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5 Breastfeeding Challenges
You CAN Overcome!

There are 5 common breastfeeding challenges that often confront new mothers. Luckily, you don't need to throw in the burp rag and give up! You can overcome these challenges easily.

Breastfeeding did not come "naturally" to me. I (and my babies) had to work through some tough times. Breast feeding is a process of learning about yourself and your baby. It's about working as a team (here's your pep-talk!).

breastfeeding challenges
When Baby Ain't Happy...
Ain't NOBODY Happy!
{Photo by blinzelblinzel}
Sometimes it comes together like milk and cookies; while at other times it's more like oil and water. But if you keep mixing, eventually the two will come together.

You know that saying? Insanity is doing the same thing over and over and expecting a different result. Well, if you're experiencing breastfeeding challenges like these, it's time to shake things up and do things differently.

Common Breastfeeding Challenges



Breastfeeding Challenges #1:
Inverted Nipples

When you press the areola (the darker-skinned area around the nipple) between two fingers, the nipple should protrude and become erect. If it seems to sink and disappear into the areola instead, it is said to be "inverted" or "tied". This will cause problems with breastfeeding. The baby will have a hard time grasping the areola and getting milk from the ducts (making him grumpy!).

Oftentimes the "flat" nipple will go soft after a few minutes of sucking, making it hard for your baby to maintain his latch.

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The Solution:

This problem is easily solved. If you discovered your nipples were inverted before delivery, you'll need to purchase a breast shield. This hollow-dome device will be worn inside your bra during the day (although you may not want to wear them outside the home). The circular area creates a gentle uniform pressure around the areola, causing the nipple to protrude. Eventually the nipple will naturally take this shape and you'll be ready to nurse.

If you discovered your nipples were inverted after delivery (or if the shields didn't work) a lactation consultant or nurse at the hospital can help you draw out the nipple with a breast pump before putting the baby to breast. The suction created by the machine can make an otherwise flat nipple stand out enough for your baby to latch on properly. Usually this kind of intervention is only necessary for a little while.

The Medela Contact Nipple Shield is a shield that you use while your baby is nursing. There's a little cut-out notch for his little nose to go. It will help draw out your nipple and help him maintain his latch even if your nipple goes soft and doesn't stay erect. If you put a little dab of lanolin cream under the plastic, it will help hold it in place. Note: These shields come in different sizes, so click on the link above to see the size best for you.


Breastfeeding Challenges #2:
Latching Problems

An improper latch can be attributed to 90% of all breastfeeding challenges. If your baby's cheeks remain smooth while she is sucking, she's got a good latch. If your baby's cheeks dimple, the latch is incorrect and you'll need to break suction (insert the tip of your finger into the corner of her mouth) and try again.

An incorrect latch can lead to sore, bruised, or cracked nipples. It will also fail to properly compress the ducts within the breast to express the milk your baby wants. Frustration for both of you will be the result.

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The Solution:

Hold your breast with your thumb above the areola, your fingers and palm on the underside of the breast. Gently compress the breast and tease your infant's upper lip until she opens wide. When that happens, quickly move her open mouth to your breast. (Always baby to breast, never breast to baby!) The football-hold or cross-cradle hold are good positions to start with. You can see these positions (and others) here. Getting the latch right is the first step to elminating many breastfeeding challenges.

Keep your fingers behind the areola and be sure the nipple is pointed level or slightly DOWN to keep it from rubbing on your infant's hard palate (ouch!). Your fingers should be no closer than 2 inches to the infant's mouth. Click here to see the specific steps to breastfeeding.


Breastfeeding Challenges #3:
Cracked Nipples

I can speak from experience (a long time ago) that cracked, bruised, and sore nipples HURT. There was a time when I would weep while nursing. (That time was before the EiR was started!) Fortunately, it doesn't have to be that way. Cracked nipples are almost always caused by incorrect positioning at the breast or incorrect latching that allows the baby to bite or traumatize the nipple.

You should not have sustained pain while breastfeeding. There may be a few seconds of discomfort at the beginning (as your nipple is stretched), but it should go away within 20-30 seconds. Your nipples will develop a callus that will make breastfeeding easier later on.

If your nipple is sensitive at the tip, it is probably entering your baby's mouth at an upward angle and rubbing on her palate. Re-latch with your nipple pointing downward.

If your nipple is sensitive at the base, it's most likely being chewed during feedings. Your baby needs to take the entire areola (or as much as possible) into her mouth when she latches on, so the nipple is lying against her tongue. If she doesn't open her mouth wide enough for the areola, your nipple will be gummed continually and your baby won't get enough milk. Crying mother and screaming baby will quickly send Dad to Walgreens for formula.

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The Solution:

There are many things you can do/try to help alleviate pain and prevent further trauma to your breasts. I've listed them here in order of minor-to-major interventions you can try.
  • Wash your breasts only with water, not soap. Creams, lotions, and vigorous rubbing will not help, and could even aggravate your nipples further. (PURE lanolin is an exception to this - but make sure your breast is dry before applying.)
  • After each feeding, express a little milk and rub it onto the sore nipple. The dried milk will leave a protective covering on the nipple.
  • Try varying the positions and limit "comfort sucking" (when baby just wants to suck and isn't hungry) to 10-15 minutes.
  • In humid climates, try to expose your breasts to the air as much as possible. Avoid plastic shields, or plastic-lined nursing pads since they may encourage the growth of bacteria on the breast. Some moms have even used a blow-dryer (on low) to help keep their breast dry after feeding.
  • If your baby is premature or really small, he could be struggling to get your nipple and areola into his tiny mouth. Using the football-hold or lying down may help him get more of the areola into his mouth. (See these holds here.)
  • Think in terms of shorter, but more frequent,nursing sessions.
  • Apply ice onto the nipple (to help numb it) right before nursing.
  • Wear breast shields under your bra,
  • If you are bleeding, or each feeding seems to hurt worse, you can use a breast pump to give you a break. Pump regularly and feed the baby breastmilk with a bottle. Reintroduce your breast after you've had a few days of healing.
  • Tylenol (acetaminophen) or Ibuprofen can be taken 30-60 minutes before you nurse. This shouldn't become a habit and is only for short-term situations to help you continue nursing. The American Academy of Pediatrics has approved Tylenol and Ibuprofen for nursing moms.

Breastfeeding Challenges #4:
Let-Down Problems

"Let-Down" is when your milk begins to flow. This is a natural process that happens automatically, making it a reflex. "Automatic" means your brain chooses for you, without your consious decision (like breathing). Usually if there are problems with let-down, it's psychological. It can be caused by too many distractions (if you're in public), embarrassment or anxiety about nursing, fatigue, or pain.

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The Solution:

Set up a calm "nursing station" in your home that's comfortable and relaxing. I always sit in a comfy chair (I'm addicted to gliders) with pillows sticking out all over. Besides soothing music, try sipping a smoothie or other comforting drink. (If you drink coffee or caffeinated tea - make sure you increase your water intake!) Listening to relaxing music while breastfeeding has also been effective for some mothers.

Try to get as much rest as possible, napping when he is napping. Allow people to serve you with the house, meals, watching older kids etc. If you find yourself without much support, consider hiring a sitter for older children or a cleaning service for a few weeks/months. SitterCity currently offer a 7-day free trial - click here to see it. They can help you find qualified and safe babysitters in your local area.

Do not smoke, consume alcohol liberally or use illegal drugs. All these things can interfere with let-down, affect the content of breastmilk, and are harmful to your baby.


Breastfeeding Challenges #5:
Engorgement

Engorgement is a common malady that nursing mothers experience. It is when your breasts are overfilled with milk and get rock-hard. The build up of pressure can sometimes be very painful. Engorgement makes it difficult for your baby to latch on properly.

This swelling will also cause congestion in your breast and slow down the milk flow, so even if your baby does manage to latch on, she may be frustrated with how slow the milk is coming. Constant engorgement can even inhibit further milk production.

Engorgement is the most frequent of the breastfeeding challenges. It happens most in the first few days and weeks of breastfeeding as your lactation is getting established. However, it can happen any time when feedings are skipped. Waking up engorged in the morning is not uncommon.

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The Solution:

There are several things you can do to help ease the pain of engorgement.

The best preventative remedy is to nurse your baby whenever he is hungry, emptying both breasts every two to three hours in the first few weeks.

If you're already engorged, here are some suggestions:

  • Soak a washcloth in warm water and lay over your breast, or take a warm shower.
  • Try using a cold compress on your breast as you use your hand to express milk. (Hold the breast between your thumb and forefinger and apply light pressure until the milk begins to flow.)
  • An old favorite? Cabbage leaves. Wash and dry the leaves and place them on your breast under your bra. Leave on for 20 minutes, up to 3 times a day. Sounds wierd? It actually works, I promise!
  • Massage your breasts from under the arm down towards the nipple. This will help reduce soreness and ease milk flow.
  • If you really need to, Tylenol or Ibuprofen can be taken to help relieve engorgement pain. Pain medication should not be taken regularly, but only as a last resort. If you are continually struggling with engorgement and feel you need to take medication almost constantly, speak with your doctor.
  • Experience the wonders of Booby Tubes. These flax-filled tubes of joy will provide hours of soothing spa-like comfort. They truly are amazing and a personal favorite. (A must-have for those first few weeks and the last few weeks, during weaning.)

Do You Have Breastfeeding Challenges that Aren't Listed Here?

Post Your Question for Others to Help


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Pushing through these breastfeeding challenges will give you a renewed sense of accomplishment and pride in being HER mom, HIS mother.

Try these solutions to help you push through these breastfeeding challenges. If you're still struggling after trying them, ask your local lactation consult, doctor, or even other moms here at the EiR for help. We want you to have a good breastfeeding experience!

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Photos used on this page were found at www.flickr.com and were used with permission and according to guidelines.

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