Common Breastfeeding Issues

Breastfeeding is a journey and each mother’s journey is different. Some new mums might find breastfeeding to be a delight and a wonderful way to form a strong connection to their newborn. For others, breastfeeding can be a challenge. We’ve detailed below some common breastfeeding issues to get you prepared for what breastfeeding can entail.

Sore Nipples

Sore or cracked nipples are very common when you first start to feed a newborn. It can take a few days or weeks to adapt to the frequent and strong suck of a newborn on your breasts and having sensitive nipples that may sting, ache, burn or feel tender is very normal.

Treating sore nipples starts with assessing why your nipples are sore. Sometimes sore nipples can be caused by your baby not latching properly (with pain normally lasting about 30 seconds when a baby first draws your nipple into their mouth). Other reasons can include medical problems like a nipple infection or dermatitis.

Treating sore nipples

If you are suffering from sore nipples caused by breastfeeding, ask for assistance from a health professional to see if your baby is latching properly. If the latch appears to be correct, you can try the optional treatments below:

- Try using a nipple shield to protect your nipples (make sure to clean and sterilise between feeds),
- If pumping breastmilk make sure that you are using the correct suction cup (flange) size for your nipples. You can measure up flange size correctly with your midwife. This is a common mistake and nipples can get damaged when you first use a breast pump,
- Washing your nipples with water after feeding,
- Continue to breastfeed whilst treating sore nipples if you can. If you are in too much pain, feed your baby expressed milk and rest the nipple for 24 – 48 hours. Reintroduce the nipple after resting for a short time,
- Apply your breast milk and or nipple balm to treat the sore nipple,
- Rest hydrogel pads onto your nipples for pain relief and healing,
- Try air out as much as possible including wearing loose tops, and if needed,
- Talk to your Dr or pharmacist about your pain relief options.
 
Lack of Milk Supply

Milk supply is considered low if you are not producing enough milk to meet your newborns growth needs. Most mothers produce enough milk for their newborns but for those who don’t produce enough straight away don’t feel guilty.

Causes of low milk supply

- Your baby not having a correct latch or feeding effectively,
- If your baby isn’t feeding often enough (newborns need to feed between 8 – 12 times within a 24 hour period),
- Supplementing breastfeeding with formula milk feeds, so your baby is feeding less frequently from the breast,
- Previous breast surgery affecting milk supply,
- If you have recently suffered from mastitis (detailed below),
- Taking oral contraceptive pills that contain oestrogen,
- Smoking and some medications, or
- Medical conditions causing reduced or no milk production.

There are ways to improve your milk supply with appropriate support. The key for solving most low supply issues is through frequent stimulation and emptying milk from your breasts.

Key tips on increasing supply:

- Hold your baby skin-to-skin at the breast when feeding,
- Try to breastfeed every 2-3 hours,
- Make sure that your baby is latching correctly and is both sucking and swallowing,
- Offer both breasts twice at each feed – this will help to make sure that your newborn is draining each breast efficiently,
- Express breastmilk after feeds to further stimulate milk production,
- Whilst feeding or expressing, massage or compress your breasts to assist with milk flow,

If the above tips don’t help, talk to your care provider about prescription medicines that can assist with increasing milk supply.

Too Much milk supply (hyperlactation)

Hyperlactation tends to happen early in the breastfeeding journey and can cause full, leaking breasts. Breast pain, severe engorgement and painful milk letdowns are common with too much milk supply. For your baby, having too much milk supply can make breastfeeding difficult, with the flow of milk being too forceful, making them gassy, or causing them to gain too much or too little weight (from drinking to much foremilk and not enough backmilk).

Causes of hyperlactation:

- Having too much prolactin (milk production/stimulation hormone) in your blood,
- Pumping more milk than your baby needs, or
- Using medications to increase milk production.

How to reduce your milk supply:

- Talk to a lactation consultant about feeding techniques and expressing,
- Position your baby on the breast so that gravity slows down the flow of milk, and
- Frequently burp your baby during feeds.

Generally, hyperlactation calms down within a few weeks. If the problem continues, talk to your health care provider.

Blocked Ducts

Sore lumps in the breasts that come up when you are a breastfeeding Mum can be caused by a blocked milk duct.

How to Treat Blocked Milk Ducts:

Before Breastfeeding:
- Have a warm shower try to break up the lump by massaging the breast under water or apply a warm compress to the breast and then try to massage.

During Breastfeeding:
- Take your bra off to feed,
- Check your baby’s latch and vary breastfeeding positions,
- Feed baby on demand, not aiming to empty the breasts. Feeding baby more frequently than normal can result in increased milk production which can worsen inflammation and narrow your milk ducts.

Try not to:
- Use a breast pump when you have a blocked milk duct. Pumping does not provide the opportunity for bacterial exchange between your baby’s mouth and your breast which can change the microorganisms in breast milk. Breast pumps can also cause additional trauma.

If you are unable to clear the blockage you might develop mastitis. If you start to develop a fever, headache, muscle aches or chills or if your breasts become inflamed, sore, hot swollen or discoloured, consult with your doctor as you may have developed mastitis (an inflammation of the breast sometimes causing infection).

Each new mother’s breastfeeding journey is different. Whilst it can be difficult, if breastfeeding is something that you want to do for your baby keep at it. You and your baby will find your way.