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Common problems while breastfeeding and how you can tackle them.

5 common problems you might encounter on your breastfeeding journey and some tips on overcoming them.


This is the next article commemorating world breastfeeding week between 1st - 7th Aug


1. "NOT ENOUGH MILK!"


This is the most common problem that forces new moms to turn to formula milk.


Know about colostrum: Breast milk production in a newly delivered mother begins slowly and takes a few days to become well established. This is perfectly normal. The initial 24-48 hrs the breast produces a thicker yellow coloured fluid called colostrum which is rich in nutrients and immunity factors needed for your baby. This could be as less as 1-5ml on the first day and that is perfectly alright. The baby’s stomach is about the size of a marble at this time and just a few drops of colostrum are enough to satisfy her hunger.


Don’t miss the golden hour: Start to breastfeed in the first 1 hr after delivery to ensure maximum benefit. If you have had a normal delivery or an uncomplicated cesarean and your baby is healthy, you should begin to breastfeed her within this hour. If for some reason your baby is not with you and kept in the NICU or the hospital nursery as adviced by your doctor, don’t worry. If possible try using an electric breast pump to stimulate milk production in your breasts and begin feeding the baby as soon as you are able to be with her.

Repeated suckling by the baby. A newborn baby has just come out of a dark, quiet, warm and cozy environment of the mother’s womb into a bright, loud and cold world. She will take a while to get used to it. While she is adjusting, her only way of expression is to cry. So everytime the baby cries it is not due to hunger. This is true even for an older baby. It is common for relatives and others to constantly suggest that you are not making enough milk needed for the baby. This may not be necessarily true. It just reduces your confidence and convinces you to start using formula milk early.


Formula milk may do the job of filling your baby's stomach but it is definitely less preferred to breast milk. It lacks the rich immunoglobulins (immunity providing proteins) that are present in breast milk and the many other benefits of breastfeeding.


Giving formula curbs the baby’s hunger and reduces her chance of suckling at the mom’s breast. So the lesser the baby sucks, lesser is the stimulation for milk to be produced in the mother’s body. It becomes a vicious cycle. So unless completely unavoidable, try not to introduce formula milk at an early time when your breast milk supply is not fully established. Tune out the million voices of unsolicited advice and keep letting the baby suckle at your breast every 1-2 hrs. Switch sides every 15-20 minutes. Keep practicing the right latch and positioning.



Skin to skin contact between mom and baby: If your baby is still not able to suckle effectively or is cranky. soothe her by placing her on your bare chest after removing the swaddle. Let the baby’s skin come into contact with your skin.


Inside the womb all she could hear was your heart beat and breathing. So when you put her on your chest and she hears these familiar sounds and feels the warmth of your skin, she will calm down. She may even move towards the nipples instinctively. Once she is calm, you can try positioning her again to feed.


Skin to skin contact also stimulates the mother’s body to release oxytocin, the milk secreting hormone. Oxytocin also has stress relieving effect on the mother. You could also use a newborn baby sling and try baby wearing . It has the same effect.


Increase your fluid intake: Make sure to drink atleast 3-4 lt of water or other fluids everyday. Eat foods rich in protein and calcium. Continue to have your supplements. Your calorie requirements will be high at this time so eat frequently.


Avoid nipple confusion: Nipple confusion is when the baby loses interest in the real breast and prefers other artificial nipples like pacifiers and feeding bottles. Do not introduce pacifiers or bottles at an early stage when your baby has not yet got the hang of breastfeeding. If you need to express your breast milk and feed, use a cup and spoon or palladai.


2. Sore nipples

Normally breastfeeding is not painful. If you have the positioning and the latch right, breastfeeding will be comfortable for the mother. Sore nipples happen because you have not yet mastered the correct latch and positioning. Don't lose heart. It will get better as you feed more often.

Sit comfortably with your back well supported or lie down to your side. Do not hunch over the baby. Lying down and feeding is only recommended if you are unable to sit up. Be careful not to fall asleep. Look at the picture below to ensure the right latch between the baby's mouth and nipple.


Find helpful videos HERE to get the right position.


Use a lanolin containing nipple gel/cream, coconut oil, kokum butter. These are safe for the baby and you need not wipe off before the next feed. Do not use soap on the nipples during bath.


Look for hunger cues in your baby like smacking her lips, turning head from side to side, clenching the fist, protruding her tongue. Begin feeding at this time instead of letting her get too hungry and cranky when positioning may become difficult.


3. Engorged breasts:

Sometimes the breasts get filled with milk and become hard and painful making it difficult to feed. This happens when you don’t feed often, if the baby is not suckling effectively or in case of a blocked milk duct.

  • Get the positioning and latch right,

  • Feed on both breasts at every feed.

  • Feed more often.

  • Massage gently to avoid any pockets of milk.

  • Use your index and middle fingers to gently press just behind the nipple to relieve some of the pressure and guide your nipple into the baby's mouth,

  • Soak a clean cloth in some warm water and keep it on the engorged breasts to relieve pain.

  • Use pain relieving medications as advised by your doctor.

In case you develop a fever, redness or unusual swelling of the breast, contact your doctor immediately.


4. Inverted or flat nipple.


Size of the nipple does not determine effective feeding. Some women have flat or pulled in nipples making latching on a bit more difficult. This is not a cause of major worry. If you feel your nipples are not the right size, speak to your doctor or lactation consultant. There are ways in which they can help you achieve the right latch in spite of it.


5. Nipple and breast infections


Repeated suckling by baby, injury to the nipple and prolonged moisture can cause fungal infections in the nipple. The nipple becomes red, inflamed and may have cracks or excoriations. Even with a good latch, you might still have pain and cloth brushing over the nipple may be painful. This fungal infection may spread into the baby's mouth causing oral thrush.

  • Avoid tight fitting bras and synthetic materials.

  • Change bras often and wash them in hot water

  • Keep the nipples dry in between feeds

  • Do not use breast pads as they can retain moisture and irritate the nipples

  • Wash your hands before and after each feed

  • Consult your doctor. He/she will prescribe antifungal medications.

  • Pump out your breastmilk and feed till the symptoms subside.

  • Wash the parts of the breast pump throughly and place in boiling water after each use.

Repeated breast engorgement can cause serious infections of the breast like mastitis or breast abscess requiring antibiotics. Consult your doctor immediately at the first sign of fever, redness or unusual breast swelling.


Resources:

https://www.llli.org/breastfeeding-info/

https://www.nhs.uk/conditions/pregnancy-and-baby/problems-breastfeeding/



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