Breastfeeding tip and solutions

Dr. James Kim

Updated: October 1, 2012 6:04AM

As a new mother, you want the very best for your baby and you wonder if breastfeeding is truly best.

Breastfed babies have fewer ear infections, gastrointestinal disorders, asthma and allergies. Babies are not allergic to breast milk, although they may be allergic to something the mother is eating. Nursing your baby also contributes to brain development and strong teeth and bones.

Benefits extend to mothers, too. Breastfeeding guards against ovarian and breast cancer, post-partum depression and weight gain — breastfeeding burns about 500 calories a day. It also helps shrink the uterus to pre-pregnancy size.

The American Academy of Pediatrics recommends exclusive breastfeeding for baby’s first six months. Even after other foods are introduced, breastfeeding should continue through at least the baby’s first birthday.

Although breastfeeding is considered natural, learning to nurse a baby takes time and patience. Here are some common challenges women experience during nursing, along with possible solutions.

Engorgement

Signs of breast engorgement include swelling, throbbing, hardness or lumpiness, flat nipples and swollen lymph nodes under the arm pits. Engorgement typically occurs during the initial weeks of nursing your first baby (with subsequent babies, many mothers experience little or no engorgement) or during weaning.

Skipping feedings, nursing just on one breast or incorrect latching may contribute to engorgement. Engorgement will subside when breasts adapt to the nursing routine. If engorgement prevents baby from latching on correctly, express some milk first.

Latching on

If baby is not properly latched onto the breast, he’ll struggle to obtain adequate milk. This might also create sore nipples for his mother. When correctly latched, baby’s upper and bottom lips are slightly rolled back, his cheeks are fully rounded and his nose and chin touch the breast. It’s important for the baby to place his lips around part of the areola and not just the nipple.

You should see and hear swallowing as the baby nurses. When you remove your nipple (break the suction by sliding a finger between your breast and baby’s mouth), it should look elongated.

Sleepy baby

Newborns tend to be sleepier than babies older than two weeks old, but keeping a sleepy baby interested in the breast is challenging. Factors contributing to sleepiness include hypoglycemia (low blood sugar), jaundice, a slow let-down reflex in the mother and overstimulation.

However, to obtain sufficient calories and hydration, very young breastfed babies need to nurse about every two hours for 20 minutes each time. If your baby is dozing away at the breast, try these tricks:

• Slide a finger between your breast and his mouth.

• Gently compress your breast to dribble some milk into his mouth.

• Stroke his cheeks with your finger or nipple.

• Frequently switch breasts.

• Burp him.

• Undress him.

• Lightly tickle his soles or palms.

Nipple pain

In the early weeks, some tenderness can be expected, but consult your doctor if nipples are cracked and bleeding. Causes of sore nipples include improper latch, thrush and overuse of breast pumps.

Remedies include cold compresses, ice packs, rinsing nipples after nursing to remove baby’s saliva, changing soaps and applying lanolin. With your pediatrician’s permission, if nipples are really painful, you might try an over the counter pain reliever.

Low milk supply

Mothers may mistakenly blame a low milk supply when a baby suddenly wants to nurse often. Yet when babies experience growth spurts, usually at six weeks, three months and six months, increased nursing signals the breasts to generate more milk. Otherwise, if your baby is nursing every two to three hours and is producing six to eight wet diapers a day, he is receiving plenty of milk. If not, low milk supply might be a result of one of the following:

• Stress in the mother

• Improper latch in baby

• Overuse of a pacifier or nipple shield

• Smoking

• Oral contraceptives

• Pregnancy

• Insufficient time at the breast

• Polycystic ovarian syndrome

• Hypothyroidism

Plugged duct/mastitis

Engorgement, delaying feedings, tight bras and hasty weaning can encourage the formation of plugged ducts, but they can occur for seemingly no reason, too. If untreated, plugged ducts can lead to mastitis (breast infection). A plugged duct will feel tender; in mastitis, red streaks appear on the breast and the mother may run a fever. In both situations, treatment is continued nursing. For relief, use warm, wet compresses or express milk while taking a warm shower. Mastitis may require antibiotics.

By following the above suggestions, you and your baby will soon be a happy, successful nursing couple.

James Kim, M.D., is a board certified obstetrician and gynecologist who treats patients at Adventist Hinsdale and La Grange Memorial hospitals.

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