The seven key challenges cited by women for using second-line strategies are shown in Table 3. More than
one third reported ‘nipple pain’ (n = 25), ‘baby would not settle’ (n = 25), ‘not enough breast milk or colostrum’
(n = 23), and ‘fatigue’ (n = 23). The category ‘baby could not latch – other reasons’ (n = 23), contained eight
challenges to breastfeeding including uncoordinated suck, breast refusal, flat and/or inverted nipple shape, engorgement,
and jaundice.