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Overcoming breastfeeding problems

Definition

Problems with breastfeeding are common in new mothers. Most problems can be easily treated or solved. If you have a breastfeeding problem, contact a lactation consultant. This is a person who specializes in breastfeeding.

Alternative Names

Plugged milk ducts; Nipple soreness when breastfeeding; Breastfeeding - overcoming problems; Let-down reflex

Recommendations

Breastfeeding (nursing) your baby can be a good experience for both mother and baby. It takes time and practice to get comfortable with breastfeeding. Things you can do to help the process include:

NIPPLE SORENESS

It is common to have some discomfort when your baby begins feeding in the first few days or weeks. Some breastfeeding mothers say nipple soreness feels like a pinching, itching, or burning sensation. This discomfort will go away over time.

Nipple soreness may be caused by many things, including:

For many women, there is no clear cause of nipple soreness. A simple change in your baby's position while feeding may ease soreness.

You might have sore nipples if your baby keeps sucking as he or she comes off the breast. You can help your baby learn to let go by gently inserting a finger into the side of the mouth to break the suction.

Skin that is too dry or too moist can also cause nipple soreness.

Some baby's chew or bite on the nipples when they start teething.

BREAST ENGORGEMENT OR BREAST FULLNESS

Breast fullness is the slow buildup of blood and milk in the breast a few days after birth. It is a sign that your milk is coming in. It will not prevent you from breastfeeding.

Breast engorgement is caused by back up in the blood vessels in the breast. The breasts are swollen, hard, and painful. The nipples may not stick out enough to allow the baby to latch on correctly.

The let-down reflex is a normal part of breastfeeding. Milk made in the milk glands is released into the milk ducts. Pain, stress, and anxiety can interfere with the reflex. As a result, milk will build up. Treatment includes:

Nursing often (8 times or more in 24 hours) and for at least 15 minutes at each feeding can also prevent engorgement.

Other ways to relieve breast engorgement:

NOT ENOUGH MILK FOR THE BABY'S NEEDS

The mother's supply is based on the baby's demand for milk. Frequent feedings, adequate rest, good nutrition, and drinking enough fluids can help maintain a good milk supply.

Checking weight and growth frequently is the best way to make sure your baby is taking enough milk. Talk to your health care provider if you are concerned about how much milk your baby is getting.

PLUGGED MILK DUCT

A milk duct can become plugged. This may happen if the baby does not feed well, if the mother skips feedings (common when the child is weaning), or if the mother's bra is too tight. Symptoms of a plugged milk duct include:

Sometimes, a tiny white dot can be seen at the opening of the duct on the nipple. Massaging the area and putting gentle pressure on it can help to remove the plug.

BREAST INFECTION

A breast infection (mastitis) causes aching muscles, fever, and a red, hot, tender area on one breast. Call your provider if you develop these symptoms.

Breast infections often occur in mothers who:

Treatment often includes:

Continuing to nurse from the affected breast will help healing take place. Breast milk is safe for the baby, even when you have a breast infection.

THRUSH

Thrush is a common yeast infection that can be passed between the mother and the baby during breastfeeding. The yeast (Candida albicans) thrives in warm, moist areas.

The baby's mouth and the mother's nipples are good places for this yeast to grow. Yeast infections often occur during or after antibiotic treatments.

Symptoms of yeast infection in the mother are deep-pink nipples that are tender or uncomfortable during, and right after, nursing. White patches and increased redness in the baby's mouth are symptoms of a yeast infection in the baby's mouth.

The baby may also have a diaper rash, a change in mood, and will want to suckle more frequently. Call your provider to get a prescription for an antifungal medicine for affected members of your family.

ILLNESS

If you develop a fever or illness, contact your provider. You can safely continue breastfeeding during most illnesses. The baby is likely to benefit from your antibodies.

References

Newton ER. Lactation and breastfeedng. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 23.

Payne PA, Tully MR. Breastfeeding. In: Ratcliffe SD, Baxley EG, Cline MK, Sakornbut EL, eds. Family Medicine Obstetrics. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2008:section C.

Stettler N, Bhatia J, Parish A, et al. Feding healthy infants, children, and adolescents. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 42.


Review Date: 8/30/2014
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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