Beginning Battles in Breastfeeding
Story by Aniela Whah-Wills
“Breast is best,” but it can hurt nonetheless. After you’ve brought that beautiful bundle of joy home and things just aren’t working as easily as you had hoped, it’s time to ask for help. From breasts as hard as rocks to a baby that won’t latch on, we’ve got solutions to the most common problems in getting the knack of breastfeeding.
A Perfect Fit? Look at the Latch
Babies were designed to nurse. But how they make that first connection can mean a world of difference in breastfeeding. Proper latch is essential. Heather Barber, a certified postpartum doula with Mat-Su Midwifery, says step one is to “make sure that no matter what position you choose, they are rolled in tightly to you: Their belly button is facing your belly button. If a belly button is facing up, they have to twist their neck and they tug.” The second step is to get baby to open wide. You can do that by brushing your nipple on baby’s lips and backing away until he opens up wide enough. The third step is the most important. Make sure their top lip barely comes over the nipple and the bottom lip and tongue are on the brown tissue below the nipple, but not actually touching it. Barber says: “Mommies have been told to center the nipple into the mouth, but the bottom lip and tongue are doing all that compression on the nipple itself.” That’s what leads to sore nipples.
Another way to check the latch is to check the shape of the nipple itself. If it looks like a tube of lipstick, like it’s been slammed in a book, or anything other than round, the latch is not right and it’s time to see a lactation consultant.
Sore, Cracked and Bleeding
Jen Aist, supervisor for the Lactation Program at Providence Alaska Medical Center, calls sore nipples “nature’s alarm system” that alerts moms something’s not right with the latch. “Tender is normal,” she says, but any pain that “makes you want to kick something is not normal” – such as bleeding, cracks, blisters and bruises. That’s when, she says, “(moms) need to come in and get help. Don’t wait for it to get better; 24 hours is a huge difference in newborn time and babies can do down the tubes really fast.”
After addressing any latch issues, moms can get help for cracked nipples by trying a few different products. A nipple shield helps for cracks. As for creams, Aist recommends Mother Love Nipple Cream over lanolin, because of its many “healing ingredients.”
Follow the baby’s nose. If it appears the baby has little room to breathe between his nose and your breast, adjust the baby so his jaw drops down on the breast. You can also try different positions like side lying or the football hold. Experiment until you find what’s most comfortable.
If it feels like you’re carrying bricks around in your bra, chances are you’re engorged. Typically, engorgement is uncomfortable, but not painful and should go away within 24 hours. To ease the discomfort, Aist says you can ice your breasts or take a warm shower. Barber says if it reaches the point of being miserable, use a warm compress, do some massage and hand express. You can also apply cabbage leaves, as the natural lactic acid helps to break down the swelling. Leave the leaves on until they are warm and wilted. If you feel the need to pump, only remove enough milk to soften the tissue. Barber warns for every drop you take off, it will signal your body to make more, starting the engorgement process again.
A similar complaint of nursing moms is plugged ducts. That’s when the baby is not emptying the breast effectively and the breast gets clogged. Debbie Hicks, RN, BSN, IBCLC, a lactation consultant at Full Spectrum Pediatrics, advises moms to heat and massage, while putting the baby on the breast every few hours and, if necessary, pump after feeding the baby.
To prevent plugged ducts, avoid underwire bras, even nursing ones, as the wire tends to dig in and cause break down. A nursing bra is best. When moms wear regular bras and flip them up, it also cuts off the glands above.
If you have a plugged duct, a fever and start feeling like you have the flu, it’s likely Mastitis, an infection that needs antibiotic treatment.
Lack of Supply
From too much to too little. Many moms feel like their baby is not getting enough milk. The best way to determine if that’s true is to weigh the baby before and after a feeding, while also watching the baby’s weight gain overall. Supply is easiest to manipulate during the first two weeks of life. If you know you’re going to go back to work, Aist suggests beginning pumping when the baby is a week old, as the prolactin levels are double then. She warns not to blindly take herbal supplements without knowing the risks. For example, fenugreek is bad for people with diabetes or asthma.
Hicks recommends Mothers Milk Tea or More Milk Plus – both can found in natural foods stores and nursing boutiques. “Moms need to take it until they exude the smell of maple syrup, which takes about three days,” she says.
Barber says beyond pumping or herbs, moms need to check their own behaviors. They should be getting enough rest, calories, hydration and breast stimulation.
Sleepy or Uncooperative Baby
Jaundice and sleepy babies may not show any interest in breastfeeding, or might fall asleep shortly after latching on. To wake them up, strip them down to a diaper and undress yourself to the waist. Wrap yourself and the baby in a blanket in what’s called “The Kangaroo Hold.” The baby will naturally gravitate to the breast to feed. You may also need to finger feed, cup or bottle feed while working out the kinks. Aist says to remember: “Rule No. 1 is feed the baby.”
When it comes to modesty, Aist reminds moms: “You don’t have to breastfeed in public ever, if you don’t want.” She says it takes the pressure off moms who are still trying to figure out how to breastfeed without the help of four hands and six pillows.
Nursing blouses and bibs allow for private space. If you’re still nervous, sit in front of a mirror and nurse, looking at all the different angles to see how better to cover up your breasts, baby and belly.
A Supportive Family
An unsupportive family can bring breastfeeding to an end before it really begins. Get Dad on board with your decision to nurse and make sure other family members understand too, so you won’t be tempted to let Aunt Milly feed your baby a bottle when you’re flat out exhausted.
Help! What do I do?
During your pregnancy is the best time to start researching breastfeeding. Ask if your doctor or pediatrician’s office has a lactation consultant. You can also call the La Leche League for help.
Providence offers a Cuddlers Group meant to encourage moms to help each other through the challenges of bringing a new life into the world. It meets twice a week. When in doubt, ask for help.