Breastfeeding Basics: Breastfeeding Challenges & Solutions

BREASTFEEDING BASICS
Breastfeeding challenges and solutions

Caring for your breasts

Wash your breast during your normal daily shower or bath.
Additional soaps, creams, lotions or ointments are not necessary.
Rub the colostrum or breast milk into your nipple area after your feed your baby. This will help condition it.
Leave your nipples exposed and let them air dry after breastfeeding.
Use 100 percent cotton or disposable breast pads without plastic liners. Change them as often as necessary to keep your breasts and nipples dry.
If breast pads stick to your nipples, moisten the pads with warm water before removing.
If your nipples are sore, apply medical-grade lanolin (i.e., Lansinoh, Purlan). Ask your lactation consultant or health care provider for more information.
You may want to wear a bra while sleeping for comfort and support.

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Flat nipples
You will be able to breastfeed, but you should avoid the use of artificial nipples until nursing is well established.

Don't use pacifiers.
Early attachment is important. Do not use bottles until baby has successfully latched on.
Wearing breast shells/cups inside your bra between feedings may help form nipples.
Roll nipples between your fingers or pump before feeding to help shape nipples and make them easier to grasp.
After birth, room-in with your baby so you can feed frequently to prevent/minimize engorgement.

Sore nipples
Nipple tenderness is normal and usually goes away with time. However, pain is a warning that something is wrong. Proper positioning, latch-on and removal from the breast may help.

Feed baby before he begins to cry.
Wait until your baby's mouth is wide open to feed him. Do not allow slurping or nibbling, and do not stuff your nipple into baby’s mouth.
Re-examine your latch-on and positioning techniques; you may need an adjustment.
Remember this saying: “tummy to tummy, chest to chest, the chin and nose should touch the breast.”
Remove baby from the breast by breaking suction first.
Keep baby positioned upon the breast; don’t allow dragging off the breast or stretching and pulling the nipple.
Avoid pushing/pulling the breast away from the baby’s nose; instead, adjust his position slightly until a nostril is visible.
Apply warm moist compresses after breastfeeding.
Express a little milk and massage into your nipple.
If your nipples are cracked, bleeding or damaged, talk to a lactation consultant or your health care provider.
Avoid breast pads.
Wear plastic breast shells to promote air circulation, speed healing and keep bra from touching nipples.
Apply warm saline solution (1/4 teaspoon salt to 1 cup water) with cotton balls.

Engorgement
This swelling of the breasts may be brought on by onset of heavy milk production. Engorgement may last from one to 10 days.

Symptoms are:

Tight, full, heavy breasts that are warm to the touch.
Difficulty with latch on due to flattened nipple and swelling.

To alleviate engorgement:

Breastfeed or pump your breasts at regular intervals.
Apply warm, moist packs to your breasts for five minutes. This helps open ducts and encourages milk flow. Longer application may increase swelling.
Massage your breasts with gentle circles to encourage milk flow.
Pump or express milk to soften areola; then nurse your baby.
After nursing or pumping, wrap ice in a towel and place it on your breast for 10 to 15 minutes to provide pain relief and reduce swelling.
For severe engorgement, apply ice first to reduce swelling, then heat for five to 10 minutes and massage, then nurse or pump.
Use analgesic/anti-inflammatory medications. Be sure to talk to a lactation consultant or your health care provider so you know which medications are safe to take while breastfeeding.

Baby-related breastfeeding challenges

Sleepy baby

Some babies are difficult to arouse for feedings. Don't force feed, but try some of the following tips. To wake your baby:

Change his diaper
Hold him skin-to-skin
Rub his back
Tickle his feet
Wash his face
Unwrap blankets from around him

Other methods to try include:

Express a few of drops of colostrum and allow your baby to suck it off your little finger.
Avoid bottles and pacifiers between feedings.
Attempt to breastfeed for 10 minutes. If you're not able to arouse your baby, place him skin-to-skin on your chest and try again in 30 to 60 minutes.

Fussy high-demand baby

Some babies have periods of frantic, fussy behavior when it is difficult to get them to breastfeed.

Learn to anticipate when your baby is ready to breastfeed but is not fully awake and/or frantic.
Dim the lights and turn off the television and telephone.
Be patient and don't take it personally. Your baby is not rejecting your milk.
Remember: sometimes babies are just fussy - it's no one's fault if this happens.
If you're feeling overwhelmed, put your baby in crib and take a break.

To calm your baby:

Swaddle or hold him snugly.
Let him suck on your little finger.
Avoid pushing on the back of baby’s head or forcing him onto your breast.