While nursing your baby is a natural process, it’s also a learned art – information and support are essential for ensuring you can deal with any difficulties and actually enjoy the experience.
“Breastfeeding takes time and effort – and sometimes pain – but it’s well worth learning,” says Dr Nan Jolly, an international board-certified lactation consultant (IBCLC) and La Leche League leader.
Dr Jolly lists these common breastfeeding challenges moms experience when breastfeeding. Here’s her advice on what you can do to overcome these:
Breast engorgement means your breasts are painfully overfull with milk. This can be very stressful if you’re anxious about successfully feeding your baby and painful if you’re still recovering from your 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.
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. You don’t need to wash it off, but ensure you use it sparingly.
- Expose your nipples to the sun for a few minutes in the early morning or late afternoon, and don’t wear a bra for about 10 minutes after each feeding session, as fresh air well helpthem recover.
- Massage a little breast milk into the affected area.
- Use a safe pain reliever recommended by your doctor or pharmacist if necessary.
Blocked ducts and mastitis
A blocked duct, which is literally a blockage in the fine ducts of the breasts, sometimes leads up to mastitis. It’s the build-up of milk behind the blockage, which causes pain and the lump you can feel. Usually you won’t have a fever.
- Massage over the area towards the nipple and areola while your baby is sucking. This isso that you get the benefit of ‘push and pull’ to relieve the blockage. You can also put cold packs on your 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 your 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 6-8 to weeks. After that your supply should stabilise.
Stabbing pains in your breasts, sore and tender nipples or white patches on the inside of your baby’s cheeks (can 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 basically a 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.
- Don’t douche.
- Eat an unprocessed diet, focused on fresh fruits, vegetables, wholegrains, raw nuts and seeds. Include live-culture yoghurt, too.
- Consult your doctor as soon as possible.
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.
If you have inverted nipples, where the nipple retracts into the breast instead of pointing out, it’s important to see someone before delivery of your baby so that you can get help with breastfeeding.
- If your baby can’t latch, the most important thing is not to use nipple shields in the first 3 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.
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,” says Brenda Campbell, international board-certified lactation consultant, nurse and midwife. She says less than 1% of moms won’t make enough milk for their baby, but often moms who think they don’t have enough milk, start supplementing their babies’ feeds with formula. “This can damage your milk supply,” Brenda cautions moms.
- 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 your baby has to feed against the force of gravity. Lying on your side may also be helpful.
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.