Breastfeeding your baby is one of the most loving, nurturing things you'll ever do. At the hospital, you may get some basic instruction on breastfeeding. Or maybe your doctor has given you some guidance. But even with help, you and your baby may need some time to get used to breastfeeding, or you may run into some little problems along the way. Here is some information on common breastfeeding issues and some suggestions that may help.

Issues for Mom

Engorged Breasts

Engorgement may happen if your milk comes in very quickly the first day. Your breasts may swell, become painful, and feel hard and heavy.

To try to avoid engorgement, start nursing as soon as your milk comes in and feed your baby often, eight to 12 times a day. Continue feeding through the night, too. Let your baby nurse for 10 to 20 minutes on each breast. If he feeds on only one and the other one feels uncomfortable, try a breast pump to express some of the milk. Or release milk manually by massaging your breast toward the areola with one hand while supporting it with the other. Then compress your breast just outside the areola to release some milk.

To help relieve the pain of engorgement, try putting cold packs, crushed ice in a plastic bag, or cold cloths on your breasts between feedings. And keep hot water away from your breasts when showering or bathing. If, after a day or so, you still have a lot of discomfort, contact your doctor or lactation consultant.

Problems with Let-Down

"Let-down" is the term for the automatic reflex of your body releasing milk in response to your baby's suckling. It usually works just fine without any effort on your part. If it doesn't, it may be because you're distracted, tired, or have breasts that are painful. For some women, feeling embarrassed or anxious about breastfeeding can interfere with let-down.

The remedies are simple. Try to rest if you're tired and ask friends and family to help out with other chores when you're breastfeeding. Also, try a change of scene. Move to another room where you'll have privacy and won't be distracted.

Milk Supply

The most common reason why moms stop breastfeeding is the concern that they aren't producing enough milk. But that's not usually the case. The best way to know if your baby is getting what he needs is by focusing on him, not on your breast milk. For example, is your baby gaining weight? Does he gulp and swallow during breastfeeding? Does he wet his diaper six or more times and have at least two bowel movements daily?

If the answers to these questions are "yes," chances are that your milk supply is just fine. Of course, always talk to your doctor about any questions you may have about your baby's health and development. And for an idea on how to stimulate milk production, scroll down to the section on nursing trainers.

Sore, Cracked Nipples

Your nipples might become sore at the spots where your baby compresses them with his mouth or presses them on his tongue.

The best remedy is prevention. Make sure your baby is latched on properly when he feeds. He should be sucking on your breast and your nipple should be far back in his mouth. Changing the position of your breast or your nursing position helps, too.

If your nipples become cracked, try cold compresses after feedings. But don't use the nursing pads with plastic linings, because they can keep moisture on your nipples. In fact, it's a good idea to let your nipples air-dry when possible. A lotion or lanolin can help soothe cracked nipples. Just be sure the nipple is dry before applying lotion. If the soreness doesn't improve in a few days, talk to your lactation consultant.

Leaking

Leaking nipples happen more frequently with some women than with others. To lessen or stop the leakage, apply pressure to your nipples directly with your thumb and index finger. Or try crossing your arms tightly across your breasts. Absorbent breast pads can help protect your clothing.

Plugged Ducts

A tender, red area on your breast near the areola is a sign that you have a plugged lactiferous duct. There are a few things you can do yourself to unplug it. When you're in the shower, let the hot water flow over your breast while massaging it from the area behind the plugged duct toward the nipple. Then it's a good idea to nurse your baby right afterward. Keep up the breast massage during these activities or when applying a warm compress to your breast.

Mastitis

"Mastitis" is another name for breast infection. Fortunately, breast infections aren't very common. And you can lower your risk of getting one by emptying your breasts regularly, avoiding tight clothing, and trying to stay rested.

A breast infection may start out just like a plugged duct. But if it's a true infection, your temperature may be elevated and you may feel achy and tired. If you have a temperature, contact your doctor. He or she may recommend an antibiotic or a common pain medication. But always check with him or her first before taking any medication on your own.

If you do get a breast infection, you don't have to wean your baby. In fact, it's better for you to keep your milk moving.

Food Sensitivities

What you eat and drink affects your breast milk and may affect your baby. Some babies have food sensitivities or allergies that bring on colic-like symptoms. These include crying, fussing, frequent nursing, and tummy discomfort. Things that may trigger these responses are "gassy" foods like cabbage, garlic, onions, or broccoli. Milk products too, like cheese, yogurt, or ice cream. Caffeine in coffee, tea, soft drinks, and chocolate candy or hot cocoa can cause irritability and also more frequent need for feeding.

How will you know if your baby's symptoms are from food sensitivities or colic? It might be colic if symptoms occur three times a day after your baby is two to three weeks old, and last for at least three hours a day until he is about three months old. Food sensitivity reactions happen only when eating something specific. Once that item is removed from your baby's diet, the symptoms will stop. Of course, you should always consult your baby's doctor.

And that's the best way to tell. If you suspect your baby is having a reaction to something you ate, take it out of your diet. You can always reintroduce foods one at a time to see how your baby responds.

Issues for Your Baby

Nipple Confusion

Your baby sucks a pacifier or bottle nipple differently from the way he breastfeeds. So if he has been bottle-fed or given a pacifier before he's really gotten used to nursing, he may have some confusion. So make sure breastfeeding is well established for your baby before offering him a pacifier or bottle-feeding him.

Sucking Difficulties

Some babies do better with breastfeeding than others do. An excited or hungry infant might be so eager that he doesn't latch on well. Or your baby might be satisfied by getting just a taste of milk and then stop nursing. If your baby is a "sipper," try to keep him interested. Singing a little song or rubbing his back might get his attention. Also, it may help to try increasing your milk flow by massaging your breast. For additional guidance on helping him become an aggressive eater, talk to your doctor or lactation consultant.

Nursing Trainers

A nursing trainer, or supplemental nurser, is a device that helps supplement your milk supply while you're actually breastfeeding. Trainers are used by women whose milk supply has decreased, maybe because of illness or missed feedings. It consists of a plastic container for formula or expressed breast milk, connected to a thin, flexible tube.

You wear the container around your neck and tape or hold the tube next to your breast. When your baby nurses, both your nipple and the end of the tube are in his mouth. As your baby sucks, he gets milk from your breast and from the tube. This may encourage him to nurse, and you to produce more breast milk.