don’t let other people make you feel guilty about feeding out and about if that is your choice.   Likewise, if you don’t feel comfortable feeding in front of others don’t feel like you must.

A few Tips

Look out for feeding rooms: A growing number of shopping centres and department stores provide nursing areas for mothers.  These can provide somewhere to sit, and privacy if you want it for breastfeeding.   It is worth looking online to see what places are available in case you need them.

Layers are your friend: I was comfortable feeding in front of others. However, I preferred to show as little skin as possible.  Layers helped.  I would wear a stretchy tank top underneath a baggy t-shirt, with a feeding bra underneath.   Before latching, I would reach beneath my t-shirt to unfasten the bra and pull my tank top underneath the breast.  I would then lift the baby to the breast while lifting the baggy t-shirt. Baby will keep the breast covered.   It took a little practice, but in time it became an easy way to feed modestly. If you have a mishap don’t worry.  You are a human, who is keeping another human alive with your body.  Be proud to be you.

When to stop breastfeeding

Experts recommend trying to breastfeed for at least 6 months if you can. (“Breastfeeding – Deciding When to Stop”, 2012)  It is, of course, a personal choice.  Some people find breastfeeding too much pressure, as it means that they always have to be within close proximity to the baby, and aren’t able to let friends and family support as much as they would like.  Others enjoy breastfeeding and want to continue as long as possible.

You will probably know for yourself when it is right to move.   With my firstborn, there came a point where he was losing interest in feeding so stopping was natural.  With my second, she struggled to settle without night feeds so I continued those till about 15 months.  Find what works for you, and don’t feel pressured either way.

Breastfeeding during the first six months is the most beneficial. After that, there is growing evidence that it can still be beneficial.  (Wisner, “Extended Breastfeeding: Can You Nurse for Too Long?”, 2020)

When you have been struggling to breastfeed and can’t continue

The first few months of being a parent are challenging mentally, physically and emotionally.   When you are already worn down struggling to breastfeed can be a devastating blow.   You might feel like breastfeeding is part of what you picture when you envision life with a newborn. If you have to move to formaula it is natural to feel sad, even angry, to find that you have been robbed of that.

Unfortunately, sometimes things in life we want to change are unchangeable.   When that happens, it is okay to be sad. It’s ok to spend a little time mourning the motherhood journey that you were envisaging.  But please don’t stay there.  Your little one will grow faster than you could ever imagine. You don’t want these early days to be dominated by sadness. 

If you are a mother who has been struggling to breast feed, and moved onto formula, you may feel out of control. However, there are things that you can still control. 

Firstly, remember that ‘no’ is a complete sentence.  Just because other people can physically feed your baby, you don’t need to let them.

 The beautiful thing about bottle feeding is that you can look into your baby’s eyes. This is a physical impossibility with breastfeeding.  Perhaps create a personalised playlist for some of your feeds. Make a special feeding place, and bond with your baby through feeds in your own unique way. Remember this too shall pass, choose to make it beautiful.

Yes.  Being a parent is exhausting, you deserve it.

Should I eat cake if I am formula feeding

Yes.  Being a parent is exhausting, you deserve it.

A Final note

Breastfeeding is an extensive and deeply personal topic.   We have looked at a little of the science behind fixing common problems and a few practical tips.  There is so much more information out there if you do want to know more. 

The most important thing to remember is, that while you care for your baby you should care for yourself too.

I wish you all the peace

Hannah Louise

References

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Gianni, Maria, et al. “Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation.” Nutrients, vol. 11, no. 10, 20 Sept. 2019, p. 2266, www.mdpi.com/2072-6643/11/10/2266, https://doi.org/10.3390/nu11102266.

https://www.facebook.com/nhswebsite. “Milk Supply – Start for Life.” Nhs.uk, 13 June 2023, www.nhs.uk/start-for-life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/milk-supply/. Accessed 21 Jan. 2025.

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“Keeping Baby Awake during Feeding | Happy Baby Organics.” Happy Family Organics, www.happyfamilyorganics.com/learning-center/article/how-to-keep-your-baby-awake-during-feedings/.

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—. “The Psychological Benefits of Breastfeeding: Fostering Maternal Well-Being and Child Development.” Cureus, vol. 15, no. 10, 27 Nov. 2024, www.cureus.com/articles/187248-the-psychological-benefits-of-breastfeeding-fostering-maternal-well-being-and-child-development?score_article=true#, https://doi.org/10.7759/cureus.46730.

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