Breastfeeding. It’s one of those things mums-to-be often assume comes as naturally as breathing.
Out pops baby and onto the breast they go. The start of a dreamy journey of snuggly feeds and general newborn gazes.
Let’s pause right there for a moment. We’ll brush over the ‘out pops baby’ bit (because the idea of anything the size of a baby’s head just ‘popping’ out of something the size of a large lemon is #hilarious) but milky bubble of breastfeeding? It’s not always that easy. And continuing the myth does a huge disservice to new mums.
Breastfeeding, especially initially, can be tough. It doesn’t always come naturally. It can be stressful with questions like ‘Is my baby getting enough milk?’ and ‘Am I doing this the right way?’ cropping up. For some women, it can be painful. Cracked nipples and engorged breasts are no fun for anyone.
Fortunately, most breastfeeding problems can be overcome with patience, persistence and the right advice.
Here are the four most common breastfeeding problems new mums face and how to fix them.
The problem? Pain while feeding
Pain while feeding is a biggie. It’s a commonly perpetuated idea that the early days of breastfeeding are always painful. And while a certain amount of discomfort is to be expected (your nipples generally aren’t used to having a ravenous sucking machine attached every two to three hours), intense pain is not. Nor is cracked and/or bleeding nipples or nasty blisters.
When these things occur, there is something wrong with the way baby is latching onto the breast. When it comes to breastfeeding, ‘the latch’ is pretty much the most important thing to nail as quickly as possible. A ‘good latch’ means that baby is getting a decent mouthful of nipple and breast and is able to extract milk efficiently. It’s also generally pain free. A ‘poor latch’ usually means that baby is attached in a shallow way, perhaps only sucking the nipple and unable to remove milk as efficiently. This often means they need to clamp down or suck harder causing pain and nipple damage.
Get professional help from Day One. Breastfeeding is a learnt skill. Most maternity hospitals have a Lactation Consultant on staff. Ask to see them and explain the issues you’re having. If you’ve left hospital, get in touch with the Australian Breastfeeding Association or hire a Lactation Consultant privately to visit you at home. The key is getting to the bottom of the problem early. This will minimise damage and help you build your confidence.
The problem? Milk supply
Many new mothers worry that they don’t have enough milk. This usually coincides with their baby experiencing a fussy period where parents wonder if baby is hungry. With breastfeeding, unlike bottle feeding, you can’t see exactly how much baby is getting which can lead to stress. The good news? Most women are capable of making enough milk to nourish their baby. Again, breastfeeding and gauging how much milk you’re producing is a learnt skill. It takes time to build confidence.
There are a number of easy ways to tell whether baby is drinking enough. The Australian Breastfeeding Association recommends looking for the following indicators:
- At least six very wet cloth nappies or at least five very wet disposable nappies in 24 hours. The urine should be odourless and clear/very pale in colour. Strong, dark urine suggest that the baby needs more breastmilk and you should seek medical advice.
- A young baby will usually have three or more soft or runny bowel movements each day for several weeks. An older baby is likely to have fewer bowel movements than this. Formed bowel motions suggest that the baby needs more breastmilk and you should seek medical advice.
- Some weight gain and growth in length and head circumference.
- Good skin colour and muscle tone. Does she look like she fits her skin? If you gently ‘pinch’ her skin, it should spring back into place.
- Your baby is alert and reasonably contented and does not want to feed constantly. It is however normal for babies to have times when they feed more frequently. It is also normal for babies to wake for night feeds. Some babies sleep through the night at an early age while others wake during the night for some time.
The problem? Engorgement
Overfull, swollen breasts are not fun for anyone. Engorgement is very common when establishing breastfeeding, especially when your ‘milk comes in’ during the first few days after birth. That doesn’t make it any less uncomfortable though! Engorgement can lead to issues with latching as baby struggles to get a good mouthful of breast tissue. Continual engorgement can also lead to blocked ducts and mastitis so it’s important to get it under control quickly.
Some level of engorgement in the first weeks of breastfeeding is very normal. To help relieve the pressure, the ABA recommends the use of heat before feeding, feeding baby regularly, gently massaging the breast tissue to help the milk to move and using cold packs or chilled, washed, cabbage leaves after a feed to reduce inflammation. It’s also important to ensure you’re wearing a comfortable, supportive and well fitted nursing bra as tight fitting underwires can cause blockages and further discomfort. You can also try hand expressing a small amount of milk before feeding to soften the area and make it easier for baby to latch.
If continued engorgement is an issue, it’s worth seeking professional advice to uncover the root of the problem. The ABA or a private Lactation Consultant can help you get the issue under control.
The problem? Infection
For some women, issues establishing breastfeeding can lead to complications, namely mastitis or thrush. Mastitis is an inflammation in the breast tissue which is often caused by a blocked milk duct that hasn’t cleared. It usually occurs when the breasts have not been emptied properly, leading to a build up of milk and an eventual blockage. Mastitis can come on suddenly with women often reporting that they feel like they may be getting the flu. A red patch on the breast or visible lump may also be present. Nipple thrush is often the result of nipple damage which has allowed the Candida albicans organism to enter the tissue. The most common symptoms are burning, itching, or stinging in the nipple itself. In other words; OUCH!
Mastitis and nipple thrush can be treated effectively but are common breastfeeding problems that require medical intervention, especially mastitis, which can get worse very quickly. If you think you have the beginnings of mastitis the ABA recommends the following:
- Rest as much as you can
- Keep the sore breast as empty as possible by feeding your baby often
- Apply warmth to the sore area before a feed
- Feed from the sore breast first, when your baby’s sucking is stronger
- Massage the breast gently while your baby feeds
- Change feeding positions to help shift the blockage
- Talk to an Australian Breastfeeding Association counsellor for ideas on other feeding positions
- Express if needed, before, after and between feeds
- Cold packs after a feed may help relieve pain and reduce swelling
- Gently massage the affected area towards the nipple while in the bath or shower
If you’ve tried all the above strategies and things aren’t improving, or if it’s only been a few hours and you are feeling very unwell, see your GP as soon as possible in case you need antibiotics to stem the infection.
With nipple thrush, it’s important to recognise the issue and treat both yourself and your baby to prevent the infection transferring back and forth between you both. The Royal Women’s Hospital recommends the following:
- Treat your baby’s mouth using an oral gel or drops.
- Use an antifungal medicine and antifungal nipple gel/cream on yourself to treat the cause and symptoms.
- Make sure you treat any other site of fungal infection in the whole family, i.e. vagina, nappy rash, feet.
- Keep your nipples dry by frequently changing breast pads as thrush grows well in a moist and warm environment.
- Clean teats and dummies thoroughly after use and boil for five minutes. Replace weekly if possible.
- To prevent the spread of thrush, wash your hands thoroughly after nappy changes and before and after applying any creams/lotions.
- Wash towels, bras and cloth nursing pads in hot soapy water and air dry outside.
For help with breastfeeding in Australia, contact the National Breastfeeding Helpline on 1800 686 268.
If you’re already nailing it, take a look at our hilarious post about the thoughts that go through a mum’s head while breastfeeding.