The Breastfeeding Café with Professor Amy Brown

This issue we ask: I'm due next month and planning to breastfeed. What challenges should I be aware of?

Just like anything, breastfeeding can sometimes get complicated. It’s essential to spot if something isn’t quite right and know where to go to get the support and information to get you and your baby back on track. Here are some of the most common issues women experience when breastfeeding, and some gentle advice. If you experience any of these symptoms, do seek support from your healthcare professional.

If your breast feels sore, warm and has a lump or darker patch, you might have a plugged duct where the milk is getting blocked in some way. Sometimes this can develop into mastitis, where your breast will become inflamed and you’re likely to start experiencing flu-like symptoms.

If your nipples feel itchy and sore you might have thrush. Thrush is a fungal infection that likes warm, moist places and is more likely if you have cracked nipples. The main symptoms of thrush are a burning or stabbing pain, itching and general soreness. Your nipples might look shiny or flaky. Your baby might have white patches in their mouth or film on their lips, and she can be fussy or upset during feeds.

If your nipple looks white after a feed you might be experiencing nipple blanching – where the blood flow has been cut off or reduced during the feed by an issue with your latch. The nipple may look misshapen too. Usually this is due to a shallow latch and your nipple being compressed, but babies can also sometimes try to clamp down on your nipple if the flow of milk is too fast for them.

Blanching can also occur due to vasospasm, which happens when a blood vessel starts to suddenly constrict itself and not let blood through. This can happen in the nipple and it is usually very painful. Vasospasms are sometimes caused by Raynaud syndrome (also known as Raynaud’s phenomenon), in which sufferers experience vasospasm in their extremities – usually their fingers and toes, but also their nipples. In Raynaud’s related vasospasm the pain usually lasts for a while and often happens on both sides.

You’re more likely to experience Raynaud’s of the nipple if you had symptoms in your fingers or toes before you were pregnant.