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Common Breastfeeding Problems

Solutions to sore nipples, infections, and more, plus resources for breastfeeding moms.

WebMD Feature

Reviewed By Charlotte Grayson

Common Breastfeeding Problems
Solutions to sore nipples, infections, and more, plus resources for breastfeeding moms.

Whether you are an experienced mom who has breastfed before, or a new mother nursing for the first time, you may run into a number of common problems.

 

Although most are not serious enough to keep you from breastfeeding, some can make breastfeeding a more uncomfortable and less fulfilling process for you and your baby.

 

The good news: Often you only need make a few minor adjustments in technique or style to get your body and your baby in perfect sync. "Breastfeeding should be a pleasurable experience for both mother and baby. If it's not, then it's important to identify the problem early on and make whatever changes are necessary," says Pat Sterner, a lactation counselor at the Mount Sinai Medical Center in New York.

 

Some of the more common breastfeeding problems ? and solutions ? follow.

 

Sore Nipples

 

"Many women find that their nipples not only feel sore after every feeding, they are red and pointy instead of round and smooth -- all indications that your baby is not 'latched on' properly," says Sterner.

 

The "latch" as experts call it, is the way your baby connects to your breast. When done correctly, your baby will open his or her mouth very wide and take in a good deal of breast tissue. This means that your nipple ends up way in the back of your baby's mouth where the hard and soft palates meet.

 

"When your nipple is sitting way back there in the hollow, there is nothing to pinch, so it should not cause any nipple soreness at all," Sterner tells WebMD.

 

If, however, your nipple is sitting in front of your baby's mouth, you're going to feel the pinch every time baby's tongue comes up -- and baby is not going to have an easy time feeding.

 

The solution, says Sterner, is to insert your finger into the corner of your baby's mouth to break the latch as soon as you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola into the mouth.

 

Experts say you can further ease pain by avoiding the use of soap on your breasts, which can be drying and irritating. Instead, wash with plain water. You might also want to let some milk air dry on your breast after feeding, which can help reduce some inflammation and soreness.

 

To keep nipples soft and supple, try any of the lanolin-based creams specifically for nipple inflammation, such as Lansinoh, Belli Cosmetics Pure Comfort Nursing Cream, or PureLan 100 Nipple Cream by Medela.

Next: Infections or Painful Lumps.

Infections or Painful Lumps  

Even when your baby is latched on correctly, you may develop a sore or tender spot in your breast, or even a painful lump. Says lactation expert Carol Huotari, this commonly results from a plugged milk duct, or the beginning of an infection known as mastitis.

 

"Either problem can be easily remedied, and you don't have to stop breastfeeding in the meantime. It's perfectly safe to continue, even when an infection is present," says Huotari, manager of the Breastfeeding Information Center at La Leche League International in Schaumberg, Ill.

 

If the pain is from a blocked milk duct, experts at La Leche say you should apply moist or dry heat compresses to your breast for 10 minutes, three times a day. Also, massage your breast in a warm shower. As the duct unplugs, you may express some milk, which helps relieve pain. Continuing to feed on that breast is important because breastfeeding helps further open the milk ducts, says Huotari.

 

Though early treatment will usually prevent a plugged duct from becoming infected, this is not always the case. So if you have pain and tenderness and also find you are fatigued, running a fever, and have some flu-like symptoms, you might have a breast infection.

 

Normally, says Huotari, the same method used to treat plugged ducts works for an infection -- heat packs, along with bed rest. If your fever does not break in 24 hours, however, you may need an antibiotic to stem the infection. Call your doctor. In the meantime, experts say don't stop breastfeeding.

 

"Although it may seem counterintuitive to breastfeed while you have an infection, because breast milk contains such a high level of antibodies, your baby is safe," says Huotari.

 

Yeast Infections or Thrush

 

Yeast infection is a less troubling but still uncomfortable condition on the surface of the breast skin. This problem can develop even after weeks or months of successful nursing. The culprit is thrush, a form of yeast infection that thrives on milk. This infection will likely affect both you and your baby.

 

Signs of thrush include red or pink shiny skin that usually itches, and may flake or peel, says pediatrician Audrey Naylor, MD. To learn if your baby is infected, look for white spots on the inside of the cheeks, or sometimes a persistent diaper rash.

 

You might also find that you have symptoms of a vaginal yeast infection -- a clumpy white discharge and extreme itchiness.

 

If you do have a breast yeast infection, Naylor says you don't have to stop breastfeeding. But you and your baby do need treatment.

 

"See your doctor and let her or him make a recommendation for treatment. Don't try to buy a drugstore product and treat the infection yourself," says Naylor. While some products are safe to use while breastfeeding, others are not. Only your doctor will know for certain what is right for you and your baby.

Next: Engorged Breasts.

Engorged Breasts

 

Engorgement is normal and can develop when your milk begins to flood your breasts, usually between the second and sixth day after you start nursing your baby.

 

"Once milk starts to come into the ducts, there is also a flooding of lymph fluid and blood, which causes the tissue in the breast to swell," says Sterner.

 

Because that swollen tissue pushes down on the milk ducts, the ducts can sometimes clamp shut. When milk can't be expressed, it builds up inside the breast and engorgement occurs.

Sterner says your best solution is to place cold packs on the breast, along with clean washed cabbage leaves. Leave these on your skin for about 20 minutes. Both can help reduce the swelling and allow the ducts to open.

 

"Right before you are ready to nurse, put a warm pack on your nipples for a few minutes -- this will also help with the 'let down' [milk flow] and can encourage feeding," says Sterner.

 

Showers are not recommended when you have engorged breasts, warns Sterner. The warm, pounding water can dilate blood vessels, increasing the swelling and congestion in your breast.

"Most important is to keep on nursing," Huotari tells WebMD. "The more milk that is expressed, the less chance you have of engorgement."

 

Resources for Nursing Mothers

 

Nursing mothers are often surprised to discover how little their obstetrician or pediatrician knows about breastfeeding problems. Lactation consultant Katy Lebbing, IBCLC, says that as recently as the mid-1990s, a full 50% of medical schools were graduating doctors without a single day's training on breastfeeding.

 

In one study published in the American Journal of Preventative Medicine, the obstetrical staff of a California hospital answered just 53% of the questions correctly on a simple 15-minute quiz about breastfeeding. Only 14% of the doctors said they felt confidant about their knowledge on this subject.

 

If you have questions concerning any aspect of breastfeeding, including medical issues about your breast health, you'll often get the right answers fastest by contacting a lactation counselor.

Usually, the hospital where you delivered your baby will have at least one lactation counselor on staff. This counselor may have even visited you shortly after you gave birth to help you begin breastfeeding.

 

Most lactation counselors are also available for at-home consultations after you leave the hospital. If this isn't the case, they can suggest private practice lactation experts to help you.

 

Although many people experienced with childbirth, such as doulas and midwives, may be able to help you with breastfeeding, try to find lactation consultants with the initials IBCLC after their names. This stands for International Board of Certified Lactation Consultants.

 

An alternate credential is RLC -- for registered lactation counselor. Both credentials mean the counselor has received special training and has certified expertise in breastfeeding.

 

The following organizations can help you find a lactation counselor in your area:

  • Le Leche League International. The oldest name in the breastfeeding arena, this worldwide organization has counselors and group leaders nationally and internationally. To access its huge database of experts, visit the web site: www.laleche.org. Or call (800) LALECHE. You can also try your local telephone directory under La Leche League, where you might find a local chapter.

  • International Lactation Consultant Association. This group helps train lactation consultants worldwide and provides many of the guidelines and training materials used to teach breastfeeding counselors. Visit its web site, www.ILCA.org, to access a national database of experts. You can also email info@ilca.org or call (919) 861-5577.

Originally published Sept. 29, 2003.

Medically updated May 2005.

 

SOURCES: Pat Sterna, RN, IBCLC, lactation counselor, Mount Sinai Medical Center, New York. Carol Huotari, IBCLC, certified lactation counselor, manager of the Breastfeeding Information Center, La Leche League International, Schaumberg, Ill. Audrey Naylor, MD, president and CEO Wellstart International, San Diego. Katy Lebbing, IBCLC, La Leche League International. American Journal of Preventative Medicine, January-February 1995; vol 11: pp 26-33. The Womanly Art of Breastfeeding  40th Anniversary Edition, La Leche League International. The American Academy of Pediatrics.

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Last Editorial Review: 7/13/2005 3:56:22 PM


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