Solutions to common breastfeeding issues

Breastfeeding is well worth the practice and patience that it may require. Here are some common concerns that breastfeeding moms sometimes encounter and solutions to minimize discomfort. Call your physician or lactation educator if your breast is sore and hot, has an area of spreading redness, or if you feel feverish (your temperature is over 100° F).

Hard, swollen breasts

Hard, swollen breasts are painful and usually occur soon after birth. That's because your milk is just coming in, and your body and your baby are adjusting to the volume of milk that will be needed. Engorgement also can occur if your baby is not latching on properly and cannot drain the breast completely.

To ease the discomfort:

• Breastfeed your newborn every two to three hours—even if you need to wake your baby to do so—so you empty your breasts frequently.
• Take a hot shower or place a warm, wet cloth on breasts to relieve pain.
• Express a little milk (by hand or pump) if your breasts are too full for your baby to latch on.
• If your little one doesn’t breastfeed long enough on both sides to soften them, use a breastpump until both breasts feel comfortable.
• Use cold packs between feedings to limit swelling.

Sore nipples

Sore or cracked nipples are painful and can be caused by a baby's incorrect positioning at the breast or if the baby isn’t properly latched on. Vigorous sucking can also cause soreness and discomfort. Regardless of the reason, it's pain you don't have to live with. Contact a certified breastfeeding consultant who can help you assess why you develop sore nipples.

To help your nipples heal:

• Alternate breastfeeding positions from the cradle hold to the football hold, which will shift the pressure to a different area of your breasts.
• Be sure your baby is properly latched on, with her mouth encircling the entire areola.
• Avoid alcohol-based lotions.
• Avoid using soap to wash your breasts and allow your nipples to air dry.
• Wear cotton clothing next to your breasts (a breastfeeding bra or a loose-fitting top). Remove plastic liners from your bra.
• If your nipples are too sore to have your bra or clothing touch them, use breast shells with large nipple openings and holes for air circulation along with soothing cream safe for breastfeeding on the nipples and areola.

Plugged milk ducts

A tender-to-the-touch lump anywhere on your breast or in your underarm area usually indicates plugged milk ducts. Plugged ducts occur usually if the breast isn't adequately drained during breastfeeding. This soreness may relieve itself over a few days, but keep an eye on it. If the lump becomes red and the redness spreads, you may develop a breast infection and fever, which will require immediate attention from your physician.

Here are some pointers that can help:

• Apply dry or moist heat to the area and gently massage it. Nurse or hand-express some milk while the breast is still warm.
• Offer the sore breast first and encourage your baby to feed longer on that side.
• Apply heat to the breast before feeding.
• Massage the area between feedings.
• Take a hot shower or apply a warm, wet cloth to the area before breastfeeding.
• Avoid wearing a tight breastfeeding bra or one with underwires that might restrict milk flow.

Breast tingling

You may experience some tingling as your breasts adjust to breastfeeding.

Here are some pointers that can help:

• If tingling only occurs when your baby starts breastfeeding, it's a normal sign of "let down”, or your body releasing milk.
• If your temperature is higher than 100° F or if one of your breasts is sore and hot, call your doctor. You may have a breast infection and require medication.

Painful breasts

About two to six days after your baby's birth, your milk will come in. For some women, this can be painful and can make breastfeeding difficult.

How to remedy: You can cope with your abundant milk supply by gently massaging the upper part of your breasts, applying a warm or cool relief pack, taking warm showers, and by breastfeeding frequently.

Making sure your baby is positioned correctly during each feeding usually brings relief. She should be lying with her whole body facing you. And your nipple should be covered almost completely with your baby's mouth, her tongue on the underside of your nipple. When removing your baby from your breast, remember to break the suction by gently sliding your finger in between your nipple and her mouth.

Chapped nipples

How to remedy: If your nipples are chapped or tender, try placing a soothing gel patch inside your bra to prevent friction. The patches cool on contact. Gentle moisturizing balm will also soothe chapped and tender breasts. Wash nipples only with water and not with soap or rubbing alcohol, which can cause cracking. Leaving milk on the nipple after breastfeeding can also help prevent dry nipples.

Inflamed milk duct

When one of your milk ducts becomes inflamed, you may notice tenderness or even a sore lump in your breast.

How to remedy: Wet or dry heat on the breast can help, as well as showers and wearing a looser bra for a few days. Breastfeeding frequently from the affected breast will also help to unplug the duct, and try changing your baby's position often. If problems persist, consult your breastfeeding consultant or doctor.

Milk reduction

How to remedy: Just as plenty of rest and fluids help build your milk supply, fatigue can reduce it. Pay attention to your milk supply as you start getting back to your routine. If you notice a reduction, take it easy and drink more fluids.

Difficulty latching on

How to remedy: Try different feeding positions. Also make sure your baby takes enough of your nipple and areola into her mouth.