Help! Breastfeeding is Painful! Is Something Wrong?
The early days and weeks of breastfeeding can be difficult as mom’s hormones are shifting dramatically and she is getting less sleep than she is used to. Sore nipples can make the adjustment even more stressful. Some well-meaning friends or family members might tell moms that they need to “toughen up” their nipples, or advise them to give up and just bottle-feed. If your nipples are hurting, it is important to find the cause of the pain and to make the necessary adjustments so you can continue breastfeeding.
Discomfort in the early days of breastfeeding is not uncommon and might be normal, as long as it is mild, it lasts only a few seconds at the beginning of a feeding, and the nipples look normal after feeding. Toe-curling pain that lasts throughout the feeding and/ or between feeds, and nipples that are misshapen, white, scabbed, or cracked are not normal. Moms who are experiencing these things are encouraged to seek help from an IBCLC right away.
Most of the time, sore nipples can be resolved by making some adjustments in how the baby is positioned at the breast. The vast majority of nipple pain is caused by positioning and latch errors. Sometimes, small adjustments can make a big difference in mom’s comfort!
Could My Baby Have Tongue-Tie?
If you are experiencing pain while breastfeeding, it is important to seek help from an IBCLC who can help you with positioning, evaluate your baby’s latch, and evaluate your baby for anatomical variances such as tongue or lip-tie. If your baby does have a tongue or lip-tie, and you are having breastfeeding difficulties, there are some very affective treatment options that your IBCLC can discuss with you. Sometimes a tongue-tie is hard to see. Sometimes, a baby might have an obvious-looking tongue-tie, but a full evaluation is necessary to make sure there are not other problems going on.
If it’s Not Tongue-Tie, What Could it Be?
Some other things that can cause severe nipple pain include Raynaud’s Syndrome, skin conditions, or infection. The baby may have difficulty with sucking and require suck training. Some babies have misalignment that causes sucking difficulties, and can be helped by a specialist in Cranio-sacral therapy.
If you are hurting, get help right away! There is no need to continue suffering, when an IBCLC can help you find out what the problem is and what to do about it.
Even though breastfeeding is natural, it is not always easy, especially in the early days and weeks. Speech and walking are also natural, but it takes some practice and some pretty good coaching before speech or walking become easy for us.
It is also natural to have difficulties with breastfeeding at first. If you are having any difficulties with breastfeeding, I make lactation consultations in your home, and I can help you on the path to a breastfeeding experience which feels natural and comfortable to you. Call or email me, I can help you usually within 24 hours of your request!
Help! My Baby is Feeding All the Time! Is This Normal?
In the early days of your baby’s life, between the hormones, the visitors, the other children and pets, and the exhaustion, it’s easy for moms to feel overwhelmed! Add to this a baby who seems to want to breastfeed all the time, and moms can despair and lack confidence.
On your baby’s first day of life, he will take an average of 1 to 2 teaspoons of colostrum per feeding. Those tiny meals allow your baby to lose some of the extra fluids that are in his body at birth, empty his bowels, and practice lots of feedings without taking in too much.
Your baby might not have many meals in the first 24 hours, but by the second day of life, he will be eating 8 to 12 times or more per day! Most babies cluster feed in the evening and nighttime hours during the first few days of life. Cluster feeding simply means your baby wants to have several meals back to back. It’s important to understand that when your baby cluster feeds, this is perfectly normal and expected, and it does not mean that something is wrong or that your baby is starving.
If everything is fine, why is my baby sucking so much?
Each time your baby latches, even though he isn’t getting a large meal, he is doing a very important job: telling your body to make lots of milk for him. As he sucks at the breast, your breast is changed and milk production is triggered. The more he latches in the first few days, the more milk you will be making in the first weeks and months.
More sucking now = more milk later!
Your colostrum is all your baby needs, and it’s really important to not despair and give your baby formula during those few nights of cluster feeding! Continuing to offer him your breast when he is acting hungry, even if he just had a meal, will:
1. Give baby everything he needs and wants
2. Trigger your breasts to make lots of milk
3. Help prevent engorgement
4. Help calm you and increase your confidence.
Anytime you are not sure if things are going well, make sure to consult your pediatrician or an IBCLC. I can visit you in the comfort of your home to assess a feeding and make a customized feeding plan for you. I will weigh your baby with my hospital-grade baby scale before and after he eats, so we will see how much he's getting. I am available to come to your house to help you usually within 24 hours of your request! Contact me here.
Having a baby in the NICU can be extremely stressful and traumatic for families. Moms who want to breastfeed experience additional stress because they are separated from their babies most of the day.
Pumping milk for your NICU baby is worth the effort!
If you have any questions about pumping milk for your NICU baby, I can help you. I have experience in the NICU both as an RN and as an IBCLC.
In-home consultations are usually available within 24 hours of your request. If you have any concerns, don’t hesitate to call and get help!
If your baby was born before 37 weeks, he was premature. Some babies who are born between 34 and 37 weeks are healthy and large and strong, but they need to be watched closely to make sure they feeding well and gaining enough weight.
Babies’ brains grow and develop a lot during the last few weeks of pregnancy. If your baby was born early, his brain is still growing and developing just as it would if he were still in the womb. As his brain grows, he becomes more and more ready to take all of his meals from breastfeeding; but in the early weeks, he might not be ready, and supplementation may be necessary.
It is very possible for you to breastfeed your premature baby, but you might face some challenges. You might have to pump frequently to make sure you establish a good milk supply if your baby does not have the stamina to take a full meal from the breast. Before your baby’s brain is mature enough, he might not be able to stay awake long enough to take full meals from the breast. There are distinctive suck patterns that you can look for to know when your baby is strong enough and awake enough to take a full meal at the breast. A weighed feeding will also help you know how much milk your baby is taking, and if he needs more.
It is important to remember that your early baby is probably behaving and feeding normally for his age and that feeding challenges are not your fault! A Lactation Consultant can help you make a plan that allows for your baby to thrive while guiding you toward your breastfeeding goals. When working with an IBCLC, you will be able to figure out how much supplement your baby needs, and explore different feeding options that work best for you.
I would love to help you make a feeding plan that works for you and your family. I am available to visit you in your home, with my hospital-grade baby scale, so we can evaluate how your baby feeds and how much milk he gets during breastfeeding. I am usually available within 24 hours of your request. Please call or email me if you have any concerns about breastfeeding your premature baby! I can help you!
What are Plugged Ducts?
Plugged ducts occur when cells and breast milk get stuck in the milk duct and the milk does not drain properly. Plugged ducts can cause a painful, red lump on the breast behind the duct as the milk gets backed up.
What Causes Plugged Ducts?
Plugged ducts can be caused by poor milk drainage. It is important to have a lactation consultant check the baby’s latch and assess the baby for tongue tie. A poor latch or tongue tie can lead to inadequate milk drainage, which can cause a plugged duct.
A lactation consultant can also assess mom’s breast for milk blebs. Milk blebs can block the nipple pore from allowing milk to come out. If mom is using a nipple shield, experiencing oversupply or engorgement, sore or damaged nipples, thrush, she is at a higher risk for plugged ducts.
Plugged ducts can also be caused by chronic inflammation from unresolved or inadequate treatment of previous mastitis.
Moms who are interrupting or abbreviating feeds, tired, over stressed, busy, not getting enough rest or proper nutrition, experiencing illness, dehydration, or anemia, or eating too many saturated fats have a greater risk for plugged ducts.
How to Prevent and Treat Plugged Ducts
Make sure mom is getting some rest, and look for ways to reduce stress. Good hydration and nutrition – a well rounded diet with limited saturated fats – will help.
Supplements of Vitamin C and Lecithin have been shown to improve clogged ducts.
Eliminate pressure points on the breast (squeezing the breast during feeds, tight or restrictive clothing, etc.)
Use a moist, hot compress and gentle massage before feeding, and gentle pressure behind the lump during the feeding.
If you are struggling with plugged ducts or milk blebs, I can help! Click here to request an appointment. I will come to your home and help determine the cause of your breast pain and make you a customized feeding plan to help you get back to feeding in comfort.
Pumping at work is a big source of stress and worry with new moms. Most employees are protected by law to pump breastmilk while at work and must be provided with time for pumping and a clean, private place to pump that is not a bathroom.
Breastfeeding women are tremendous assets to their employers; they are organized, hard workers, creative, and motivated. Most importantly, their babies tend to be sick less often than formula feeding babies, which keeps mom at work instead of taking sick days.
Skipping pumping sessions can be painful, can lead to mastitis, and can put mom's milk supply at risk. NPR recently posted this article about missing pumping at work. Perhaps it will help your boss and co-workers understand how important it is for you to get a break to pump.
I am available to help you make a plan for returning to work. Contact me for an appointment and I will help you feel confident and ready to return to work.
All moms are working moms, but this mom redefines "working mom". All respect!
The answer depends on whom you ask, so let’s ask the experts.
The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend breast milk only for baby’s first 6 months of life, and continued breastfeeding with the addition of solid foods from 6 months to at least one year.
Many studies worldwide have shown that the health benefits of breastfeeding to mom and baby are dose-dependant, meaning, more is better. For example, the longer a woman breastfeeds, the lower her lifetime risk of breast cancer, ovarian cancer, type 2 diabetes, and other illnesses. This longevity affect is cumulative, so breastfeeding multiple babies increases the protective power of breast milk on mom’s health.
Furthermore, the health benefits to the baby are increased the longer the baby breastfeeds. The longer the baby breastfeeds, the less likely he will experience health risks such as childhood cancer, diabetes, obesity, and certain infections. Older babies and toddlers still need immunity protection from breast milk because their immune systems are not mature yet. There is great nutritional value for a toddler in his mom’s breast milk.
Studies have also demonstrated that children who were held often and for long duration as babies, and who received comfort from breastfeeding as toddlers, grow to develop confidence and independence. When toddlers learn that they are safe and nurtured, they grow into confident children.
The American culture has decided that breastfeeding older babies or toddlers is weird, and that cultural norm hurts our babies and families. Worldwide, and throughout history, babies have been breastfed well into childhood, and this practice has been perfectly normal and healthy for children and communities.
It is important for you to decide how long to breastfeed your baby based on the scientific facts of the health and emotional benefits to you and your baby from extended breastfeeding as well as the impact that breastfeeding has on your family. If you decide to continue breastfeeding beyond your baby’s first birthday, you are perfectly normal! You and your baby will benefit, and there is nothing harmful about this practice. Feed on, mama!
Click here for the AAP policy statement on breastfeeding.
Can I breastfeed if I have had a breast reduction?
There are many reasons women have breast surgery, and cosmetic concerns are by far the most common. However, there are some risk factors, such as obesity, diabetes, hypothyroidism, or PCOS, which need to be considered when a woman has had breast reduction surgery and later wants to breastfeed. Make sure you discuss your health history with your lactation consultant so that she can help you make a feeding plan that will best meet the needs of you and your baby.
The likelihood of you being able to exclusively breastfeed depends on the surgical technique used, the amount of glandular tissue removed, and the resultant integrity of blood supply and nerve pathways.
The pedicle technique leaves the nipple and areola attached to the breast gland on a stalk of tissue. A wedge is removed from the undersides of the breast; for the most part, the breast tissue, blood supply, and some nerves remain intact, and breastfeeding will have varying degrees of success.
The free nipple technique removes the nipple areola entirely. The blood supply to the nipple areola is severed and nerve damage occurs.
The amount of breast tissue removed does not appear to affect breastfeeding. The most important factors that do affect breastfeeding are the integrity of the nerves and of the milk ducts. Incisions around the areola are more likely to cause nerve damage and severed milk ducts than incisions in the fold under the breast or in the armpit.
If your breast surgery involved removing some of the milk making glands, this will likely affect the volume of milk you can produce. Milk ducts are more likely to be cut when surgical incisions are made around the areola or into the body of the breast, rather than incisions made in the fold under the breast or in armpit. Milk ducts do regrow, and the rate of regrowth is faster during pregnancy and breastfeeding. This means that you can possibly produce more milk with subsequent pregnancies.
Nerves can regenerate over time, at about 1 mm per month. The more time has passed since your surgery, the more sensitive your breasts and nipples are likely to become, which increases your likelihood of producing enough breast milk. The amount of sensation in your breast will be an important indicator of the amount of nerve damage sustained. If you can feel both touch and temperature on your areola and nipple, you are more likely to experience normal milk ejection during breastfeeding.
Tips for breastfeeding after breast reduction surgery:
One of the most common concerns I hear from moms is, "I don't know if I have enough milk." There are a few easy ways to know, so that you don't have to guess if your exclusively breastfed infant is getting enough to eat.
First of all, if you are feeding your baby on demand (not scheduling feeds, but feeding whenever he is hungry), and your baby is eating 8 times (or more) per day, that is a good sign.
Secondly, by the time your baby is 5 days old, if he is having at least 5 wet diapers a day and at least 1 yellow poopie diaper per day, this indicates adequate milk intake.
A third sign that your baby is getting enough is that breastfeeding is comfortable to you and your breasts are not hurting. This is a sign that your baby has a good, effective latch.
It is important that you can hear your baby swallowing when he is feeding. Your baby should be visibly more relaxed at the breast after he feeds than he was before the meal.
The most obvious way to monitor if your baby is getting enough is to check his weight. Obviously this is only helpful on days that your baby gets a weight check, and is not helpful on a day to day basis. Make sure you keep your baby's appointments with his doctor so that any possible problems can be identified early.
If you are experiencing all of these things, that is a very good sign that breast-feeding is going well and that your baby is getting enough milk:
These are NOT signs that you aren't making enough milk for your baby:
These are signs that your baby might not be getting enough:
If you have any concerns, call your baby's doctor or an IBCLC right away.
Greensboro Lactation Consultants can perform a "weighed feeding", meaning your baby will be weighed before and after a feeding. This will help us determine how much milk your baby is taking. I can be reached by phone here and by email here. In-home consultations are available usually within 24 hours of your request, so if you're worried about it, don't wait!
Beth Sanders, BSN, RN, IBCLC