As natural as we are all told breast feeding is, it is important to remember that it doesn't always come easy for a new mom or baby. Here are the top 5 most common problems mothers face with breast feeding and tips from our Lactation Counselor, Susan Cohen.
Engorgement
Pain swollen breasts, happen to most women when their milk "comes in" which is typically three to five days after birth. Engorgement typically lasts for a day or two and then subsides.
We are commonly asked what mothers can do to help with the discomfort they often experience during these early days:
- Use heat and massage before pumping or nursing followed by ice or cool cabbage leaves afterwards
- Take warm showers or do warm baths to help relax the breast and then massage them to allow the milk to flow.
- Ibuprofen can help with pain relief as well
Know that even though your breasts may feel full, it is normal for breast production to be low during the first few days and then increase. If you start to experience flu-like symptoms, please call your provider.
Low Milk Supply
One concern we hear from parents a lot is, is my baby getting enough milk? Here are some indications your baby is eating enough:
- You are breast feeding on demand 8-10 times/day or pumping 7-8 times/day (or a combination of pumping and breastfeeding)
- Your baby is making 6-8 wet diapers per day, having yellow, curdy stools and gaining weight
- Moms who pump breast milk can expect 1 oz total at each pump session by the end of the first week post-partum and 2-3 oz per session after 2-3 weeks.
If you do not pump or nurse at night or if you offer bottles and don't pump at that time to keep up your supply, your supply may decrease. As a rule of thumb: the more you pump or breastfeed, the more milk you will make. Some things that can affect your milk supply are: decongestants, breast reductions, PCOS or thyroid disease.
Sore/Cracked Nipples
Breastfeeding should not be painful and pain with breast feeding may mean that the baby is not latching properly. The baby's mouth should cover your areola (the brown skin around your nipple), not just be latched on the nipple. In order for milk to be released, your baby needs to pull on the ducts behind the nipple to release milk and needs a wide open mouth to get a deep latch. To help accomplish this, remember to bring your baby to the breast, not to put your nipple in the baby's mouth.
Other causes of sore nipples can include:
- A yeast infection on the nipple - This is a condition that can be treated by your provider
- Baby's tongue tie - This is a condition diagnosed by your provider
- Flat nipples - This can make it hard to center the breast in the baby's mouth. A nipple shield can help as well as a manual hand pump for inverted nipples
- Too much pressure on a breast pump - Remember to only turn the pump pressure up as high as is comfortable and productive
Painful Breasts
When your baby latches, it may initially be painful but if the pain persists or comes back after the engorgement phase, there may be a problem.
- Red, painful breasts may indicate mastitis -- an infection of the breast that will required antibiotics to treat. This does not affect milk quality so it is recommended to keep pumping or nursing to ensure your supply stays up.
- A clogged milk duct can be relieved with warm compresses and massage while pumping of breast feeding on that breast.
- Avoid underwire bras as these can lead to clogged milk ducts. Keep your breasts as empty as you can by using hand massage while you pump and by nursing early and often.
Where Can I Turn for Reliable Information on Breast Feeding?
We know that between corporate promotions, social media and blogs, it can be confusing to make sure your source for health care information is reliable. We recommend these reliable resources for accurate and research-based information:
- Our certified lactation counselor at Cherry Creek Pediatrics
- Stanford University - offers helpful videos on breastfeeding in the first hour, latching, hand-expressing milk and much more
- New Mother's Guide to Breastfeeding - a book published by the AAP
(has up-to-date information on how to establish a breastfeeding routine, as well as troubleshooting tips)