Advice to the commissioner of health and mental hygiene: what you are doing is not enough. Sure, just in time for World Breastfeeding Week, New York City has announced that it will stop sending new moms home from public hospitals with free formula samples. That is a fine start, but a tiny fraction of what will be needed if New York really wants to create an environment that supports breastfeeding.

There have been reports in the real estate section of the New York Times about the prevalence of breastfeeding in the restaurants of Park Slope. But despite the perception that any mom who wants to do so runs around the city with a baby attached to her breast, many women find it surprisingly difficult to get the medical support we need to make breastfeeding work.

Because here is what no one tells you before you leave the hospital with your newborn: For some women getting breastfeeding right turns out not just to be about positioning the baby correctly at the breast. For many others it requires medical attention to treat the myriad of complications that can arise. While a skilled lactation consultant may be able to diagnose breastfeeding problems, she is not licensed to prescribe medicine. And physicians otherwise highly regarded in the treatment of women and children often do not know how to treat lactation disorders.

Soon after the birth of my twins this winter, the three of us came down with a yeast infection that caused breastfeeding to be so uncomfortable that I would dose myself with Motrin all day long. In addition, I felt shooting pain in my breasts whenever my milk came in, which since I was nursing twins was pretty much constantly. It quickly became too painful for me to go outside in the winter cold. My OB-GYN was so fantastic during my pregnancy and delivery that I probably would have jumped off the Brooklyn Bridge had he suggested I do so. But now he told me that the shooting pains in my breasts sounded normal, and promptly prescribed me medicine for the yeast. When the breastfeeding pain continued, I took a look on the Internet and learned I had been given a dose of medicine meant to treat a yeast infection in another part of a woman’s body — one pill instead of two week’s worth.

In the end, I contacted one of the few doctors in the New York area who treats breastfeeding problems. She operates out of Westchester but makes house calls in Manhattan, so I borrowed an apartment to see her. She prescribed me the correct medicine to beat the yeast and told me that the shooting pain was abnormal as well. It turns out that I had developed a circulation problem in my breasts.

The problem is, I’m not the only one with a story to tell of breastfeeding problems wrongly diagnosed and mistreated. A casual survey of Park Slope moms turns up more than a few who suffered through the first weeks and months of breastfeeding, even though they had money to pay lactation consultants and a commitment to nursing their babies. Two other moms I know also suffered with what one called “excruciating” pain until finally finding their way to one of those few doctors who knew how to treat a yeast infection of the breast, which also often takes root in the baby’s mouth.

Sometimes the problem is with the baby, not the mom. My friend Leslie’s baby lost such a large amount of weight during his first days of life that his breastfeeding-friendly pediatrician insisted he start on formula. It took a lactation consultant that Leslie called to pin-point a tongue-tie as the breastfeeding problem, not a breastmilk-supply problem on the mother’s part as had been suggested. An ear-nose-and-throat surgeon confirmed the lactation consultant’s diagnosis, clipped the baby’s frenulum (the tiny piece of skin between the tongue and the floor of the mouth). The baby has been breastfeeding like a pro for nearly six months now. Leslie wonders why the nurses and doctors at the hospital along with the pediatrician all missed the cause of her baby’s breastfeeding difficulties. “Given it’s so easy to check, it angers me that no one in the medical establishment did so,” she says.

This isn’t a whine, just a report of the facts of the matter, which is that even for moms who want to breastfeed, free formula samples at the hospital are pretty low on the list of obstacles.

It’s true, the city is taking other steps. According to a press release, they are making breastfeeding support readily available both for the mom’s hospital stay and afterwards. But if the city’s hospitals really want to put their weight behind breastfeeding they should invest not just in pumps and consultants, but in teaching their doctors how to diagnose and treat the medical problems that can come between a baby and her mother’s breast.

Ms. Phillips-Stoll is a graduate student in clinical psychology and a mother of twins.