Calling in the pros: Lactation consultants

Am I making enough milk?

If you're making enough milk, your baby will show signs that he is getting enough to eat, including:

  • feeding 8 to 12 times in 24 hours (about 15 to 45 minutes per feeding). Four weeks after delivery, feeding usually decreases to 6 to 8 times per day
  • making 6 to 8 wet diapers every 24 hours
  • making stools at least once per day for the first month and every 1 to 10 days after that
  • gaining weight normally (usually 5 to 8 ounces, or 0.14 to 0.23 kilograms, per week)
  • making swallowing sounds while feeding
  • appearing healthy, alert, and active

If you're concerned about your milk supply, contact your doctor or lactation consultant.

Am I making too much milk? What can I do about it?

You may be making too much milk if your breasts feel very full and uncomfortable, your baby is fussy or gassy between feedings, your baby feeds only for a short time (5-10 minutes), or if your baby clamps down at the nipple to try to stop or slow down the flow of milk.

Often, your milk supply will adjust itself after the first few months. To help slow down milk production, use the same breast for all feedings within a 3 to 4 hour window, then switch to the other breast for the next 3 to 4 hour window. If necessary, you can also try to slowly increase the length of time you feed your baby from one breast. You can pump the breast that's not being used just to relieve pressure and then stop if it is feeling uncomfortable. Any more will trigger the breast to make more milk. If this doesn't work, contact a lactation consultant.

How do I get my baby to latch on well to my breast?

Tickle your baby's bottom lip with your nipple and wait for her to open her mouth wide. When she does, bring her towards you, chin first, as you aim your nipple towards the roof of her mouth.

You can tell if your baby is latched on well if her nose is almost touching your breast and her lips are rolled out. At least half an inch (about 1 cm) of your breast (near the nipple base) should be in your baby's mouth. The latch should not be uncomfortable for you. If it is, adjust your baby's position by pushing the baby's bottom towards your body with your forearm. You may also try to gently pull down on the baby's chin so she has more of the breast in her mouth. If this does not work, detach your baby by putting your finger gently between her gums and try again. However, unlatching and re-latching the baby is not recommended, as it can end up causing you more pain and frustrate the baby.

What is a lactation consultant, and when should I call one?

A lactation consultant is a health care professional specially trained to help parents manage breast-feeding issues.

You may wish to contact a lactation consultant if:

  • you need breast-feeding advice or support
  • you're having problems with your milk supply
  • you're not sure if your baby is feeding well
  • your baby doesn't seem to be gaining weight
  • you have breast or nipple pain
  • you have a complicated situation, such as twins, a baby who is ill, or a baby with a cleft palate

Your doctor or health clinic can help you find a lactation consultant, or you can check the listings in your phone book.

All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

Breast pain and other breast problems

Breast-feeding shouldn't hurt. But some women suffer from breast problems and pain when they breast-feed. Here's what you can do to manage some common causes of breast pain and discomfort:

Blocked ducts

A blocked milk duct (a channel that milk flows through in the breast) is not a type of breast infection. What usually happens is that the mother has a painful, swollen, firm mass in the breast, about the size of a pea or larger. The skin over the affected area may be slightly red and tender. Fever is rarely seen. A milk duct can become blocked due to a poor latch, which leads to poor emptying of the breast.

A blocked milk duct will usually resolve itself within 1-2 days. During that time your baby may be fussy because the milk may come out slower. You can help clear the duct quicker by doing such things as massaging the sore area before and during breastfeeding, using a heat pack on the area before feeding or a cold pack after feeding, feeding from that breast often (ensure you have a good latch), and getting some rest. If the pain persists or if you develop a fever, speak to your doctor or lactation consultant.


Mastitis is a breast infection that can happen if a milk duct becomes blocked and infected. Mastitis can cause breast pain, fever, and fatigue. To deal with mastitis, breast-feed frequently to help relieve the blockage in the milk duct, get some rest, apply a heating pad to the affected area, soak the breast in warm water for 10 minutes three times a day, and gently massage the breast. Don't worry about your baby catching the infection if you breast-feed – your milk has antibacterial substances that protect him. However, if feeding from the affected breast causes pain and interferes with the breastmilk flow, you can start with the unaffected breast instead. If things don't get better within a day, contact your doctor, as antibiotics may be needed to help heal the infection.

Breast engorgement

Breast engorgement occurs when your breasts become uncomfortably full of milk. The first instance of breast engorgement usually happens 2 to 4 days after birth, when your milk "comes in." This is sometime also referred to as postpartum breast engorgement. In this case, it usually goes away within 12 to 48 hours. Other reasons for engorgement can also include:

  • you are producing too much milk
  • you experience a delay in nursing or pumping milk from the breast
  • your frequency of feeding diminishes because your baby is beginning to stop breast-feeding
  • you are wearing a poor-fitting bra or tight clothing that puts extra pressure on the breast
  • you’ve had previous breast surgery

To deal with engorgement:

  • Start breast-feeding as soon as possible after birth.
  • Breast-feed often – at least 8 times every 24 hours
  • Before switching sides, wait until your baby falls asleep or comes off the breast.
  • Before feedings, briefly apply a warm compress, then express some milk. Use cold compresses between feedings. You can also express some milk before or between feedings to help soften your nipple to make it easier for your baby to latch onto.
  • Gently massage your breasts. Move downward from the top to the nipple, using a circular motion.
  • Don't miss feedings. Use a breast pump if you are unable to breast-feed.
  • Wear a properly fitted nursing bra

If these tips don't help, talk to your doctor or lactation consultant.

Sore or cracked nipples

The best way to manage this problem depends on the cause. There are many possible causes for sore or cracked nipples, including:

  • improper positioning of the baby
  • improper use of a breast pump
  • a short tongue, a high palate, or other conditions affecting your baby's mouth
  • nipple infections
  • breast engorgement
  • nipple confusion (a pacifier or bottle uses a different sucking technique than breast-feeding; if the baby uses this technique while breast-feeding, it may cause nipple pain)
  • allergic reactions to personal care products

Your doctor, nurse, or lactation consultant can help you sort out the cause of the problem. Your doctor can also help you manage nipple infections and irritations (which may require medications) and identify any health conditions in your baby that may be causing the nipple soreness.

You can also try rubbing some breast milk on the sore areas. Breast milk can help soothe the area and also has some antibacterial properties. Don't apply wet tea bags, honey, or cooking oil to your breast – this won't help and could make things worse.

All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: