Breastfeeding problems – what to look for and what to do
Breastfeeding is a truly magical experience for me. I am so passionate about nursing and helping other mamas be successful nursing if it is their wish on their motherhood journey. With so much misinformation or lack of information given to new moms, breastfeeding problems are all too common. It can be overwhelming to come home with a brand new baby and struggle with getting the right latch and stressing about whether they are getting enough from you. I am here to help! If you have questions, I would be happy to chat with you (contact me here)! And, if I can’t help you, I will do everything I can to get you in touch with someone who can! You are not alone, mama! and YOU ARE ENOUGH!
~ you are enough ~
That being said, breastfeeding can be difficult and it can be a struggle to troubleshoot as a new mom, or even for many experienced mamas! Let’s touch on some of the most common problems, what to look for and how to resolve them!
Baby is fussy at the breast or refuses to nurse
Sometimes if a bottle is introduced early or too often, babies may begin to prefer the bottle over the breast because it is so much easier for them to get the milk. It takes only about 3 muscles in the jaw to retrieve milk from a bottle, but it takes almost every muscle in the jaw to remove milk directly from the breast! (BTW this is so amazing to me!) Many hospitals or LC’s recommend waiting 2 weeks to up to 6 weeks before introducing a bottle. You can check with your LC for questions and use your discretion.
Lip and tongue ties can also cause baby to be fussy or refuse the breast. Ties are a bit of skin attaching the lip or tongue to the gums making it hard for the tongue or lip to stretch out or away. For more information on lip and tongue ties, check out this article from Breastfeeding USA which explains more about what ties are, what effects they can have on babies and why they may be caused. Ties can cause tension and discomfort for baby (as well as many other issues), making it likely that they may be fussy during nursing. A nipple shield may provide some help prior to getting ties revised. Check with your pediatrician or lactation consultant for assessment or advice.
Breasts feeling full and sometimes to the point of soreness is common and normal in the first few weeks after baby is born when your milk has come in. At that point, your body is regulating your milk supply and getting used to the amount of milk your breasts will be holding. After the first few weeks, this feeling should die down and your breasts shouldn’t feel too full.
If engorgement continues to be a problem, this could mean you have an oversupply. Oversupply is most often due to bad latch from a tie. When baby is not efficiently draining the breast or is sucking more to compensate for being inefficient at draining, this can send the wrong signals to the body, causing supply issues.
Low supply / Low pump output
I think this is the most common thing I see and hear women mention! If you are exclusively feeding at the breast, it can be hard to gauge how much baby is eating, making it hard to know if he is getting enough. The best way to make sure baby is getting enough is to make sure he has enough wet and dirty diapers. Baby should have 6 wet diapers per day. Exclusively breastfed babies can go 5-7 days without having a dirty diaper.
It is so common for women to see huge freezer stashes of milk and get worried that they aren’t producing or pumping enough milk for their baby. I am guilty of it myself. However, you don’t need a huge freezer stash. You only need enough for 1-2 days in case of emergency or planned outings. If you are going back to work and planning for your return, start pumping about 1 week before you return. You should try to have enough to get you through the first couple of days and then your daily pumping can be for baby to consume the next day or so.
Keep in mind that, as a general rule of thumb, breastfed babies only need 1-1.5 oz per hour. So if baby goes 2 hours between feedings, each serving would be 2-3 oz. Pace feeding is important when bottle feeding, also. Taking breaks every minute or two during bottle feeding allows baby to digest the milk and slow down, allowing the signals to be sent to the brain when baby is full. Eating fast has the same effect on baby as it does on adults. When you eat really fast, your body doesn’t realize that you are full until it’s too late, making it extremely easy to over eat.
As with oversupply, if you have an undersupply, it is most likely caused by a latch issue due to a tie. If you believe you have supply issues, you are not pumping enough, or you believe your child may have a tie, talk with your doctor and/or lactation consultant for medical advice.
Nipple pain / soreness or cracking
Nipple pain is most often caused by a bad latch. When latched baby’s ear, shoulder and hip should be in a line, the mouth should encompass breast tissue rather than just the nipple, the bottom lip should be curved out along the breast tissue. Lip or tongue ties also make it difficult for babies to latch properly. It can be painful and cause internal tension for baby to properly latch and suckle. Ties should be assessed by your pediatrician or lactation consultant specializing in ties. Latch issues can cause soreness and sometimes cracking of the nipple.
Another reason for nipple pain could be teething. When babies are teething, their saliva becomes acidic which can cause discomfort and pain for mama.
Thrush can also be a cause of nipple soreness. Thrush is a type of yeast infection which can infect a mother’s breast milk and nipples and baby’s mouth. There are a variety of things that can cause thrush, such as mama taking antibiotics or having an infection somewhere else in her body. To learn more about thrush, visit Le Leche League. If you believe you have thrush, consult your physician or pediatrician.
For soreness and cracking, I recommend a good nipple butter like Earth Mama. This can help give you some relief and topical healing. It is also recommended to let your nipples have some free time! Let the girls air out when possible to promote healing and relief. Hang in there, mama!
Biting at the breast is the worst! I get it, mama! Been there… Biting is usually the result of teething. As baby’s teeth begin to come in, they are testing them out and seeing how they work. It is also relieving for them to bite and put pressure on the gums. Unfortunately, this can mean a few painful encounters for mama. Coming up with a protocol for biting and sticking strictly to it is so important!
When baby bites, break the latch and firmly tell baby “No Biting” and end the nursing session for a few minutes. The key is to be consistent every time biting occurs. If it continues, you can also consider giving a little bit of pain relief prior to nursing, such as frozen teething toys. This can help soothe the gums and make it less likely for baby to bite.
Falling asleep at the breast
It is common and completely normal for babies to fall asleep at the breast. If you believe baby is not finished eating or not eating enough before falling asleep, you can use a variety of different techniques to try to wake baby up a bit more to get him to nurse. Changing baby’s diaper right before feeding will usually do the trick! I usually tickle Samson when he begins to fall asleep at the breast and it wakes him just enough to get him to keep suckling.
Clogged ducts / mastitis
Clogged ducts can occur most often when longer periods of time elapse between nursing or pumping sessions than regular. Until baby is taking more solids than breast milk, it is best to keep nursing every 2-3 hours with one 5 hour stretch at night. Clogged milk ducts can be treated at home with gentle massage, hand expression in a warm shower/bath, dangle nursing (where you lay baby on his back and allow your breast to fall directly above baby while on your hands and knees over him). The best expression of milk when you have a clogged duct is nursing directly with baby. Breast pumps are not as effective as baby’s mouth and you want to make sure to completely drain the breast.
If left untreated, clogged ducts can develop into an infection called mastitis. If this develops, consult with your doctor for treatment. Most often it is treated with antibiotics.
Consistent spit up
Contrary to popular belief, spitting up after every feeding is not normal. Most often, spitting up is a symptom of a lip or tongue tie. As mentioned above, check with your child’s pediatrician or lactation consultant for assessment.
The bottom line is YOU CAN DO THIS, mama! Look for answers and resolve if you are having issues! Don’t give up on your worst day. 🙂 Let me know if you are struggling with other breastfeeding issues in the comments below or through my contact page!
**The information in this article is for reference only and should not be considered medical advice. If you have concerns about your health or your child’s health, consult your physician or a lactation consultant**
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