Worth It? Wednesday: Getting Through Common Problems with Breastfeeding

Many mothers (including myself) have considered giving up breastfeeding due to encountering some difficulties along the way. Yet, myself and others have chosen to persevere through these issues and our little ones have benefited immensely. It is so important for your child to have breastmilk for their entire first year. The nutritional and emotional benefits are endless and nothing can replicate this way of feeding your baby. When you choose to breastfeed your baby, it is a good idea to know how to deal with common issues that may come up. Fortunately, most issues with nursing have easy fixes so you and baby can get back on track with feeding quickly. See more information on the full benefits of breastfeeding in my other post here.
Engorgement
Engorgement is the term used to describe swelling and fullness within the breast tissue. This usually occurs when your milk comes in soon after baby's birth (within 2-3 days), when a feeding is missed, or when baby begins sleeping through the night. I struggled with this when my daughter began sleeping through the night at a couple months of age. I would wake up during the night and pump because the pain became unbearable. I soon learned this was not a solution to the problem, as it was actually causing me to continue to produce a large quantity of milk overnight. Instead it is best to try to not pump until your next morning feeding (if you have to get some relief, pump only enough to allow you to be comfortable). Also wear a well fitted, supporting bra with nursing pads during the night. This will eventually cause your overnight milk supply to diminish.
To relieve engorgement when your milk comes in, try using warm compresses on your breast just before feeding for about 2-3 minutes at most. This will help with milk flow during the upcoming feeding as well as prevent any clogged ducts. Additionally, massage the breast while baby is nursing to help your milk flow freely. Cold packs can also be applied to your breasts after nursing to help decrease any swelling.

Blocked Milk Ducts
Blocked ducts are areas within the breast where milk flow has become clogged/stopped. The blocked milk duct will fill and thus stretch beyond what is normal causing the surrounding breast tissue to become tender/painful. Symptoms of a plugged duct can include a hard, red and/or painful lump in the breast. Usually only one of the breasts is affected and it's onset is gradual. To treat plugged ducts, feed on the affected side first, massaging it, and being sure to empty the entire breast. Additionally, a warm shower may help. If the problem persists for longer than a couple days, it is necessary to call your physician. If you notice that the same area within your breast continues to become blocked try switching feeding positions as well as avoiding any type of clothing that compresses you breasts, such as underwire bras.
Dry/Sore/Cracked Nipples
This condition often occurs in the first days of breastfeeding your newborn. The cause is most often your baby's position during feeding as well as an incorrect latch. One must address these issues first and then additional treatments can be employed. One of the best treatments is using a pure lanolin ointment applied to the nipples. The ointment need not be washed off before feeding your baby.

Mastitis
Mastitis is an inflammation of the breast caused by an infection. Symptoms include a hard, red streaked, warm and painful to the touch, swollen area of one breast. Often a high fever and flu symptoms are also present. Causes can be engorged breasts not being effectively emptied/blocked milk ducts, bacteria entering into breast tissue through dry/cracked nipples, breasts being damp/wet (if you leak during night and sleep this way), etc. Treatment includes increased fluids, plenty of rest, continued nursing particularly on affected side (milk is still safe for baby), alternating warm (mobilizes infection fighters) and cold (relieves pain) compresses, and antibiotic therapy. I encountered this with each of my daughters, both times within the first few months of nursing, and it is very important to seek treatment promptly (can lead to abscess). Once treated with antibiotics you will begin to feel like yourself again within 24 hours and the pain should begin to resolve.
Overactive Milk Ejection (forceful letdown)
As your milk production increases in the beginning weeks and months of breastfeeding, let-down of milk may occur at too fast of a rate for baby to swallow resulting in gagging, coughing/choking, spitting up/gas, or an all together refusal to nurse. To manage this condition try nursing baby in a more upright position to facilitate swallowing. Positioning baby on her side is another way to nurse as it allows any extra milk to drip out of the side of her mouth. You may also want to pump or hand-express until let-down occurs. Then allow your baby to nurse at a more regular and slower flow rate. Burping baby frequently is also important to prevent spitting up due to excess swallowed air. You also will want to avoid any extra pumping or warm showers as both of these will increase milk supply causing more of a problem. Most mothers that struggle with this find that letdown becomes less forceful and milk supply has regulated around 4-6 months of age.
For additional breastfeeding information and support head over to the La Leche League. They have several online resources answering common questions and also offer a search to find groups near you. I have attended a few of the group meetings and they have been extremely beneficial plus they are free/donation only!