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Breastfeeding: when it hurts, or you’re not sure it’s working
For anyone who is breastfeeding or trying to, in the first days or months in, and for the people beside them. This page passes on, by name, what the Office on Women’s Health (OWH), the CDC, WIC Breastfeeding Support, the Department of Labor and the National Library of Medicine say: how to tell whether your baby is getting enough, sore nipples and the latch, engorgement, plugged ducts and breast infection, what you can eat, drink and take, pumping and how long milk keeps, your rights to pump at work, and formula and stopping. It builds the questions to ask at a visit. Take only what you need today.
Right now
- A fever, with a breast that is sore, warm or red? OWH says a breast infection (mastitis) can cause fever or flu-like symptoms, and breasts that feel warm or hot to the touch and appear pink or red. It says to ask your doctor for help if you have a fever, if you do not feel better within 24 hours of trying its tips, or if your symptoms get worse.
- Both breasts affected, pus or blood in your milk, red streaks, or symptoms that came on severely and suddenly? OWH says to see your doctor right away.
- Worried your baby is not getting enough? OWH says to talk to your baby’s doctor, and that the signs to watch are wet diapers, bowel movements and weight gain: its first-week diaper chart is in this guide. The CDC says to talk to a lactation consultant or your baby’s nurse or doctor if you are concerned about meeting your baby’s needs.
- Your baby has trouble breathing after a feeding, or at any time? WIC Breastfeeding Support says that if your baby ever has problems breathing, call 911 or go to your nearest emergency room.
- Thoughts of hurting yourself or your baby? Call or text 988 at any time. You can also call or text the National Maternal Mental Health Hotline, 1-833-852-6262.
- Want to talk to someone about feeding today? OWH’s helpline is 1-800-994-9662. Its page says Monday through Friday, 9 a.m. to 6 p.m. Eastern time, in English or Spanish.
If you cannot reach a provider and you are frightened for yourself or your baby, go to an emergency room or call 911. That line is ours, and so is the 988 line. This page is not for emergencies.
More help
- After the birth, coverage, WIC and rights at work: Pregnant, or with a new baby.
- If your mood is low: Postpartum depression.
- If your employer will not let you pump: When something is wrong at work.
- For a visit: Get ready for your appointment and My medicines.
- Birth control: Birth control: finding what fits. Smoking: When you want to quit smoking.
- Food and WIC: When you need food.
- No insurance: When you need a doctor and can’t pay.
- All our free tools.
Looking after a baby or child? The pages on this site for a baby or child, on one list.
Other guides on this site that go with this page
Free to read. We chose these ourselves; no professional did. Each guide was written with AI and has not been reviewed by a professional. They are general information, not advice.
- Reflux in babies (spitting up, GER and GERD): what is normal, the warning signs, and the treatment: a baby who spits up a lot (reflux, GER and GERD): what is normal and how common, the signs that mean calling a doctor right away, the tests, the treatment, and changes to feeding.
- Eating well and staying active in pregnancy: gaining slowly, what to eat, what to avoid, moving safely, and after the baby: eating well and staying active in pregnancy: gaining weight slowly, what to eat and drink, folate and a prenatal vitamin, what to avoid, staying active safely, and after the baby.
- Prolactinoma: high prolactin, the signs, the tests, and the treatment: prolactinoma and high prolactin (a benign tumor of the pituitary gland, milk from the breasts, periods that changed or stopped, or less interest in sex): the signs, what else raises prolactin, the tests, the medicines, surgery and radiation, and pregnancy.
- Thyroid disease and pregnancy: an overactive or underactive thyroid, the medicines, and after the baby: thyroid disease and pregnancy (an overactive or underactive thyroid while pregnant, Graves’ disease or Hashimoto’s disease, or a thyroid that changed after the baby): why the thyroid matters for the baby, the signs, the medicines used in pregnancy and when to stop and call, a higher dose of thyroid medicine, postpartum thyroiditis, breastfeeding, and iodine.
- Diabetes and pregnancy: getting ready, the risks, the blood glucose targets, insulin, and after the baby: diabetes and pregnancy (type 1 or type 2 diabetes, pregnant or planning a pregnancy): getting ready, the risks for the baby and you, the blood glucose targets, insulin and medicines, and after the baby.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor, nurse, midwife or lactation consultant has reviewed it. Changed on October 10, 2026. When this guide was first published, on October 9, 2026, most of its lines came from four articles of the MedlinePlus Medical Encyclopedia. That text is licensed from a company, and its notice does not allow it to be reused this way, including by AI. We had decided not to lean on it and then did; that was our mistake. Every line that came from those articles is gone, and each part of the guide has a dated note saying what went. The facts here were read on October 10, 2026, in English unless we say otherwise. On womenshealth.gov, from the Office on Women’s Health: Common breastfeeding challenges, Making breastmilk, Pumping and storing breastmilk, and Weaning your baby (each updated October 23, 2025), and its helpline page (updated December 17, 2020). On cdc.gov: Breast Milk Storage and Preparation (reviewed March 25, 2026), How Much and How Often to Breastfeed (reviewed April 16, 2026), Weaning (April 16, 2026), and five pages written for health care providers: Maternal Diet and Breastfeeding (August 25, 2026), Alcohol (April 13, 2026), Tobacco and Electronic Cigarettes (September 23, 2025), Prescription Medication Use (September 23, 2025), and Contraindications to Breastfeeding (December 8, 2025). On WIC Breastfeeding Support, from the Department of Agriculture: Low Milk Supply, Engorgement, Help for Sore Nipples, Nutrition While Breastfeeding, Breastfeeding and Alcohol, Drugs, and Smoking, When Breastfeeding Isn’t Working, and Combination Feeding and Maintaining Milk Supply. On dol.gov: Pump at Work (revised January 2026). And the Summary of the National Library of Medicine’s own Breastfeeding topic page, read in English and Spanish, which it credits to the National Institute of Child Health and Human Development. The page says whose words it is passing on, and what is marked “ours” is our own. The sources write about “mothers” and “women”, and where we pass on their words we keep them. Where the sources differ: the CDC and WIC give different numbers for alcohol and for caffeine, and the guide gives both. What went on October 10 with nothing in its place, because no page we may pass on says it: how rare low supply is in the encyclopedia’s words; dry or moist skin, bra fabric and an oil for sore nipples; its description of thrush; what to give a teething baby; its list of when to contact a provider about a breast infection; antibiotics and abscess; an amount of fluid to drink; hepatitis B and C; getting pregnant while breastfeeding, and periods; its narrower account of the pump-at-work law; and its words of comfort about formula. What we left out or did not read: the steps for a latch and the breastfeeding holds (OWH has pages with pictures that we did not read); the federal advice about which fish to eat; OWH’s line about the flu, which we could not check against a current page; OWH’s steps for oversupply, a strong let-down and reverse pressure softening; the CDC’s full list of reasons to stop breastfeeding for a while; every price, including what a pump or formula costs; how to choose, prepare or store formula; cleaning pump parts; milk for a premature or sick baby; any page written for people with HIV; whether break time to pump is paid; any state’s law; the name, label or dose of any medicine; and the hotline’s own pages (what we say about the National Maternal Mental Health Hotline is what the National Institute of Mental Health says, read for our postpartum depression guide). We called no number. It saves nothing and loads no tracking.