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Problems with breastfeeding in a child. Breastfeeding - possible problems. Irregular nipple shape

Despite the fact that women know about the benefits of breastfeeding even before the birth of a child, the number of “artificial” babies is not decreasing. Moreover, babies often become breastfeeding during the first month of life - due to the fact that the first breastfeeding, and subsequent ones, were organized incorrectly. Therefore, it is advisable to understand how to competently establish breastfeeding without negative consequences for the mother and the newborn.

First feeding: how to put a baby to the breast?

Ideally, the first feeding occurs immediately after birth and lasts no more than 1-2 minutes. This process can be called feeding very conditionally - a child who has just been born does not feel hungry. Other factors are important here:

The situation looks somewhat different when childbirth takes place by caesarean section. In most domestic maternity hospitals, the baby can be given to the mother only on the second day after birth. However, there is no need to be afraid of this: the claim that such practices can affect the ability to breastfeed is nothing more than a myth, and here’s why.

Firstly, a delay in the onset of lactation after a CS is quite common. Milk may appear 3-5 days after surgery. That is, breastfeeding the baby will still not work.

Secondly, the mother receives a short time-out, allowing her to recover from the effects of anesthesia and cope with the acute period of postoperative pain.

On the first day of breastfeeding, it is important to learn how to breastfeed your newborn correctly. The baby should grasp not only the nipple, but also the areola, his lips should be slightly turned outward, and his nose should rest against the chest above the nipple. Natural feeding specialists, either at hospitals or invited from outside, can help in this matter. They will tell you in detail and show you how to put your baby to the breast and check that the feeding is correct.

Cracks, congestion and decantation: three important issues during breastfeeding

The process of establishing guards rarely goes without complications. The first of them is that they cause a woman considerable discomfort. As a rule, this problem worries young mothers precisely in the first days or weeks of feeding, while the skin on the nipple is not sufficiently roughened. In such cases, ointments and gels with lanolin or vitamin B help. In extreme cases, you can use a nipple shield - but very limitedly and for a very short time, since the shields significantly reduce the volume of lactation and in the first days this can cause its complete cessation.

The second problem is milk stagnation. This happens if too much milk comes in in the first days, and the baby, for one reason or another, does not eat very actively. Signs that stagnation has occurred are a swollen, hard, painful and hot gland. To avoid this, it is recommended to include a limited amount of liquid in your breastfeeding diet during the first month. And if there is already a problem, actively express excess milk manually or using a breast pump.

Bottles and pacifiers: necessary or not?

You can gradually add fruits and berries, while avoiding red and citrus fruits. For example, green and yellow apples, pears, melons, watermelons, persimmons and bananas during breastfeeding in the first month are not only allowed, but also encouraged. Gradually, the “fruit and berry” share can be increased to a quarter of the diet, especially in the summer season.

The issue of seeds deserves special attention. Sunflower, pumpkin and sesame seeds are a storehouse of useful microelements; moreover, they allow you to saturate your diet with “good” fats and promote lactation. The restriction on a woman’s consumption of seeds while breastfeeding in the first month is the baby’s individual intolerance to them. You should also carefully peel them and not eat them salted.

But even if the baby tolerates the seeds well, you should not abuse them, absorbing hundreds of grams. It is important to remember that any foods during breastfeeding in the first month should be selected and introduced into the diet with caution and with an eye on the newborn’s reaction. If the child becomes restless, spits up profusely, refuses to breastfeed, or develops constipation or diarrhea, it is better to temporarily exclude the suspected product from the menu and return to it in a few weeks.

Recommendation: Today, almost any recipe for breastfeeding in the first month can be found in the public domain. Before trying them on yourself, carefully study the ingredients, as some recipes contain very unexpected ingredients, such as spices, strawberries or honey, which may become allergens for your child. It is better to clarify in more detail what is possible for you in the first month of breastfeeding, taking into account the characteristics and health status of the baby, from the observing pediatrician.

Diet per month

How much should a baby weigh at 1 month?

Nursing bra

And finally, let’s talk a little about mom’s comfort, namely, whether wearing a bra is a mandatory attribute. Note that its absence or presence does not affect the lactation process. But in order to support heavy breasts, and therefore avoid ptosis in the future, a properly selected bra is indispensable. In addition, pads can be placed in its cups to absorb milk when it leaks.

In principle, any size accessory is suitable for these purposes. However, it is better to choose a special nursing bra - made from natural, breathable fabrics, with deep cups, wide straps and, preferably, unfastening in the front. In this bra, you can comfortably feed your baby anywhere at any time, with some skill, even on the street.

All mothers know the importance of breastfeeding, but not everyone knows what problems they will face. We'll talk about them today. And above all, this topic will be relevant for expectant mothers.


Cracked nipples

This problem can occur even if you smeared them with cream and applied the baby to the breast correctly. And if this happened, then there is only one thing left - to heal them. But the first thing to do is make sure the butts are correct, because perhaps you did something wrong. Give this issue due attention.

And the second is actually healing. They can be healed with quite affordable drugs, for example, Bepanten. This is a healing cream that helps cope with wounds and cracks. In addition to it, you can use Actovegin, Biopin, Rescuer, Methyluracil ointment, Solcoseryl gel.

You should not agree to what is offered in most maternity hospitals - this is to lubricate the cracks with brilliant green and go for ultraviolet irradiation. After all, you already have dry skin that requires hydration and healing, and greenery only dries it out.

Third is the question hygiene. Sometimes cracked nipples occur due to the use of disposable breast pads. They are needed by those women who have weak breasts and milk leaks constantly. This problem is especially relevant in the first months of feeding, because lactation is not yet regulated.

Disposable pads are usually made of synthetic materials and are additionally equipped with an oilcloth that protects against getting wet. And reusable ones are made of cotton and can be washed.

Therefore, if you have cracks in your nipples, we remove the disposable pads. And we try to walk bare-chested as much as possible. If this is not possible, then you need to buy a special cup that allows the nipple not to touch the laundry. Thanks to this, the nipple will be ventilated.

And of course, don’t forget about oiling your breasts. You can even use regular melted butter.

Excessive milk flow

Typically, an excessive flow of milk occurs when the baby begins to suck more than before. Most often this happens during illness, because if a child gets sick, he refuses all complementary foods and eats only mother’s milk. In this regard, the body interprets this incorrectly and sends the wrong signal. On the 2-3rd day, the flow of milk becomes enormous, and at this moment the baby can already recover and eat porridge again.

This can happen in the first days after the baby is born, and after 3-4 months. How to deal with this?

If you just gave birth to a baby, then for the first two days you can drink liquids as much as you want. But on the third day, even if you really want to, the amount of liquid should be minimized. Instead of a glass, we drink a sip, and so on throughout the day. Otherwise, on the third day you will be faced with the fact that your breasts will be of enormous size, stone-like and painful.

But what if there is still a lot of milk? Of course, on the first day the baby will “be full” and after the butt will sleep for 3-4 hours. But you will only feed him with one breast. But what to do with the second one, because it’s full of milk? The baby will not fit everything in one go.

We will have to live through this time. Don't be fooled by pumping, otherwise you will only confirm to your body that it needs to produce a lot of milk. To avoid this, it is necessary to alternate breasts and not change them twice in 15-20 minutes, as in the colostrum period. It is enough to feed the baby with one breast, and after he gets enough sleep and wants to eat again, give him the second. Such manipulations will reduce lactation and avoid overcrowding.

But it happens that the child cannot take the breast, cries and spits it out. And you understand that it is so crowded and dense that the baby is simply uncomfortable. Then you go to the bathroom and do massage with shower. Under the influence of hot water, the milk passages relax and milk begins to flow. If this does not help, then standing under hot water, start massage the breasts(from the periphery to the center) and press slightly on the nipple areola. In this case, the milk will definitely flow.

Many women express milk because they are afraid. But he never appears in one moment. Usually the reason for its appearance is, and you definitely won’t miss it. It manifests itself as engorgement of some lobe of the mammary gland.

Lack of milk

First of all, you need to make sure that there is really little milk, and you don’t think so. Because many mothers worry that they don’t have enough milk just because of their inexperience. If a baby cries, it is most likely due to a lack of milk, although the baby has dozens of reasons for this, ranging from memories of birth to a tooth that will grow only after three months.

Therefore, before doing anything, you need to check whether you really do not have enough milk. To do this, you should pay attention to the baby’s weight and the number of wet diapers per day.

In the first two days, the baby loses weight and this is called physiological weight loss. You need to know about this to be calm. Starting from the third day, the baby’s weight goes up and in the first month he should gain about 500-600 grams. Of course, all children are individual, but weight should definitely not stand still.

If you don’t have scales or something prevents you from doing this, then you can count the number of wet diapers. By the age of two weeks, the baby should urinate about 12 times a day.

When you have conducted similar research and still come to the conclusion that there is not enough milk, the question immediately arises - what to do?

First of all, ask the question: do you feed your baby at night? Did it happen that the child sleeps almost all night, pees little, does not gain weight, and the milk supply has decreased?

The second question to ask is how often you feed your baby, and whether this happened because you switched to regimen feeding. Is it possible that once every four hours is very infrequent for breast stimulation? Maybe you use nipples or pacifiers and give your baby water? After all, if he drinks water, he will not be able to handle a lot of breast milk, and because of this, the demand will be less.

You also need to pay attention to the alternation of breasts, because there is a so-called foremilk and hindmilk. The front one is more liquid and allows the child to drink, but there is little fat in it. The back, on the contrary, is rich in fat. In order for the baby to receive high-quality milk, it is necessary to alternate breasts and not forget about it.

The next issue that will need to be resolved is yourself. Many mothers forget about themselves, immersing themselves in the world of the child. And this is also the reason that there may be no milk. For example, you forget to eat. And food is very important for lactation. Some mothers immediately after giving birth decide to get in shape and go on a diet, forgetting that if the body does not have enough vitamins and food in general, milk will not be produced.

Important follow a diet and sleep schedule. If your baby falls asleep at 9 or 10 pm, you shouldn't run to the kitchen and put away dirty dishes, wash the floors or anything else. Go to bed with your child, because sleep between 22:00 and 00:00 is the most beneficial, according to experts. When you enter this mode, it will be much easier for you to get up at night to see your child, and it will be easier to get up in the morning. And accordingly, you will have time to do more. Moreover, those women who sleep little tend to feel tired and gain weight.

If there is not enough milk, then you need to drink. Preferably every time during feeding. Place a 200 ml cup of water or tea next to you. But you shouldn’t pour yourself coffee with condensed milk, because it’s an allergen. In general, there are three biggest allergens for a baby - refined sugar, cow's milk and fish. Condensed milk is milk and sugar mixed together.

So it's better to drink herbal teas that improve lactation. Herbs include nettle, fennel seeds, dill and anise. You can use the drug Apilag, created from bee products.

You can also increase lactation with massage. To do this, buy anise or fennel essential oil (3-4 drops are enough) and add it to another oil (olive, peach, almond, vegetable). And then massage your chest. As an additional remedy, you can use aromatherapy candles.

Also note that there is never a shortage of milk 24 hours a day. Usually there is a lot of it at night and in the morning, and in the afternoon and evening the amount decreases. This is not always the case, so you should pay attention to how your own biorhythms work.

If this happens, then it is necessary to prepare for this minimum in advance. At about seven o'clock, send your spouse for a walk with the child, and at this time prepare yourself something tasty. It's better if it's a rich soup. Then you should brew tea and take a hot shower, because it simulates lactation. And when your baby and husband return from their walk, you will probably have more milk than you had yesterday.

How to resume breastfeeding?

Lack of milk is far from the only problem that can be encountered during the birth of a child. Sometimes it is necessary to return to breastfeeding (BF) if immediately after birth it was not possible to attach the baby to the breast. This may be due to the fact that the baby was born prematurely and was placed in a special box, a complication during childbirth, a mother’s illness, etc. But when his condition stabilizes and the mother wants to resume breastfeeding, there is often not enough milk. Therefore, it is necessary to introduce additional complementary foods. Of course, you can use a regular spoon, but it is best to purchase a “soft spoon” from which nothing will splash out.

There are also additional modern devices that are attached to the mother's chest, but they are usually quite expensive. If you can’t buy something like that, you can take a regular syringe without a needle and feed the baby formula through it.

Symptoms and treatment of lactostasis

Lactostasis is a rather unpleasant thing, characterized by stagnation of milk, but not all women experience it. Exactly like other problems. Its first symptom is pain during feeding. If you feel pain, then first of all, palpate and you will probably find lumps in some lobe of the chest.

Second, this increased body temperature, which may not be on the first day, but in 100% of cases it will be. Therefore, if you find yourself with one of these symptoms, then try not to make the mistakes that most women make.

If your breast hurts, you need to be patient and not transfer the baby to another breast. Breasts with lactostasis need to be sucked to prevent it from getting worse. It is important to make sure that this stagnation goes away, and no one can do this better than a child. Therefore, we feed the baby with a sore breast, but position it in a certain way. You need to place it so that the lower lip and lower jaw are directed towards the seal.

If everything is done correctly, then you can get rid of this disease in one day. Of course, you will feel a loss of strength, weakness, pain. However, it’s worth going through and it’s not worth lowering your temperature. As soon as you remove the cause, the temperature will subside.

Compresses made from white cabbage leaves, which can be applied to the sore chest, can provide additional help. They help relieve swelling and pain. Cabbage leaves need to be changed every two hours.

After the temperature subsides, you can make a warm compress from propolis tincture. To do this, take a bandage or a piece of gauze. Blot it with propolis and apply it to the affected area of ​​the chest. Then, apply another piece of fabric, but a larger one, and wrap your chest with a warm scarf.

Breast massage, which you can do yourself, also helps with stagnation. To do this, take the fabric, place it on your chest and start making twisting movements, as shown in the picture.

First one way, then the other. This massage is quite easy to do.

Psychological problems

In addition to physiological problems during breastfeeding, women also face psychological ones. For example, your friends who came to visit you in the maternity hospital have not been able to have a child for seven years. Of course, they are happy for you and a smile never leaves their lips, but subconsciously you know that they are unhappy, because they dream of a baby. By thinking about this, you are programming yourself in advance, and this is not about the evil eye or other mystical nonsense. During childbirth and the first month after it, a woman and her child are very vulnerable. And if the baby usually only cries, expressing his dissatisfaction, but the mother takes everything upon herself. This can lead to lactostasis and loss of milk.

Any conflicts can also provoke the appearance of this disease.

Therefore, it is important to be in a good mood, and if you discover any of these problems, think about whether there are psychological reasons for its occurrence.

Share this information

Cathy Garbin, child health nurse, midwife and lactation consultant:
Katie, a mother of two, was a research fellow at the renowned Human Lactation Research Institute, founded by Peter Hartmann, for seven years, providing support to breastfeeding mothers in clinics and at home. Now she still works as a family consultant, and also conducts seminars for treating physicians and speaks at international conferences.

Breastfeeding is a skill like driving a car, and in the first month, mother and baby may encounter some obstacles along the way. It takes time and experience for it to become familiar to both of you. Addressing breastfeeding problems in the first month helps establish good milk supply and increase the duration of breastfeeding in the future. Below you will find tips on how to overcome the main breastfeeding problems that mothers often face from the end of the first week to the end of the first month after giving birth.

Problem #1. A painful lump appears in the chest

Lumps and lumps in the breasts of a nursing woman can appear for various reasons. One of the most common is a blocked milk duct, which results in a hard, painful lump that can become inflamed.

Solutions

  • Massage the inflamed area especially during feeding or pumping to clear the blockage.
  • Gently apply a warm flannel cloth to your breast or take a warm shower before feeding to ease discomfort.
  • Continue breastfeeding as usual to avoid milk accumulation, which can cause mastitis.
  • Try expressing milk from a sore breast after feeding to ensure complete emptying. This will help remove the blockage and restore patency of the duct. See which breast pumps* Medela offers and choose the one that's right for you.
  • Try ultrasound therapy. If your ducts are repeatedly blocked, your lactation consultant or healthcare professional may suggest this procedure to help restore your milk supply. The procedure is carried out by a physiotherapist.
  • Contact your doctor if you notice signs of infection (breast redness and tenderness or flu-like symptoms such as fever, aches, malaise and headache), or if you think the lump is not related to breastfeeding.

Problem #2. Breasts are red and sore

If one or both breasts are red and painful, and this is not due to blockage of the ducts, the possibility of mastitis, that is, inflammation of the breast tissue, cannot be ruled out. Mastitis causes redness, burning, and tenderness in the breasts combined with flu-like symptoms: You feel hot and cold, your joints ache, and your temperature rises above 38.5°C (101.3°F). If these symptoms occur, seek medical attention immediately. Mastitis needs to be treated as soon as possible, as your condition can worsen in just a few hours.

Mastitis can be caused by the following reasons:

  • lack of treatment for blocked ducts,
  • bacteria that have entered the breast through cracks and damage to the nipples,
  • improper attachment of the baby to the breast,
  • long periods between feedings,
  • breasts too full
  • wearing a bra that is too tight or clothes that cut into the skin,
  • abrupt weaning of the child from the breast,
  • excess milk.

Solutions
In addition to seeking medical help:

  • Continue to breastfeed or express milk frequently. Your milk is still safe for your baby. Its release will help clear blocked ducts and prevent painful milk accumulation. Abruptly stopping feeding or pumping may worsen symptoms. After feeding, it is advisable to express any remaining milk.
  • Give the baby the sore breast first. This way the child will be able to empty it completely. If it hurts too much, start feeding from the healthy breast, and when milk begins to flow, return to the first one.
  • Rest well, drink and eat. You need to get enough fluids and good nutrition.
  • Massage the sore area under a warm shower or apply a warm flannel or heat pack to clear blockages and relieve symptoms before feeding or pumping.
  • Apply a cold pack after feeding to reduce inflammation.

Problem #3. My strength is running out

Breastfeeding in the first weeks can be very tiring and seem endless. The baby will ask for the breast every few hours, day and night, and you are not yet strong after childbirth.

Solutions

  • Take care of yourself. This may be easier said than done when you have a newborn in your arms, but still try to get as much rest as possible, eat well and regularly, and drink more water. Do not refuse the help of your partner, relatives and friends, or even hire an assistant if you can afford it.
  • Feed while lying down. This will allow you to relax and reduce stress on sore spots, stitches or C-section scars.
  • Don't skip feedings. Your partner may offer to bottle feed your baby while you rest. However, despite this temptation, it should be remembered that it is better to establish milk production in the first four weeks through breastfeeding. Once breastfeeding is established, you can give your baby expressed milk, but before that, ask family members or friends to help you with other tasks so that you can focus completely on breastfeeding.

Problem #4. How can I increase my breast milk supply?

It's easy to doubt your breast milk supply is adequate, especially when your baby experiences developmental milestones between the third and fourth weeks. You may think that your baby asks for the breast more often because he doesn't have enough milk. However, if the number of wet and soiled diapers does not change - see Breastfeeding: What to Expect in the First Month - your baby will likely latch on to the breast more often to soothe himself. The baby is surrounded by many new sounds and images, from which it is easy to get tired, and he feels safe at the breast.

Solutions

  • Do not try to supplement your baby with formula, unless doctors are concerned about his weight gain or fluid loss. Continue to breastfeed your baby. This will help increase your breast milk production naturally.
  • There is no need to feed on a schedule. Feed your baby on demand. In this way, breast milk production will adapt to his needs.
  • Use a breast pump to help increase breast milk production while continuing to breastfeed.

Problem #5. I have too much milk

Solutions

  • Express some breast milk at the beginning of feeding to reduce the strength of the tide. Don't pump too much as this can make the situation worse - only pump as much as needed to relieve discomfort. Try hand expressing or use a breast pump (check out Medela's range of breast pumps* and find the one that suits you best).
  • Use a towel or diaper to absorb excess milk, or place the milk collection pad** on the other breast while you feed the first.
  • The child must feel supported. Hold him firmly (this gives a feeling of security) and in a comfortable position so that he can turn his head. Talk to your baby during the first quick flush, then he won't be scared by surprise and won't push the breast away.
  • Contact a lactation consultant or health care professional who will observe you and be able to suggest unilateral feeding or changing breasts by the hour (“breast duty”) to normalize milk production.
  • Be patient. Problems with milk production usually go away within a few weeks.

Problem #6. My breasts are different!

You notice that your baby has a preference for one breast, or that one breast produces more milk than the other, resulting in different breast sizes and shapes. This happens quite often and does not pose any problems for breastfeeding. If this does not bother you or your baby, you can leave everything as is. If this makes you uncomfortable, try the following techniques.

Solutions

  • When breastfeeding, offer your baby the less in demand breast first., since babies usually suckle more vigorously at the beginning of feeding.
  • Use a breast pump to increase breast milk production in the smaller breast.
  • Don't give up on bigger breasts. It is necessary to continue to feed at fuller breasts to avoid blocked ducts and mastitis.
  • Consult your doctor. Sometimes the reason that the baby is latched on only one side is an ear infection. However, some positions may cause discomfort, so try to hold the child more upright. In addition, a breast infection can change the taste of milk and also cause breast milk refusal.

Problem #7. A bubble appeared on the nipple

With frequent feeding, painful friction sometimes occurs on the chest,
A blister of blood may appear in the nipple or areola.

Solutions

  • Ask a consultant or lactation specialist check how the baby latch onto the breast. A shallow latch can cause blisters on the nipples and areolas.
  • Consult your doctor, what medication you can take to relieve the pain if necessary.
  • Try it other feeding positions to avoid putting pressure on the painful area.
  • Lubricate the inflammation with clean lanolin agent.
  • Use breast pads** to avoid rubbing the blister with clothing and speed up healing by circulating air, or try cooling hydrogel pads** to help relieve pain while also promoting healing.
  • Try expressing milk. Using a breast pump can be an alternative way to obtain breast milk without irritating the bladder. Choose the correct size of the funnel so that the nipple can move freely and the bubble does not rub against the walls of the tunnel.
  • Do not puncture the vial as this may lead to infection.
  • if the problem persists and causes you pain.

Problem #8. A painful white spot appears on the nipple

When the opening of the milk duct becomes clogged with milk or a thin layer of skin grows over it, a small white or yellowish spot may appear at the tip of the nipple. For some, these blocked ducts, sometimes called milk blebs or blisters, cause pinpoint pain, especially during feeding or pumping. Others do not experience any discomfort. The white blisters may persist for days or weeks until the skin breaks and the hardened milk comes out.

Solutions

  • Follow the tips above for solving problems with friction bubbles.
  • Remove the blockage if you see that the milk plug begins to bulge. Try to squeeze it out very carefully with clean nails.
  • Continue breastfeeding or pumping to restore the patency of the milk duct. If the milk duct clears during feeding, it will not harm the baby in any way.
  • Apply a hot, damp flannel cloth to the vial immediately before feeding or pumping. This will help the blocked duct open. You can also try quickly rubbing the area with a clean, damp cloth.
  • Hand express some milk before feeding, trying to push out the hardened milk clots. If this doesn't help, feed your baby or express milk as usual. Repeat several times a day.
  • Soak a cotton swab in olive oil and place it in your bra, pressing it against the nipple with the bubble. This will help soften the skin.
  • Seek medical help if the problem persists. Your healthcare provider may remove the plug with a sterile needle. This should be done immediately after feeding, when the bottle is maximally inflated.

Problem #9. My nipples hurt when feeding

At the beginning of breastfeeding, your nipples may become more sensitive, sore and even sore, but this usually goes away after a few days. If a specialist has checked your baby's latch and the inflammation persists, or your nipples hurt every time you feed, you may need medical help to resolve the problem.

The following symptoms and signs that appear on one or both breasts during or after feeding may indicate a bacterial infection or thrush:

  • burning, itching or sharp pain of moderate or severe degree in the nipples,
  • pain in the nipples intensifies when in contact with clothing,
  • pain in the nipples persists, despite attempts to attach the baby differently,
  • nipples hurt to touch
  • stabbing, shooting, burning or deep aching pain,
  • chest pain during feeding and almost an hour after,
  • bright pink nipples,
  • change in the color and texture of the areola (bright pink, darkening, dryness or flaking),
  • white rash on the breast or areola.

Also check if your child has the following symptoms and signs:

  • dense white spots or coating on the tongue,
  • white indelible spots on the cheeks,
  • a bright red rash with spots on the butt that does not help with baby diaper rash creams.

Solutions

  • Consult your doctor. He will most likely suggest testing for infections to make a diagnosis. Bacterial and fungal (yeast) infections are treated with different methods, so appropriate treatment should be started as soon as possible. There are other reasons that can cause similar nipple pain, such as eczema, psoriasis or vasospasm (narrowing of blood vessels) in the mother and latch problems or a tongue tie in the baby. Therefore, it is very important to make an accurate diagnosis.
  • Maintain strict hygiene. Wash your hands before and after feeding and applying any medications, and after changing diapers. Change your bra pads regularly, wash bras, tank tops and towels in high-temperature water, and wash your breast shields thoroughly. Breastfeed Med. 2009;4(2):111-113. - Protocol Committee of the Academy of Breastfeeding, "ABM Clinical Protocol No. 20: Breast engorgement." Brestfeed Med (Breastfeeding Medicine). 2009;4(2):111-113.

    2 Jacobs A et al.S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe und Frauenheilkunde. 2013;73(12):1202-1208. - Jacobs A. et al., "RecommendationsS-3 on the treatment of inflammatory diseases of the breast during breastfeeding."Geburtshilfe und Frauenheilkünde. 2013;73(12):1202-1208.

    3 Amir LH. Academy of Breastfeeding Medicine Protocol Committee.ABM clinical protocol# 4: Mastitis, revised March 2014. Breastfeed Med. 2014;9(5):239-243. - Amir L.H., Protocol Committee of the Academy of Breastfeeding, “AVM Clinical Protocol No. 4: Mastitis,” as amended March 2014. Brestfeed Med (Breastfeeding Medicine).2014;9(5):239-243.

    4 Kent JC et al.Principles for maintaining or increasing breast milk production. J Obstet, Gynecol, & Neonatal Nurs. 2012;41(1):114-121. - Kent J.S. et al., "Principles of Maintaining and Increasing Milk Production."F Obstet Ginecol Neonetal Nurse. 2012;41(1):114-121.

    5 Amir L.Breastfeeding managing ‘supply’ difficulties. Aust fam physician. 2006;35(9):686. - - Amir L., “Breastfeeding: problems of “supply.” Aust femme physical.2006;35(9):686.

    6 Trimeloni L, Spencer J.Diagnosis and management of breast milk oversupply. Journal Am Board Fam Med. 2016;29(1):139-142. - Trimeloni L., Spencer J., “Diagnosis and correction of excess breast milk production.”Journal Am Board Fam Med. 2016;29(1):139-142.

    7 Berens P et al. Academy of Breastfeeding Medicine.ABM Clinical Protocol# 26: Persistent pain with breastfeeding. Breastfeed Med. 2016;11(2):46-53. - Behrens P. et al., Academy of Breastfeeding Medicine, “ABM Clinical Protocol No. 26: Persistence of Pain during Breastfeeding.” Brestfeed Med (Breastfeeding Medicine). 2016;11(2):46-53.

    8 Australian Breastfeeding AssociationWhite spot nipple; March 2015. - Australian Breastfeeding Association [Online], "White Spots on Nipples", March 2015 [visited 02/08/2018].

While waiting for the birth of a baby, every woman is overcome by worries related to the health of the unborn child and breastfeeding problems, because she so wants the best for her little one.

Breast milk is the best natural product that fully meets the needs of the child. It is easily digestible, does not cause allergies, and contains iron. With breast milk, the baby receives antibodies from the mother that prevent infectious diseases. In addition, breast milk does not contain germs. Breastfeeding also helps to establish an emotional bond between mother and child.

But, unfortunately, today you can rarely meet a mother who does not know what problems with breastfeeding are. Let's take a closer look at them.

Main problems with breastfeeding


Small, flat nipples

Some women's nipples may be too small and flat. At first it is difficult for the baby to latch onto such a breast, so be patient, because gradually during the feeding process they will stretch out. First, you can put silicone covers on the nipples, which will make it easier for the baby to suck. One option for nipple traction is to use a breast pump. But remember, the only effective way is to frequently, correctly attach the baby to the breast.

Not enough milk

Every second mother worries whether she has enough milk to feed. In such cases, first of all, you should not panic, because there is a connection between the psychological state of the mother and milk production, especially in the first weeks after childbirth. The more your mother worries, the less likely you are to achieve a positive result.

Lactation disturbances can be caused by a number of factors:

  1. Fatigue and lack of sleep. Keep in mind that fatigue delays, reduces or disrupts lactation. During breastfeeding, you need to get plenty of rest.
  2. Feeding not on demand, not at night. Night feedings are an excellent way to maintain sufficient lactation. Night feedings should be maintained for as long as possible.
  3. Poor maternal nutrition. The quality of a woman’s nutrition during breastfeeding is of great importance not only for her health, but also for the usefulness of mother’s milk. If a nursing mother is malnourished, the content of protein, fat, and vitamins in milk sharply decreases. Therefore, it is advisable for the mother to eat before each feeding of the baby (5-6 times a day). This helps to improve the secretion of the mammary glands.
  4. Using bottles. Do not forget that sucking from a bottle is much easier, and the baby quickly gets used to the nipple and then refuses to take the breast. The consequence may be cessation of lactation. If the doctor recommends supplementary feeding to the child, then give the mixture from a spoon.

The baby cannot or does not want to suckle

Let's try to determine the main reasons why an infant cannot or does not want to breastfeed:

  1. congenital defects (cleft lip, short frenulum, etc.);
  2. abdominal pain (usually colic goes away within 4-5 months);
  3. intracranial pressure;
  4. stomatitis (white spots in the mouth);
  5. teeth are being cut;
  6. Bad mood;
  7. and etc.

If your baby refuses to breastfeed for certain reasons, you should not give up, but look for ways to solve the problem.

Lactostasis

Another problem with breastfeeding is painful lumps in the mammary gland, which are associated with stagnation of breast milk in the ducts - this is lactostasis. This causes problems with the breasts during feeding.

The main causes of lactostasis are:

  1. insufficient emptying of the breast;
  2. improper attachment to the breast;
  3. hypothermia;
  4. overwork;
  5. incorrectly selected underwear;
  6. injury or blow to the chest.

To avoid lactostasis, it is necessary to achieve maximum emptying of the breast. In this case, it is necessary to put the baby to the breast as often as possible and carefully express the rest of the milk. The seal must be massaged with special care.

Treatment of lactostasis with folk remedies involves the use of a compress of cabbage leaves, chamomile decoction, and arnica. It is also necessary after feeding to apply a diaper to the breast, moistened with cold water, for 5 minutes (cold will help make you feel better, relieve swelling and slightly reduce the flow of milk into the stagnant lobe of the breast).

You can often overcome lactostasis completely on your own if you follow the above steps. At the same time, do not forget that if your breasts remain hard for more than a day, or the lump does not go away, be sure to seek help from a breastfeeding specialist.

It often happens that a woman has a desire to breastfeed her baby, and she conscientiously listened to lectures at prenatal training courses on feeding a child, and her relatives are all in with both hands, and life makes its own adjustments. In this article we will focus on the most common problems that arise during breastfeeding, which can occur in any woman. But we will not touch upon complex cases that require professional pediatric care. So, the following problems may arise in the maternity hospital.

1. Sore nipples

These are painful sensations that occur only when the child grasps the nipple, and disappear as the child sucks on the breast. This phenomenon is temporary. The skin of the nipple is very delicate. Therefore, it takes some time for the breasts to get used to sucking. This condition does not require special treatment. The main thing is to monitor the correct attachment of the baby to the breast.

2. Inflammation, bruises, cracks in the nipple occur when:

  • incorrect attachment of the child to the breast: from the very beginning, it is necessary to ensure that the child opens his mouth wide, grasps the areola completely, lips are turned outward, and the chin is pressed to the chest. If the baby sucks on the breast only by the nipple, then the mother experiences pain during feeding. Such sucking always injures the nipple. Therefore, you don’t have to endure it, as many women do. You need to carefully place your little finger in the corner of the child’s mouth, open the mouth and take out the nipple. Then, wait until the baby opens his mouth wide and give him the breast correctly. And remember, proper breast latch is a skill that your baby will learn with your help;
  • The use of breast simulators contributes to the baby's pacifier and pacifier confusion. And as a result, improper breast grip. Therefore, remember the rule - until the child has learned to grasp the breast correctly, he should not see the nipple and pacifiers;
  • improper breast care: washing the breast with soap before each feeding, using disinfectants (for example, brilliant green) leads to washing off the protective fat layer from the surface of the nipple, and it remains defenseless. Sometimes inflammatory changes occur in women who use waterproof breast pads. Therefore, let us recall the rules of breast care: you need to wash your breasts during a hygienic shower, that is, once a day; After feeding, you can treat the nipple with hind milk and leave the breast open to air dry; use underwear and breast pads made of cotton fabric, preferably without seams.

If abrasions or inflammation of the nipple occur, it is often enough to correct the position of the baby at the breast and follow the rules of breast care. The frequency of feedings is not limited. If nipple inflammation does not go away within 7 days or is wavy in nature, you should consult a doctor. There may be a fungal infection and special treatment is required.

A nipple crack can be quite deep and bleed after feeding. During feeding, pain is noted. To treat a fissure, you will need to temporarily, for 12 hours, wean the child from feeding the problematic breast. She needs to be expressed at least 3 times a day and the baby needs to be spoon-fed expressed milk if he doesn’t have enough milk from the healthy one. To treat a crack, a wound-healing ointment without a specific unpleasant odor is suitable.

3. Dry breast skin

It may occur 2-5 days after birth and be accompanied by pain. The breasts increase in size and become hot, firm and shiny due to swelling. There is a complication of milk outflow. The most common reasons for this are:

  • delayed breastfeeding;
  • limiting the duration of breastfeeding;
  • improper attachment of the baby to the breast;
  • rare breastfeeding.

Therefore, the main prevention of dry breast skin is to put the baby to the breast as early and correctly as possible and to ensure that the baby is fed upon his first request, without limiting either the frequency or duration of sucking.

Delayed breastfeeding most often occurs in the case of a cesarean section or health problems in the child. Of course, these are special cases that require special attention from the maternity hospital staff and relatives. If the birth occurred by cesarean section, you must:

  • attach the baby as early as possible, preferably while still in the operating room, even if the mother is still under the influence of sedatives;
  • the child must be in the same room with the mother to ensure that the child is fed as required. Of course, a woman will need help in caring for a child;
  • if for some reason the baby cannot be temporarily put to the breast, it is necessary to establish pumping of both mammary glands as soon as possible after birth (at least within the first 12 hours). It is necessary to express milk for 15-20 minutes, 6-8 times a day in sterile jars so that it can be used to feed the baby. You can read more about this in our article.
  • Put your baby to the breast often if he can breastfeed. To make it easier for your baby to grasp the hard areola, you can pump your breasts a little before feeding. If the baby cannot suckle, then it is necessary to express the breast manually or with a breast pump;
  • stimulate the oxytocin reflex before feeding or pumping;
  • drink warm tea or herbal decoction (not coffee);
  • take a warm shower or apply a warm compress to the mammary gland for 10-15 minutes;
  • massage your back and neck;
  • lightly massage your breasts;
  • stimulate the skin of the nipple;
  • relax;
  • After feeding, to reduce swelling, apply a cold compress for 15 minutes.


4. Blockage of the milk ducts (lactostasis) and mastitis most often result from:

  • violation of the rules of feeding a child: restrictions on the duration and frequency of sucking, improper attachment to the breast, pressing with fingers on the chest during feeding;
  • wearing thick underwear;
  • stress and excessive stress: lead to a decrease in the frequency of the baby’s attachment to the breast and a decrease in immunity;
  • cracked nipple - are an entry point for infections;
  • breast injury - leads to damage to breast tissue. This makes it difficult to release milk. Accumulated milk causes dry skin and pain on palpation. Blocked milk ducts can cause milk to leak into the breast tissue and cause further non-infectious inflammation called non-infectious mastitis. The skin over the inflamed area turns red and becomes hot to the touch. At the same time, body temperature can even rise to 40ºС.


If you take the necessary measures in time, relief can occur within 24 hours:

  • determine the cause of milk stagnation and eliminate it;
  • before attaching the baby, stimulate the oxytocin reflex as described above;
  • pump the sore breast before feeding the baby, and then put him to the breast at the moment when he really wants to eat;
  • try to put the baby on the sore breast as often as possible;
  • change positions when breastfeeding. It is known that the baby sucks milk better from the part to which the lower lip faces.

Remember, treatment for a blocked duct is best done under the supervision of a doctor or breastfeeding specialist.

5. Flat or inverted nipple

Sometimes this becomes a reason for a woman’s anxiety and uncertainty about breastfeeding. Speaking about the importance of correctly attaching a baby to the breast, we pointed out that the baby should suck not from the nipple, but from the breast. That is, he needs to completely capture the areola. Therefore, in most cases, a flat nipple does not become an obstacle to latching on to the breast if the mother attaches the baby to the breast correctly.

It is very important to latch on to your baby correctly from day one, until the milk arrives and the breasts become firmer. You can experiment with baby positions at the breast, for example, try feeding in the “soccer ball” position, that is, from under your arm. Try stretching the nipple before feeding using a breast pump or syringe. During the sucking process, the baby will stretch the nipple more and more each time and adapt to the specifics of the mother's nipple. If, nevertheless, the child cannot suckle effectively within a week or two, then it is necessary to express milk and feed the child from a cup. At the same time, be patient and offer your baby the breast every time.

6. Insufficient milk supply

Let's first determine by what criteria we can say that the baby really does not have enough milk. Here are reliable signs of milk deficiency:

  • infrequent urination of the child: less than 6-8 times per day;
  • poor weight gain (less than 450-500 grams per month).

That's all! Neither frequent and prolonged feedings, nor the child's frequent crying, nor the child's refusal to suckle at the breast, nor the volume of milk “eaten” by the child at one time (control weighing), nor soft breasts are true signs of a lack of milk.

If you find out for yourself that there is really little milk, then you need to find the real reason for the deficiency. And remember, there are many ways to improve lactation.

Check yourself whether you are doing everything according to the rules of natural feeding. Because, most often, hypogalactia is caused precisely by factors associated with violation of these rules:

  • Rare feedings.
  • Incorrect attachment of the baby to the breast.
  • No night feedings.
  • Using pacifiers or pacifiers.
  • Supplementation with water or additional feeding.
  • Short feedings.
  • Poor breast emptying with lactostasis.
  • Incorrect introduction of complementary foods.

In these cases, there is only one piece of advice - correct all the mistakes, and the milk will not take long to arrive. It is possible that you will need professional help. In particular, if the amount of supplementary feeding is already quite large. But in any case, be patient and you will succeed! Some people advise the mother to eat and drink more, get more rest, or take medication to increase milk production. Understand that you can sleep around the clock and drink liters of lactation teas. But if you do not put your baby to your breast as expected, milk will not increase.

Remember, the main stimulator of lactation is the child.

Carry your baby in your arms more often, provide skin-to-skin contact, latch on to the breast more often and let the baby suckle as much as he wants, feed at night, take every opportunity for sleep and rest, drink so as not to feel thirsty and eat enough. Let someone else go to the store for groceries, and you can rest. After all, only you can give your baby the most valuable nutrition for him - breast milk.

Sometimes, at the stage of the maternity hospital, delayed lactation is observed, due to severe stress, traumatic birth, fatigue and the mother’s lack of self-confidence. In such cases, the support of loved ones and medical personnel is very necessary.

Taking certain medications (such as diuretics) can lead to milk deficiency. Consult your doctor and find an adequate replacement for this drug.

Cases when a child really needs supplemental feeding are very rare. The volume and type of supplementary feeding must be selected individually, under the supervision of a doctor. But in any case, try to put your baby to your breast as often as possible, give milk replacer from a cup or spoon, and continue breastfeeding for as long as possible. After 6 months, with the gradual introduction of complementary foods, you will eliminate the milk replacer. The baby will eat purees, cereals and continue to breastfeed.