Early Difficulties Breastfeeding

by Melissa D. Jaramillo

You've made the decision to breastfeed your baby. Good for you! It can be a very wonderful experience for you both, along with providing your infant with the best nutritional start possible. This does not mean that it always comes easy and most women will experience some discomfort and even pain during the early postpartum days.

Here are some of the more common problems and methods for coping:

Engorgement

This is one of the most common issues of breastfeeding that occurs within the first few days postpartum. Basically, when your milk comes in (normally on the 2nd or 3rd day following birth), the glands of your breast become filled (engorged) at a point before a stable production schedule has been established. When breasts are not sufficiently drained the results can be quite painful -- and the cycle begins. Tenderness, swelling, warmth, and pulsating pressure may occur. At times the inflammation may cause the breasts to feel feverish and hard lumps may startle the new mom to become concerned.

Treatment:

1. First bit of advice is to breastfeed your baby often...and then breastfeed some more. Honestly, the more you nurse, the greater the relief. At this particular point creating the proper demand/supply balance is what you are after. To stabilize your supply you will need your baby's help. Remember, the two of you are a team!
2. Second, don't skip feedings during this time particularly. While it is understandable to feel exhaustion and the thought of "it's just one bottle" is quite tempting, the outcome will serve to defeat your efforts to battle engorgement. Even pumping is not nearly as effective as your newborns suckling.
3. Third, if your areola seems too large or hard for your infant to latch onto, try applying warm compresses or even hand expressing prior to your nursing session.
4. Fourth, wear a supportive nursing bra -- even overnight -- until you are more comfortable.
5. Fifth, massage your breasts (or have your partner do so), when you are completely relaxed. Doing so while in a shower is particularly soothing.

Sensitive/Painful Breastfeeding

Even when things start off well, suddenly you may experience a great sensitivity during the feeding. This, while normal, certainly is uncomfortable and as one mother described "is likened to someone shooting me with a thousand needles all at once." For some mothers, this sensation only lasts a couple of seconds and then goes away. For others, it can last throughout the feedings over the course of several days. Either way, it can become a detriment to your goal for breastfeeding if left untreated.

Treatment:

• Positioning: Check to be certain that your baby is positioned properly and is not latching on solely to the nipple. Attempt to get as much of the areola in your baby's mouth as possible. For more on proper positioning, read Sore nipples and Starting out right.
• Acetaminophen (Tylenol): If nursing sessions themselves are painful, take this pain medication approximately one half hour prior to feeding. This is considered safe for both you & your baby under most circumstances. Please check with your care provider if you have any questions or desire something stronger.
• Massage/Numbing: You can choose to apply ice packs prior to nursing to numb the area if needed. Also, massaging the breast -- particularly the nipple -- helps stimulate the milk flow. This instigates relief in itself.

Cracked Nipples

Remember as a child after playing in the harsh winter winds how severely cracked and chapped your lips became? Now as a newly lactating mom, you may be painfully reminded - only this time in a much more sensitive area! The majority cause of cracked nipples is due to poor positioning.

Treatment: