Many new mothers have trouble breastfeeding, and most feel awkward and a little clumsy the first few times they try, even when everything goes smoothly. Try not to worry if breastfeeding doesn't come easily. Feeding your baby is the most natural thing in the world, but it still takes time -- and sometimes more than a little trial and error -- to get it right.

Start breastfeeding as soon as you can. If you're in a hospital, ask to put your baby on your breast while you're still in the delivery room. She may not begin to feed right away, but she'll probably explore the breast and try to suck. Some babies will latch on and nurse immediately. Request to have your baby “room in” with you during your hospital stay. This is a great opportunity to bond with your baby. You'll also have the chance to learn her rhythms and respond to her cues.

In some cases, babies will need to spend time under close observation in the hospital and won't be able to breastfeed immediately after delivery. In such cases, many women find an electric breast pump to be an invaluable tool. The breast pump will allow you to store milk as well as keep your milk production flowing. That way, your breasts will be ready to do the job when your baby is ready to nurse.

Your midwife can help, and most hospitals have lactation consultants who can give you advice and aid with any problems you experience. Labor and delivery nurses are also highly trained and knowledgeable. Take advantage of all this experience during your hospital stay. Request to see a lactation consultant or ask a nurse to spend some time helping you get started. Ask lots of questions and have the nurse or consultant watch what you are doing. This is the best time to learn and to get yourself -- and your baby -- off to a good start. These days, hospital staff are usually pressed for time, so you may have to be assertive to get help.

If you have problems after you get home from the hospital, seek help before you and your baby become discouraged with the entire process. Your problem can probably be resolved with a few minor adjustments. Your physician will be able to refer you to a lactation consultant. You can also contact your local chapter of La Leche League, a nonprofit organization that supports breastfeeding women.

Nipple soreness: Most women feel some nipple soreness in the first days and even weeks of nursing. If one breast is more painful than the other, start with the less sore one first, because your baby will nurse more aggressively when you first put her to your breast. If the soreness gets worse rather than better over time, your baby may not be positioned properly on your breast. Hold her close to you so that she doesn't have to turn her head to reach your nipple. Her mouth and nose should be directly in front of your nipple, and her chin should be resting on your breast. If it hurts when she latches on, ease her off and try again.

Nipple soreness can also be caused by dry skin, which can lead to painful chapping and cracking. Avoid using too much soap when you bathe, and use lanolin or another gentle moisturizer to soothe and protect dry nipples. Olive oil and breast milk itself can also restore the skin's natural oils.

Too much moisture can irritate your nipples, too. Make sure you have a comfortable nursing bra made of natural, breathable fabric. Disposable nursing pads will help keep your nipples dry throughout the day.

Sore nipples can also be a symptom of thrush, a yeast infection that is passed between mother and baby during nursing. If your nipples are very pink and there are patches of white in your baby's mouth, it is likely that you both have thrush. Your doctor will prescribe an antifungal remedy, which should ease your symptoms.

Finally, your baby may develop habits that can make nursing painful. Some babies stop nursing by pulling very hard on the breast as they break the suction. When your baby is finished nursing, slip a finger between her lips and your nipple and ease her off the breast. When your baby begins teething, she may try to chew on your breast to ease her swollen gums. To prevent this attack, put some clean wet washcloths in the refrigerator and give her one to chew on right before she nurses. Most babies learn mercifully fast to not use their teeth when nursing.

Engorgement: Your breasts will naturally become firm and full when your milk comes in a few days after your baby is born. If you wait too long between feedings, your breasts may become engorged: hard, swollen, and painful. Your nipples will flatten, making it difficult for your baby to latch on. To relieve engorgement, you may need to pump your breasts. According to La Leche League, putting cold compresses on your breasts between feedings is a good way to reduce swelling -- but be sure to put a layer of fabric between your skin and the cold pack.

Some women may find heat soothing, but La Leche League advises only using heat immediately before feeding or pumping and limiting it to a few minutes. Heat can increase swelling and hamper your milk flow. Avoid engorgement by feeding your baby regularly and allowing her to nurse until she's full.

A breast pump can come in handy at this point because you can pump off some of the milk and refrigerate it or freeze it for later. Also, some women who have trouble having the baby at the breast can do well by pumping the milk and feeding it to the baby in a baby bottle.

Plugged milk duct: Soreness and redness in one area of the breast may be signs of a plugged milk duct. Massage the area gently. Tight bras can cause plugged ducts, so make sure yours all fit properly and provide adequate support without binding. Plugged ducts can also be triggered by periods of engorgement, so try to stick to your breastfeeding routine as closely as possible.

Mastitis: This condition, also called “breast infection,” results in fever and achiness as well as extreme soreness and redness in the breast tissue. Breast infections usually occur when a nursing mother is chronically tired, has a plugged milk duct, or wears restrictive bras. If you have symptoms of a breast infection, contact your healthcare provider immediately. If you are diagnosed with mastitis, your doctor will prescribe antibiotics to clear up the infection.

While you're recovering, try to get adequate rest, and make sure you're eating well and drinking plenty of water. Warm showers, baths, and hot compresses can ease discomfort. Whatever you do, don't stop nursing. The regular flow of milk will actually help fight the infection. However, often women will need antibiotics. If your breasts are engorged and you have fever or areas of streaking or redness on your breasts, you should be seen by a doctor. If left untreated, these infections can sometimes turn into abscesses that need to be drained and may cause a woman to have to give up breastfeeding.

Inadequate milk supply: Breastfeeding is based on supply and demand. If you feel you aren't producing enough milk, try feeding your baby more often and let her nurse until she's full. Make sure you are getting plenty of rest, eating nutritious meals, and drinking plenty of water. Develop a routine and try not to skip feedings. As long as your baby is gaining weight, you probably have nothing to worry about. If you have questions, consult a lactation specialist or talk to your physician.

Lack of support: One problem women may face is a lack of support from those around them. Depending on the attitudes of your family and friends, your decision to nurse your child could be met with every reaction from encouragement to indifference to disapproval.

Try not to let negative attitudes discourage you. Consider the gift you are giving your child: According to the American Academy of Pediatrics, children who are breastfed are less likely to experience illnesses such as ear infections, allergies, diarrhea, pneumonia, or meningitis. There is also growing evidence that breastfeeding can lower the risk of sudden infant death syndrome (SIDS). Breastfeeding also promotes bonding between mother and child, and it's good for your long-term health: Breastfeeding builds bone strength and reduces the risk of ovarian cancer and breast cancer.

If you aren't receiving enough support for breastfeeding, get some. Find other breastfeeding mothers through a mothers' group or local La Leche League chapter. Encourage disapproving friends and family members to educate themselves before offering their opinions.

It's important to remember, too, that you're not a failure if you can't breastfeed. Some babies have conditions that make them unable to breastfeed, and some mothers find that they can't breastfeed their babies no matter how hard they try. What's important is that you love your baby and do the best that you can.

-- Connie Matthiessen is a former staff writer for the Center for Investigative Reporting who has written widely on health and medical issues.

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First published October 11, 2005
Last updated May 8, 2007
Copyright © 2005 Consumer Health Interactive

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