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.
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.
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!
Your new baby has a very tiny little stomach. Very small amounts of colostrum in the early days is plenty for him to grow healthy and strong. Your colostrum is perfect for him, and it’s unlikely that he will need anything else!
Let’s take a look at the amount of colostrum that your baby needs in the first 4 days.
On baby’s first day of life, he needs about 2 to 10 ml per feeding, which is about the size of a cherry! In his first day of life, he will take about one ounce total.
On your baby’s second day of life, he needs about 5-15 ml per feeding – that’s about a teaspoon to about half an ounce per feeding, or about the size of a walnut. He will eat 8 to 12 times (or more) on day 2.
From month one to month 6, your baby needs 3 to 5 ounces per feeding, or a total of 25-35 ounces per day. Breastfed babies do not need as much milk as formula fed babies do, and they do not require more and more as they get older.
If you have any concerns about how much milk you are producing, or if you are unsure that your baby is getting enough, please talk about your concerns with a certified lactation consultant.
I am available for in-home consultations usually within 24 hours of your request. Call or email me if you have any concerns.
Beth Sanders, BSN, RN, IBCLC