Overcoming Breastfeeding Problems

Breastfeeding is an art, something mother and baby have to learn. Sometimes this learning process may be accompanied by challenges and problems that have to be solved.

Sore nipples

Sore nipples can be so painful that women decide to wean. Although some nipple tenderness in the early days of breastfeeding is rather common, breastfeeding in general should not hurt.

Nipple pain and sore nipples indicate that something goes wrong. In most cases sore nipples are caused by improper positioning and incorrect latch-on or incorrect removal of the baby from the breast. Therefore always turn to your lactation specialist if you experience nipple pain or sore nipples.

As soon as the cause for the discomfort is evaluated the problem can be solved. If the pain is extreme it might be advisable to temporarily interrupt breastfeeding. During such an interruption you must express your milk to avoid engorgement and to keep up your milk production.

Your lactation specialist can inform you about breastpumps and hand expression and about alternative feeding methods to feed your baby during this time.

If you want to support the healing process, modified lanolin  can be applied to the nipple. Moist wound healing is considered the treatment of choice. Avoid any ointment that must be wiped of before feeding the baby. This will irritate the skin even more.

Breastshells can help protect sore nipples.

Engorgement and mastitis

Engorgement It is important to distinguish between pathologic engorgement and the physiologic engorgement that occurs in the first days after birth. Pathologic engorgement is often times caused by bad breastfeeding management, which means infrequent or inadequate feedings. Your breast (or both) becomes hard, full and tender. It may feel warm and you might feel miserable. It is possible that you might be running a temperature.

The first goal is it to reduce the engorgement so your baby can feed effectively at the breast. As soon as your baby is able to suck effectively, your breast will be emptied and softened. If your baby will not breastfeed or is not breastfeeding long enough to relief the engorgement, you should either hand express or use a breastpump to remove the milk.

Your lactation specialist can inform you about breastpumps and hand expression.

Apply moist heat before feeding or expressing and use gentle massage to stimulate your milk ejection reflex. Cold compresses after breastfeeding or expressing will help to relieve pain and swelling. Prompt treatment is the key to avoid possible complications.

Mastitis

Mastitis describes a situation of an inflammation of the mammary gland or the breast tissue. Mastitis can be caused by internal or external pressure that leads to a milk stasis in the breast. That means that mastitis can develop from engorgement. If you have a hot and red area of the breast, if your breast feels tender in a certain area and if you feel generally bad with flue-like symptoms, headache, and fever immediately turn to your health care professional. Mastitis needs prompt treatment. You need a lot of rest and adequate medication.

Frequent breastfeeding or expressing of the milk is crucial. Abrupt weaning or temporary interruption of breastfeeding can delay healing or cause further complications.

Milk coming-in

On the second or third day after birth you will experience some degree of engorgement. This is due to a gradual build up of fluid that causes your breasts to swell and become somewhat warmer. This kind of engorgement is physiological and a positive sign as it tells that the milk is “coming in”. Continue to breastfeed frequently and unrestrictedly. The physiologic engorgement does not mean that you have an oversupply and it is important to have the baby frequently drain the breast to avoid problems with a pathologic engorgement.

Too little / too much milk

Many mothers live in the fear of an inadequate milk supply but in most cases this fear is unsubstantiated. If you are afraid that you do not have enough milk first watch for the signs that indicate your baby is getting enough. If you really experience too little milk ask your lactation specialist for help to increase your milk supply and stay in contact with your health care professional.

The following tips may help you to increase your milk production:

Milk production follows the system of supply and demand. That says the more milk is drained from the breast the more milk will be produced. This is why you should increase the frequency of feeds. Try to breastfeed every two hours during the day and every three hours during the night.

Only a well positioned and correctly latched-on baby can stimulate the breast adequately. Therefore check or have your lactation specialist checking the positioning and latch-on of your baby.

Breastfeed at least 15 minutes per breast and offer both breasts at each feeding.

Try switch nursing. As soon as you realise your baby slowing down in sucking and swallowing, remove the baby carefully from you breast and switch to the other side.

Get enough rest. A few days of bed rest with the baby and nothing else to do but resting and breastfeeding can be very efficient.

Avoid all kinds of artificial nipples (bottles and pacifiers). All sucking should be at the breast.

If it is necessary to supplement, use a cup, SoftCup Advanced Cup Feeder, a spoon or a syringe instead of a bottle.

Additional pumping might be appropriate.

Too much milk can be annoying, too. Mothers who produce too much milk may suffer from full, engorged breasts, plugged ducts, and mastitis. Your lactation specialist can support you if it is necessary to reduce you milk supply.

The following tips may help you to reduce your milk production:

Offer only one breast at each feeding. Allow your baby to breastfeed on this one side as long as he wants and keep him at this breast for the next two hours if he wants to nurse again. To avoid engorgement in the other breast, hand express just enough milk to stay comfortable. But express only if necessary and only the amount you need to feel relieved. Do not empty the breast completely. 

Apply cold compresses to the breast after feeding the baby.

Drink a cup of sage tea. Sage contains a natural form of estrogens that can decrease your milk supply. Peppermint tea has a similar effect but not as strong as sage tea.

Multiples

It is possible to breastfeed twins or triplets. The key to successfully breastfeeding twins or triplets is the same as for every mother breastfeeding her baby: You need to understand the basic principles of breastfeeding, e.g. the phenomena of supply and demand and the importance of correct positioning and latch-on.

The most urgent problem with multiples is not the milk supply but time. Therefore you should learn to feed your babies at the same time. Feeding your babies simultaneously will safe time. Ask your lactation specialist for help to learn different positions that allow feed more than one baby at the time in a comfortable manner.

Going back to work

Not every mother can be a stay-at-home mother for a long time. But even if you have to go back to work rather soon after birth you can breastfeed. With some advance planning, it is possible to successfully combine work and breastfeeding.

Try to stay at home as long as possible. If you delay starting working outside home until breastfeeding is well established – usually after four to six weeks - this enhances the chance for successful breastfeeding.

About two weeks before you return to work it is useful to learn to express your milk and to know how to store it. Ask your lactation specialist about correct and efficient expressing of your milk. Start to build up a supply of expressed breastmilk. You will have a better feeling if you have some milk on stock when you start working.

Look for opportunities to express and store your milk at your workplace.

Choose a babysitter or caretaker that supports your wish to breastfeed and allow enough time to get your baby accustomed to the babysitter.

Let somebody else introduce the bottle to your baby or try alternative feeding methods to feed your baby while you are away.

Look for clothing that facilitates breastfeeding or pumping.

Try to arrange for part-time or flex-time work

Health issues

Sometime you may face special situations. You or your baby may have medical complications; you might be separated from your baby and fear for the well being of your little one. But even in such a difficult situation you may begin or continue to breastfeed or expressing your milk.

Breastfeeding and your milk provide optimal nutrition and other benefits for your baby even or especially if special health care might be needed.

Health issues with baby

If your baby is born with a cleft lip or palate, if he has a neurological impairment or suffers from other medical problems, your milk will most probably be the best nutrition available. And only you can provide your milk for him.

There are only few very rare conditions where a baby is not allowed to have breastmilk or can not be feed only with breastmilk.

Health issues with mother A lot of people think that if a mother is ill, she cannot breastfeed. But this is not true. Weaning is rarely necessary when a breastfeeding mother is ill and often times it is far easier to breastfeed. Breastfeeding saves time and energy. In most cases it is possible to find medications that are compatible with breastfeeding.

If it will happen that you fall sick, in most situations there will be a solution to save your breastfeeding relationship. Sometimes it might be necessary to temporarily interrupt breastfeeding but it is possible to resume breastfeeding even after a break.

Ask your health care professional and your lactation specialist for help in such special situations.