Breast Feeding Issues

These are some of the breast feeding issues you may encounter in the first weeks after childbirth and some suggestions to deal with them.

Breastfeeding

The baby is put to the breast within half an hour to an hour following the birth however it may take a a day or two for both you and the baby to adjust. If you experience feeding problems or are concerned about how well your baby is feeding, do not delay in alerting your LMC.

Some suggestions:

• If your baby is a slow feeder, rub his or her back, abdomen and legs to stimulate the rooting reflex.
• Push aside the part of your breast that covers the baby's nose to make room for him or her to breathe comfortably.
• To get the baby to turn toward your breast, place your nipple against the baby's cheek.

Breast engorgement

Breast engorgement occurs when the breasts produce more milk than the amount that is being expelled by breast-feeding, pumping, or manual (hand) expression. The milk overflows from the glands and engorges the breasts.The breast milk usually arrives 72 hours following the birth of your baby. You may notice your breasts are hard, sore, warm and throbbing. Some women may also have slightly swollen axillary (underarm) lymph nodes. This is a normal part of early lactation and usually lasts for about 24 hours if you are breastfeeding. The baby may suck from the nipples but will not receive much milk. However, the baby's sucking will cause the breasts to produce more milk, further overfilling the milk glands and increasing engorgement. If you are not breast feeding, the engorgement may last up to 48 hours, until the body recognizes that it does not need to continue producing breast milk.

Some Suggestions:

• Wear a well-fitting bra for support.
• Apply warm compresses to the breasts to stimulate milk flow.
• If breastfeeding, continue to breast feed making sure the baby feeds from each breast, alternately or express frequently if you are expressing for the baby.
• Although a low-grade fever is normal (37.7degree celsius), consult your LMC if your temperature rises above that. This could indicate mastitis.

Sore Nipples

Nipple soreness is common during the first few days of breast-feeding but usually subsides soon thereafter.Make sure the baby is correctly latched on the breast. Allowing the baby to suck on the end of the nipple rather than the full nipple and some of the areola tissue and pulling the baby away from the nipple while he or she is still sucking, can harm the integrity of the nipples. If soreness does not subside as you grow accustomed to breastfeeding, check with your LMC. Cracked nipples can lead to mastitis.

Some Suggestions:

• Changing positions at each feeding.
• Make sure you dry your nipples after each feeding.
• If nipples start to bleed, stop breastfeeding and speak with your LMC.

Nipple Confusion

It is important not to introduce artificial nipple of the bottle to the baby during the first few weeks following birth if you are breast feeding. The baby becomes “confused” between the mother’s nipple and an artificial nipple of a bottle. Babies with nipple confusion will not latch on to the mother’s nipple and become fussy when a mother tries to breast-feed.

Some suggestions:

• Delay the introduction of bottles until a few weeks after childbirth to prevent nipple confusion.
• Use a cup or a syringe to give baby expressed milk during the first few weeks if you need to give baby extra milk.

Mastitis

Mastitis is a bacterial infection that can occur in one or both breasts during breastfeeding. Signs of mastitis include red, hot, painful, or inflamed breasts and other flu-like symptoms such as headache, nausea, temperature (38.4 degrees Celsius or greater), or chills. Breast-feeding with mastitis is generally not harmful to the baby and may actually help speed up recovery. This infection occurs most frequently during the first month of breastfeeding. Mastitis during breast feeding can be causd by breast engorgement, a blocked milk duct or cracked or damaged skin around the nipple.

Some Suggestions:

• Speak with your LMC if you suspect that you have mastitis.
• Your LMC may prescribe antibiotics to clear up the infection and will advise you as to whether you can continue breastfeeding.
• If mastitis is untreated, 10% of women develop a breast abscess that may require surgical drainage.

Inadequate Milk Supply

The amount of milk produced is directly related to how often and how long the baby is breast-fed. When an baby suckles at the mother’s breast, milk is flows out from the nipples. This suction signals the mother’s body to make more milk. Therefore, the less a mother breast-feeds (or expresses milk from her breast if she is expressing), the less milk her body produces. This supply/demand relationship is established so that the baby can be weaned successfully. The most common way to increase milk supply is simply to breast-feed more often (or express milk from the breasts).

In very few mothers an inadequate milk supply may be due to other complications, such as a problem with the baby’s sucking or a physical problem with the mother. Mothers who continue to have inadequate milk supplies even if they have tried emptying their breasts should consult with their LMC or a Lactation Consultant if the LMC is no longer involved in their care.