Breastfeeding Difficulties - MotherLearning to breastfeed may be easy for some women, while more difficult for others. Listed in the directory below, you will find additional information regarding breastfeeding difficulties for mothers, for which we have provided a brief overview. Sore NipplesSore nipples are probably the most common difficulty mothers have when breastfeeding. Sore nipples may be caused by different factors. Determining the cause of sore nipples dictates the appropriate treatment. A certified lactation consultant (IBCLC) will be able to help and suggest intervention. Breastfeeding should not hurt, and the skin on your nipple should not break down any more than the skin anywhere on your body should break down. However, mild tenderness, similar to the kind of tenderness some women experience with their menstrual cycles, is fairly common for the first week or two of breastfeeding. Then it should go away. If your nipples feel painfully sore or the nipples or areola feel bruised, it is more likely that it is related to an improper latch-on process or ineffective sucking. Suspect a difficulty with baby's latch or sucking if your nipples become very red, raw, blistered, or cracked. A latch or sucking difficulty or a structural variation in the baby's mouth might result in nipples that look creased or blanched (turn white) at the end of feedings. Certain creams or dressings may promote healing, but others can actually cause more damage. Also, avoid any treatment that might result in drying the nipple tissue, which may lead to cracking of the skin. When nipples become red and burn, or feel extremely sore after weeks or months of pain-free breastfeeding, it may be due to a yeast infection such as thrush. Yeast may appear as white patches in the baby's mouth or it may show up as a bright red diaper rash. Specific medications are needed to treat yeast infections. Contact your baby's physician for more information and treatment. Insufficient or Delayed Milk ProductionMost mothers worry at some point that they do not have enough milk. A delay in the time when milk "comes in" sometimes occurs in mothers dealing with certain health conditions. Do not wait to get help if milk production is ever a concern. The sooner you intervene, the better. Ask a certified lactation consultant (IBCLC) and your physician to help you figure out what might be the problem affecting milk production, so that you and your baby can begin to correct it. Infrequent or insufficient breastfeeding (milk removal) is the most common reason for a delay in the time when the milk "comes in," for insufficient milk production, or for any drop in production. A review of the number and length of breastfeedings should always be first thing you do if you are ever concerned about milk production. Occasionally, a mother has a health condition that may temporarily delay the large increase in milk production usually seen between three to five days following birth (postpartum). These mothers do not begin to obtain large amounts of milk until seven to 14 days after giving birth. If this happens to you, do not feel discouraged. Continue to breastfeed frequently even if you also must give your baby a breast milk substitute for a few days. Research has yet to discover whether the cause for a delay in increased milk production is due to a health-, pregnancy-, or birth-related condition itself, certain medical treatments for such conditions, or a delay in frequent breastfeeding that often occurs with such conditions. Some of the conditions, or treatments, that experts think may contribute to a delay include the following:
Low Milk ProductionWhat causes low milk production?Occasionally, a delay in the time when milk "comes in" turns into an ongoing problem with low milk production. Sometimes, a mother has been producing sufficient amounts of milk, and then milk production slowly, or quite suddenly, decreases. Some of the conditions associated with a delay may also have an ongoing effect on milk production, including, but not limited to, the following:
Mothers with previous breast surgery that cut some of the nerves, milk-making tissue, or milk ducts, may have difficulty producing enough milk to fully feed a baby. Other factors can also lead to insufficient milk production. Maternal smoking has been shown to result in less milk. Some medications and herbal preparations have a negative effect on the amount of milk produced. Hormonal forms of birth control, especially any containing estrogen, have been found to have a big impact on milk production. However, some mothers report a drop in milk production after receiving/taking a progestin-only contraceptive during the first four to eight weeks after delivery (postpartum). Milk production may also decrease if you become pregnant again. If insufficient milk production seems to be a problem, yet the baby seems to be sucking effectively, your physician or certified lactation consultant (IBCLC) may recommend the following:
You also may want to:
Think positive. Although insufficient milk production usually can be reversed, any amount of milk you produce is valuable for your baby. Try to remember that your baby is 25 to 90 percent breastfed rather than feel discouraged that he/she is also receiving a breast milk substitute. Flat or Inverted NipplesTechniques for flat or inverted nipples:An effective breastfeeding baby usually has little trouble breastfeeding even if his/her mother's nipples appear to be flatter. A less effective breastfeeder may need some time to figure out how he/she can draw the nipple into the mouth with latch-on. Although the benefit of using hard plastic breast shells is not conclusive, some mothers find it helps to wear them in the bra between feedings. Breast shells exert a small amount of traction to help draw the nipple outward. Using a breast pump to draw the nipple out just prior to breastfeeding may also help. If nipples invert, or "dent" inward, with stimulation, try the interventions mentioned for flat nipples. Nipple eversion devices are available. Ask a certified lactation consultant (IBCLC) for information. Occasionally, a mother has one or more severely inverted nipples. If one breast is less affected, your baby can breastfeed on only one breast. Most women can produce enough milk in one breast to exclusively breastfeed their babies. Plugged Milk DuctsWhat are plugged milk ducts?A plugged duct feels like a tender lump in the breast. Some mothers seem to be more prone to developing them, but usually they occur when a mother goes too long without emptying her breasts, or if insufficient milk is removed during feedings. Review your baby's feeding routine and see if the time between one or more feedings has recently changed for any reason. Sometimes, a mother gets busy again with a task and does not realize feedings are being delayed. Ineffective sucking may contribute to plugged ducts. Also, check that the material of nursing bras or clothing bunched during feedings is not putting pressure on milk ducts in a certain area of the breast. If you develop a plugged duct, be sure to breastfeed/remove milk often and alternate different feeding positions. It often helps to apply warm compresses to the area or soak the breast in warm water. Massage above and then over the affected area when breastfeeding and after application of warm compresses.  Click Image to Enlarge MastitisWhat is mastitis?Mastitis is often used interchangeably with the term breast infection, but mastitis may also be due to an inflammation. Often a reddened area is noted on the breast. Inflammatory or infectious mastitis may develop for reasons similar to those for plugged duct development, and the same interventions usually are helpful. It is especially important to keep the affected breast "empty" through frequent breastfeeding. If you develop flu-like symptoms or your temperature increases to 100.4° F or higher, call your physician. An antibiotic probably will be prescribed for 10 to 14 days. Be sure you take the entire course of the medication or you may experience a recurrence. |
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