Common Concerns

Feeding a baby is one of the most natural things in the world — and also, for so many families, one of the most unexpectedly difficult. If you’ve landed on this page, chances are something isn’t quite right and you’re trying to work out whether what you’re experiencing is normal, whether it will improve on its own, or whether you need help.

The honest answer is that most feeding difficulties are resolvable — but very few resolve without the right support. The earlier you seek help, the easier it is to get feeding back on track.

Below are some of the concerns I hear most often from the families I work with. You may recognise one. You may recognise several. Either way, know that you are not alone, you are not failing, and help is available.

Mild tenderness in the very early days of breastfeeding is common as both you and your baby learn. But pain that persists beyond the first week or two, or pain that is sharp, burning, or makes you dread feeding, is never something you should simply push through.

Nipple pain is one of the most common reasons mothers stop breastfeeding before they want to — and in the vast majority of cases, it has a cause that can be identified and addressed.

Common reasons for nipple pain include a shallow or incorrect latch, tongue tie causing a baby to clamp or chew rather than suckle properly, thrush (a yeast infection affecting the nipple and breast tissue), bacterial infection, Raynaud’s phenomenon causing nipple blanching and burning after feeds, or an oversupply of milk causing forceful letdown.

If your nipples are cracked, bleeding, blistered, or coming away from feeds looking flattened or lipstick-shaped, please don’t wait for it to resolve on its own. These are signs that something mechanical isn’t working and that your latch or your baby’s oral function needs to be assessed.

A good latch is the foundation of comfortable, effective breastfeeding — and getting there isn’t always straightforward, especially in the early days.

If your baby is slipping off the breast repeatedly, only managing a shallow latch, clicking during feeds, or if feeding is painful despite trying different positions, something isn’t quite right with the way your baby is attaching. This doesn’t mean you’re doing it wrong. It often means there’s a physical reason — tongue tie, lip tie, high palate, or post-birth tension in the jaw and neck — that no amount of repositioning alone will fix.

A proper assessment involves watching a full feed, checking your baby’s oral anatomy and function, and identifying the specific reason attachment isn’t working. From there, practical, tailored guidance makes far more difference than general advice.

Concerns about milk supply are among the most common reasons mothers contact me — and also among the most anxiety-inducing. The fear of not making enough milk for your baby is powerful, and it’s often made worse by the fact that you can’t see how much your baby is drinking.

True low supply — where milk production is genuinely insufficient — does exist, but it is less common than many parents fear. More often, concerns about supply arise from normal newborn behaviour (frequent feeding, cluster feeding, fussiness at the breast) being misread as signs that milk isn’t enough.

That said, supply problems can and do develop — often as a downstream consequence of something else. Poor latch, tongue tie causing inefficient milk transfer, infrequent feeding, supplementing with formula before supply is established, hormonal factors, or previous breast surgery can all affect supply over time.

The key to resolving supply concerns is understanding the root cause — and that requires a proper assessment rather than generic advice to “feed more often.” I can help you understand whether your supply is genuinely low, why it may have been affected, and what practical steps are most likely to help in your specific situation.

If your baby is slipping off the breast repeatedly, only managing a shallow latch, clicking during feeds, or if feeding is painful despite trying different positions, something isn’t quite right with the way your baby is attaching. This doesn’t mean you’re doing it wrong. It often means there’s a physical reason — tongue tie, lip tie, high palate, or post-birth tension in the jaw and neck — that no amount of repositioning alone will fix.

A proper assessment involves watching a full feed, checking your baby’s oral anatomy and function, and identifying the specific reason attachment isn’t working. From there, practical, tailored guidance makes far more difference than general advice.

Supply problems don’t only mean too little — having too much milk can be just as disruptive for you and your baby, and it’s talked about far less.

If you have an oversupply, your breasts may feel constantly engorged and uncomfortable, your letdown may be so forceful that your baby gulps, chokes, or pulls away from the breast in distress, and feeds may be chaotic and unsettled. Babies who have a mum with an oversupply can often swallow a lot of air, leading to significant wind, colic-like symptoms, and green, frothy stools. They may also seem to feed frequently despite the volume of milk available, because rapid, overwhelming feeds leave them uncomfortable rather than satisfied.

Oversupply can be managed effectively, but it requires a careful, graduated approach. Getting the balance right matters — reducing supply too aggressively can tip things in the other direction. This is exactly the kind of nuanced situation where IBCLC-level support is genuinely valuable.

A blocked duct — where milk becomes backed up in a section of the breast — causes a hard, tender lump and can develop into mastitis (inflammation of the breast tissue) if not resolved promptly. Mastitis can cause flu-like symptoms, fever, and significant pain, and if left untreated may progress to a breast abscess requiring medical treatment.

Recurring blocked ducts or mastitis are almost always a sign that something about feeding mechanics needs to be looked at. Common contributing factors include a poor latch, oversupply, going too long between feeds, a restrictive bra, or returning to work and going longer without feeding or pumping.

If you are experiencing your first bout of mastitis, please contact your GP — antibiotics may be needed. But if blocked ducts or mastitis keep coming back, that pattern deserves a proper feeding assessment to address the underlying cause, not just repeated courses of antibiotics.

Few things are more exhausting — or more distressing — than a baby who is constantly unsettled, difficult to soothe, and seemingly in discomfort. When this is your reality, it’s hard not to feel desperate for answers.

While colic is often attributed to digestive immaturity, feeding can play a significant role in an unsettled baby. A baby who is taking in a lot of air during feeds due to a poor latch or tongue tie, a baby who is being overfed due to forceful letdown, or a baby who is underfed due to inefficient milk transfer can all present as a colicky, uncomfortable, difficult-to-settle baby.

It is always worth having feeding assessed before assuming colic is simply something to be survived. In many cases, addressing a feeding issue makes a noticeable difference to a baby’s comfort and behaviour — and to the whole family’s quality of life.

Watching your baby’s weight plotted on a chart and seeing it fall or plateau is deeply worrying. Weight gain is one of the most important indicators of whether feeding is working — and when it’s not where it should be, it needs to be taken seriously and investigated properly.

Poor weight gain is nearly always a sign that a baby isn’t transferring enough milk, whether that’s because of latch issues, tongue tie, low supply, or a combination of factors. It can also follow a period of illness or a difficult start.

If your health visitor or midwife has raised concerns about weight gain, or if you are worried yourself, please don’t wait. A full feeding assessment can identify why milk transfer is being compromised and put a clear plan in place. In the meantime, I would always encourage you to follow the advice of your healthcare team regarding supplementation if it has been recommended — your baby’s immediate nutritional needs come first, and there is no shame in supplementing while we work to improve feeding.

Tongue tie is one of the most common yet most frequently missed causes of feeding difficulties — and it’s a particular area of my expertise.

If your baby has a restricted tongue, it affects their ability to latch deeply, maintain suction, and transfer milk efficiently. This can manifest as nipple pain, latch difficulties, poor weight gain, an unsettled baby, clicking during feeds, or any combination of the above.

The important thing to understand is that not all tongue ties are visible — posterior tongue ties, in particular, are routinely missed by non-specialist checks. A proper assessment requires examining the function of the tongue, not just its appearance.

As both a qualified tongue tie practitioner and an IBCLC, I can assess, diagnose, divide, and provide comprehensive feeding support post-procedure — all as part of one joined-up pathway.

For a full explanation of tongue tie, what to look for, and what assessment and division involve, please visit my dedicated Tongue Tie page. 

Going back to work is one of the most common points at which breastfeeding — even when it’s been going well — hits new challenges. Managing a pumping schedule, maintaining supply while feeding less frequently, introducing a bottle, navigating a baby who refuses a bottle or a cup, and managing engorgement during work hours are all real, practical challenges that many parents face.

With the right planning and support, many families continue to breastfeed successfully after returning to work — but getting ahead of those challenges before they arise makes a significant difference. Whether you’re planning ahead or already back at work and struggling, I can help you find a practical approach that works for your situation and your baby’s needs.

Some families choose to combine breastfeeding with formula feeding from the start. Others move to combination feeding after difficulties with exclusive breastfeeding. Either way, doing it thoughtfully — in a way that protects your milk supply and meets your baby’s needs — takes a little more consideration than simply introducing a bottle.

Introducing formula without a clear plan can cause supply to drop quickly as the breast receives fewer signals to produce milk. Timing, volume, and the type of bottle used can all make a difference. I can help you combination feed in a way that gives you the flexibility you need while protecting your breastfeeding relationship for as long as you want it.

Feeding a premature baby, or a baby who has spent time in a neonatal unit, comes with its own unique set of challenges — and it’s an area I have deep personal experience in from my thirteen years working on SCBU at Conquest Hospital.

Premature babies may be too immature to breastfeed directly at first, requiring support to establish and maintain milk supply through expressing. Transitioning from tube feeding to breast feeding requires patience, specialist knowledge, and a great deal of sensitivity. The emotional weight of having a baby in neonatal care adds another layer of complexity to the whole experience.

If you are currently in a neonatal unit or have recently brought a premature baby home and are trying to establish or maintain breastfeeding, I understand this journey in a way that most lactation consultants simply don’t — and I would be honoured to support you through it.

Many parents worry about whether they can continue to breastfeed when they or their baby are unwell, or when medication has been prescribed. The reassuring truth is that in the vast majority of cases, breastfeeding can and should continue through illness — and most commonly prescribed medications are compatible with breastfeeding.

If you have been advised to stop breastfeeding due to medication and you’re not sure whether that advice is correct, it’s worth seeking a second opinion. Resources such as the Breastfeeding Network’s Drugs in Breastmilk helpline provide evidence-based information, and I’m happy to help you find the right guidance for your specific situation.

Feeding aversion — where a baby who has previously fed well begins to refuse the breast, bottle, or both, often arching away, crying, or fighting feeds — can be one of the most distressing things a parent can experience. It can feel deeply personal and deeply confusing.

Feeding aversion can have many causes, including reflux or discomfort during feeding, a forceful letdown that overwhelms a baby, pressure or negative associations built up around feeding, illness or teething, or a significant change in routine or milk flow. Identifying the specific trigger is the first step to finding a way through it.

Sometimes parents reach out not because they have a specific, nameable problem, but because something just doesn’t feel right. Feeding is taking too long. Their baby seems unsatisfied. They’re exhausted in a way that feels different from normal new-parent exhaustion. They can’t quite put their finger on it, but they know something is off.

That instinct is valid. You don’t need to arrive at a consultation with a clear diagnosis or a specific question. You just need to show up, tell me what’s been happening, and let me help you work out the rest.