How to deal with Breastfeeding problems

January 15, 2014

breastfeeding_ressizeJulie Carden, Infant Feeding Specialist, Lactation Consultant (IBCLC) and Tongue Tie Practitioner at Carmenta Life presents this checklist of common breastfeeding problems for a New Mum and her top tips on how to deal with them for breastfeeding success (not misery).  

Babies are born to breastfeed. Some mums and babies find breastfeeding is natural and enjoyable. However, for many others it can be a challenging journey. Successful breastfeeding can be a wonderful and rewarding experience for Mum, and those lucky babies have the very best start in life. Though, when problems occur, overcoming these issues can feel overwhelming, especially without the right support.

If you are struggling then it’s good to know that most issues that mothers may encounter are very preventable!

Some issues can be due to a structural problem with the baby, or the mother, and these can usually be solved to help breastfeeding work. And most breastfeeding issues actually stem from a poor latch.

Firstly, it’s important to understand the physiology of how breastfeeding works, and how to achieve an optimal latch. With this education you then know what to look out for and see the warning signs preventing problems before they start. Do take a look at my article:
‘How to succeed with breastfeeding your baby’. 

The most common issues include: 

Sore nipples
It’s widely perceived that it is normal for breastfeeding to be painful. This is a myth!
Breastfeeding should be pain free. If it hurts, it is because baby is not latched correctly. Normally this is due to incorrect positioning and attachment.
Tip: Remember to tuck baby in really close, encourage a wide gape with nipple just under the nose, and keep the nipple pointing up towards the roof of the mouth.

This occurs when baby is not draining the milk effectively. This causes blocked milk ducts which may become infected causing mastitis.
1. Ensure that baby is draining the breasts fully so they feel soft after a feed.
2. Ensure a good latch and strong sucks and swallows throughout the feed.
3. Compression of the breast (squeezing) often encourages stronger suckling to ensure good drainage of the fatty (hind) milk.
4. If there are any tender, red or lumpy areas on the breast it is important to massage these during and in between feeds to disperse any blocked ducts. It may help to start feeds on the affected side until it is resolved.
5. It may be necessary to express after feeds to ensure good drainage.
6. If symptoms worsen or a fever is experienced, a visit to the GP is recommended incase antibiotics are required.

Thrush is a fungal infection that can occur in the breasts and nipples. Often living naturally in the body, it can become overwhelming if the immunity is low, causing sore/itchy/painful nipples during and after feeds, and baby may have a sore mouth and bottom.
1. It is a good idea to boost the immunity, especially if antibiotics have been used, by taking a multi vitamin with probiotics, probiotic drinks/yoghurts or acidophilus tablets.
2. If thrush is indicated, a prescription of Daktarin cream for the nipples is effective, and baby needs to be treated too, usually with Nystatin, which any GP or Health Visitor can advise on. If there is infection deep within the breast this can also be treated.

Perceived low milk supply
Normally nature produces the correct quality and quantity of milk for a baby at each stage of his/her development. Good milk production is maintained by the baby having unlimited access to the breast day and night, ensuring a good latch, and, importantly, ensuring the breast is drained well. This encourages stimulation of the milk hormone, prolactin, as milk is produced on a ‘supply on demand’ basis.
1. Obstacles that may hinder milk supply, are routine/timed feeds, offering bottles/supplements, poor latch. To increase milk supply it is important to offer the breast frequently.
2. Expressing after feeds for really good drainage helps, and a galactogogue (medicine to increase milk supply) may be useful. These can be herbal eg. Fenugreek, or prescribed.

Milk Bleb
This is seen as a small dot of white on the end of the nipple. It is caused by one of the many milk exit holes becoming blocked by skin forming over the opening. It can be painful and cause blocked ducts.
1. Gently massaging oil on the nipple can help to soften the skin so it naturally breaks as baby feeds.
2. Gentle abrasion with a clean flannel may help.
3. Good hand hygiene is important to prevent infection. In extreme circumstances a sterile needle is used to gently break the seal.

Vasospasm of the nipples
Otherwise known as constriction of the blood vessels behind the nipple. It is common in the winter and if Mum has a tendency towards having cold fingers and toes, or Raynards phenomenon. It tends to be worse with a poor latch, or if Mum is very anxious. And it tends to improve with warmer weather, better latch and confidence.
1. Keeping the nipple area warm is the key, only exposing the breast for a feed and covering up quickly after.
2. A warm area to feed, and warm clothing help.
3. If it becomes more of a problem, a visit to the GP may help.

Tongue Tie
This is when the frenulum, or piece of skin which connects the baby’s tongue to the floor of the mouth, is shorter or more forward. This may result in restriction of tongue movement, which may lead to breastfeeding difficulties – such as sore nipples, blocked ducts, poor drainage of the breasts, difficulty in latching and maintaining good suction and weight loss in the baby.
1. If there are breastfeeding issues after addressing any latch problems and basic feeding issues as discussed, it is a good idea to see a breastfeeding expert to check for tongue-tie.
2. Prevention is better than a cure. It is alway a good idea to check baby has the best latch possible right from the beginning. If any difficulties start to arise, seek professional help sooner rather than later.

Carmenta Life, offer a free breastfeeding support clinic and tongue tie assessment in their Berkhamsted Clinic every Thursday 1-3pm with Julie Carden and Cathy Johnson, experienced Lactation Consultants with a background in midwifery.  Julie Carden is a tongue tie Any breastfeeding mum is welcome, it is informal and relaxed Tongue Tie Practitioner, having trained at Southampton General Hospital.
The clinic is more like a cafe – it’s relaxed, informal, impartial (and non-judgemental!) and there is no need to book. Just Drop-in.
Cathy and Julie are both on hand to offer their combined year’s of experience, support and answer your questions.

One to one support:
Home Visits and Private Consultations for Breastfeeding support or Tongue Tie Assessment and Consultations at a time to suit you.
Held at your home or Carmenta Life.

For more information, contact:
Julie Carden – 07702 669558
Cathy Johnson – 07899 995622



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