Common Breastfeeding Problems
Sore Nipples
Most women are surprised when they begin breastfeeding, it’s all a bit more painful and complicated then what they were prepared for. It all seems so easy!
Breastfeeding is a skill that is learned and takes time to get the hang of. It also takes time for your baby to learn how to feed and this starts at birth.
Women attempt their first breastfeed in a way they have traditionally learned through family, friends and media. This is often uncomfortable and a position that isn’t the most optimal for baby or mother. This leads to the nipple getting squashed by the baby’s mouth as they feed. The nipple becomes damaged and painful and can sometimes bleed. Ouch!
The most common reason for sore nipples in the first couple of days after birth are usually related to the attachment of the baby to the breast and the frequency of feeding.
The top ways you can assist sore nipples:
Baby led-attachment - Place baby skin to skin on your chest and allow baby to crawl to the breast and self-attach. This allows baby to smell and feel the breast as they find the nipple leading to a better attachment.
Change positions – If you are feeding in the cradle position, why not change to the football? Switching positions changes the way the baby’s mouth attaches to the breast and can assist with sore nipples.
Check your baby’s attachment to the breast – is the baby’s mouth around the edge of the nipple and not sucking on the end? Did you attach when the baby opened their mouth wide? Can you hear the baby swallowing the milk?
Cracked Nipples
Frequent feeding and sub-optimal positioning and attachment can often lead to cracked nipples. Nipples will need time to heal so that you can continue your breastfeeding journey.
We recommend:
Feeding the baby according to feeding cues – licking, searching, sucking.
Squeezing colostrum onto the nipple before and after feeds to assist healing.
Ensure correct baby attachment technique whilst breastfeeding.
You can apply products such as nipple creams and hydrogel discs as per manufacturer instructions. Note: Some creams require the nipple to be washed prior to feeds.
Once applied, allow the nipples time to dry. Drying is important as this prevents infection.
Please Note: Sometimes with cracked nipples you may experience bleeding. Blood can be transferred to the baby whilst breastfeeding. This may look scary, but it is perfectly safe for the baby to have.
Full Breasts
Around Day 3-4 after birth, you may start to notice your breasts are filling and feeling fuller then usual. This is known as your milk ‘Coming in’.
When your milk comes in you may notice:
Your nipple and the area around your nipple (areola) becomes darker
Breasts feel firm and lumpy to touch
Baby is unsettled and wanting to feed frequently which is normal
Baby has loose bowel motions
Breastfeeding with full breasts:
Get into a good position – being in a good position always helps
Express off before the start of a feed- hand express around the areola to shape the nipple easily for the baby’s mouth.
Feed from both breasts – If you feed from one breast, try offering the second breast or expressing a small amount.
Alternate breasts – if the first feed is from one side (Right), Offer the other side (left for the second feed)
Between Breastfeeds
Use a heat pack or a warm shower, then massage – this helps to soften the breasts and move lumps
Express some milk – Sometimes you may have to express a small amount of breast milk off after to feed to relieve discomfort
Wear a comfy bra – a supportive bra with no underwire will help with breast fullness
Apply cold after breastfeeding – a cold pack on the breasts for a few minutes assists with discomfort. Midwife tip: Fill x2 nappies with water and put into the freezer, then apply to breasts.
What’s that lump under my arm when I’m breastfeeding?
Some mothers have extra breast tissue in their arm pit. This can become swollen if the breasts are full. Apply cold pack to relieve discomfort, if concerned seek medical attention.
Low Milk Supply
Worrying about milk supply is a common problem, particularly when you begin breastfeeding.
If there is true low supply, it’s a temporary situation that can be improved with the right techniques and support. Seek advice from your midwife, a lactation consultant, a Maternal Child Health Nurse or GP.
How do I know my baby is getting enough milk?
Following the first week:
Babies are waking for feeds on their own.
Settled between feeds.
Having 6-8 soaked nappies in 24 hrs.
Passing a yellow stool daily.
Possible causes of low milk supply
Baby is not attaching well at the breast and milk transfer is reduced. Nipple pain and damage might also be present.
Baby isn’t feeding often enough – most babies feed between 8-12 times in 24 hours.
You have introduced formula milk as well as breastfeeding.
A breast surgery that can affect milk supply – more commonly a breast reduction.
Recent diagnosis of mastitis.
How do I increase my milk supply?
Increasing milk supply can take time, it involves frequent stimulation and emptying of the breasts. It is important that you seek support and advice from a midwife, lactation consultant or Child and Family Health Nurse.
Placing baby skin-to-skin – this helps to stimulate the hormones responsible for making milk whilst keeping baby awake (Baby should be in nappy only so there is direct contact with the skin).
Frequent feeds – Baby should be feeding at least 8-12 times daily (usually about 2-3hrly). You may need to wake your baby to feed more often. Tip: Baby will feed more frequently in the early hours of the morning as this is when the milk-making hormone (prolactin) is the highest!
Attachment – Make sure the baby’s attachment to the breast is good. You should be able to hear suck and swallow if the baby is feeding well. Tip: You could try ‘switch feeding’ to encourage the baby to wake and drain your breast more efficiently.
Expressing – express after feeds to encourage further stimulation to the breasts. Ensuring the breasts are drained effectively will increase milk supply.
Compression – massaging the breast as the babies feeding assists with drainage and flow.
Medication – this is usually a last resort, but some medication can assist with milk supply. Discuss with your lactation consultant or doctor about this.