Supporting Families in the Early Days of Breastfeeding: Common Challenges and Effective Reassurance

When a parent struggles with breastfeeding, you’re often the first person they turn to—many times before they’ve even considered consulting a lactation specialist. This means your words, reassurance, and guidance have a lasting impact on whether they continue or give up. 

The good news? You don’t need to be an expert in lactation to make a difference. Research into human lactation is rapidly evolving and no one expects you to have all the answers, but knowing a few common challenges and effective ways to respond can change the course of a family’s feeding journey. When a referral is needed, IBCLCs and other lactation specialists are eager to partner with you to provide an added layer of support.

Preventing Overwhelm

Many new parents assume that breastfeeding is very simple but find themselves underprepared and overwhelmed once baby comes. At that point, your role is to help uncover the cause of their overwhelm and respond accordingly. 

Your best offering, however, is preventative. Prenatal education is crucial, and you may be a patient’s only source of information. Strongly encourage parents to take a prenatal breastfeeding class, even if they’re undecided about how to feed their baby. Have a handout listing local classes, lactation support, links to educational videos, FAQs, etc. (Most lactation consultants would be glad to provide you with one!) Provide a small sound bite of breastfeeding education at every appointment. It’s never too early to start. 

Checking In

Many parents don’t realize their struggles indicate there is a problem. They assume their difficulties are just “part of breastfeeding” and don’t ask for help, sometimes because they don’t know help exists. 

We can help surface these hidden challenges by checking in frequently throughout the entirety of their breastfeeding journey. Here are some questions that can make a big difference: 

• How is feeding going for you and your baby?
• What has been easier than you expected? What has been harder?
• Do you feel breastfeeding is going the way you hoped?
• How are you feeling during and after feeds—comfortable, in pain, or somewhere in between?
• How does your baby seem after feeding—satisfied, fussy, sleepy, still hungry?
• Many parents have questions even if things seem to be going okay. Is there anything you’d like more support with?

Low Milk Supply: Real and Perceived

Milk supply is a significant area that requires us to walk the line between trying to provide reassurance that most likely everything is okay while not dismissing patients and missing real issues.

Many parents expect a full milk supply right away and are thrown off by the colostrum phase of milk production in the first several days of life. Milk at this stage is clear or gold colored, thick, sticky, and present in very small volumes. Many people don’t even see colostrum and assume they have no milk, when in reality they have exactly the right amount. Even when milk transitions, normal output is often much less than parents expect. 

Formula supplementation often gets introduced even when milk supply is normal. When supplementing, families benefit from education on appropriate amounts, paced bottle feeding (to prevent babies from preferring faster milk flow), and protecting milk supply when baby is nursing at every feed.

Still, true low supply does occur. We do our patients justice when we treat milk supply like a vital sign. Insufficient supply usually signals an underlying cause. If a parent wants to get to the bottom of it, validating their concern and connecting them with an IBCLC who specializes in low milk supply can make a lasting difference.

Your best course of action? Provide lots of prenatal encouragement. Normalize small amounts of milk. Offer a checklist of signs baby is getting enough. Validate concerns and invite follow-up if questions remain.

Whether milk supply concerns are real or perceived, investigation and reassurance are always warranted. 

Normal Vs. Abnormal Pain

Many lactating parents are told that pain is just a part of breastfeeding, but this false narrative must be challenged. 

Inquire about your patient’s pain. If they are within two weeks postpartum and experience brief pain after latch that resolves within 30 seconds, this may be a normal part of the learning process. Any pain lasting longer, or discomfort that continues throughout a feeding, is not normal and warrants further evaluation. 

Latch Issues

There are many causes of latching problems: body tension, torticollis, developmental delays, tone, positioning, restrictive oral anatomy, strong milk ejection reflexes, and more. When parents raise latch concerns, it’s worth digging deeper. Even a baby who’s gaining well may be compensating for an inefficient latch, and problems can emerge later if left unaddressed. 

Two issues that often come up in practice are nipple shield use and tongue tie. Be cautious with nipple shields, as they can be difficult to wean from. When used, explain that they are a temporary tool, not a long term solution. 

Depending on your field, parents may come to you asking if their baby has a tongue tie. This is an area of evolving research, and we now know that visual inspection of a frenulum alone is not enough. A true assessment requires observing a feeding and evaluating suck skills and milk transfer—something most primary visits don’t allow time for. 

The most supportive approach you can take with latching issues is to validate the parent’s concern, avoid overreassuring, and refer to a lactation consultant or feeding specialist for a comprehensive evaluation.

Working Together for Families

Breastfeeding challenges are common, but parents don’t need to face them alone. As a trusted provider, your role in listening, asking thoughtful questions, and offering early reassurance sets the tone for a family’s feeding journey. And when specialized support is needed, IBCLCs and other lactation specialists are ready to collaborate with you, helping ensure families get the best of both worlds: your medical expertise and dedicated feeding support. Together, we can make the early days of breastfeeding less overwhelming and more sustainable for the families we serve.