If childbirth wasn’t miraculous enough. Soon after bringing your little one into the world, something else miraculous happens: You lactate, or your breasts produce milk.
Breastfeeding may come naturally for some women, but it’s not always a piece of cake. For some breastfeeding mothers, it can be downright challenging (and yes, even painful). Some new moms may even beat themselves up, thinking it’s somehow their fault that they can’t seem to work out what comes so naturally for other moms and mammals.
Talk to a certified lactation consultant
Before you throw your hands up and stop breastfeeding, just like anything new in the beginning, remember there’s a learning curve with breastfeeding.
One of the biggest reasons that women struggle with breastfeeding when they leave the hospital is they lack access to information and support in that “critical first week.” This is where a certified lactation consultant (IBCLC) can help. They are a free resource and can provide everything from tips and tricks for nursing to pumping to storing your liquid gold (breast milk).
“A lactation consultant is a certified health professional who specializes in breastfeeding issues,” said Shelbie Radom, MSN, RN, IBCLC, a lactation consultant and prenatal educator at Banner Health in Colorado. “Your lactation consultant can work with you and your baby to increase your chances of having a long and successful breastfeeding experience.”
7 common breastfeeding challenges and how to fix them
That said, you could still run into some challenges. Radom shared seven of the most common breastfeeding challenges new moms face and how to conquer each and every one of them.
1. Low milk supply
If you’re concerned that your breast milk isn’t coming in or you’re not producing enough, you aren’t alone. Many moms worry about low milk supply, but most of the time your body makes exactly what your baby needs. However, your breasts must be stimulated frequently the first hours, days and weeks in establishing a milk supply.
“Insufficient breast milk production is actually rare,” Radom said. “More often, other factors can cause low milk supply or breastfeeding issues, such as not breastfeeding frequently enough, supplementing with formula without pumping, an ineffective latch, certain medications, premature births and pregnancy-induced high blood pressure.”
Here are some tips to help you make more milk:
- Breastfeed often, at least every two to three hours. In the early weeks, your baby will eat eight to 12 times every 24 hours. Don’t skip feedings/pumping; follow your baby’s cues and let them tell you when it’s time to eat.
- Use your hands along with feedings/pumpings. Hand expression is one of the best ways to increase milk production.
- Offer both breasts at each feeding. It’s OK for your baby to nurse on only one breast at a feeding occasionally, but if this happens regularly, your milk supply will decrease. You might pump the other breast to relieve pressure and protect your milk supply until your baby begins taking more at each feeding.
- Avoid bottles and pacifiers in the early weeks.
- Talk to your health care provider about certain medications. Antihistamines such as Benadryl and Zyrtec, as well as certain types of hormonal contraception, can dramatically decrease milk supply.
- Take care of yourself. Get as much rest as you can, eat well, avoid alcohol and nicotine, stay hydrated and let others help you.
“Working with a lactation consultant is very important if you are concerned about low milk supply,” Radom said. “We need to monitor your infant's weight gain very closely. We can make a pumping plan to supplement breastfeeding. We can also evaluate the pump you have.”
2. Engorgement (hard and painful breast swelling)
While some new moms worry about not making enough, others may feel like they are literally about to burst. It’s normal for your breasts to become larger, heavier and a little tender when your breasts are overfull of milk.
This normal breast fullness will gradually go away in a few days as your body adjusts to your baby’s needs. However, engorgement can lead to a plugged duct or breast infection, so it’s important to try to prevent it before this happens.
Here are some tips to relieve your symptoms
- Apply a warm moist heat compress to your breasts followed by breast massage before every feeding at least every 2 to 3 hours.
- You may apply ice after feedings up to 20 minutes to decrease inflammation and for comfort.
- Do not apply moist heat or ice to nipples.
3. Mastitis and fungal infections
Mastitis is a breast infection that is typically due to bacterial infection from a damaged nipple. Your breast may suddenly become hard, red, warm or painful. But, red streaks, fever or flu-like symptoms are late signs.
Radom said that you can still breastfeed, but it’s important to see your health care provider and get an oral antibiotic. “Breastfeeding can usually help to clear up the infection and remove the clogged duct,” she said.
Thrush, a fungal infection, is another common problem among breastfeeding mothers and babies. This is an infection caused by the overgrowth of yeast. It can cause sore nipples, achy breasts and white spots on the inside of your baby’s cheeks, tongue or gums.
If you have concerns about thrush, call your health care provider and your baby’s provider so you both can be correctly diagnosed and treated at the same time. This will help keep you from passing the infection back and forth.
4. Sore nipples
When you first start breastfeeding, your nipples may be sensitive or tender as you and your baby adjust to breastfeeding. But contrary to what you have heard, breastfeeding shouldn’t ever be painful. Breastfeeding should be comfortable once you’ve found some positions that work and a good latch is established.
Here are some tips to reduce nipple pain
- Ensure a proper latch. You’ll know your baby is latched properly if your nipple and at least half of your areola are completely sucked into baby’s mouth. An incomplete latch means you will likely feel a pinch (ouch!) and might end up with sore or cracked nipples. If you're still uncomfortable after a minute of nursing, gently press your clean finger in the corner of your baby’s mouth to break the seal, then try again, making sure their mouth is open wide.
- Try changing positions each time you breastfeed to put pressure on a different part of the breast.
- Avoid wearing bras and clothes that are too tight and put pressure on your nipples.
- Avoid using harsh soaps or ointments on your nipples. You can express a little breast milk after feeding and let your nipples air dry after to help them heal and keep them healthy.
- If pain persists, talk to your health care provider or lactation consultant.
5. Inverted, flat or very large nipples
Just like our belly buttons, women’s nipples come in all shapes and sizes. If your nipples turn inward, are flat or very large, it can sometimes make it harder to breastfeed, but there are remedies for them.
“Most babies can breastfeed no matter what mom’s nipple is like,” Radom said.
If you’re worried your baby isn’t latching well because of the shape or size of your nipple, talk to your provider or a lactation consultant. They can teach you steps to help you and your baby adjust.
Only your baby’s health care provider or a certified lactation consultant can diagnose your baby as tongue-tied, but it can cause latching problems, sore nipples and a cranky baby.
When a baby is tongue-tied, it means the tissue connected to the floor of their mouth is too short or extends too far to the front of the tongue. Radom said not to put this off and immediately seek help if you have concerns.
7. Baby gassy or fussy after feeding
If you notice your baby is gassy, extra gassy or fussy after feedings, they may be swallowing or gulping a lot of air and may not be properly latched.
“All babies will swallow some air during breastfeeding and/or bottle feeding, but the best way to help them with gas is to ensure your baby has a good latch to try and prevent too much air from being swallowed,” Radom said.
In addition, here are some other things that can help:
- Burp your baby well between breasts and at the end of each feeding.
- Try to avoid overfeeding or feeding them too quickly.
- Consider your diet. Many mothers worry that their diet is the cause of infant gas, but Radom said this is most often not the case.
“If you’re noticing increased fussiness, then it may be helpful to track when your baby is gassy and look back at what you ate to discuss with your provider or lactation consultant,” Radom said.
Every woman’s breastfeeding experience is different, so you may experience some or none of these problems. If you do, remember to reach out to your health care provider or a certified lactation consultant and schedule a visit.
“Don’t wait,” Radom said. “The sooner you are seen the better.”
If you have additional questions or concerns, Banner Health has a number of breastfeeding support groups and classes in your area. You can also find more lactation services and support at bannerhealth.com.