Common problems in breastfeeding and ways to handle it | Part 2

4) Breast engorgement

Within 72 hours after you give birth, an abundance of breast milk becomes available to your baby. As that happens, more blood flows to the breast and some of the tissue swells. This caused full, swollen and engorged breasts. Not every postpartum mother experience engorgement.

These could be the reasons:

i) Mothers does not position baby properly or does not put baby often enough to the breast.

ii) Excessive or habitual pumping can lead to overproduction of milk and prolonged engorgement.

These are the solutions:

i) Keep in mind that engorgement is a positive sign: mother is producing milk to feed baby and soon with baby's help, mother will produce the right amount.

ii) Before feeding, gently express some of the milk to soften the breast. This makes it easier for your baby to grasp the nipple and areola.

iii) While baby is nursing, gently massage the breast that baby is on. This encourages milk to flow and will help relieve some of the tightness and discomfort.

iv) Avoid having your baby latch on and the suckle when the areola is very firm. To reduce the possibility of nipple damage and to help your baby latch on, manually express or pump your milk until your areola softens.

v) Nurse frequently, around every 2 to 3 hours even if it means waking your baby.

vi) After feeding, if your breast is still hard, express the remaining milk.

vii) Avoid pumping milk except when you need to soften the areola or when your baby is unable to latch-on.

viii) To relieve the pain and help relieve swelling, apply cold packs to your breasts for a short period after nursing.

ix) Don't apply direct heat such hot water bottles unless to soften the areola and help your milk let-down. Rather than alleviate the pain, this may aggravate the condition.

x) Some nursing mother find relief by applying fresh green cabbage leaves to their breast. Strip the main vein from two larger, outer leaves and cut a hole in each one for your nipple. Rinse and dry them well before laying them on your breasts or sliding them into cups of your bra. (Caution: Don't spread the cabbage too long.Cabbage has high absorption properties and may resulted drained in your milk production)

xi) If you are really in pain, take mild pain reliever prescribed by a doctor.

xii) Wear a supportive nursing bra, even during at night. Be sure it isn't too tight.

Look ahead! Mother will get past the engorgement and soon to be able to enjoy breastfeeding relationship with a baby.

5) Inverted nipple

Inverted nipples retract or pull inward when stimulated or suckled. Their appearance may range from slightly dimpled and indented to very clearly indent in the center. That sometimes can make it difficult for baby to latch on and breastfeed.

Check nipples by squeezing the areola about one inch behind the nipple with your thumb and index finger. If the nipple pulls inward, it's inverted.

Breastfeeding with an inverted nipple can be a challenge, but there are many different ways to manage it. Mother can draw out an inverted nipple by using a breast pump for a few seconds prior to feeding the baby. Several other techniques and lactation devices are designed to help with inverted nipples. A Lactation Consultant can make a recommendation based on individual needs.

If only one nipple is inverted, baby may be able to latch-on easily on the other side. Mother can pump the other side and save the milk for later use.

Changes in breasts during pregnancy may make nipples protrude more than usual. But, inverted nipples can pull in even more when your breasts become engorged and, in extremely rare cases, deeply inverted nipples can sometimes obstruct milk flow. During pregnancy, some women use breast shells (also called shields or milk cups) to correct inverted nipples. They are made of two pieces of hard plastic - an inner ring with a protective dome over it-that you wear inside your maternity bra during your last month of pregnancy. The ring exerts a constant, gentle pressure that gradually draws out an inverted nipple. Some experts recommend massaging nipples to help protrude. Warning: Excessive nipple stimulation during pregnancy can make your uterus contract and is potentially dangerous for hig-risk pregnancy. Consult with a doctor before begin treatment for inverted nipples.

After delivery if the condition has not improved, mother may need to seek breastfeeding guidance from a doctor or lactation expert. Remember, mother's top priority is giving sufficient milk to baby. Mother may have to express breastmilk for a week until nipples protrude enough to nurse.

6) Leaking breast

Leaking breasts are a reminder that lactation is going well. It is also the body's way of preventing engorgement and relieving that feeling of fullness nursing moms get in their breasts. Every breastfeeding woman is different - while some mothers never leak, others can barely keep their nursing tops dry.

Leaking is unpredictable, unfortunately. Some mothers leak only during the early weeks of breastfeeding while others may leak for many months. The hormone oxytocin, which causes the milk ejection reflex (MER) or let-down, is responsible - which is why you notice that one breast leaking while nursing baby.

Leaking generally stops once baby has mastered breastfeeding (giving baby frequent, unrestricted access to the breast helps).Some say leaking is a problem only until the sphincter muscle in the nipple gets in shape, and should stop soon after. How quickly or slowly this happens varies from woman to woman. Don't worry, when the leaking eventually stops, you'll still be making plenty of milk to meet the needs of baby.

To cope:

When mother begin to feel tingly sensation of milk let-down, apply firm pressure to your breasts by crossing your arms over your chest and hugging yourself. Mothers can also use the base of palm of hands to press over the nipple.

Use cloth nursing pads instead of disposables, which have been linked to breastfeeding problems. Their plastic lining, while keeping clothes dry, keeps the areola damp, exacerbating nipple soreness and fungal infections such as Candida (also known as thrush). Mothers can make their own nursing pads from cut-up cloth diapers. If mother is breastfeeding at home, keep a cloth diaper nearby to soak up milk from the leaking breast and save the pads for outing.

Waer clothing that camouflages wetness. Prints work well. Or carry a jacket or sweater that mother can put on quickly if breasts are leaking.Breastfeed more often or manually express milk. When mother begin to feel that fullness, let baby relieve the pressure before mother leaks. If mother is away from baby, slip into a private place and manually express some milk. If mothers don't relieve the pressure, they could develop a plugged breast duct or mastitis, a breast infection which is painful and will keep mother in bed for at least 24 hours.

Hanz's Note: This note was made as a quideline for lactating mothers and practically applies to most lactating mothers. Do take note that problem solution sometimes vary from one mother to another. Prevention is better than cure and that what should be taken into account. If problem still persist, kindly seek medical attention with your respective medical practitioner who is pro-breastfeeding and well-versed in lactation.