Breastfeeding problems

Sore nipples, engorgement, or fatigue convince other women that they should stop. Here are solutions to all these problems. If you need more hands-on help, call your hospital or family doctor for a referral to a lactation specialist. These experts can show you or tell you how to solve a breast-feeding problem.

Cracked and sore nipples

The key to preventing sore nipples is to ensure that your baby latches on correctly. Nipple pain will decrease once you and your baby have developed a proper latch.

To soothe sore nipples after each feeding, rub a few drops of colostrum or hindmilk into your nipples. (Hindmilk has antibacterial properties.) Expose your breasts to air and light as often as possible. Use a blowdryer on a low setting for several minutes to improve drying, circulation, and healing.

Soap can irritate your nipples. When you're bathing, you'll find that water is sufficient to wash your breasts. Beware of products that promise a quick cure.

Nipple creams are not recommended. The Canadian Institute of Child Health (CICH) notes that there are no studies showing topical applications to be of any benefit, and the institute points out that the vitamin E and unpurified lanolin in some of these products can be harmful to your baby.

Nipple shields can significantly reduce your milk supply and the infant's milk intake, and interfere with suckling. If you choose to use shields, have your baby weighed regularly to ensure that he's gaining weight adequately.

Flat or inverted nipples

If you have flat or inverted nipples, you may have heard that you won't be able to nurse. Don't believe it! Babies breast-feed, they don't nipple-feed. If your baby is able to latch on correctly, receiving a good mouthful of breast, then flat or inverted nipples will not likely cause a problem. Before feeding, gently roll your nipple between your thumb and forefinger to help the nipple stand out. As for breast shells for inverted nipples, a recent multi-centred trial found that they only overcomplicate the breast-feeding process.

Leaking

Your milk may start flowing when you're at home and you hear your baby waking up. Or, less conveniently, your breasts may start to leak in the boardroom while You're giving a presentation. Some women can stop the flow by folding their arms and pressing down on their breasts. Others wear print rather than solid-colour tops for camouflage. Breast pads can help prevent leaks from showing, but they should be changed when they get wet or even moist if you want to prevent sore nipples or infection. Pads made from cotton or paper or cotton flannelette are best. Avoid breast pads that have plastic or waterproof liners because they don't allow air to circulate to your nipples.

Breast infection

If your breast is hot, red, and painful and you have flu-like symptoms of fatigue, chills, and a fever, you may have a breast infection called mastitis. It occurs in I to 5 per cent of nursing mothers; its cause may be less frequent nursing, cracked nipples, or inadequate milk drainage.

Be assured that there's nothing wrong with your milk. In fact, for a more rapid recovery, you should nurse more frequently. Offer the baby the painful breast first, varying the baby's position to ensure drainage.

Acetaminophen can reduce pain as well as fever. Applying warm wash cloths to the breast may also offer some comfort. Consult a physician if your symptoms persist for six to eight hours-antibiotics may be necessary.

Plugged milk duct

If you notice a small, hard lump that's sensitive to the touch and may be red, you might have a plugged milk duct. The obstruction may occur because the breast has not been fully drained for a long time or because there has been pressure on the duct. Untreated, a blocked milk duct can cause an infection. Take a hot shower or apply hot compresses, gently massaging the area in the direction of the nipple. Feed your baby every two hours, always starting with the affected breast. Vary your feeding positions to facilitate milk flow. If the lump persists after two days, consult your doctor or lactation consultant.

Breast-feeding in public

A 1995 study by Health Canada revealed that embarrassment to mothers and their partners is a common reason why women choose either not to breast-feed or to stop nursing. Breast-feeding advocates argue that women need not feel ashamed of their bodies; certainly, nursing in public doesn't mean that you flaunt your breasts. To be discreet, choose two-peice outfits with tops that can be lifted to nurse. Go for extra privacy with a jacket or cardigan, drape a shawl over your shoulder, or use a nursing bib.