When things go wrong, breastfeeding can become painful and joyless. You’ve probably heard stories about, or experienced, cracked nipples, blocked ducts or alarming lumps the size of golf balls.
While nursing your baby is a natural process, it’s also a learned art – information and support are essential for ensuring enjoyment and dealing with potential difficulties.
“Breastfeeding takes time and effort – and sometimes pain – but it is well worth learning,” explains Dr Nan Jolly, an International Board Certified Lactation Consultant (IBCLC) and La Leche League leader.
She says women aren’t prepared for breastfeeding, since most health professionals do not receive specialised training in this field.
Incorrect latching and positioning are at the root of most breastfeeding challenges, so sorting these out early is vital. Feeding your baby on cue, not according to a schedule, and breastfeeding as soon as possible after birth are also crucial factors for success.
Having rocks on your chest is no picnic – especially if you’re anxious about successfully feeding your baby or still recovering from the birth.
- Empty your breasts regularly by demand feeding. This means you shouldn’t establish a feeding schedule in the early months.
- Don’t time feeds – babies are individuals and some need more milk than others. Breastfed babies can nurse up to 12 times in a 24-hour period, at different times and at varying lengths.
- After your baby has fed from both breasts, empty any excess milk by massaging your breasts firmly but gently downwards towards the nipple.
- Alternate between cold and warm compresses to increase your milk flow.
- Take a cabbage leaf out of the fridge, or dunk it briefly in just-boiled water, make a hole for your nipple, and tuck into your bra. Change it every few hours.
2. Nipple nightmares
Incorrect latching is usually the cause of red, painful and cracked nipples. If you’re having trouble holding your baby correctly and he’s struggling to latch, speak to a La Leche League leader, midwife or IBCLC to master your technique.
- If your nipples are cracked, massage a small amount of nipple cream into them after each feed. This doesn’t need to be washed off and must be used sparingly.
- Expose your nipples to non-midday sun for a few minutes, and don’t wear a bra for about 10 minutes after each feeding session, as fresh air aids recovery.
- Massage a little breast milk into the affected area.
- Use a safe pain reliever recommended by your doctor or pharmacist if necessary.
3. Misbehaving milk ducts
Tender or sore masses on your breasts are usually caused by blocked milk ducts. To prevent this, feed on cue and express between feeds to prevent engorgement.
Stabbing pains in your breasts, sore and tender nipples or white patches on the inside of your baby’s cheeks (which can’t be scraped away) may indicate a thrush infection.
Both you and your baby will need to be diagnosed and treated by your healthcare provider, since thrush is easily spread during breastfeeding.
Thrush is yeast overgrowth and can be caused by diabetes, cortisone, the contraceptive pill, tight clothing, perfumes, an impaired immune system, antibiotics and even pregnancy.
- Wear cotton underwear and avoid scented products.
- Do not douche.
- Eat an unprocessed diet, focused on fresh fruits, vegetables, wholegrains, raw nuts and seeds. Include live-culture yoghurt.
- Consult your doctor as soon as possible.
5. Strange lumps and bumps
There are several masses that may cause discomfort. Consult your healthcare provider before attempting any remedies.
- Galactoceles are nodules caused by blocked milk ducts. However, they usually don’t appear until weaning. If they don’t disappear on their own, they can be aspirated by your doctor.
- Milk blisters are caused by milk collecting underneath a thin layer of skin over a milk duct. To treat them, soak the area in olive oil or Epsom salts, and follow with a hot compress before a feed. The blisters usually burst without interference, but you can gently scratch the skin with a clean fingernail between feeding.
- Montgomery glands (found in the areolae) may become infected through pressure or a scrape or cut. Breastfeed as much as possible, place your breast in warm water before feeds, and gently massage the lump.
This is a breast infection requiring prompt medical treatment. If you do not address the problem, it may result in a breast abscess.
Symptoms of mastitis include a shiny, hot, red and painful area on one breast, chills, nausea, fever or fatigue. Causes include engorgement, blocked milk ducts and damaged skin in the nipple area.
- Your doctor will prescribe antibiotics and rest.
- Continue to breastfeed, starting with the breast that is not infected. When you feel a let-down reflex, switch to the infected breast, as the faster milk flow will make it easier to handle the pain.
- If you are diagnosed with an abscess, a lactation consultant will be able to help you continue breastfeeding during this painful period.
Beth Cooper Howell is a freelance journalist based in the Eastern Cape. She has a keen interest in holistic health and progressive parenting. She has written a book on breastfeeding, enjoys interviewing experts on cutting-edge parenting topics and believes that nothing beats being barefoot in the veld.