Despite the best of intentions, breastfeeding does not always go as planned. With a lack of education and support for breastfeeding mothers, it’s very common to experience issues and challenges related to feeding. However, with the proper support, many new mothers can overcome these challenges and go on to have a happy breastfeeding relationship with their baby.
Engorgement is one of the first issues that breastfeeding mothers can face, and occurs around day 3-5 after childbirth. This is a condition where the breasts become very full, and women can experience pain and tenderness. Babies also have a hard time latching onto the breast, as it is difficult for them to get the nipple into the mouth. Engorgement should resolve itself in 48 hours if mothers receive proper treatment.
To treat engorgement, mothers can:
- Nurse often, and on cue
- Massage the breasts, especially before latching
- Apply warm or cold compresses
- Use green cabbage leaves (applied to the breasts) – there is a chemical in green cabbage that may help to reduce milk supply
- Women should not be pumping, unless specifically instructed by a lactation consultant (LC)
When a baby is not latched properly, milk will not be drawn from the breasts (leading to engorgement and other problems.) In order to nurse efficiently, babies need to draw the nipple all the way back to their soft palate – an “asymmetrical” latch allows the baby to get more of the bottom areola and less of the top, so that the tongue can properly compress the milk ducts. Check out this information sheet to get a proper visual of what a good latch should look like.
Sore or cracked nipples
Nipples that are very sore (or even cracked and bleeding) are usually a sign that the baby is not latched correctly (however, there are other reasons you could be experiencing sore nipples.) The first step is to be seen by a certified LC – they can assess the latch and provide direction. Occasionally, sore nipples are caused by fungal infection (candida) which can be diagnosed and treated.
Nipple ointment is a good temporary measure to provide relief, but many professionals do not recommend using nipple shields unless you are being following by an LC. Nipple shields can cut down on milk supply and they are sometimes hard to stop using when babies get used to the shield.
Mastitis is an inflammation of the breast caused by an infection, plugged milk duct or allergy. Symptoms include a hard, sore spot on the breast, which can be warm to the touch and quite painful. Some women also experience flu-like symptoms, such as fever and aches/chills.
Treatment can include bed rest and plenty of fluids if symptoms are mild. Women should continue to breastfeed often and empty the breasts completely. If symptoms worsen or persist after 24 hours, antibiotics may be needed.
Supplemental Nursing System (SNS)
An SNS or lactaid allows the baby to be supplemented (with breastmilk, formula or water) while still being at the breast and breastfeeding. Mothers who use an SNS typically have a baby who is not gaining weight and requires extra nourishment.
The liquid is stored in a regular bottle, and a tiny tube leads out from the bottle and is placed into the baby’s mouth while they’re at the breast. The milk drips out slowly through holes in the tube – the baby stays satisfied, and mothers can continue to experience the baby at the breast. For more information on the SNS, check out Jack Newman’s information sheet.
Occasionally it may be necessary for women to take medications while breastfeeding. Although there is some data available for more common medications, often the evidence on safety is lacking. Women need to make the best decision for their own health and the health of their baby, and this decision should be made with a healthcare provider. For more information on specific medications, mothers can always call the Motherisk Helpline, based out of Sick Kids: 1-877-439-2744 or http://www.motherisk.org/
For any breastfeeding questions and issues, check out the following links: