Breastfeeding might be Nature’s way of nourishing Baby, but boy oh boy can it be challenging at the start. Don’t be discouraged! It takes time and patience to establish breastfeeding because this is a new skill for both you and Baby. Although it might not seem so right now — especially if your painful nipples are keeping you awake (we’ve been there) — there is light at the end of the tunnel. Here are some of the most common breastfeeding challenges moms face, and solutions for them.


Challenge #1: Sore or Cracked Nipples

DZY5GOVCAOYup, it feels like an avalanche of pain when you have cracked nipples!

What is it: Cracks, blisters and/or bleeding caused by improper latch or positioning.

Solution: Ensure your baby is in the proper position for breastfeeding before he latches on, and make sure he latches on correctly. His nose should align with your nipple so that his head is tilted back before latching on, allowing him to take your nipple deep into his mouth. (If you’re not sure how to check for a proper latch, get help from a lactation consultant!)

(See also: Breastfeeding: The Latch)

Sore or cracked nipples are painful, so offer the ‘good’ breast first. As Baby feeds and gets fuller his suckle will be less strong, so when you offer the sore side next, it will not hurt as much. If the pain is unbearable, nipple shields can offer some relief and help you continue to nurse your baby. Breast shells can also help to prevent your clothes from chafing against your sore nipples.

In the meantime, speed up the healing process by applying some of your breast milk onto the cracked areas after breastfeeding, and let them air-dry. Nipple creams such as Lansinoh may also be used as an alternative.

Challenge #2: Engorgement

photo-1429087969512-1e85aab2683dIt feels like you’re swollen and about to burst — and it hurts too!

What is it: Swelling of the breast caused by insufficient emptying of the breast. As your breast milk comes in in the first few days after birth, your breasts will start to feel heavier and fuller. While it’s one of the most common breastfeeding problems, delayed treatment can lead to problems with latching, severe discomfort, and a low-grade fever.

Solution: Nurse often and on demand — your baby removes milk more effectively than the breast pump. If the breast has become hard, making it difficult to get a good latch, gently massage to soften it and hand-express a little before feeding to get the milk flowing. Of course, the more you nurse, the less likely it is for your breasts to get engorged!

After swelling, apply a cold cabbage leaf to help reduce the swelling. Change the cabbage leaves every two hours or when they become limp. The swelling should clear up after 24 hours from extreme fullness with frequent feeding.

Challenge #3: Blocked Ducts

photo-1441802763029-b621005a04a5Clear the (milk) ducts and all will be well

What is it: Localised swollen lumps in the breast as a result of milk being ‘backed up’. This is usually due to milk not removed effectively during nursing. You may feel lumps that are tender to the touch and hurt when pressure is applied.

Solution: Before feeding, apply a warm compress (such as a warm towel) to your breasts and gently massage them to stimulate milk movement. Offer the affected breast first and continue to massage your breast during feeding to promote milk flow. If Baby is always breastfed in one position, vary feeding positions (such as the football hold and side-lying position) to encourage milk flow in the whole breast. Also make sure that your nursing bra isn’t making things worse by being too tight.

Challenge #4: Mastitis

photo-1444159759392-aeeb3d5851c1Feels like this. In your breasts.

What is it: Inflammation of the breast tissue caused by obstruction of milk flow. Often accompanied by a fever and flu-like symptoms, mastitis comes on suddenly and usually affects one breast. The breast will show a pink, tender, hot, wedge-shaped area.

Solution: Treat mastitis the same way you would treat blocked ducts. Frequent emptying of the breast is key. In addition, apply cold packs or chilled cabbage leaves to the breast after each feed to relieve the pain. Drink plenty of fluids to boost circulation and rest as much as possible. If the condition doesn’t improve after 12 hours, seek medical attention as mastitis can lead to complications such as breast abscess if not treated properly or in time.

Challenge #5: Thrush

photo-1438760731177-5b230a60ec95Not this kind of fungus of course, but oh what a pretty one this is!

What is it: A fungal infection in the nipples or breast tissue, which causes incessant itchiness, soreness and shooting or radiating pains in the breast. Baby will also be affected. His mouth will show a thick white coating and his bottom will show a bright red rash with spots around it.

Solution: If you or your baby have been diagnosed with thrush you will be both need to be treated. Antifungal tablets and creams are prescribed to treat breast or nipple thrush, while thrush in your baby’s mouth is treated using an oral gel or drops.

In addition, thwart the growth of thrush by keeping your nipples dry and washing your hands regularly. Change breast pads frequently and sterilise teats and pacifiers thoroughly after use. Also make sure that any clothing that comes into contact with your nipples, such as towels, bras and nursing pads, are washed in hot soapy water and dried properly.

Challenge #6: Low Milk Supply

Manual breast pump and mother feeding a newborn babyIf Baby does not empty the breast, you can pump the rest out

What is it: Not enough breast milk to meet Baby’s needs. There are many reasons for this, such as lack of sleep, too much stress, supplementing with formula, ineffective latch, infrequent feeding, waiting too long to start breastfeeding, and a premature baby.

(See also: Breastfeeding Your Newborn: Frequent Feeding)

Solution: Understand your breast milk supply. Breastfeeding is a process of demand and supply. The more your baby needs, the more your breasts will produce so bring Baby to your breast for frequent nursing. Offer both breasts at each feed so that milk is removed from both breasts, and if you need to supplement, remember to express out your breast milk to keep the milk supply going. It also doesn’t hurt to drink more fluids. Soup is a great way to increase both your fluid and nutrients intake at the same time!

Take heart in the knowledge that breastfeeding gets easier with time. As Baby grows and gets better at latching, as you become more used to the feeling of Baby sucking, there will come a day (at around six to weeks or maybe even before) when you’ll pick Baby up, latch him or her on, and it will seem like the most natural thing in the world to do!

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