Newborn feeding concerns in the early weeks

What are the red flags to look out for in the first 3 weeks of breastfeeding?

We will be interchanging the words breastfeeding, bodyfeeding, chestfeeding, and nursing throughout this piece.

As doulas we help many parents on their feeding journeys with their babies. When it comes to nursing, it is easier to troubleshoot struggles or hurdles earlier on. So be vocal! State what you are noticing. If you are growing a concern reach out to your doula and/or lactation professional immediately. They can help discern if its a simple fix or something that needs more attention.

Let’s walk through these together.

Red Flags in the First Three Weeks 

1) Nipple pain 

With breastfeeding there can be some discomfort as the feeding relationship gets established. Some tenderness upon the initial latch may happen. This is in the range of normal. The rule of thumb for when nipple pain is signifying a bigger issue is:

The entire feed should not be painful.

If you notice the feed is painful it is a great idea to stop the feed. Enduring intense pain should never be a part of nursing your baby. To unlatch your baby the secret is to break the suction. Place your pinky finger between the baby’s lips and your breast tissue, breaking the seal. Then gently pull the baby away. Simply pulling your baby off of the breast will cause your nipple to stretch and increase the likelihood of injury! And nipples stretch real far! We don’t recommend you find out just how far.

We asked Kirsten Sonneville-Douglass, an IBCLC of Live, Latch, Love, about pain and chestfeeding. She has worked with many MDDS clients and even leads a local support group for infant feeding at a hospital!

Kirsten has this to say about pain:

Some soreness can be expected for new breastfeeding/chestfeeding moms. But there is a difference between soreness and pain. I’ll ask a mother to close her eyes during a feeding session and ask herself….’do you feel a tug or a pinch/bite?’ If it’s a strong tug, ok, but if it is a pinch or bite, stop, and start again. Most often a simple adjustment in positioning or latch will help.

My big piece of advice is ask for support/help. You don’t need to be in pain and if you are, there’s something not right.

2) Cracked & bleeding nipples 

Nipple trauma can happen. Especially if a latch issue persists. This can lead to what no one wants, cracked and bleeding nipples. Unfortunately this can be an extremely common issue as the bodyfeeding process is learned by both the new parent and new baby.


-Stop using any fragranced oils, perfumes, soaps, or other products as they could promote dryness.

-Use a nipple ointment, gel, or butter specialized in healing. These are helpful to provide some soothing comfort and promote healing.

-Hand express breastmilk and spread it over the nipple. Let it air dry.

Some cream/ointment options are:

Something to keep in mind as well from a lactation professional:

Lanolin is basically chap stick, it won’t fix big problems. If you have cracks, wounds or very tender spots, it’s time to get hands on help to address the underlying causes about why the trauma is happening.

Adrian Fear, Huron River Lactation

Adrian Fear, owner and IBCLC at Huron River Lactation says:

Pain is not normal. If you are experiencing pain that makes you hold your breathe, count to 10, cringe, or want to avoid feeding at the breast, it’s time to reach out for additional help! Lining up those resources during pregnancy is a easy start. Know who you can call for expert help. Find out if they can they bill your insurance or what the cost will be.

3) Hot/tender breasts 

Engorgement is a process that is very common in the early days of establishing a supply in a chestfeeding relationship. Though not every person will experience it. In this process breasts may become hot or tender. Some tenderness and warmth can be normal, but if it persists, is unbearable, or presents with a fever, or flu like symptoms, it may be a sign of mastitis. Mastitis is a breast infection that can cause pain, fever, and overall feelings of unwell. Reach out to your healthcare provider if you think you’re experiencing signs of an infection!

When to seek help:

Always verbalize how you are feeling. If any of your struggles are causing constant pain, you are concerned, or it doesn’t seem to be improving, it is time to reach out. It is better to reach out for support sooner than let a small issue develop into something bigger.

If you have a postpartum doula supporting you, they can guide you with tips, and ideas to overcome common struggles. They also know when you should reach out to a lactation professional. We recommend knowing ahead of time who will reach out to when you need help beyond basic needs. Both Kirsten and Adrian mentioned in this piece are high on our list for folk to reach out to!

Who to call?

Local breastfeeding resources

Pediatricians and OBGYN offices typically have great referrals for support in their systems as well. Often these meetings are covered by insurance as well.

We want your bodyfeeding experience to be as easy of a transition as possible. Look out for these signs and don’t hesitate to get support when you need it!

Authored by Andrea Stainbrook

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