Breastfeeding - common problems and some solutions

It is important to acknowledge that breastfeeding does not come easily to everyone and that problems are common. However, with help and a positive attitude, you can overcome these.

Take time to understand the basics of breastfeeding, breastfeeding positions and how your baby should latch on.

For personal support, contact the South African La Leche League (LLL), which is a Non-Governmental Organisation (NGO) that offers information and encouragement - primarily through personal help – to women who want to breastfeed their babies. LLL offers mother-to-mother help from volunteer leaders through monthly meetings and telephone help.

1. Poor milk flow
   
2. Sore nipples
3. Engorged Breasts - overfull, hard and uncomfortable
4. Tender Lumps In Breasts - Blocked Duct
5. Mastitis - Breast Milk Leaks Into Breast Tissue

Poor milk flow can lead to engorgement, mastitis, blocked ducts or abscesses

Your milk production and flow are closely linked to how well rested you are and how comfortable and relaxed you are feeling. If these are compormised, your milk production may be too. Take care of yourself and ensure that you eat well and drink plenty of water.

Ask yourself:

• Did I have too many visitors?
• Do people around me make me feel uncomfortable when I feed?
• Is there an obstrcuction to my milk flow  e.g. clothing, finger pressure?
• Has there been a sudden reduction in breastfeeding?
• How well am I nurturing myself and being nurtured by others?

Sore nipples

Causes: Poor positioning or Thrush

Poor Positioning

Make sure that your baby sucks your nipple and not the breast. Your nipple and most of the areola should be in your baby's mouth

Solutions:

• Recheck positioning and, if necessary,ask a medical practitioner to help you
• If your nipple is sore during a feed, don't continue. Break your baby's suction by placing your little finger in the corner of your baby's mouth, take him off and try again
• When you're not feeding, "air" your nipples as much as you can to help them heal
  
• Rub colostrum or breast milk into your nipple between feeds and allow to dry naturally
• Cold cabbage leaves or calendula can relieve pain of engoregement
  
• Get professional help before your pain or discomfort becomes unbearable. You may ask a breastfeeding counsellor, lactation consultant, health professional, midwife, experienced friend or relative

Thrush

Symptoms of thrush include red, sore, shiny nipples, maybe white spots on them, maybe cracks. Pain continues after feed (sometimes shooting pains) and/ or itchiness. Thrush may be visible in baby's mouth or bottom.

Solutions:

• Anti-fungal medication from a medical practitioner
• Bath with a solution of 5ml bicarbonate of soda in 1 cup (230ml) cooled, boiled water

Engorged breasts - overfull, hard and uncomfortable

Causes: Poor positioning that results in the breast not draining properly, baby not feeding frequently enough, too much expressing, which can artificially increase milk production. Engorged breasts may lead to a build up of milk in your breast and slowing down of lymph and blood supply, which swell the breasts.

Solutions:

• Check positioning: ask for help
• Feed more frequently and for longer
• Completely empty one breast before offering the other
• Express a little milk between feeds and just before feeds to help baby latch on
• Try putting warm face cloths on your breast  or soak in a warm bath to help milk to flow

Tender lumps in breasts - blocked ducts

Causes: poor positioning

Solutions:

• Try different positions and check for a good latch
• Start on lumpy side for a couple of feeds
• Gently stroke lump towards nipple as baby feeds
• Support breasts from underneath to improve drainage
• Massage breast and express after feeding if breast is still lumpy

Mastitis - breast milk leaks into breast tissue

Symptoms:

• Feels like you are getting flu
• Red inflamed area on breast, sore, hot to touch
• You may have chills or feel hot all over

Causes:

• Problems with milk flow (interrupted routine, pressure on breast or poor positioning, infrequent feeding)
• Strong preference for one side
• Restrictive clothing (particularly bra)
• Emotions e.g. if you'rei irritated or disappointed by perceived lack of support or nurturing

Solutions:

• Bed rest
• Lots of fluids
• Feed frequently, affected side first to drain milk from sore area
• Gently massage lumpy areas while baby feeding
• Extra care re positioning to ensure breast well drained
• Express some milk
• Ask others to care for you
• Cold compresses or cabbage leaves can relieve pain and reduce swelling
• May need pain killers or antibiotics perscribed by your doctor

Source: National Childbirth Trust (NCT) Ante-natal Course (London, UK, Sept 2005)

For more information about breastfeeding, visit http://www.babycentre.co.uk/baby/breastfeeding/