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Breastfeeding involves constant learning for new mothers, especially those who may be delivering a child for the first time. Positioning, latching and managing feed timings, may make them encounter breastfeeding problems. Most mothers can overcome these teething nursing challenges, if they are supported well.
Size and shape: Many mothers unduly worry about the size of their breasts. Smaller breasts are able to produce enough milk. Storage capacity of a smaller breast is less than a larger breast, which means it will fill faster, and a mother may have to feed more often.
A mother with larger breasts may need help in latching as their breasts may sag as well. The mother needs to learn how to support the breast while feeding either with her hand, if possible, or by using a firm towel roll or/and an alternate way to position the baby.
Engorgement: Around 3-4 days after delivery, breasts become hot, heavy and hard. In most cases, they simply are full partly with milk and partly with more blood supply and lymph. When milk is flowing, frequent unrestricted, effective suckling by baby and expressing extra milk is all what is needed.
Sometimes when milk is not removed effectively, breasts may become engorged. They become tight, shiny and painful and areola becomes hard. This occurs if the baby is not latched properly or milk is not removed efficiently or mother is producing excessive milk. Early initiation of breastfeeding at frequent intervals, avoiding giving anything except mother s milk, latching properly and expressing extra milk prevents engorgement.
Treatment includes applying a hot moist pack before feeding or expressing and cold compresses after feeding to relieve pain.
Blocked duct: Sometimes, one section of breast becomes red, inflamed, painful and milk does not flow. This is due to inefficient draining of milk from that section, tight clothing or incorrect way of holding breast. Treat by improving suckling position, feeding in different position to make sure baby empties all segments of breast, gently massaging effected area towards nipple while feeding and wearing loose clothes.
Mastitis and abscess: If engorgement is not relieved, it may develop into mastitis which is inflammation of breast tissue. The infection usually occurs due to cracked nipples. When breasts are red, painful, and tender, and milk does not flow, the mother can have fever. If mastitis is not treated early, it may develop into an abscess which is formation of pus in a particular area. Remove some milk and continue breastfeeding. Sometimes, a mother may not like to feed from an infected breast. Then remove milk with a hand or pump. She may need medicines to relieve pain and fever and antibiotics to treat infection. Remember that the mother needs rest, not the breast.
Flat nipples, which are short, are of concern to a new mother. Many times, nipples look small but when pulled out, the tissue underneath and nipple form a good shape for the baby to suck well. When nipples are so flat that the baby is not able to feed, seek professional help which includes exercises to pull out nipples, using a nipple puller or nipple shield.
Inverted Nipples: Occasionally when a nipple is pulled out, it goes into the breast deeper. This is an inverted nipple. Mother with an inverted nipple must take expert advice. She needs a lot more encouragement, repeated reassurance along with practical advice.
Long nipples: When nipples are rather long, a baby may suck only on the nipple and may not get enough milk. Go for a deeper latch. As the baby grows, he or she will be able to latch properly. Until then, the mother may express and feed.
Sore and cracked nipples: A poor suckling position is the most common cause of sore nipples. If soreness is not corrected, skin gets damaged, bacteria may enter and may cause infections in breast tissue. This may not make a mother feel like feeding or lead her to either abruptly end a feeding session or feed after long intervals. When the baby does not get enough feed and milk is not removed, breasts may become engorged and subsequently end in causing low supply.
Prevention includes learning proper feeding techniques, avoiding wearing tight clothing and limiting washing and cleaning breasts to once a day.
Refusal to feed could be a perceived or actual problem. A newborn trying to latch moves her head from side to side (rooting), and a mother may think the baby is saying no to feed. In fact, a baby may be trying to find the nipple and latch. You should know;
* A baby with a blocked nose or sore mouth may not be able to feed.
* A baby who is born early or with less birthweight may not latch at all.
* An ill baby (having jaundice, vomiting, diarrhea, fever) may not feed.
Some conditions in a mother may lead to refusal. These include milk coming too fast or too slowly, scheduled feedings, a mother may have used a different scented soap or spray or eaten a strong smelling food like garlic or menstruating or has mastitis.
To treat these breastfeeding problems, find the underlying cause. Management includes keeping mother and baby together as much as possible, reassuring and building mother’s confidence, asking mother to give expressed milk and increasing milk supply.
In most cases, timely interventions help mothers to successfully restart breastfeed.
To conclude, some mothers may face some breastfeeding problems, but most of these are preventable. The key lies in learning the correct positioning and latching.