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Baby Feeding » Feeding Difficulties
It is not unusual to experience difficulties in breastfeeding in the first few weeks after birth. Almost all breastfeeding problems are due to the baby not being properly positioned.
Sore Nipples
Sore Nipples are common during the first few months and are often the result of incorrect positioning at the breast. Your baby's sucking will probably due to hormonal changes and the strong sensations create some tenderness around the nipples. 'Airing' your breasts is often the best healing remedy. Either spends as much time as you can with your breasts uncovered or cut the handle off a tea strainer and places the cup part between your nipple and bra. This will let your nipple breath and will stop the bra material chafing the sore skin. You can also offer the least sore breast first and check with your breastfeeding counsellor on the right positioning. Avoid excessive washing of your breasts as it strips the skin of its natural protective oil (one wash per day with warm water and soap is enough). Smearing some expressed milk over the nipple and areola some-times helps to relieve soreness. A 'wet breast' can also cause irritation, so, use breast pads to keep your nipples dry between feeds.
If none of the above works, just let your milk flow before starting each feed. Do this by expressing some milk gently or placing warm flannels on the breast. If your baby is not sucking enthusiastically, try feeding him when he's really hungry or sleepy. You should also watch for stubborn white patches in your baby's mouth. These could be signs of thrush, a source of soreness. Seek treatment from a GP if this happens.
Engorgement
Engorgement is the feeling of fullness or tenderness in the breast. Although the discomfort does not last for very long, it needs to be dealt with quickly to prevent inflammation. You need to feed your baby often to release milk. A splash of warm water helps to relieve tightness and start milk flow, particularly in the beginning when your baby may have difficulty in latching onto the breast. Placing a cooled cabbage leaf inside your bra will relieve the heat and discomfort. Change the leaf when it begins to go soft. Expressing your milk also releases the flow and relaxes the areola so that baby will find it easier to suck. Massage the breast in gentle strokes with your fingertips to reduce swelling. Cold flannels or a pack of frozen peas on the breasts also aid in constricting blood vessels and reducing swelling.
Mastitis
Mastitis is a condition caused by an infection or a blocked milk duct and can be recognised by a sore red patch on the breast. Consult your GP for advice on how to treat the infection. To clear a blocked milk duct you should gently massage the breast from the red patch towards the nipple several times a day. Your GP may also take nose and throat swabs from your baby along with a milk sample to determine if there is bacteria causing the infection. If you feel feverish make sure you have plenty of rest and fluids, and apply hot or cold compresses on the affected area. You should continue to breastfeed, particularly from the sore breast. Recurrent mastitis indicates that the baby's feeding position may not be right or that your bra is not fitted correctly, so consult your breast-feeding counsellor.
Blocked ducts
Blocked ducts are caused by a blockage of milk and can be recognised by a painful lump in one of your breasts. Wearing ill-fitting bras and tight clothes, using a drip catcher, pressing your hand on the breast during a feed, or long lapses in between feeds, are all contributing factors. It also becomes a problem if your baby feeds less due to an illness. Continue breastfeeding, as stopping will just make it worse. To clear the ducts, experiment with your baby's feeding position - lean forward during feeds as gravity helps to drain the breast. Gently massage any lumps towards the nipple during and after feeds; you can also use a comb and olive oil to 'comb' your breasts. Arm movements like cleaning the floor or window help to increase blood supply to the breast. Make sure you are drinking enough fluids.
Poor weight gain
Poor weight gain in your baby usually has two causes. It may be an indication that your baby is not positioned well at the breast so is sucking the nipple rather than the areola. Check the positioning with your breastfeeding counsellor or try different positions to see if this helps. Make sure his mouth is wide open before he latches on to the breast. Feeding for too short a time on each breast so that he is only getting the foremilk, which is low in calories, could also cause it. In this case allow your baby to feed for as long as he wants and wait for him to drop off the breast before offering the other one. Don't time feeds. If he falls asleep after only a few minutes you could try tickling his feet or changing his nappy to wake him up. Make sure you are eating and resting well, particularly in the afternoon when babies will often be hungrier.
Don't expect breastfeeding to be easy from the outset. Like all new skills, you and your baby will need to learn how to breastfeed comfortably and successfully. It can take up to 6 weeks for your milk supply to become well established so frequent feeding is common in the early days. Once established though, breastfeeding can be a re-warding and satisfying experience for both mother and baby.