Milk Matters - Tips - Potential Breastfeeding Problems

Milk Matters

Tips for Potential Problems

Preparing for your Baby's Birth

Potential Breastfeeding Problems

Sore Nipples
Full Breasts/Engorgement
"Not Enough Milk"
Over-Supply "Overfeeding"
Weight Gain
Stopping night feeds
The crying baby

Sore Nipples

Sore nipples in the first few days are due to poor latching.
The only way to prevent and heal sore nipples is by correcting the latch, as described under "A Good Latch"
Holding your baby in the underarm or cross-hold positions can go a long way in assisting with a good latch.
Creams used with discretion may be helpful but only correcting the latch will resolve painful nipples.
Laser treatment with an experienced physiotherapist, who helps correct the latch, can be helpful
Painful, burning nipples when the baby is older is usually due to a thrush infection. Please see your doctor immediately should you experience this.

Full Breasts / Engorgement

Full Breasts:

Round day 3 and 4 your breasts may feel full and heavy but much relieved after your baby has fed, this is perfectly normal.
You may need to express a little milk, to soften the areola, if your baby cannot get a good grip or latch.
This fullness diminishes with time, by 6 weeks your breasts may remain soft between regular feeds.

Engorgement:

This happens when the breasts are hard, painful and unyielding i.e. no milk flows even when your baby is able to latch.
This condition is painful and distressing to both you and your baby.
Standing under the shower or using hot and / or cold compressors, then massaging the breasts gently is a good way to stimulate milk-flow.
Once you are able to establish a milk flow, your baby is likely to manage a good feed.
A good latch, demand feeding and waking your baby if he sleeps for too long will prevent engorgement.

"Not Enough Milk"

One of the most common reasons for stopping breastfeeding is when mothers feel that they do not have enough milk. Most often, the situation is in fact perfectly normal for example:

Understanding that there is only a little milk (colostrum) in the first few days and that the milk only comes in between days 2 and 5 is vitally important.
Many woman also think that their supply is inadequate around 4 to 6 weeks when the breasts settle down and no longer fill up as they used to. This too is perfectly normal.
Some mothers may never; others only sometimes experience the tingling of the let-down reflex.
It is normal for the breasts to stop leaking after a few weeks
Your baby's weight gain may initially be less than a formula fed baby's.
Many babies are more "demanding" at some time during the day, most often in the evenings. This may be interpreted as having "too little or weak milk", however allowing your baby to cluster feed (breastfeed often) at this time, allows your baby to sleep really well when she does eventually settle down.
Many babies have obvious growth spurts round 2-3 weeks, 6 weeks and 12 to 14 weeks and may require more frequent feeds for a while. Once your supply has increased due to the extra stimulation, feeding times will settle down again.

Over-Supply "Overfeeding"

Once your baby is over 6 or 8 weeks of age, and you have an abundant supply of milk but your baby is restless, fretful and difficult to settle, in spite of frequent feeds, it is possible that you have an over-supply. Although breastfed babies do not really overfeed it is possible that your baby drinks a lot without being satisfied because he is not getting the fatty milk at the end of a feed.

Fortunately it is not difficult to reverse such a situation:

Make very sure that your baby is well positioned and latched.
Remember especially to take the baby to the breast and not the breast to the baby.
Feed your baby on one breast only per feed. Even when he wants more after his 'winding' time put him back onto the same breast.
Offer the other breast at the next feed.
If your baby coughs and splutters, because the milk-flow is too fast, lie back when feeding, feeding against gravity helps to slow the milk-flow down.
Encourage him to stretch the time between his feeds by a half-hour or an hour.
He should settle into a reasonable pattern.

Weight Gain

Comparing with others

Breastfed babies gain weight at different rates when compared to formula fed babies.
In fact girls and boys even gain weight at different rates.
It is also more likely that the baby whose parent are both, lets say, over 6 ft tall is going to gain more weight when compared to a baby with small parents.

Gaining "too much"

If your baby drinks well, is healthy and contented, do not listen to those who might tell you that your baby is gaining too much weight.
Even the sturdiest breastfed babies loose the extra covering when they start crawling and walking.
That is also provided your baby eats a balanced diet, when starting solid foods. Avoid giving cereal more than once a day.

Poor weight gain

Should it be confirmed that your baby is not gaining sufficient weight or she feeds for hours at a time:
Have your baby's position and latch checked
Offer more frequent feeds
Wake her for feeds if necessary
Avoid giving formula feeds.
Giving one or two, extra expressed breastmilk feeds, by cup, is an excellent way of increasing your milk supply and your baby's weight gain.
Use breast compression when the suckling slows down, to allow her to have more of the fatty hind milk. (Read more on Articles Page)

Stopping night feeds

There is no denying, having a baby is tiring. Sleep depravation is no fun. The advice often given is; "give your baby formula milk with the evening feed". Well meaning, but not always conducive to successful breastfeeding. The fact is breastfeeding at night is far easier and less tiring than formula feeding.

It would be better to follow your babies hunger cues and 'cluster feed' him in the evenings if that is what he is asking for. He is then far more likely to have a longer sleep during the night.
Trying to enforce fewer night feeds could lead to milk reduction, due to the long intervals between feeds, more stress and less sleep.
It could be helpful to have your young baby sleep in your room, even in your bed. Consider the pros and cons.
Alternatively Dad could bring baby to you for feeds and or take him back and change his nappy after one or more of the night feeds.
When your baby is around 6 weeks or older Dad could offer him a feed of expressed breastmilk once in a while so that you can catch a little extra sleep.
Most babies will require fewer night feeds around 12 weeks, some much sooner. It all passes all too quickly, don't wish this precious time away.

The Crying Baby

Firstly, the possibilities of illness like urinary tract infections, ear infections or reflux need to be ruled out. You therefore need to be re-assured by your doctor and baby clinic that your baby is well and gaining weight.

What to do?

In the early days the natural thing to do is to calm then feed him.
Sometimes, however, it is only a nappy that needs to be changed or a little comfort needed.
Only wind baby for five minutes or so, after feeds as too much handling after a feed can also make him irritable.
Kangaroo him, sing to him, rock him, walk him in a carrier or pram, or go for a drive.
Make sure he is not too hot or too cold.
Sometimes a baby senses his mother's distress and anxiety and quietens if someone else takes him.
Remember crying is a baby's way of communicating and does not always mean that something is wrong.
Some babies are particularly wakeful, restless, aware of their surroundings and therefore more demanding. These infants do not conform to the idealised picture of the perfect baby who simply eats and sleeps. In fact, few do.
They in particular need kangarooing, entertaining or carrying around in a carrier or sling until this phase passes and the mother needs dad's help and support.
Baby massage, body stress release or a trained paediatric chiropractor may be helpful.