Breastfeeding challenges can surprise even experienced mothers. But coping with most breastfeeding issues is fairly simple, and in some cases, easier than sterilizing bottles! Here’s a look at some of the most common challenges of breastfeeding.
Most women experience nipple soreness in the early weeks of breastfeeding. If nursing is worse than just uncomfortable, there could be a problem, such as thrush or poor latch. A proper latch between baby’s mouth and mother’s breast is necessary to ensure baby is getting enough milk and to prevent nipple trauma. A bad latch can even hurt.
Common nursing problems
Fremont mom Jennifer Constigan’s first child had a difficult time latching, which prevented him from nursing and from taking a bottle. She worked with Seattle Children’s Infant Feeding Program on “suck training” — teaching her baby to latch and suck effectively. Constigan learned that part of the solution can be simply to persevere and wait for babies to mature. Despite significant challenges, Constigan recalls, “in a mere six to seven weeks we were breastfeeding well.”
Thrush is a very common and often painful yeast infection that can exist in the baby’s mouth and the mother’s nipple. Thrush often occurs after antibiotic treatment, including that given during labor. Because thrush is easily passed back and forth, it’s important to treat both the mother and the baby simultaneously. Whatever treatment is used on the mother’s nipple must be safe for the baby to ingest. Signs of thrush include bright pink, painful nipples, stabbing pains in the breast, and white patches on the skin inside baby’s mouth.
North Seattle mom Melanie Burch struggled with unexplained pain while nursing her first baby. “I had horrible shooting pains,” she says. Her son’s persistent diaper rash was a clue that it was thrush, which she treated with her pediatrician’s help.
Many mothers fear nipple pain from biting. In reality, a baby cannot bite while nursing because the baby’s tongue gets in the way of the teeth, but sometimes babies will chomp down before or after nursing. Betty Fitzsimmons, a veteran La Leche League leader from Tacoma who has breastfed her 11 children, recommends: “Keep your little finger ready to go into the corner of the baby’s mouth to stop the bite when you feel it coming on. Biting does not have to be the end of a good nursing relationship. It is just another challenge to find the answer that works for both the mom and baby.”
Supply and Demand
Many mothers worry that their babies are not getting enough milk. But in reality, “primary insufficiency is exceptionally rare,” according to Barbara Orcutt, R.N., M.N., a member of the team of lactation consultants at Birth & Beyond in Seattle. “Delayed lactation is more common.” Delayed lactation can be caused by separation of baby and mother, poor assistance for first feeds, interruption of mother while she is trying to feed, introduction of formula and exclusively pumping instead of nursing baby at the breast.
Because breastfeeding is a supply-and-demand system, the more you nurse, the more milk you make. “Newborns’ bellies are so tiny and breast milk is so easily digested, that they need to feed at least eight to 16 times every 24 hours,” says Emily Healy, a lactation consultant with Puget Sound Breastfeeding Services. “The first step to getting milk supply back on track is skin-to-skin contact between mom and baby.” This contact stimulates the hormones that help your body make milk.
In rare cases when milk supply is truly not sufficient, that deficiency can be related to physical concerns, such as poor latch or hormone imbalances. In more extreme cases, prescription medications can be used to help induce lactation.
While many mothers feel anxious waiting for their milk to come in, sometimes milk comes in quickly and leads to uncomfortable engorgement, making latch difficult. The only way to release the pressure is to get that milk out. While pumping can help a lot, it’s important to remember the rules of supply and demand. If you pump too often, you will continue to make more than your baby needs, which can lead to more engorgement. So, go gentle on the pump and soothe the pressure with alternating cold packs and warm showers.
Plugged milk ducts
To avoid plugged milk ducts, feed the baby often enough to really empty the breasts regularly. A plugged duct can be resolved by massage, warm packs and even changing nursing position to get the baby to remove milk from all areas of the breast.
Plugged ducts can lead to the more serious complication of mastitis, which is an infection in the breast. Mastitis is more common in mothers who are stressed. It’s important to remember that breastfeeding is a lot of work for a body and you deserve some extra rest and good nutrition.
“A day in bed with baby is a perfect prescription for mastitis,” says Raissa Larson, a La Leche League leader from north Tacoma. “You can ask your doctor about over-the-counter anti-inflammatory medication.” Antibiotics are sometimes prescribed as well.
Social support encourages breastfeeding success. While there are situations in which breastfeeding cannot work, those situations are rare. Burch remembers her struggles with thrush and mastitis with all three of her children. “What kept me going was the resolve that I was just going to do it!”
“It’s important to remember that it’s a process,” says lactation consultant Jennifer Enich, who works at Seattle Children’s in Seattle and volunteers as a La Leche League leader. “Each time a woman breastfeeds a baby, both the mother and the child have to learn how to breastfeed together. It’s a unique situation each time.” Just remember: Help is available.
Tera Schreiber is a nursing mother who experienced a handful of the common obstacles in nursing her children, and she is grateful for the amazing community of lactation support in the Puget Sound area.