Common Breastfeeding Problems

Call a Lactation Consultant for help and more information on any problem
Sore nipples: Some tenderness for 30-60 seconds, as from any new endeavor can be expected (think of starting a new exercise routine), but pain that makes you not want to breastfeed the next time is too much. Think of the “pebble in the shoe,” or chapped lips that you apply lip balm to many times a day.
  • Deeper latch, Fingers – one above the nose, one at the chin -sandwich the breast, fingers parallel to lips, same oval shape. Gentle push on shoulder blades for a deeper latch. Hold for 6-10 sucks if pain is decreased slowly release and remove fingers.
  • Baby held closer, baby’s chest, chin and cheeks touching your breast.
  • Use less sore breast first so baby will be more relaxed and co-operative
  • Apply ointments with pure ingredients after feedings, Here are several other options:
  • https://docs.google.com/document/d/1PQYGfnzznf7-tQBgblAgyyKrRNQGn2RZ9m0i3SmMiVw/edit?usp=sharing
 
Engorgement: The more often baby feeds in the first 3 days, the less likely you will experience profound engorgement- painful, hard breasts.
  • Reverse Pressure Softening, ”RPS”, follow any links online. There is even a video available. This technique gently moves some of the build up of fluids in the breast, clearing space for the milk to move freely into the milk ducts and out to baby.
  • Gently move hands toward armpit to help move fluids into lymph system. See https://vimeo.com/65196007. See also Breast Gymnastics, by Maya Bolman
  • Use cold/ice packs to reduce swelling, washed cabbage leaves are another cool option.
  • Warm showers often cause an engorged mom to leak which reduces some pressure
  • Pumping can relieve engorgement, but too much can cause oversupply. Only use if above ideas don’t work, do RPS 1st, and limit to 2-3 X/24 hours.
Ductal Inflammation: hard, painful lump or area in the breast, AKA  plugged ducts
  • Avoid by keeping track of areas that are getting hard, tender or hot after a feeding or pumping. Help that area to release at this and next feeding with gentle massage and taps.
  • Through ultrasound we now know that lots of fluid (edema) gathers around an inflamed duct, making it even harder to remove milk and can reduce output. Use cold compresses to reduce swelling, take an anti-inflammatory pain medication as advised by health care professional (HCP). Use massage as in Vimeo link above under engorgement.
  • Think of the plug like a traffic jam, use breast gymnastics & a jiggly motion to loosen rather than trying to move it through the breast as where you feel the pain may not be exactly where the plug is and the milk ducts are not in a straight line. Everything is as GENTLE as handling your baby.
  • Keep breastfeeding, drink plenty of fluids, get extra rest.
  • If you develop a fever, and flu-like feelings, you may have mastitis. See your HCP. You may need antibiotics, though many times you can wait 24-48 hours to see if your body fights it off without an Rx. See new protocol #36 from Academy of Breastfeeding Medicine 2022.
  • Some women take lecithin 1200mg 4 times/ day per Dr. Jack Newman to help break down the fatty plug. Not recommended long term, only 1-2 weeks if it helps or Choline.
  • Ultrasound therapy is being used if one area stays plugged after all the above efforts didn’t bring relief for more than 3 days. May need an ultrasound to rule out another problem.