What it means:
When a baby has trouble latching deeply and comfortably onto the breast or chest, it can affect milk transfer, cause pain or engorgement, and lead to weight gain difficulties.

When help is needed:
Small adjustments in positioning and latch technique can make a big difference — getting help early can prevent bigger challenges down the road.

Major Milestone:
The goal is a deep, comfortable latch that allows for effective milk transfer and pain-free feeds for the parent. While nipple pain is common, it’s not normal, so seek help if needed.

Quick Tip:
Start with skin to skin or try a new position.

Milk Supply Issues

What it means:
When there isn’t enough breastmilk or chestmilk to fully meet a baby’s needs.

When help is needed:
If your baby isn’t gaining weight well, seems constantly hungry after feeds, has fewer wet or dirty diapers than expected, or if you notice a drop in pumping output, support for milk supply can help.

Major Milestone:
The goal is to establish and maintain a milk supply that matches your baby’s needs, whether through direct nursing, pumping, or a combination.

Quick Tip:
Milk supply is driven by frequent, effective milk removal — early help with latch, feeding frequency, and pumping strategies can make a big impact.

What it means:
When the body produces more milk than the baby needs, which can lead to issues like forceful letdowns, baby coughing or choking during feeds, gassiness, or engorgement.

When it’s needed:
If your baby struggles with fast milk flow, feeds seem frantic or very short, you experience frequent clogged ducts, or your baby is very gassy or fussy during feeds, support for managing oversupply can help.

Major Milestone:
Engorgement is normal beginning from days 2-5 when you milk is first coming in and should resolve in 24-48 hours.

Quick Tip:
Nurse on demand and allow baby to fully empty one side prior to starting the other.

What it means:
Clogged ducts happen when milk temporarily gets stuck in part of the breast, causing a tender lump. If not treated, it can sometimes lead to mastitis — an infection that causes redness, swelling, pain, and flu-like symptoms.

When help is needed:
A clogged duct should resolve in 24-48 hours. If you get recurrent clogged ducts, an evaluation with a lactation consultant can help determine the underlying reason for the clog to help prevent them from recurring. If you begin to get systemic symptoms (reddened breast and flu-like symptoms), seek immediate help from a physician.

Major Milestone:
The goal is to clear the clog, keep milk flowing well, and prevent infection or future complications.

Quick Tip:
Frequent milk removal, starting feeding on the plugged side, and changing the baby’s position at the breast may allow the plug to exit the breast.

What it means:
Some babies have a strong breastfeeding preference and may refuse alternate feeding methods, like the bottle.

When help is needed:
A lactation consultant can help when a baby needs to learn how to drink from a bottle or cup, whether it’s due to a parent returning to work or another reason.

Major Milestone:
It may take some time for a baby to learn a new feeding method. The goal is consistent, positive exposure without force feeding.

Quick Tip:
Offer the bottle when the baby is calm and not overly hungry. A non-nursing parent may try to offer the bottle in a more upright position then the cradled breastfeeding position. See “bottle feeding refusals” in common concerns that feeding therapists address for more information to consider.

What It Means:
Newborns can be sleepy and may not stay alert long enough to breastfeed effectively. This is common in the early days and can impact milk intake. Medical issues can also make it difficult to remain alert, so reach out to the pediatrician with any concerns.

When Help Is Needed:
Urgent concerns should be addressed immediately with the pediatrician. A baby may benefit from an evaluation with a lactation consultant if the baby consistently sleeps through feedings, gains weight slowly, or if a newborn is feeding less than 10-12 feeds per 24 hours.

Major Milestone:
With time and recovery from birth, most babies will learn to regulate their sleep/wake and feeding patterns.

Quick Tip:
Feed the baby when they begin to show early hunger cues - waking up, rooting (turning mouth toward a stimulus). Use gentle stimulation to keep the baby awake during nursing—such as undressing them slightly, using skin-to-skin contact, or tickling their feet. Try switching sides or compressing the breast to encourage sucking.