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Solutions to possible breastfeeding concerns

Breastfeeding

It is not uncommon for pregnant women and mothers of newborns to express concerns about breastfeeding. It is important to remember that the longer you breastfeed, the greater the health benefits for you and your baby. The following section outlines some possible breastfeeding concerns and some solutions to help you and your baby.

Breastfeeding concerns:

Sore nipples

During the first week, it is common to feel some mild pain or tenderness when your baby latches onto your breast. This initial tenderness should disappear as your baby begins to feed. If the pain continues it is important to remove your baby from the breast and reposition them before they latch on again.

Poor latch

The most common cause of nipple soreness is poor latch. Ensure your baby is positioned and latched well. Allowing your baby to continue feeding when the latch is painful can quickly cause nipple damage. On the other hand, once their latch is fixed, your nipple will often heal quickly.

To help with healing:

If fixing your baby’s latch does not get rid of the pain or nipple damage, it is important to contact a breastfeeding professional for help.

  • hand express a few drops of breastmilk;
  • rub the drops onto your nipple; and
  • allow the drops to air dry after feeding.
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Tongue tie and lip tie

Sometimes babies are born with structural changes in the mouth that make it hard for them to latch properly at the breast. An example of this is a tongue tie or lip tie, which restricts movement in a baby’s mouth making it hard for them to latch properly and transfer the milk from the breast.

Some signs that may indicate a tongue or lip tie are:

  • baby is sliding off the breast when feeding;
  • baby is making clicking noises when sucking; or
  • sore or damaged nipples despite paying attention to the latch.

If you are noticing any of these signs it is possible that your baby needs a tongue or lip tie to be clipped. This is a simple and fast procedure called a frenotomy and can be done in a doctor’s or dentist’s office. You can expect very quick relief of nipple pain after this procedure. See a breastfeeding professional for advice right away if your baby shows signs of a lip or tongue tie. If the lip or tongue tie is serious, your milk supply will likely be affected so it is important to get help as soon as possible (ideally within a couple of days). To find a practitioner in Halton who offers the procedure, dial 311.

Infection and reaction to irritants

If nipple or breast pain is not improving it is important to contact a breastfeeding professional for help.

Irritation, bacterial and fungal infections can cause nipple pain.

Signs of infection or reaction may include:

  • rashes on the nipples or the breast;
  • scaly or shiny nipples; or
  • shooting or burning pain in the breast.

If you are experiencing any of these signs it is important that you see a breastfeeding professional as soon as possible to determine the cause of your pain and prevent further damage to your nipples. For example, if you or your baby has developed a condition called thrush (yeast) infection, you will both need to be treated to avoid passing the infection back and forth.

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Biting

Sometimes when you are breastfeeding an older baby it is easy to begin to pay less attention to the latch and position of your child. This may mean your child isn’t latching on as well as they should, which can cause nipple pain. When babies are teething they will sometimes attempt to bite down while at the breast. Holding your baby nice and close and making sure they are latched well will help to avoid both of these causes of nipple pain.

Sore breasts

There are several possible causes of breast pain. The most common issues are described in the video What To Do About Breast Pain. Any time you are experiencing breast pain that is not improving with your attempts to resolve the problem, it is important to contact a breastfeeding expert.

Causes of breast pain:

  • Engorgement
  • Blocked ducts
  • Mastitis
  • Thrush (yeast) infection
  • Engorgement

    In the early days of feeding it is common for your breasts to swell up with milk and become tender. This is called engorgement. Your breasts produce more milk than your baby requires in order to make sure they get enough; your body will gradually adapt to meet your baby’s needs. Feeding your baby early and often can help prevent and relieve this discomfort. Feed your baby according to their hunger cues (external PDF) and pre-term hunger cues (external PDF) and don’t limit the frequency or length of their feeds.

    Sometimes babies find it hard to latch because of the swelling. If this happens:

    • hand express a small amount of milk, or use reverse pressure softening; and
    • use cool compressed on your breast to help reduce swelling.

    Discomfort from engorgement should only last for a couple of days. See a breastfeeding professional if the engorgement is not improving.

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    Blocked ducts

    Call your health care provider if a breast lump will not go away or you have signs of mastitis

    Sometimes milk flow becomes blocked in one area of the breast. This can happen if your baby is not latching well or is suddenly feeding much less than usual. You will likely notice a hard lump which may be tender and red.

    What you can do:

    • Breastfeed your baby at least every two hours.
    • Begin on the breast with the blocked duct.
    • Feed your baby in different positions to remove milk from all areas of your breast.
    • Apply a warm compress and use gentle massage before feeding to help with milk flow when feeding.

    Mastitis

    Call your health care provider if you think you have mastitis and your symptoms do not improve within 24 hours.

    Mastitis:

    • is inflammation in the breast;
    • is caused by infection;
    • often results in a large reddened, sore area or red streaks on the breast; and
    • may cause fever and flu-like symptoms such as headache or nausea.

    To help treat mastitis:

    • feed your baby frequently on the affected side;
    • get plenty of rest; and
    • apply heat to the affected area.

    If it is too painful to feed your baby at the breast, it is important to remove the milk by hand or with a pump. This will make you more comfortable and help to prevent the infection from getting worse.

    If symptoms are not improving within 24 hours, you may require antibiotic treatment. It is important to contact your healthcare provider. Getting help with caring for yourself and your baby will also assist your recovery.

    Thrush (yeast) infection

    Thrush (yeast) infections can also cause pain in the breast. Women with thrush will often describe a burning or shooting pain in their breast and may also experience red, shiny, itchy or sore nipples. The pain may happen between feedings.

    If you think you may have thrush, speak with your health care provider and/or a breastfeeding professional.

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    Breastfeeding and illness

    When you are sick, you can usually continue breastfeeding your baby. In fact, it is very important to continue breastfeeding so your body will make antibodies to fight the infection. These antibodies will:

    • be present in your breastmilk;
    • help keep your baby healthy; and
    • help your child fight off illness.

    Take precautions such as washing your hands frequently and continue to breastfeed whenever possible. Speak with your healthcare provider if you have any questions or concerns.

    Call Motherisk at 1-877-439-2744 for information about taking medication while you are breastfeeding.

    Medication and breastfeeding

    Most conditions can be treated with medications that are safe for breastfeeding. If you have any concerns, speak with your healthcare provider, your pharmacist or Motherisk .

    Milk supply

    Did you know?

    It’s normal for your breasts to become softer over time while you’re breastfeeding

    Many mothers have more milk than their baby needs during the early weeks of breastfeeding and some women have breast engorgement. In the beginning, your breasts will often feel very full, but over time your breasts will feel softer. This does not mean that you do not have enough milk – your body is just figuring out the right amount to make! These are normal changes.

    If you feed your baby according to their hunger cues (external PDF) and pre-term hunger cues (external PDF) without watching the clock, your body will continue to make the right amount of milk for your growing baby. Your baby’s wet and soiled diapers provide reassurance that your baby is drinking enough milk.

    Growth spurts

    You may notice that your baby seems more hungry than normal on some days. This is likely due to a growth spurt, and your body will respond to your baby’s frequent nursing by increasing milk production. The more you feed your baby, the more milk you will make.

    Growth spurts are common when your baby is:

    • 10 days
    • 2-3 weeks
    • 6 weeks
    • 3 months
    • 6 months
    • other times (when your baby seems hungrier than usual)

    Feed your baby according to their hunger cues and your body will quickly increase milk production to meet your baby’s needs.

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    Fussy baby

    Crying is normal baby behaviour. Especially in the first few months, crying is very common during the evenings and through the night. It does not always mean your baby is hungry. They may be tired, uncomfortable or want to be held.

    If your baby is fussy:

    • start by offering the breast. If she is hungry, this will soothe her, or the sucking alone may be enough to comfort her and help her fall asleep;
    • and if she is not comforted at the breast, try placing her skin-to-skin;
    • Try walking, rocking, or standing and swaying as movement often helps calm babies.
    • Check for a wet or soiled diaper, and that your baby is not too warm or cool.

    Your baby picks up on your emotions, so calming yourself (for example by taking slow deep breaths) will also help your baby to calm down. Try to arrange a break for yourself when someone else can hold your baby.

    Baby not latching

    Thinking about feeding your baby a formula supplement?

    Call 311 to speak to a public health nurse to help you make an informed decision about feeding your baby.

    Sometimes babies refuse to latch onto the breast, and will push or arch away and cry when brought to the breast. If this happens, it is important to see a breastfeeding professional to determine the cause. Make sure you maintain your milk supply in the meantime by hand expressing or pumping

    While there are many things that can affect your baby’s ability or willingness to latch at your breast, there are several things you can try while waiting to see a breastfeeding professional:

    Separation

    If you and your baby are separated, if possible, express your breastmilk so that your baby can continue to receive breastmilk. This also helps to maintain your milk supply. Hand expression or pumping should be done at least eight times in 24 hours to help your body produce enough breastmilk.

    You don’t need to use a bottle to feed your baby expressed breastmilk. Your baby can be fed your breastmilk by cup or spoon. Other feeding methods may also be possible with advice from a breastfeeding professional.

    If the separation is caused by a medical condition in you or your baby, speak to your healthcare provider about feeding your baby your breastmilk.

    Breastfeeding in public

    In Canada, you have the right to breastfeed your baby anywhere, anytime. The Halton Baby-Friendly Initiative has more information on breastfeeding in public.

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