Cracked nipples to breast milk colours: A complete guide to breastfeeding

The breastfeeding journey is often filled with ups and downs. While it can be an incredible way to connect with your baby, it can also feel painful and overwhelming at other times.

From cracked nipples to breast rashes and stretch marks, your breasts go through a lot while feeding your baby. And, emotionally, the process can also bring with it a lot of guilt for mothers — breastfeeding guilt can come from deciding not to breastfeed or even from issues related to milk supply.

It's safe to say that there's a lot to cover when it comes to breastfeeding. With this in mind, we've created the ultimate breastfeeding guide for you. From the types of breast milk the body produces, to the best contraception to use while breastfeeding, this is everything you need to know.

Let's dive in!

What are the different types of breast milk?

If you weren't already amazed at how the human body can grow, carry and birth a human, you'll be in awe of how it produces breast milk. For starters, there are a few different phases of breast milk that change depending on the baby's needs.

Colostrum

The first milk you produce is called colostrum, which is also known as 'liquid gold' thanks to the abundance of vitamins and minerals — like magnesium, vitamin A, copper and zinc — within the milk.

Colostrum helps fill any nutritional gaps your baby may be born with and contains disease-fighting proteins, antibodies and hormones to help your baby grow and develop.

While colostrum is known for its thick consistency and bright yellow colour, don't panic if your colostrum colour is clear and more watery in consistency. Milk production rates vary with each person and if the flow of colostrum is a little slower, it can cause it to be thinner in texture and lighter in colour.

While your body can start producing colostrum as early as 16 weeks, it usually only lasts 2-5 days after birth, which is when your transitional milk comes in [1].

Transitional milk

Transitional milk takes the place of colostrum and lasts roughly 2 weeks. This milk has a high-fat content and also contains a whack of lactose and water-soluble vitamins and is higher in calories than colostrum.

Mature milk

The final step of the process is the transition to mature milk, which is 90% water-based (designed to hydrate your baby) and 10% proteins, carbs and fats for growth. There are two types of mature milk: foremilk and hindmilk.

Foremilk is the liquid your baby receives at the beginning of a breastfeeding session and is rich in vitamins, water and protein. Hindmilk is the fatty liquid that the baby consumes towards the end of the same session. This is technically the same type of breast milk, but it has different levels of fat content [2].

While you don't have much control over how much of each milk your baby receives, the longer time that is left between feeding sessions allows the foremilk to build up. If you feed more frequently, there is less time for the foremilk to accumulate and your baby may receive more hindmilk.

Getting ready to breastfeed

In the weeks before you give birth, you might want to start thinking about breastfeeding. Is this something that you want to do? If the answer is yes, there are a few things you can do to prepare yourself for the breastfeeding journey.

Take a breastfeeding class

While a breastfeeding class might not be a priority for all people, it can be helpful to those feeling worried about breastfeeding, or for those who simply want more information as it helps prepares you for what to expect and allows you to ask questions before your baby's arrival.

Plus, pregnant people who learn about breastfeeding are often more likely to breastfeed than those who don't [3].

Tell your doctor of your breastfeeding plans

Communicating your wish to breastfeed to your doctor means that everyone is on the same page when your baby is born and you have a plan that you'd like to follow.

You might also want to inform your doctor that you'd like to breastfeed as soon as possible following delivery as the first hour of life is when the baby's sucking instinct is strongest and may help get your breastfeeding journey off to a good start [3].

Try antenatal expressing

Your body can start producing colostrum as early as week 16 of your pregnancy and some people experience leaking colostrum from 28 weeks onwards. This is nothing to worry about and simply shows that your body is getting ready for the arrival of your bub.

If you're experiencing colostrum leakage, you can actually start antenatal expressing from 36 to 37 weeks pregnant — be sure to check with your midwife before commencing hand expressing.

If you are going to try antenatal expression, it's recommended to hand express colostrum versus using an electronic pump (which is better for mature breast milk) as you'll only be producing a few millilitres of colostrum at this stage.

And, once you have expressed the colostrum, you can freeze this for up to 3 months or store it in the fridge for 3-5 days. Frozen colostrum that has been thawed should be used within 48 hours.

Breastfeeding in the first few days and weeks

The first few weeks of breastfeeding can be difficult as you're learning a new skill while also getting to know your baby. We're here to help demystify those early days of breastfeeding — from the let-down reflex to cluster feeding.

Frequent feeding

The process of breastfeeding your baby can be a lengthy one and it might feel like you're constantly feeding. This is totally normal for newborn feeding, with the general rule of thumb that you breastfeed as often as your baby wants to nurse.

In fact, you can't really breastfeed too often but you can definitely feed too little, so it's important to aim for eight to 12 feeds in a 24-hour period [4]. You might also experience cluster feeding in the afternoons and evenings — this is when your baby wants short feeds frequently over a few hours [5].

Let-down reflex

The let-down reflex plays an important role in breastfeeding and usually occurs within seconds of your baby attaching to your breast. As the baby sucks, the nerve endings around the nipple are stimulated, which causes a release of prolactin and oxytocin [6].

The production of oxytocin is important for breastfeeding as it enables your breasts to let down the milk — hence the name! You may even experience the let-down reflex when your baby is not with you or when you see another baby, which can cause breast leakages.

Some breastfeeding parents can experience a painful let-down, especially as their body adjusts to the process of breastfeeding. There are a number of factors that can cause a painful let-down:

• Engorgement: An oversupply of breast milk can cause the breasts to become hard, swollen and sore.
• Overabundant milk supply: In some cases, your body can create too much milk in a process called 'forceful let-down', which can cause your baby to gulp and struggle to keep up with the fast flow of milk.
• Blocked ducts: A build-up of milk can cause blockages in your milk ducts and manifest as small, hard lumps in your breast.

Skin-to-skin contact

As soon as your baby is born, they are placed on your chest in a process called skin-to-skin contact. While it can assist with parent-child bonding, skin-to-skin has many other benefits.

For the baby, it helps regulate their heartbeat and temperature, while also assisting with the release of hormones that help make feeding easier [7].

For the mum, skin-to-skin releases hormones that help make breast milk, while also helping you learn their feeding cues. In the first days after birth, the Australian Breastfeeding Association recommends keeping your baby on your bare chest with skin-to-skin contact as much as possible, which also allows them to feed regularly [7].

Breastfeeding can be equally rewarding and demanding and there are times when it might feel overwhelming. For extra support, you might want to consider reaching out to a lactation consultant for breastfeeding help as they'll be able to walk you through the process and give you personalised advice.

Breastfeeding tips

There are a few ways to make your breastfeeding experience a little smoother. Here's what we recommend.

Try different breastfeeding positions

There are a number of breastfeeding positions you can try until you land on one that is most comfortable for you and your baby.

Remember that if one doesn't feel right, try another. There are so many different techniques so don't feel like you have to stick with the traditional reclined breastfeeding position.

Some positions you might want to try include:

• Side-lying: Lie on your side with a pillow under your head and place your baby opposite you, with their entire body facing you. You can support them by placing your hand on their back or popping a rolled-up towel behind them.
• Rugby ball hold: As the name suggests, imagine you're holding a rugby ball and place your baby's body under your arm, on the side you're wanting to feed from. Your baby should be lying on their back and looking up at you, with their feet facing towards the chair you're sitting in. Feel free to use a cushion to make this position easier and be sure to support their head with your hand.
• Koala hold: Sitting upright, position your baby on your lap facing you. Your baby's legs should straddle your knee as you support them with one hand and guide your breast to them with the opposite arm. This is best for older babies who can hold their heads up as you have less control over their heads and neck.

For those mums with inverted nipples, breastfeeding can be difficult at times but there are ways to overcome these challenges. Try using a breast pump before feeding to stimulate the nipple and make it easier for your baby to latch. Breast shells, which you wear between feeds, can also be helpful as they help keep your nipples in an outward position to reduce inversion.

Breast massage can increase milk supply

If you're dealing with milk supply issues, or experiencing bouts of breast engorgement and blocked ducts, breast massage can be helpful.

The main objective is to stimulate the breast tissue with targeted pressure, which helps to strengthen the natural feedback loop that regulates breast milk supply and can help increase production.

Breastfeeding massage can also assist with massaging out lumps or blockages in the milk ducts. While hand massage can help, you can also use a dedicated device, like a lactation massager, which is designed to relieve swelling, aid the let-down reflex and help fight off infection.

Fuel yourself with breastfeeding-friendly foods

While there's no hard and fast rules about the best diet to follow when breastfeeding, it is recommended that you fuel yourself with nourishing foods where possible as breastfeeding is incredibly demanding on the body and can deplete your nutrient stores.

Breastfeeding can also result in weight loss for some people as you're burning energy at a faster rate than you were previously. And, as a result, you need to be eating more food to meet your breastfeeding energy requirements.

If you don't lose weight from breastfeeding, this is nothing to worry about. Try to remember that losing weight takes time and shouldn't be rushed — especially in those early weeks after birth.

To make sure you're consuming all of the important vitamins and minerals and fueling your body, try filling your plate with the following foods:

• Leafy green veggies: Rich in vitamin A, K, C and B vitamins as well as folate, fibre, iron, magnesium and potassium. 
• Cold water fish: Omega-3s can be found in oily fish like tuna, anchovies and salmon.
• Yellow and orange fruits and veggies: Foods like carrots, corn, sweet potatoes, pumpkin, oranges and bananas are high in vitamin A, Bs, C, E, folate and magnesium.
• Dairy products: Cow’s milk, cheese and yoghurt as well as edamame beans, tofu and almonds are high in calcium. 
• Lean meats: Beef, chicken, pork and lamb are great sources of zinc, iron, iodine, B vitamins and essential fatty acids.

Tools to support your breastfeeding journey

It takes a village to raise a child and the same goes for breastfeeding — except, with nursing, your village is a stack of products that are designed to help you navigate breast discomfort and breastfeeding challenges.

A staggering 92% of breastfeeding mothers experience nursing issues. From mastitis to cracked nipples and leaking breasts, there is a lot to contend with while breastfeeding [8]. This is why Kin designed the Breastfeeding Essentials, which includes two must-have products.

The first is Kin's Nipple Balm, which soothes sore, cracked nipples and helps build skin elasticity and combat dryness. It's a salve for your poor nipples, which go through a lot and ingredients like avocado oil, lanolin and shea butter help to ease this pain.

Plus, the all-natural formula means that you don't have to wipe the balm off before feeding your bub, which is one less thing you have to think about!

The second star product is the Kin Breast Pads, which are made from lightweight bamboo and are designed to absorb moisture and ease discomfort from sensitive or sore nipples. While disposable breast pads are popular for one-time use, our pads are washable and can be used again and again, making them easy on your breasts as well as the environment.

Things to look out for when breastfeeding

There are a few things that can occur while breastfeeding and it's important to be informed in case you experience any of these things personally. Here's what you need to watch out for:

Milk blebs

Milk blebs are tiny white spots that appear on the nipple and are often the size of a pinhead. While they are small in size, a milk bleb can cause a lot of pain and discomfort.

There are two causes of milk blebs — one is when skin grows over the milk duct and causes it to become blocked. The second is when a small bit of thickened breast milk causes a blockage in the milk duct. There are a few things you can do to treat a milk bleb.

Clogged milk ducts

As the name suggests, a clogged milk duct occurs when there is a blockage in the breast, which obstructs the flow of breast milk and can cause swelling in the breast tissue that can form a lump or sore spot.

Symptoms of a blocked duct include:

• Pain in one place in the breast
• Heat and swelling in the breasts
• Slow milk flow on one side
• A milk bleb or blister on the nipple
• Thickened milk

There are a number of ways you can try to clear a clogged milk duct:

• Massage the duct with your hand or a lactation massager to help relieve swelling, clear the blockage and fight off infection
• Pop a heating pad on the breast for 20 minutes to dislodge the blockage
• Soak your breasts in an Epsom salt bath for 10 to 20 minutes
• Change the position your baby is feeding so their chin or nose is pointing towards the clogged duct.

Sore nipples

Your nipples go through a lot when breastfeeding and it's estimated that 38 per cent of people who breastfeed experience symptoms like bleeding nipples [9]. Sore and cracked nipples are often caused by a poor latch and can lead to larger issues like nipple dermatisis, mastitis and nipple thrush infections.

While it might be considered normal to experience nipple pain when breastfeeding, you can help reduce the pain in the following ways:

• Use a soothing nipple cream to moisturise the area
• Rinse your nipples after nursing and let them air dry
• Wear breast pads in between feeds.

Mastitis

Roughly 1 in 5 breastfeeding mums in Australia experience mastitis and it's safe to say that it's far from a pleasant experience [10]. Mastitis is an inflammation of breast tissue that can lead to infection and it is often incredibly painful.

Signs and symptoms of mastitis include:

• Swollen or sore breast
• Red breasts
• A burning or painful sensation
• Headache
• General-flu like symptoms

When it comes to treating mastitis, it can be as simple as continuing to feed through the pain as this can help relieve the inflammation. Other ways to tackle mastitis include:

• Use hot and cold compresses before feeding to encourage milk flow
• Try breast massage
• Rest as much as possible.

If symptoms don't ease after a day, or if you begin to feel unwell, head straight to your doctor for treatment. In most cases, they'll prescribe you with antibiotics to tackle the infection.

Breast milk colours

Did you know that your breast milk colour can change drastically depending on what you've eaten and the type of breast milk? The colours of the breast milk rainbow include:

• White: The high levels of fat in breast milk make it white. 
• Yellow: The first milk, colostrum, is often yellow in colour.
• Red: Cracked nipples can tinge the milk red with blood.
• Pink: Eating large amounts of pink and red foods like beetroot can cause colour changes.
• Orange: Foods like carrots and pumpkin can cause orange milk.
• Green: Eating green-coloured foods like spinach can affect breast milk colour.
• Blue: Foremilk is commonly blue and is caused by the presence of casein.
• Brown: When blood mixes with colostrum and comes out a rusty colour. 
• Black: Some medications can cause black breast milk.

Things to limit or avoid while breastfeeding

While soft cheeses and sashimi are back on the menu after pregnancy, there are still a few things you should avoid while breastfeeding.

Alcohol

There isn't an amount of alcohol that has been deemed 100% safe to drink while breastfeeding but in general, breast milk only contains a fraction of the alcohol consumed by mum.

In saying that, research has found that babies who are exposed to more than one standard alcoholic drink a day may experience impaired motor development [11]. Plus, alcohol can cause disruptions to their sleeping patterns.

When it comes to alcohol and breastfeeding, it's best to wait 2 hours for every standard drink you have before feeding your baby again [12]. Alternatively, you might want to consider pumping before drinking to feed your baby instead of breastfeeding.

Botox

It's best to avoid Botox entirely while breastfeeding. While each injection only contains a small amount of purified botulinum toxin type A and there isn't any conclusive evidence that says Botox is harmful to your baby, it is a chemical and does come with certain risks.

Be sure to discuss this with your doctor or healthcare provider for personalised advice. In general, most health professionals recommend waiting to get Botox injections until after you've finished breastfeeding.

Retinol and retinoids

Retinol and retinoids are popular skincare ingredients that are derived from vitamin A. And, they are well-loved for good reason — these ingredients work to reduce fine lines and wrinkles by increasing skin cell production and promoting collagen formation.

But, while these ingredients are incredible for revitalising your skin, they aren't recommended for use while pregnant or breastfeeding.

The science is a little conflicting on the safety of using retinol when breastfeeding — the Royal Hospital for Women says that over-the-counter products with low percentages of retinol are generally acceptable to use topically as very little of the active ingredient is absorbed [13].

On the other hand, a study out of the US found that skincare products with a higher concentration of retinol or retinoids are best avoided as there is a lack of evidence from peer-reviewed studies that prove their safety while pregnant and breastfeeding.

So, much like Botox, it's best to steer clear of retinol and retinoids while breastfeeding as it's better to be on the safe side.

Certain foods and drinks

While breastfeeding isn't as strict as pregnancy when it comes to the foods and drinks you can consume, there are a few things to limit or avoid while breastfeeding.

These include:

• Caffeine: This doesn't mean ditching your beloved coffee altogether but rather limiting the amount of caffeine you consume from tea, coffee, energy drinks and soft drinks. Why? Well, infants tend to metabolise caffeine slowly, which can cause sleep issues and in turn, irritability in your baby. Consider limiting or avoiding caffeine while breastfeeding if possible.
• Certain types of fish: Fish that are high in mercury, like tuna, swordfish, marlin and mackerel, are best limited while breastfeeding as high levels of mercury have been found to be damaging to the development of a baby [14]. This doesn't mean fish is off the table entirely though — opt for low-mercury options like sardines, whiting, salmon and haddock.

Nipple piercings

If you've been toying with the idea of a nipple piercing, it's probably best to wait until after you've finished breastfeeding.

While breastfeeding is possible with nipple piercings, it can make it far more difficult as there is a chance that scar tissue from the piercing can block the flow of milk to the baby [15].

If you've already got a nipple piercing, it's recommended that you remove it for the duration of breastfeeding.

If you can't remove the jewellery, be sure to tighten the piercing before each feeding session and keep an eye on your baby's latch while nursing so you can determine if they are receiving enough milk.

Can you get pregnant while breastfeeding?

A common question from parents after giving birth is whether or not you can get pregnant while breastfeeding. The answer is yes but not always — annoying, we know.

While exclusive breastfeeding can temporarily be used to avoid pregnancy, it comes with a few caveats for it to work. These include:

• Your baby must be under 6 months old
• You haven't had a period yet
• Your baby breastfeeds exclusively.

While following this technique, which is known as the lactational amenorrhea method (LAM), has been shown to have a 98-99.5% efficacy at preventing pregnancy, you must only breastfeed your baby for it to work — pumping doesn't cut it, unfortunately [16].

Contraception while breastfeeding

The good news is that there are a number of contraception options that are safe to use while breastfeeding. These include:

• Condoms
• Diaphragms
• Conceptive injection
• Intrauterine device or IUD

So, there you have it! A snapshot of what you can expect while breastfeeding. Remember that if you need help with feeding your baby, be sure to reach out and ask for it. And, if breastfeeding isn't working out for you, that's okay! There is nothing wrong with infant formula and the most important thing to remember is that fed is best.