Feeding Fundamentals

Common Breastfeeding Concerns

Having some trouble breastfeeding? You’re not alone. Here’s how to solve some very common problems.

• SORE NIPPLES - are often the result of awkward positioning or a poor latch-on. This discomfort is different from the tenderness you may experience in the first seconds of nursing; that usually goes away a week or so after birth. If the soreness persists, try different positions until you and your baby are both comfortable, and make sure your latch-on is correct. (Call a lactation consultant if you need help.)

• ENGORGEMENT is a condition that sometimes occurs in the early days in which the breast becomes full and hard with milk. Try cold compresses (or a bag of frozen peas) on your affected breast between feedings for comfort; a cool leaf of cabbage may also be soothing. To avoid it, feed your baby every two hours or so, or use a breast pump to empty your breasts at each feeding.

• MASTITIS is a breast infection that often starts when the breast is not completely emptied at a feeding. The affected area turns sore, red and hard. If these symptoms last for more than a day, call your healthcare provider; antibiotics will often solve the problem. To prevent mastitis, empty your breasts at each feeding (pumping may help). Try holding a warm washcloth to your breast before feeding or pumping; this may help the milk come out more easily.

• Concerns about LOW MILK SUPPLY often come up when the baby is about 2 months old. At this point, your body has learned how much milk to produce, and your baby may only nurse for five minutes at a time. This is not a sign of decreased milk supply: Rather, it means that you and your baby are breastfeeding successfully! You may also notice that your baby has fewer bowel movements, which might be making you nervous, too. This is totally normal; it means that your milk no longer has colostrum in it, which was having a laxative effect on your infant. Remember, if your baby is breastfeeding 8 to 12 times a day; you can hear him swallow during feedings; he is active and alert; and he is growing well, you have an adequate milk supply.

• FLAT NIPPLES, also called inverted nipples, do not protrude or become erect when stimulated or cold. In almost all cases, you can still breastfeed, however, latch-on may give you some trouble. If it does, you might try wearing breast shells between feedings or pumping just before a feeding to bring the nipple out.

Rita Pickler, PhD, RN, PNP, associate professor and chair of Maternal Child Nursing at Virginia Commonwealth University in Richmond, has been a nurse in the care of children for more than 25 years and a nurse educator and researcher for 15 years.

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