By Dara Pettinelli for TheBump.com
It’s a natural process so it should be easy, right? But just like learning how to ride a bike, you need to learn how to breastfeed – and so does baby. The Bump sought the expertise of Jane Morton, MD, a pediatrician who’s been instructing doctors, nurses and lactation consultants for more than 30 years. Dr. Morton solves your 10 most common breastfeeding problems.
Problem #1: Latching pain
It’s normal for your nipples to feel sore when you first start to breastfeed, especially if you’re a first-time mom. But if baby has latched and the pain lasts longer than a minute into your feeding session, check the positioning.
Solution: Try to achieve an asymmetrical latch where baby’s mouth covers more of the areola below the nipple rather than above. To reposition your baby, place your index finger inside baby’s mouth to take him or her off your breast. Tickle his chin or wait until he yawns so his mouth is wide open and seize your opportunity. When your baby is correctly positioned, their chin and nose touch your breast, their lips splay out and you can’t see your nipple or part of the lower areola.
If baby’s position is correct and latching on still hurts, your nipples may be dry. Make sure to wear loose clothing and avoid washing with soap. Try applying a lanolin-based cream between feedings.
Problem #2: Cracked nipples
Cracked nipples can be the result of many different things: thrush (see Problem #6), dry skin, improper pumping, or most likely, latching problems. During the first week of breastfeeding, you may have bloody discharge when your baby is just learning to latch or you are just beginning to pump. A little blood is no cause for concern and won’t harm your baby.
Solution: Check baby’s positioning; the bottom part of your areola underneath your nipple should be in baby’s mouth. Also, try breastfeeding more frequently, and at shorter intervals. The less hungry baby is, the softer the sucking will be. As tempting as it is to treat your cracked nipples with anything you can find in your medicine cabinet, soaps, alcohol, lotions and perfumes are no good – clean water is all you need to wash with. Try letting some milk stay on your nipples to air dry after feeding (the milk actually helps heal them). You can also try taking a mild painkiller like acetaminophen or ibuprofen 30 minutes before nursing. If all this fails, try an over-the-counter lanolin cream, specially made for nursing mothers and use plastic hard breast shells inside your bra.
Problem #3: Clogged/plugged ducts
Ducts clog because your milk isn’t draining completely. You may notice a hard lump on your breast, soreness and even some redness. If you start feeling feverish and achy, that’s a sign of infection and you should see your doctor. Most importantly, avoid long stretches in between feedings. Milk needs to be expressed often. A nursing bra that is too tight can also cause clogged ducts. Stress (something all new moms experience) can also affect your milk flow.
Solution: Do your best to get adequate rest (recruit your partner to pick up some slack). Also, try applying warm compresses to your breasts and massage them to stimulate milk movement. Clogged ducts are not harmful to your baby because breastmilk has natural antibiotics. That said, there’s no reason why you should have to suffer. Breastfeeding should be enjoyable for mom and baby.
Problem #4: Engorgement/high milk supply
Engorgement makes it difficult for baby to latch on because it makes the breast hard and does not conform to his our her mouth.
Solution:Try hand-expressing a little before feeding to get the milk flowing and soften the breast, making it easier for baby to latch and access milk. The more you nurse, the less likely your breasts are to get engorged.
Problem #5: Mastitis
Mastitis is a bacterial infection in your breasts marked by flu-like symptoms such as fever and pain in your breasts. It’s common within the first few weeks after birth (though it can also happen during weaning) and is caused by cracked skin, clogged milk ducts, or engorgement.
Solution: The only sufficient way to treat the infection is with antibiotics, hot compresses, and most importantly, frequent emptying. Use hands-on pumping, making sure the red firm areas of the breast and the periphery are softened. It’s safe and actually recommended that you continue breastfeeding when you have mastitis.
Problem #6: Thrush
Thrush is a yeast infection in your baby’s mouth, which can also spread to your breasts. It causes incessant itchiness, soreness, and sometimes a rash.
Solution: Your doctor will need to give you antifungal medication to put on your nipple and in baby’s mouth – if you’re not both treated at the same time, you can give each other the fungi and delay the healing process.
Problem #7: Low milk supply
Breastfeeding is a supply-and-demand process. If your doctor is concerned about baby’s weight gain compared to the standards set by the World Health Organization growth charts for breastfed babies, this may be the problem.
Solution: Frequent nursing and hands-on pumping during the day can help increase milk supply. Surprisingly, forcing fluids and eating more calories or different foods hasn’t been shown to increase milk production.
Problem #8: Baby sleeping at breast
Falling asleep while nursing is common for babies during their first few months. All that bonding makes baby relaxed!
Solution: Milk flow is fastest after your first let-down, so if you want to increase efficiency, start off at the fuller breast, then switch to the other breast sooner rather than later. When you notice baby’s sucking slowing down and his or her eyes closing, remove them from your breast and try to stimulate your baby by burping, tickling their feet, or gently talking to him or her while rubbing their back, and then switch breasts. As your baby gets older, they’ll be able to stay awake longer, so don’t fret.
Problem #9: Inverted/flat nipples
You can tell if you have flat or inverted nipples by doing a simple squeeze test. Gently grab your areola with your thumb and index finger; if your nipple retracts rather than protrudes, breastfeeding will be more challenging.
Solution: Use a pump to get the milk flowing before placing baby at your nipple and use breast shells between feeds. Once you feel like your milk supply is adequate, try using nipple shields if your baby still has problems latching.
Problem #10: Painful/overactive let-down
Your breast is like a machine: when you let-down, all the milk-producing engines constrict to move the milk forward and out of your nipple. Sometimes the working of these inner parts can hurt, especially when in overdrive. Some mothers feel a prickly pins-and-needles sensation and others just get an achy feeling.
Solution: If this feeling of pins and needles goes beyond a mere tingling and feels more like a hundred little daggers poking your breasts, you need to check for a breast infection (yeast or bacteria). Sometimes this pain develops when you have an excessive amount of milk. Try feeding baby longer on one particular breast and switching to the other only if you need to. If the result is an infection (fever, aches and chills may be present), you’ll need to get antibiotics from your doctor. No matter how unpleasant it is for you, it’s still safe for you to nurse.
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