janet babymom
Janet Fishstrom Dombro
International Board Certified Lactation Consultant (IBCLC)
San Jose, California
(408) 205-1234
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  • Information on Breastfeeding Topics
    • Common Breastfeeding Problems
    • Ideas for Increasing Milk Supply
    • Pumping Pointers
    • Pumping --How and When to Begin
    • Tips for the First Days
    • Bodywork for Babies
    • Tips for When you Must Bottle Feed
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Common Breastfeeding Problems

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”.
  • 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 touching your breast
  • Use less sore breast first so baby will be more relaxed and co-operative
  • Apply breastmilk, or pure lanolin, coconut oil for, or other ointments with pure ingredients after feedings. There are other products depending on damage to nipple.
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
  • 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.
Plugged Ducts: hard, painful lump in the breast
  • Avoid by keeping track of areas that are getting hard, tender or hot after a feeding. Help that area to release at the next feeding with gentle massage and taps.
  • Through ultrasound we now know that lots of fluid (edema) gathers around a plugged duct, making it even harder to remove milk. 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 sediment in the bottom of a bottle, use a jiggly or vibrating motion to reduce its size 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. Can use hand-held massager.
  • 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.
  • Some women take lecithin 1200mg 4 times/ day per Dr. Jack Newman to help break down the fatty plug.
  • Ultrasound therapy is being used if one area stays plugged after all the above efforts didn’t bring relief for more than 3 days.

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