Oh Baby, Don't Worry! Here's What To Do For Common Nursing Challenges - WellBeing by Well.ca
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Feeding & Meals

Oh Baby, Don’t Worry! Here’s What To Do For Common Nursing Challenges

Young mother breastfeeding her newborn baby boy

Oh Baby! is a series where an expert shares the scoop on all you need to know for the littlest members in your family.

Breastfeeding can be hard! Even as a Lactation Consultant with many years of experience supporting breastfeeding mothers, I had a myriad of challenges. Painful nipples, countless blocked ducts, a newborn baby who would not latch onto my left side, a 3-month old who refused to latch unless I was lying down (!), and 5 bouts of mastitis are just some of what I remember. Despite all of the initial difficulties, my breastfeeding experience was incredibly meaningful and with the support of wonderful lactation consultants, I was able to persevere and conquer each challenge.

If your gut is telling you that your breastfeeding experience isn’t going well, I urge you to reach out to an International Board Certified Lactation Consultant (I.B.C.L.C) to help you. While the following list of breastfeeding challenges provides some simple troubleshooting that may work to get you over a hurdle, it may be worth seeing a professional if you’re still struggling. Ultimately, the key to breastfeeding success is the latch and a lactation consultant can guide you to position your baby well to achieve good transfer of milk without pain.

Read on for some simple troubleshooting tips for common nursing challenges.

Breastfeeding Challenge #1 – Engorgement

What Is It & How Can You Recognize It?

While engorgement is most commonly seen when the milk transitions from colostrum to more mature milk (on average, 72 hours after birth), it can also happen if baby has an unexpected long stretch of sleep or possibly when baby goes on an unexpected nursing strike. Engorgement can be very uncomfortable and can also affect the milk supply. It is characterized by large, heavy, warm and hard breasts.

What Should You Do?

True engorgement, where there is no movement of milk and swelling in the breast, is not normal and can be prevented by a well-latched baby and knowledge on how to tell whether baby is getting the milk out of the breast. If you find yourself suffering from extremely full and uncomfortable breasts, definitely seek out good help. Your Lactation Consultant can also teach you techniques to move the swelling out of the areola, making it easier for baby to latch on if they are having difficulty.

Other tips to try on your own:

  • Cold: Swelling in full, engorged breasts responds best to cold so an ice-pack will work to help relieve the tension in the breasts. Applying this ice-pack (over a layer of clothes) for 20 minutes before a feed is helpful.
  • Cabbage leaves: Cabbage leaves applied to the breast can also help with the swelling and discomfort of engorgement. Using cabbage leaves 2-3 times a day for about 20 minutes may provide relief.
Breastfeeding Challenge #2 – Vasospasm

What Is It & How Can You Recognize It?

Vasospasm is characterized by a burning, stabbing pain in the nipples that may extend into the breast. It may also include colour change in the tips of the nipples; nipples can turn a white or purple colour in conjunction with the pain. Often misdiagnosed as thrush, vasospasm is caused by a poor latch which leads to the blood vessels contracting abnormally. This results in impaired blood flow to the tips of the nipples.

What Should You Do?

Get good help as soon as you can to deal with vasospasm. Help to properly position the baby at the breast will be key! Vasospasm may also be experienced if milk supply has gone down as baby will pull at the breast which compromises the latch—therefore, help may be important even for an older baby. Your lactation consultant may even recommend supplements or a medication to help to relieve symptoms.

Other tips to try on your own:

  • Warmth: Vasospasm responds to warmth as this helps blood flow and circulation. A heating pad, hot water bottle or even a hot shower will help immensely. Covering the nipples right after a feed with your nursing bra or hand is also very helpful.
  • Pectoral massage & stretching: A strong massage into the pectoral muscles above the breasts and into the underarms can help return the blood to the nipples to provide relief. Stretching in a doorway can also be helpful as this will also help blood flow.
Young mother breastfeeding her newborn baby boy at home

The key to breastfeeding success is the latch and a lactation consultant can guide you to position your baby well to achieve good transfer of milk without pain.

Breastfeeding Challenge #3 – Blocked Ducts

What Is It & How Can You Recognize It?

Tender areas that feel firm when you squeeze the breast may mean that you have blocked ducts. Blocked ducts are generally caused by a baby not emptying the breasts sufficiently and can results from a poor latch. They can also be caused by an ill-fitting bra or clothing cutting into the ductular structure of the breasts—the “straws” that bring the milk to the baby. Blocked ducts can lead to low milk supply as the excess milk applies pressure to the walls of the ducts, signalling to the brain that more milk is not needed.

What Should You Do?

Get good help as soon as you can to make sure that baby is removing milk well from the breast. Your lactation consultant can help you tell whether baby is latched on and transferring milk well. Your lactation consultant may also recommend, depending on the severity of the blocked duct, that you seek out therapeutic ultrasound which may help move the milk.

Other tips to try on your own:

  • Heat: Applying heat in the form of a heating pad, water bottle, or a hot shower will help soften the congestion in the breasts. Place the heat around the blocked areas. Be sure not to burn the skin so take care to add this over a layer of clothes.
  • Compressions: Taking a handful of breast tissue around the tender, firm areas of the breast and compressing deeply while baby is actively trying to remove milk from the breast is helpful. This is especially effective after you have applied the heat before the feed.
Breastfeeding Challenge #4 – Low Milk Supply

What Is It & How Can You Recognize It?

Research shows that the number one reason mothers give up breastfeeding is because they fear they do not have enough milk for their babies. Often, milk supply is not a concern and it may just be that baby is going through a growth spurt and feeding more frequently. Sometimes the feeling of fullness in the breast or leaking from the breast may stop even though baby may still be getting more than enough milk. True low milk supply will lead to poor weight gain, insufficient output, a baby who is upset and fussy at the breast and, of course, the necessity for supplementation.

What Should You Do?

There are many reasons why supply may be low. Getting good help to assess whether baby is latching well and transferring milk efficiently will be very important. Learning how to successfully manage a feed, such as knowing when to switch sides, is also key.

A lactation consultant will help mothers dig deeper into what may be affecting supply such as challenging birth experiences, hormonal issues, retained placenta, etc. They will also assess baby’s oral anatomy and suck and look into whether there are issues with baby’s jaw and neck, among other concerns. Further, lactation consultants can recommend you speak to your doctor about herbal remedies for milk supply and possibly even medication to increase supply.

Other tips to try on your own:

  • Milk making teas and foods: Eating and drinking enough will be key to making enough milk so make sure your diet includes sufficient water and lots of protein. While you should wait to speak to your lactation consultant and health care provider about taking herbal remedies for milk supply, lactation tea and foods for milk supply such as brewer’s yeast, flax seeds and oatmeal can be a help to boost supply and flow.
  • Relax: Stress can impact milk supply. Exhaustion and anxiety can inhibit oxytocin, one of the hormones responsible for milk production. Ensure you get lots of rest and seek out help from family members, friends or even a postpartum doula if necessary. Listening to recordings such as this one can be helpful to keep you calm and grounded as you work to get help to increase your supply.

Don’t hesitate to reach out if you feel you have a breastfeeding challenge that we haven’t addressed here! Happy Nursing!

Taya is a International Board Certified Lactation Consultant in the Toronto area.  She is passionate about prenatal breastfeeding education and sees mothers at home, the hospital and in a clinic setting postpartum to help them to reach their breastfeeding goals. She also teaches pre and postnatal pilates and really can’t get enough of babies! She has two daughters, whom she wishes were still babies! Alas, they are growing up too quickly!

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Please Keep In Mind

This article is for educational purposes only and is not intended to diagnose, treat, cure or prevent diseases. We cannot provide medical advice or specific advice on products related to treatments of a disease or illness. You must consult with your professional health care provider before starting any diet, exercise or supplementation program, and before taking, varying the dosage of or ceasing to take any medication.

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