Breastfeeding – Overcoming the Challenges

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Today marks the beginning of National Breastfeeding Week! The aim is to raise awareness and education of this natural form of feeding your baby. As a mother of two breastfed children and qualified midwife I can talk for hours about the benefits of breastfeeding, for both mum and baby. However to ignore the huge challenges that breastfeeding can bring about would be a disservice to you all. As amazing as breastfeeding can be it’s also bloody hard. This blog will outline some common challenges and how you can overcome them to continue your successful breastfeeding journey. I hope that you will find some hope and comfort here. Remember that I’m not here to judge your feeding choices, and neither should anyone else. I do not subscribe to “breast is best” or “fed is best” as neither of these statements are true. I much prefer “your baby, your business”, but if my knowledge and support can help you on the journey to want to go on then excellent! That’s the purpose of my work.
This is quite a long post. Each challenge has its own heading so scroll down and find the information most relevant to yourself. Bookmark it and come back to it whenever you need!

 

Is My Baby Latched On Correctly?

Ineffective latch can lead to pain, cracked nipples and poor weight gain in babies. Whenever you come across a breast-feeding challenge the first thing to do is check the latch! The best way for a relaxing latch is skin to skin contact in a quiet and unhurried environment.

If you aren’t sure if your baby is latching on correctly then watch the above video or ask a knowledgeable friend, healthcare professional or peer supporter to watch you feeding.

 

My Baby Won’t Latch 

A common challenge that can start from birth but may arise after your baby has had a few feeds. A great way to overcome this is through biological nurturing. Sometimes all you need to do is go back to basics. Strip off your baby to their nappy and have skin to skin time. No interruptions, no stress and no pressure. A semi reclined position is great for this and will recreate that “breast crawl” that hopefully occurred when baby is first born. If that didn’t happen for you, don’t worry! The breast crawl isn’t only limited to the first time baby feeds. They do not forget those instincts! We can often complicate things by saying ‘put your left hand here, and right hand here, now hold the head at this angle…’ when all you really need to do is relax and snuggle with your baby.

Biological Nurturing Scenario from S Colson on Vimeo.

 

Baby Is Feeding Too Often/Not Enough

Professionals used to advise women to feed their baby every 3-4 hours. Some professionals may still tell you this, and you may also hear it from well meaning friends and family who remember that advice from their own early parenting days. As with many things, advice changes as we learn more. It is now recommended to feed responsively whether you are breast or formula feeding. Respond to your baby’s needs – look out for those feeding cues! Mouthing/putting fingers in mouth is an early sign, crying is a late stage sign of hunger. Once they reach the crying stage it can be difficult for them to latch on so try and pick up on the cues as soon as you can. This will improve with time as you and your baby get to know each other better.
Cluster feeding can be a sign of a growth spurt and usually happens in an evening. It will feel as if baby is constantly attached to you and is difficult to settle in-between feeds. Set yourself up a comfy spot with plenty of snacks and drinks and respond to your baby’s needs. I promise that it won’t last all night and your baby will rest eventually! Cluster feeding is important as it increases your milk supply for the next day, when you baby knows that he/she will need the extra calories.
As long as your baby is gaining weight, is settled between feeds, is not jaundice (yellow colour to skin), and has wet and dirty nappies (dark meconium day 0 changing to mustard yellow by day 3/4) then you are feeding your baby enough. Did you know that disposable nappies have a line running underneath them? If that line is blue it means there is urine in the nappy! A great way of checking for wet nappies if you aren’t sure.
Trust in your instincts. If you are concerned about your baby’s health or behaviour then please contact a health care professional. 

 

Cracked Nipples 

If your latch is correct then your nipples won’t be sore or cracked. Breastfeeding can certainly be uncomfortable to start off with but if your nipples are damaged then something isn’t quite right, usually the baby isn’t taking enough breast into his/her mouth. If left unchecked your nipple soreness will get progressively worse and your baby may not gain enough weight as they won’t be getting enough breast milk. Use the advice above for checking your latch. In the mean time treat the nipples with a cream such as Lansinoh (you don’t need to wipe off the cream before feeding), or even express a bit of breastmilk and rub into the affected areas! Breastmilk is a great healer of cracked nipples and, best of all, it’s free! You need to continue feeding off the affected breast if possible. If this is very difficult and/or painful for you then you can use nipple shields. This means your supply will continue to be stimulated but your nipples are protected. 


Engorged Breasts

When your breasts feel full, hard and uncomfortable then they are engorged. It’s important to deal with this before it leads to mastitis, which can occur when the milk stops flowing.
Engorgement can be a sign of ineffective milk removal so make sure your positioning and attachment is correct or ask a knowledgeable person to do so for you.

Keep the milk flowing by feeding responsively. If your breasts are too full for baby to latch on you can hand express first. This will soften the breast. You can either hand express over the sink or into a sterilised container to be fed at a later time. A health professional should have shown you how to hand express before you were discharged from their care, but this video from Unicef is a great teacher/reminder.

 

Mastitis

Mastitis can follow on from engorgement if it is not correctly managed. It can occur in one or both breasts. They will feel hot, hard and painful to touch and there will more than likely be pain while feeding. You will also have flu like symptoms. As difficult as it is you need to continue feeding as often as you can to remove the blockage in your ducts. If you are struggling to get the milk flowing then gentle massage, hand expression or using warm compress can help start things off. You will need to see your GP ASAP for a course of antibiotics. It is safe to take paracetamol if you feel you need it. 

 

Thrush

thrush

Thrush is a common infection that women are all too familiar with but did you know you can also get thrush on your nipples? You will see the tell tale white substance around your nipples and when feeding it can feel like sharp pins being pressed. This is usually a sign that the thrush infection is inside your breast. You may also notice thrush inside your baby’s mouth as a white covering on the tongue that does not come off or bleeds if you gently try to remove it. If you suspect thrush you can contact your healthcare professional or your local pharmacist. They will need to treat both you AND your baby as the infection can be passed back and forth between your nipple and your baby’s mouth.

 

Need More Support? 

I really cannot recommend Unicef Baby Friendly website enough. There are so many great videos on every breastfeeding topic. The information is the gold standard, and should be what every healthcare professional follows.
Remember to utilise your midwife if you are still under midwifery care. Use the contact numbers they have given you. Please do not be shy about asking for their help!

Peer support groups can be a good resource. The peer supporters have usually undergone training, although not necessarily Baby Friendly, and it creates a support network of other mums for you on all topics, not just breastfeeding! Some will come to your house but most have regular groups. These can be run out of community or Sure Start centres. Your midwife or health visitor should know what is available in your local area.

If you live in the Nottinghamshire or Derbyshire areas I am available for face to face or Skype breastfeeding support. As a qualified midwife trained to Baby Friendly standards you know my support and information will be gold standard. Please contact me if you want any further information on my services.

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