Breastfeeding Problems

  • By:  Emily Nobles, WHNP

When frustration hits, follow these tips for happy nursing!

While breastfeeding has benefits for both babies and moms, many women face challenges with breastfeeding. The Centers for Disease Control and Prevention (CDC) tracks statistics on breastfeeding.

According to the CDC’s 2018 Breastfeeding Report Card, while 83 percent of women started breastfeeding, only 57.6 percent were still breastfeeding after 6 months. This rate goes down further to 35.9 percent of mothers breastfeeding after 12 months. These statistics illustrate that while many U.S. women want to breastfeed, a much smaller percentage will continue breastfeeding.

In the days and weeks after the baby is born, women can face many problems with breastfeeding. For some women these difficulties can cause them to stop breastfeeding early. Some of the most common problems include difficulty with getting the baby to latch, nipple pain and soreness, breast engorgement, and breast infections. Another commonly cited reason for discontinuing breastfeeding is the mother feeling that her milk supply is too low.

One of the first hurdles that women face is getting baby to latch onto the nipple. This problem is often addressed when women are still in the hospital after delivery. Most hospitals in the United States have lactation specialists on staff to help women with breastfeeding.

The nurses who care for the mother and baby after delivery also have knowledge about breastfeeding. The nurses and lactation specialists can often help to show a woman what a good latch looks like and how to get the baby to latch on effectively. A good latch can often prevent other breastfeeding difficulties, such as pain and inefficient feeding.

Nipple pain and soreness is another issue that many women face when they start breastfeeding. It is not uncommon for women to have pain in the nipple in the first minute of a breastfeeding session. If the pain is lasting throughout the entire session, it can sometimes be a sign of a problem.

The nipple can become bruised and cracked with breastfeeding, even if the latch is good and baby is feeding well. Lanolin ointment can be used to relieve sore nipples. Over the counter pain relievers such as Tylenol and Motrin can also help with this pain.

Some women feel nipple pain in between breastfeeding sessions and a cool or warm compress can be helpful. Some companies sell gel pads that can be placed over the nipple and worn inside a woman’s bra. This can protect the nipples from irritation between breastfeeding sessions.

Breasts Engorged?

Simple Solutions Help Your Milk Flow

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Breast engorgement occurs when the breasts become very full with milk. Breast engorgement can be a sign of a woman’s milk “coming in” and often occurs 2-4 days after the baby is born. This can cause the breasts to feel tight, swollen, and painful. It can also make it difficult for the baby to latch on effectively.

The best treatment for, and prevention of, breast engorgement is frequent breastfeeding. As the baby eats, milk is removed from the breast and can relieve engorgement. If the baby is having difficulty latching on, it can be helpful to express some milk with a breast pump or hand until the breast softens enough for the baby to latch on. A warm washcloth or taking a warm shower can also help to relieve some of the pain and to allow the milk to flow more easily.

Even when breastfeeding is going well, a woman often will have some discomfort in the first weeks. It is sometimes hard to know what discomfort is to be expected and what might be a more serious problem.

One problem that can occur is a breast infection, or mastitis. Signs of an infection include having a fever and having a warm, red, swollen area of the breast. Some women can develop flu-like symptoms, such as chills and muscle aches, with mastitis. It is important to be seen by your healthcare provider if you have any of these symptoms. Treatment for mastitis can include pain relievers, such as Tylenol or Motrin, and sometimes use of an antibiotic. Women who have mastitis can continue breastfeeding.

One of the biggest barriers to continued breastfeeding is the issue of milk supply. This can be a problem of actual low milk supply or “perceived” low milk supply. Perceived low milk supply occurs when a woman’s milk supply is adequate, but she feels like her baby is not getting enough to eat. This is a very difficult problem for new moms because you cannot physically see how much a baby is eating when he or she is breastfed.

The best way to know if milk supply is adequate is if the baby is gaining weight appropriately and if the baby has an adequate number of wet diapers and stools per day. It is also important that baby is eating an adequate number of times per day. In the first week of life, the breastfed baby will often eat 8 to 12 times in a day. Number of feedings per day usually decreases to 7 to 9 times per day as the baby reaches 4 weeks.

While tracking feedings and number of wet and dirty diapers can be done at home, the baby’s weight is usually tracked by the baby’s pediatrician. If the pediatrician finds that baby is not gaining weight as expected, he or she will assess for difficulties with feeding and make a plan to remedy any issues.

Many women believe that because breastfeeding is a natural process, it should be second-nature to learn. The truth of the matter is that almost all women have difficulty at some point with breastfeeding. It takes time, effort, trial and error, and a great deal of support for women to learn how to breastfeed. There are many resources available for women who are breastfeeding, including healthcare providers, lactation consultants, and breastfeeding support groups.

Emily Nobles, WHNP, is a nurse practitioner at Atlantic Ob/Gyn located in Va. Beach and Chesapeake. For more information, call 757-463-1234 or visit www.atlanticobgyn.com.

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