Brenda Campbell, International Board Certified lactation consultant, nurse and midwife gives expert advice on how to overcome common breastfeeding challenges:
- If you have inverted nipples, where the nipple retracts into the breast instead of pointing out, it’s important to see someone prior to delivery in order to get assistance with breastfeeding.
- If your baby can’t latch, the most important thing is not to use nipple shields in the first three weeks, as these suppress milk supply. Initially, you should manually express and then pump to get your supply well established and then consider seeing a lactation consultant, who will assist you to breastfeed your baby.
Blocked ducts and mastitis
- A blocked duct, which is literally a blockage in the fine ducts of the breasts, sometimes precedes mastitis. There is a build-up of milk behind the blockage, which causes pain and a lump that you can feel. Usually you won’t have a temperature.
- If you have a blocked duct, massage over the area towards the nipple and areola while the baby is sucking, so that you get the benefit of ‘push and pull’ to relieve the blockage. You can also put cold packs on the breast to relieve the discomfort.
- If this develops into mastitis, you’ll probably run a temperature, feel feverish and have flu symptoms like aches and pains. This is an infection in the breast and may require antibiotics. However, if you contact a lactation consultant early – within the first 24 hours – antibiotics can often be avoided.
- You’ll need to go to bed, drink plenty of fluids and feed your baby on the infected side first in order to drain the breast thoroughly. There’s no harm in your baby nursing from the infected breast. But if your baby isn’t nursing effectively, you may need to pump to completely drain the breast.
- Untreated mastitis can lead to an abscess in the breast tissue, which may require the assistance of a breast specialist. So it’s important to get help immediately if you’re suffering from mastitis.
- Both these conditions are linked to fatigue or to skipping feeds at night before lactation is properly established. Don’t skip feeds in the first six to eight weeks. After that your supply should stabilise.
- Thrush is an opportunistic organism that thrives in moisture and warmth so when you’re breastfeeding, it’s possible to get it on your nipples and areola and in your baby’s mouth and gut.
- If you have intense itchiness on your nipple, and they’re shiny pink and go on to become painful when the baby latches, you’ll need to treat your breasts and your baby’s mouth and bum with the appropriate treatment. Try to reduce sugar intake, white bread, and ‘jungle juice’. Consult a lactation expert as soon as possible.
Not enough milk
- Rest in the first few weeks after birth is extremely important as stress can hinder the body’s ability to release breast milk. The fact is, less than 1% of mothers won’t make enough milk for their baby. But mothers, who often think they don’t have sufficient milk, start adding formula for their babies which can damage their milk supply.
- If, for some reason, you have low milk supply, a lactation consultant will advise you on a pumping regime to stimulate your breasts to produce more milk. There are several homeopathic and allopathic remedies which can also help.
High milk supply
If you have an abundant supply of milk, you may find your baby chokes easily or gulps at feeding time. Try lying back on a couple of pillows so that your baby has to feed against the force of gravity. Lying on your side may also be helpful.
Improper latching, cracked and bleeding nipples
- If your baby doesn’t grasp your nipple and areola comfortably, or if your nipples are cracked or bleeding, get assistance from a lactation consultant as soon as possible. If left too long, nipples can be severely flattened and milk supply may be reduced.
- The best remedy for painful nipples is your breast milk. A lactation consultant may also recommend an appropriate cream to speed up healing.
- Sometimes it’s a matter of guiding you and your baby to a better latching position, but there could be an underlying cause, such as tongue ties, when the frenulum connecting the tongue to the bottom of the mouth, or the top lip to the gum, prevents the baby from opening his mouth and latching properly. This condition is easily resolved with a visit to a good paediatric surgeon– and the sooner after birth, the better – for a quick and almost painless release of the frenulum.