Problems When Breastfeeding

Experts recommend exclusive breastfeeding until the baby is six months.

Breast milk is the best diet for infants. Breastfeeding has several health benefits for the mother and her baby; moreover, it also builds an emotional bonding between them. Experts recommend exclusive breastfeeding until the baby is six months. This means that apart from breastmilk, the baby should not be given any fluids or solids till they reach six months of age, even water. This, however, may not be done because of several problems a mother may face when she is breastfeeding her young one. Most of these problems can be solved by seeking medical help. Thus, whenever a woman finds it difficult to breastfeed, it is advisable to seek help from their doctor, nurse, or a board-certified lactation counselor.

Some of the common problems mothers face when breastfeeding are described below.

Insufficient breast milk production: Many women give up breastfeeding because they think that their breast milk is not enough in quantity for the baby. Insufficient milk production may occur if

• There was inadequate breast development during pregnancy.
• The mother underwent breast surgery or radiation therapy.
• There is a hormonal imbalance in the mother.
• The mother takes medications that interfere with milk production.

To stimulate milk production, the mother may

• Feed the baby from both the breasts during feeds.
• Stay calm and relaxed while feeding the baby.
• Keep the baby close to her and hold them skin-to-skin.
• Feed the baby frequently (around 8-12 times per 24 hours in the first week of life, gradually decreasing to seven to nine times per 24 hours by the fourth week).
• Take a healthy diet.
• Consult her doctor to know what is causing less milk production.

Breast and nipple pain: This may occur due to

• Breast engorgement (a condition in which the breasts become painfully overfull of milk).
• Nipple injury caused by the baby or a breast pump.
• Blocked milk ducts in the breasts.
• Breast and nipple infections.
• Excessive milk production.
• Skin conditions affecting the breast such as eczema or psoriasis.
• Sore or cracked nipples: You must consult your healthcare provider to resolve pain in the breasts or nipples. Keeping the nipples dry after feeds is important. You should not use harsh soaps or cleansers on your nipples or breasts. You must not use vitamin E on your nipples because it may be toxic for your baby in high quantities. Your doctor will also help diagnose and manage any inborn problems with the baby, such as a tongue-tie, which may be causing problems with breastfeeding. Using warm compresses and over-the-counter pain relievers such as acetaminophen and ibuprofen may lower the pain.

Mastitis: It is a common cause of breast pain. Inflammation of the breasts is called mastitis. It is often associated with breast pain, swelling, redness, and fever. Mastitis may or may not be caused by an infection. Although it can happen any time during lactation, it is commonly seen during the first six weeks after delivery. Mastitis may result due to nipple damage (such as cracked nipples) or prolonged breast engorgement. You must seek medical help if

• You have a firm, painful, and red area on the breasts.
• You have a fever higher than 101°F or 38.5°C.
• You develop muscle pain, chills, or other flu-like symptoms.

Untreated mastitis may lead to the collection of pus, forming a breast abscess that needs surgical drainage.

Fungal infections: Yeast infections are common in lactating women and can cause severe breast pain. There may be a history of vaginal yeast infection or the presence of thrush or diaper rash in their infant. The skin on the breast may appear shiny or flaky. Your doctor may prescribe treatment such as antifungal creams or gels and antifungal pills for treatment. A purple medication called gentian violet (0.25-1%) may be prescribed for application in your baby’s mouth before breastfeeding.

Bloody nipple discharge: Bloody discharge from the nipples may occur during the first few days to weeks of lactation. The condition is more common in the first pregnancy and is also called rusty pipe syndrome. Breast milk may appear pink or red and is caused by increased blood flow to the breast tissue. This usually resolves within a few days. If bloody nipple discharge continues for over a week, medical help must be sought.

Breast milk overproduction: Excessive milk production beyond the infant’s demand can also make breastfeeding difficult. Milk oversupply may cause a sudden rush of milk that may make the infant choke or cough during breastfeeding. They may even bite the mother’s nipple in an attempt to clamp to it. Milk overproduction may also cause breast engorgement and pain.

The condition may subside on its own. You may consult your healthcare provider to know if overproduction is due to some hormones or medications.