Common Problems with Breastfeeding
Breastfeeding shouldn't be painful, so if your nipples hurt when you nurse, slide your finger into the corner of your baby's mouth until their tongue releases, and take your nipple out. Try feeding again, making sure your baby is properly latched on (see How Do I Know If My Baby Is Getting Enough Milk for advice on how to tell if they're latched on correctly). If your nipples bleed or become cracked and sore, seek help from a breastfeeding supporter as not latching on is a common cause of bleeding nipples (ask your health visitor or local clinic for details on how to contact them). Cracked or bleeding nipples often get worse if they're not treated.
As well as seeking help to ensure your baby is latching on correctly, you should treat cracked nipples by rubbing a few drops of breast milk into them after each feed, and then smearing lanolin cream or white soft paraffin into the cracks to prevent scabs. Let your breasts air dry before putting on a cotton bra, and change nursing pads often. You don't need to stop breastfeeding, as suddenly stopping breastfeeding can then lead to engorgement and blocked ducts. Nipple shields are also available, they are small teats that you place over your nipple and your baby is able to feed through them. By receiving help from breastfeeding counsellors and treating cracked nipples, you'll be able to continue breastfeeding in comfort.
Blocked ducts can occur when your breast isn't drained properly, as the milk builds up in your breast tissue, creating hard lumps which obstruct the flow of milk. Blocked ducts can also be caused or worsened by wearing a bra that's too tight, so use a bra fitting service and get a nursing bra that's fitted correctly. Other causes of blocked ducts include a blow to the breast and skipping feeds. To avoid blocked ducts, make sure your baby is properly latched on, so that they drain the whole breast. Try not to miss feeds, but if you do, make sure you express your milk instead. Blocked ducts can lead to mastitis if not treated, so use these tips to treat blocked ducts:
- Before you feed your baby, put a warm flannel on your breasts to stimulate your milk ducts, or take a warm bath or shower.
- Feed your baby from your sore breast first, and offer your baby your breast more often.
- If your breasts still feel full after nursing your baby, express some milk until your breasts feel empty.
- If your breasts are painful, take paracetamol or ibuprofen to relieve pain.
- Encourage your milk to flow from your milk ducts by massaging your breasts with your fingertips in a forwards motion towards your nipple when your baby is feeding.
Mastitis is an inflammation of the breast, and women who are affected by it may feel feverish, achy, tired and tearful, and have very tender breasts with hard lumps in them. There are often red patches of skin on the breast that feel hot to the touch. Mastitis can also cause a feeling of being generally unwell. Mastitis can be treated the same way as blocked ducts (see the tips on how to treat blocked ducts above), but if you are still feeling unwell after 12 hours, see your doctor as you may need antibiotics to clear it up.
Shortly after giving birth, your breasts produce milk for your baby, the start of this process is often referred to as 'your milk coming in'. This sometimes causes breast engorgement, which is when breasts become uncomfortably full, causing swelling and breast tenderness. Engorgement will pass as your body adapts to your baby's appetite, but can come back again if you suddenly stop breastfeeding, or miss feeds. You should feed your baby as often as he wants to be fed, but if your breasts are very full your baby might have difficulty latching on. If this happens, express some milk until your breasts feel softer. Applying warm flannels or cabbage leaves on your breasts also helps to draw out excess milk and soothes tender breasts. Paracetamol or ibuprofen can be taken to relieve pain caused by breast engorgement.
Some women get thrush on their nipples when they're breastfeeding. It has a variety of causes, such as having a history of thrush, taking antibiotics, and the baby not latching on properly. Thrush causes nipple pain, burning, itching and stinging. It can cause mild to severe pain in your breast, which can feel like shooting pains, and a deep ache and burning feeling within the affected breast. Some women get bright red nipples, and occasionally there will be a white rash on the nipples. Nipples infected with thrush may have cracks in them which don't seem to heal. Pain can occur after and between feeds. Thrush won't go away by itself, and both you and your baby will need to be treated, to prevent you passing it backwards and forwards between one another.
Tongue-tie, which affects 3-10% of babies, is when babies are born with a piece of skin between the underside of their tongue and the floor of their mouth. It stops the tongue moving as it should, which can prevent them from feeding properly. If you suspect your baby has a tongue tie, take him to see the doctor. It is easily treated with a simple procedure and the sooner it is corrected, the better.