Common Breastfeeding Problems

🤔 Struggling with breastfeeding? You’re not alone!

Engorgement, ductal narrowing, and mastitis

Engorgement

Swelling that can happen in the tissue around the ducts.
Typically happens when the milk first comes in, within a few days of birth.
It makes both breasts full and painful.
If your body makes more milk than your baby eats, this can also lead to engorgement.
If your breasts are engorged, they might feel swollen, hard, warm, and painful.
Your baby might have trouble “latching on” to your nipple.

Ductal Narrowing

Occurs when swelling in part of the breast makes the milk ducts narrower. When this happens, milk cannot flow as easily. This is sometimes called a “blocked” duct.
Sometimes, ductal narrowing can cause a painful breast lump.
The skin over the lump might be red.
It can also cause a white plug at the end of the nipple.

Mastitis

Inflammation in the breast.
It can happen if ductal narrowing does not get better and continues to prevent milk from flowing.
If milk flow is blocked for more than a day or 2, mastitis can lead to a bacterial infection in the breast. This can cause more symptoms like fever, aches, or feeling very tired. This needs treatment with antibiotics.

Treatment:

Try to breastfeed regularly. Feed your baby when they are hungry, and make sure they latch on the right way. Trying different positions can also help with milk flow. If you have engorgement, it might help to gently massage the breast.
Do not try to empty your breast completely when feeding or pumping. This can cause your breasts to make more milk, which can make engorgement or ductal narrowing worse.
If your baby is having trouble latching on, you can use your hand or a breast pump to let a little bit of milk out before a feeding. This softens your breast so your baby can latch on better. If you use a pump, use it for just a minute or 2. Releasing too much milk or pumping too often can make engorgement worse.
When possible, feed your baby directly instead of using a breast pump. Pumps sometimes do not move milk past the narrowed duct. Also, pumping can make engorgement worse.
Avoid using nipple shields.
Wear a bra that supports your breasts, but is not too tight.
To help with pain and swelling, put a cold pack or cool cloth on your breasts between feedings. You can also take a pain medicine.
Do not stop breastfeeding suddenly. This can make swelling in the breast worse.

Sore Or Painful Nipples

The most important thing you can do to prevent and deal with nipple pain is to make sure your baby latches on the right way. You might feel a tugging or pulling at your nipples while breastfeeding, which is normal. But if you feel pain or rubbing, take your baby’s mouth off your breast, and then have them latch on again.

Nipple pain that lasts for a whole breastfeeding session is not normal. It can be caused by nipple cracks, blisters, or bruises. Sometimes, nipple pain and problems latching on are caused by a condition called “tongue tie,” which is when the baby’s tongue cannot move as freely as it should.

You can also try these home remedies:

If your nipples are cracked or raw, you can rub a small amount of breast milk on them or try putting lanolin ointment (sample brand name: Lansinoh) on them. If you think your nipple might be infected, call your doctor or nurse. Do not put vitamin E or honey on your nipples, because these can be dangerous for your baby.
Put a cool or warm washcloth on your nipples.
Take a pain medicine
Wear breast pads between feedings to protect your nipples.
When your baby gets older and starts to get teeth, they might sometimes bite your nipple while breastfeeding. If this happens, try to position the baby so their mouth is wide open during feedings. That makes it harder to bite. If your baby does bite you, try sticking your finger between your nipple and the baby’s mouth and firmly saying “no.” Then, put the baby down in a safe place. This helps your baby learn not to bite. You can also offer a teething ring to chew on instead.

Nipple Colour Changes

The nipples can turn white, blue, or red, and be painful. This is more likely to happen if you are very sensitive to cold. It can also happen if your nipple is injured (for example, if your baby doesn’t have a good latch-on).

To treat this, you can:

Turn up the room temperature, and wear warm clothes.
Put a warm cloth over your breasts before and after breastfeeding.

It’s also a good idea to avoid things that make this problem worse. For example:

Avoid caffeine.
Avoid nicotine (smoking or vaping).
Do not take certain medicines. These include some medicines for colds or migraine headaches, medicines used to treat attention deficit hyperactivity disorder (“ADHD”), and some diet pills. Ask your doctor if you’re not sure about a certain medicine.

Should I See A Doctor Or Nurse?

Talk with your doctor or nurse if you have problems with breastfeeding. Tell them if you have:

Pain that lasts for a whole breastfeeding session
Blood leaking from your nipples
A swollen area in your breast that does not get better after 3 days
A fever of 100.4°F (38°C) or higher, and a hard, red, or swollen area of your breast
Flu-like symptoms, including muscle aches, chills, or feeling very tired
Worries you are not making enough milk

You can also talk to a lactation consultant for help.

Reference: https://www.uptodate.com/contents/common-problems-of-breastfeeding-and-weaning?search=common%20breastfeeding%20problems&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H26

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