Breastfeeding Problems
Common Nursing Problems

Nursing

pictures of breastfeeding problems

Breast Feeding Problems

Contents

Introduction
Sore Nipples
Clogged Milk Ducts
Mastitis Breast Infection
Thrush
Engorged Breasts
Leaking Milk
Milk Blisters
Nipples Turning White




Related Guides:

Breastfeeding Guide
The Female Body

 

milk blister
Milk Blister


Mastitis

Introduction

When you are learning to breastfeed it is common to run into a problem or two. Always ask for help, tackling breastfeeding problems quickly will give you more time to enjoy your first few weeks of being a mom. In many instances the solution may be something as simple as changing breastfeeding position or feeding more often.

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Sore Nipples

Sore or cracked nipples can make nursing miserable. Fortunately nipples don't stay sore for long, the skin toughens up and the process becomes painless. If your nipples continue to remain sore it may be that you need to change the positioning of your baby while feeding. The following tips may also help:

• If your nipples start to hurt during the feeding, take your baby's mouth off the breast and start again. You can do this by sliding your finger into the side of her mouth until she releases. Read, how to breastfeed for more advice.
• If you are feeding at home, allow your nipples to breathe by exposing them to the air for a few minutes after each feeding.
• Wear breast shells (hollow plastic disks worn inside the bra) to protect your nipples during the day (not breast shields - these are plastic disks worn during feeding and are only recommended in the first few days of feeding under the guidance of a lactation consultant).
• Keep your nipples dry. If you are wearing breast pads, change them as soon as they become damp. Run a warm blow dryer over each breast after feeding.
• While the skin naturally releases oils to lubricate the nipples, using a commercial product can help prevent cracking. After feeding apply a lanolin-based oil (such as Weleda Nursing Oil) to each nipple. Avoid using petroleum based products like Vaseline. Never wash your nipples with soap or wipes, use only water.
• Tea treatment - place a cold tea bag on each nipple for a soothing treatment.
If pain or bleeding persists talk to your doctor or lactation consultant for advice. Persistent pain is not normal.

Clogged Milk Ducts

Signs

• Isolated part of the breast feels sore.
• There may be a small, hard lump that's sore to the touch.
• Symptoms can improve after feeding.

If you are producing milk faster than it is being expressed it can back up in a duct. When this happens the duct becomes swollen and blocked. Blockages can be caused by an improper latch or not feeding often enough. It is important to deal with a blockage as soon as possible so that it does not become infected (mastitis). If you develop flu-like symptoms and feel unwell, an infection may have started. The best way to deal with a clogged duct is to nurse on the affected side. Although it may be painful, completely emptying the breast of milk will ease inflammation and clear the blockage. If your baby doesn't drink all the milk, use a breast pump to clear the rest. To prevent clogged ducts:
• Don't go too long without feeding.
• Ensure your nursing bra is well-fitted and avoid underwired bras because they can compress milk ducts.
• Vary your feeding positions to avoid putting too much pressure on one area.
• Avoid weaning a baby until the clog is completely free.

Mastitis Breast Infection

Signs

• Patch of red skin that's sore to touch.
• Feeling unwell like you have flu.
• Feeling achy, tired and tearful (a bout of the baby blues?)
• Increase in temperature with chills.

This is a more serious but relatively common complication of breastfeeding. If it occurs, it usually does so in the early postpartum period. Mastitis can develop in one or both breasts. It can be caused by failure to clear a clogged milk duct, or germs from the baby's mouth entering the breasts through a cracked nipple or low resistance to infection in the mother due to stress or tiredness. Contact your doctor immediately if you have signs, you may need antibiotics and bed rest. Usually symptoms improve within 48 hours of treatment. You will be advised to continue breastfeeding while recovering; the prescribed antibiotics will be safe for the baby.

Thrush Fungal Infection

Signs

• Sore pink nipples after feeding (yet you have been feeding without problems for some time).
• Nipples hurt between feedings.
• Shooting pains in the breast.

Stop feeding immediately, and talk to your doctor. You may have thrush, a yeast infection. Your baby may also have an infection in her mouth or bum so you will both need treatment. You may need a cream to rub to your breasts and an oral thrush tablet. An alternative natural remedy which is often helpful is called gentian violet. You swab it on your nipples before and after feeding (so your baby gets it too) for 3 or 4 days.

Engorged Breasts

Signs

• Breasts feel swollen, throbbing and lumpy.
• Breasts are uncomfortably full to the point where nipples flatten out into the areola.
• Swelling can extend to the armpit.
• May be a low-grade fever.

If you have engorged breasts, milk production has suddenly increased and your breasts become swollen and hard. It usually only lasts 24 to 48 hours and is relieved by nursing. More of a problem for new moms, soon the breasts start to respond to the baby's needs and engorgement stops becoming a problem. In the meantime, don't be tempted to skip feedings because the breast is too sore, the fuller the breasts become, the more they will hurt.

Leaking Milk

Signs

• Milk leaks, drips or sprays without warning.
• Spontaneous leaks when sleeping, while in a warm shower or when you hear your baby cry.

While it may be uncomfortable and embarrassing at times, leaking milk is a common issue, particularly in the first few weeks postpartum. In most cases, as breastfeeding settles into a routine, leaks lessen. In the meantime, stock up on breast pads and don't be tempted to pump to prevent leaking. Contrary to expectation, it only makes leaking worse.

Milk Blister

Signs

• Painful white, yellow or clear dot on the nipple or areola.
• Spot is painful.
• If you press the breast the blister will bulge outwards.

This is a milk blister, also known as a milk bleb. It occurs when skin grows over a milk duct and the milk backs up behind it. It can remain for days or weeks but then spontaneously heals when the skin peels away. Milk blisters can be caused by clogged ducts, thrush or oversupply of milk. Applying a hot moist heat compress to the blister before feeding can help to 'pop' it. Alternatively you can use a sterilized needle to gently pierce the skin.

Nipples Turning White

Signs

• Nipples turn white (nipple blanching) after feeding.
• May be accompanied by shooting, burning breast/nipple pain which is sometimes mistaken for thrush.
• If color returns to the nipple and there is no pain, blanching is not the problem.

The most common cause of blanching is incorrect latching or suckling, the baby is compressing the nipple too much while feeding. In this instance the nipple is white and misshaped (flattened or creased) immediately after coming out of the baby's mouth, and pain may not start until a few seconds later. Finding the underlying cause will normally sort the problem. Vasospasm is a more severe form of blanching where blood vessels suddenly become narrowed and constricted. It can be very painful and starts a short time after feeding or in between feeds. Nipple trauma or thrush is the most common cause, but it can also be caused by Raynaud’s Phenomenon. Applying heat to the breast when needed helps to relax cramped blood vessels. Covering the nipple as soon as the baby comes off the breast may also be helpful.

  Related Articles on Breast Feeding

For more tips, see the following:

Chest problems: Special section on breast issues.
Milk supply while breastfeeding: Tips, advice and charts.

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