Courses

Breastfeeding Essentials: Overcoming Common Hurdles

What are the most common breastfeeding challenges new parents face?

Presenters: Stephanie Merlino Barr, PhD, RDN, LD; Lexis Schaefer, RN, BSN, IBCLC

Publication Date: 23 January 2026

Continuing Education Credits: Nurse Contact 1.0 CE; Dietitian 1.0 CPEU

Course Description

Learn practical, evidence-based strategies for successful breastfeeding. This course covers the benefits of human milk, common causes of nipple and breast discomfort, how to assess for an adequate milk supply, and effective strategies for managing both low and high milk supply.

Course Objectives:
  • Review the importance of human milk and breastfeeding.
  • Identify common causes of nipple and breast pain, then suggest modifications to improve maternal comfort.
  • Define an adequate breast milk supply based on infants' nutritional needs.
  • Review strategies to address under- and over-supplies of breast milk.
Key Takeaways:
  • Breast milk provides optimal nutrition for most infants.
  • Breastfeeding challenges can prevent families from meeting their lactation goals.
  • Education on typical breastfeeding patterns aids in early identification of complications.
  • Providing nutrition support to the lactating parent will benefit the breastfeeding dyad.
  • Proper positioning enables a comfortable and effective latch.
  • Recognition of normal supply variations helps prevent unnecessary treatment.
  • Frequent feeding, skin-to-skin contact, lactation support and maternal well-being are key to breastfeeding success.

Performance Indicators: 5.2.6, 5.2.7, 9.1.1

Activity Code: 191104

Related Questions:
  • Why is breastfeeding recommended for infants?
    Breastfeeding is recommended because human milk provides optimal nutrition and powerful immune protection that helps reduce an infant’s risk of infections, chronic diseases, and serious conditions such as SIDS, respiratory illnesses, ear infections, and gastrointestinal issues. It also supports healthy growth and development while offering health benefits to the lactating parent, including lower risks of diabetes, hypertension, and several cancers. Together, these benefits make breastfeeding the gold standard for infant feeding for the first months of life.
  • What breastfeeding challenges most commonly cause early weaning?
    The most common challenges include nipple pain, shallow or ineffective latch, perceptions of low milk supply, breast engorgement, mastitis, pumping issues, and infant oral restrictions. Many of these can be resolved with early assessment, support, and proper positioning.
  • What is considered a normal breast milk supply?
    By about 
    two weeks postpartum, most lactating parents produce between 500–1000 mL (16–32 oz) of milk per day. Because appetite and growth vary from baby to baby, normal supply is best defined by the infant’s growth, diaper output, and feeding behavior rather than how full the breasts feel or how much milk can be pumped at one time. Supply also naturally fluctuates throughout the day and across growth spurts.
  • What does a good latch look and feel like?
    A deep, effective latch is characterized by the infant being held close with their chin touching the breast, lips flanged outward, and more areola visible above the top lip than below. You should see rhythmic jaw movement and hear quiet swallowing. A good latch should feel like a strong tug rather than sharp pain, and the parent should be able to maintain a comfortable position without leaning forward or straining. Effective positioning is the key to achieving this type of latch.

Course Instructor Bio(s)

Stephanie Merlino Barr, PhD, MS, RDN, LD

Registered Dietitian
MetroHealth Medical Center  
Cleveland, OH, USA 

Stephanie Merlino Barr, PhD, MS, RDN, LD, is a Neonatal Dietitian in the Department of Pediatrics at MetroHealth Medical Center in Cleveland, OH. Stephanie is also a doctoral candidate at Case Western Reserve University School of Medicine’s (CWRU SOM) Department of Population and Quantitative Health Sciences. Her research focuses on early-life nutrition interventions and their relationships with growth and body composition outcomes in premature infants. Stephanie is also an Adjunct Instructor at CWRU SOM’s Department of Nutrition, where she teaches a graduate-level course on human lactation. Stephanie is an editor of the Academy of Nutrition and Dietetics Pocket Guide to Neonatal Nutrition 3rd Edition, published in July 2022, and a contributor to the Academy’s online Pediatric Nutrition Care Manual.

Lexis Schaefer, RN, BSN, IBCLC

Lactation Consultant 
Soulful Lactation, LLC 
Medina, OH, USA

Lexi Schaefer, RN, BSN, IBCLC, is an International Board-Certified Lactation Consultant and a Registered Nurse with a special interest in the field of Neonatology. Lexi received her Bachelor of Science in Nursing degree with Honors and Research Distinction from The Ohio State University. While studying nursing, she developed a passion for working with compromised infants and an enthusiasm for incorporating evidence-based practices. She began her career at MetroHealth Medical Center in Cleveland, working as a nurse in a Level III Neonatal Intensive Care Unit. Witnessing firsthand the benefits breast milk provides to medically fragile infants, she became interested in lactation in the NICU. Lexi assumed the role of Breastfeeding Champion in her unit and worked closely with the lactation team to increase breastfeeding awareness and support. Lexi received countless hours of hands-on breastfeeding support at her hospital and pursued further education to enhance her knowledge and skills in lactation support. In 2020, Lexi received IBCLC certification and transitioned to the role of lactation specialist at MetroHealth. Working alongside a multidisciplinary team, Lexi has expanded lactation support in the NICU and helped countless mothers and infants achieve their breastfeeding goals despite the challenges of an intensive care unit.

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Highlighted References:
  • Meek JY, et al. Pediatrics. 2022;150(1):e2022057988. 
  • American College of Obstetricians and Gynecologists. Obstet Gynecol. 2021;137(2):e42-e53.
  • Mitchell KB, et al. Breastfeed Med. 2022;17(5):360–376. 
  • Berens P, et al. Breastfeed Med. 2016;11(2):46-53.  
  • World Health Organization. Weight-for-age. Child Growth Standards. https://www.who.int/tools/child-growth-standards/standards/weight-for-age. 
  • Kellams A, et al. Breastfeed Med. 2017;12:188-198.  
  • Brodribb W. Breastfeed Med. 2018;13(5):307-314.
  • Pevzner M, et al. J Clin Med. 2020;9(8):2328.
  • ACOG. Obstet Gynecol. 2021;137(2):e42-e53.
  • Kujawa-Myles S, et al. Int Breastfeed J. 2015;10:18.

Abbott Nutrition’s Provider Statement for Nursing CEs:

Abbott Nutrition Health Institute is an approved provider of continuing nursing education by the California Board of Registered Nursing Provider #CEP 11213.

Abbott Nutrition’s Statement for Dietitian CPEUs:

This educational activity has been prior-approved by the Commission on Dietetic Registration (CDR). CDR credentialed practitioners will receive the specified continuing professional education units (CPEUs) for completion of this program/material.