Breastfeeding is undoubtedly a beautiful experience. However, as natural of a process as it is, it can actually be quite difficult. In fact, 92 percent of new mothers report having difficulty nursing just days after birth, according to research by the University of California, Davis and the Cincinnati Children’s Hospital Medical Center. “Just like any other skill, breastfeeding needs to be learned by both participants—mother and baby. [It] is picked up faster by some than others,” explains Helen Anderson, chief lactation officer and founder of Milkies. “Sometimes certain variables can make breastfeeding more challenging. For example, if your baby is born early or you don’t go into labor, the hormones that tell your body to make milk can be slow to start.” She points out that other common hospital practices can interfere with breastfeeding. These include wrapping your baby like a burrito or waiting too long to start breastfeeding.
Breastfeeding woes come in all shapes and sizes and, as mentioned, are rather common. Breastfeeding can be an emotional process for new moms but any difficulty is certainly nothing to be ashamed of. Here are some breastfeeding challenges that commonly inhibit new mothers from successfully establishing a routine that works for both mom and baby, plus how to remedy each situation.
Sore or Cracked Nipples
Ouch, yes. Sore nipples are incredibly uncomfortable. But they are also incredibly common, especially in the first few weeks of breastfeeding. “Sometimes this comes from a latch that needs to be corrected. We can troubleshoot that early on in a lactation visit. Sometimes the latch is perfect but the nipples are sore because they are soft and sensitive. And now there’s a baby on them feeding every one to two hours!” explains Emily Silver, a certified family nurse practitioner and former labor and delivery nurse. “We teach women how to use heat therapy (emerging their breasts and nipples into a warm water basin), utilize warm compresses, and apply their own breast milk or lanolin cream to the nipples to offer comfort and help them heal.”
She also recommends that new moms understand the difference between normal and abnormal pain with breastfeeding. “Normal pain is pain or discomfort for the first ten to 30 seconds of breastfeeding when the baby first latches on and is trying to get the milk to come out. But that then goes away once the milk starts flowing and the baby is swallowing,” she says. “Abnormal pain or discomfort is when you are still experiencing pain after the first 30 seconds. It either continues throughout the feeding or happens in the middle of the feeding.”
Hard, Sore Breasts
As if pregnancy breast tenderness weren’t uncomfortable enough, now you have to deal with postpartum breast pain. This is also known as breast engorgement. It happens right as your milk production begins and is symptomatic of sore, tight, and full breasts. “It also can affect a baby’s latch and cause them to pop off or struggle to feed,” Silver says. “We usually have women use heat and massage prior to feedings to get the milk moving, in combination with reverse pressure around the nipple. Think, putting pressure on the tissue around the nipple to move any excess fluid or milk away from the nipple to allow baby to latch on to the softer tissue.” A little hand expression or manual pumping can also help move the milk.
This pesky but common infection occurs as a result of unrelieved breast engorgement and/or plugged ducts, according to Anderson. “It usually does not happen during the first few days, but it certainly can happen anytime,” she says. “Classic symptoms for mastitis include fever and flu-like symptoms, as well as a hard, hot, painful breast since it’s almost always on one side only.” She recommends continuing to nurse but giving your doctor a call. You may need an antibiotic treatment.
Low Milk Supply
This is the most common reason why women seek out the help of a lactation consultant, Anderson says. The good news is that most moms do make enough milk. If you aren’t sure about your supply, she recommends counting the number of wet and poopy diapers. Or have your pediatrician weigh your baby before and after you breastfeed to determine the amount of milk consumed. “The best way to keep your supply strong is to breastfeed or pump frequently. Like every two to three hours, around the clock,” she says. “If your baby is gaining weight, swallowing while breastfeeding, and making dirty diapers, your milk supply is probably right where it needs to be.”
Oversupply of Milk
While some women have a low supply of breastmilk, other women have an oversupply. This leaves them constantly engorged or leaking milk. “For an oversupply, we highly recommend using the Haakaa [breast pump] to help relieve and collect milk,” Silver says. “Women are often told that they should not pump at all if they have an oversupply. While this is generally true, we do tell moms that they can pump for two to three minutes just to relieve any pain they are feeling from engorgement, but to never completely empty the breast.”
Delay in Milk Coming In
It’s normal for it to take anywhere from three to five days for mature milk to come in, according to Silver. “While women have colostrum when the baby is first born, the first 24 to 48 hours of breastfeeding can be challenging—as a baby is feeding quite often (sometimes every hour!)—to help tell the brain to make more oxytocin and prolactin for the milk to come in,” she says. “After a long labor or feeling tired after childbirth, this period can sometimes feel a bit overwhelming to our patients.” For this reason, she advises new mothers to rest their nipples for at least an hour between feedings and offers encouragement that the milk will come in. If you are worried your milk is delayed coming in, schedule a visit with a lactation specialist to troubleshoot the issue as soon as possible.
As a woman, you’re probably already familiar with yeast infections. But thrush is the kind that can form on your nipple while breastfeeding. “It thrives on breast milk and is caused by an imbalance in hormone levels. [This] creates an upset in normal levels of bacteria,” Anderson says. “Activities that can lead to thrush include having an overly moist area around your nipples, taking antibiotics or birth control pills, and having a diet that is high in sugar.” If you or your baby shows signs of thrush (for your little one, it appears as white spots in the mouth), Anderson recommends seeing your health care provider for a diagnosis.
Your little one turning up his or her nose at the bottle is not uncommon. It can be the result of a myriad of culprits. These include poor positioning and flow incompatibility with the baby, according to Leigh Anne O’Connor, I.B.C.L.C., a private practice lactation consultant and La Leche League leader. She recommends trying a bottle that’s not too fast, too slow, or the wrong size, as not all babies like all bottles. “Having a support team in place before the baby arrives will make a huge difference in how breastfeeding goes,” she says. “Also, attending La Leche League meetings while pregnant can help a person learn the vast variety of ways breastfeeding looks and learn different strategies for managing feedings.”
Breastfeeding, or nursing, may seem like a simple enough activity for new moms and their babies, but it comes with its fair share of challenges. If you encounter any issues while breastfeeding, be sure to reach out to your doctor. He or she may be able to help alleviate your physical woes or direct you to a support group for any emotional challenges that may occur.