3 Common Breastfeeding Concerns and Remedies
Breastfeeding is so much more than just delivering nutrition to your child! It is also about forming that trusting, close relationship with your baby. For centuries, breastfeeding support was provided by the family and community surrounding the mother, but so much of that support has been lost as the nuclear family has disintegrated. Many new mothers find the process of starting and maintaining the breastfeeding relationship difficult and staining and lack that community support to carry on. In this blog post, I’ll talk about the most common issues associated with breastfeeding and some simple remedies.
Sore Nipples – A Common but not normal Breastfeeding Concern
It is a MYTH that breastfeeding always hurts in the beginning! There are many reasons why you may be experiencing sore nipples, and while it is common, it is not normal. Most often, sore, cracked, or bleeding nipples can be attributed to the baby having a poor latch due to breast engorgement, poor latch due to oral restrictions( tongue, lip, or cheek ties), blebs, mastitis, and thrush.
Remedies for Sore Nipples
- A poor latch can be addressed in several ways. Having a trained professional to guide you is essential and can offer techniques on how to deal with breast engorgement. In many cases, hand expressing a small amount of milk before you offer the breast will make it much easier for the baby to latch properly. If your breast is engorged, it will be too hard and too full for the baby’s mouth to latch and maintain a good latch effectively. Expressing some milk by hand will soften the breast just enough so that baby can get a good grasp on your nipple and areola.
- You can try feeding baby in the laid-back position. Lean back on several pillows and have baby lay on you, Gravity takes over, and you are in full contact with your baby. This also takes some of the pressure off your breast making it easier for baby to get a good latch. Baby will instinctively bring his head towards your breast instead of pulling away, as can happen in a sitting or side-lying position.
- Breast/nipple shields can also offer relief from sore nipples. These shields are designed to offer temporary relief and are simple to use. If you find you need to use one, consult a lactation professional to make sure you have the proper size, as nipples come in all sizes and shapes. Having a properly fitted one is essential. You may find it helpful to get the shield warm, and a little wet before applying it to your breast, as this will help to create good suction. Baby will latch on with the shield in place, and your nipple will ideally be pulled into the baby’s mouth in the proper way.
- Natural treatment. The best treatment for sore/cracked nipples is your own breast milk! Your breastmilk contains anti-inflammatory and anti-bacterial properties that can heal not only nipple wounds, but other skin and eye infections!
- Lanolin and other ointments. There are a variety of ointments available, and if they are marketed for nipple care, then they are also safe for baby. I do recommend wiping your breast with a wet washcloth before breastfeeding to remove any excess ointment to minimize the amount that baby is ingesting.
- Breast shells. These are hard plastic domes that can be worn in your bra when you are not breastfeeding. They will create a barrier so that your nipples aren’t being aggravated by clothing rubbing on your nipples. Be very careful to keep them clean and dry as they can retain moisture and slow the healing process.
Engorgement
What is engorgement? Simply put…. It’s an overfull breast.
This can be a combination of breast milk and fluids associated with giving birth(IV fluids) & your body’s instinctual response to provide your baby with milk. After birth, your body responds by increasing blood flow to your breast to encourage breast milk production.
Your lymph nodes flow increases to remove waste products. As your body recovers from the birth process and you and your baby find a breastfeeding rhythm (or you decide not to breastfeed), this overfull feeling will subside. If you do find that you are engorged, it is essential that you address it immediately to prevent further problems.
Remedies for Engorgement
- The simplest remedy is manual breast massage. As outlined in the book “The Womanly Art of Breastfeeding,” you can use “Reverse Pressure Softening.” This will push fluid away from the areola and nipple. Using your index fingers, place them on both sides of your nipple and press steadily but gently for 1-2 minutes. This will encourage fluid to move away from the areola and nipple making it easier for baby to latch. You may also try pressing all five fingertips around the areola to create indents. After you’ve relieved, some pressure immediately offer your breast to baby. Repeat every 1-2 hours as needed.
- If you can’t relieve enough fluid with the above technique, try hand expression. For decades this is the technique used and likely the most effective way to remove milk from your breast. Placing your hands in a “C” position on either side of your breast and gently but firmly moving your fingers and thumbs towards your nipple will encourage milk flow. Don’t remove your hands and fingers from the breast during this process. Start with your hands near your chest wall and move towards your nipple. When you are near your nipple, release and repeat. After 2-3 repetitions, move your hands to a different spot on your breast. We have milk ducts and lymph nodes in many different places on our breast and it’s important to drain all these sites.
- Breast pump. If you are more comfortable using a breast pump, then be sure to go “low & slow.” Be sure to have the correct size flange, as using the wrong size can result in nipple damage and cause more pain. Seek the help of a lactation counselor to make sure you have the correct size.
- Use gravity. Lie flat on your back, this will encourage fluid drainage away from your breast.
- We all know that inflammation can be treated with cold compresses and the same applies to your inflamed breasts. You can apply cold cabbage leaves or any type of cold compress to your breasts. If using cabbage leaves, be sure to not place them over the nipple/areola as the taste my interfere with baby latching.
- If the inflammation returns and becomes a consistent problem, you may need to speak with your doctor about the use of an anti-inflammatory medication.
- If you are breastfeeding, the most important thing you can do is KEEP BREASTFEEDING FREQUENTLY! This will keep the building pressure at a minimum, and you will soon find a schedule that suits you and your baby.
Low Milk Supply
Having a low milk supply can be multi-layered and may require the support of a lactation support person and your doctor. There may be a medical reason why you have a low milk supply, or it may be that you just need to increase your breastfeeding sessions.
Remedies for Low Milk Supply
- Increase the number and length of breastfeeding sessions.
- Add in 1-2 pumping or expression sessions.
- Use herbal supplements or medications that increase breast milk production (Galactagogues). Your lactation support person may suggest trying herbal galactagogues such as goat’s rue, shatavari, fennel, alfalfa or funugreek. Foods such as oatmeal, brown rice and barley may also help with milk production. Common medications used to increase breast milk production are Motilium, Reglan, Maxeran and Glucophage. Be sure to discuss the use of herbal supplements with your doctor to avoid any possible negative interactions with other medications you may be taking.
- Eating a healthy, well-balanced diet is essential. Be sure to eat a diet high in healthy saturated fats and plenty of grass-fed animal products. Try and keep your diet to soft, warm foods for the 1st forty days after birth. Drinking plenty of warm teas can also help milk production. If you are a plant-based eater, try using organic tempeh.
Breastfeeding can be a full-time job so be gentle and patient with yourself. Remember that your baby is new at this too! Give yourself and your baby plenty of grace in those first few weeks. Seeking the help of a postpartum doula, lactation consultant or IBCLC can help you navigate
and challenges you encounter on this journey. With anything new that we do, there can be pitfalls, and its ok to feel discouraged. You CAN do this and be successful.