The Most Common Issues with Breastfeeding

Numerous women struggle in one way or another with this, and the issues run the gamut. Maybe you aren’t producing enough milk. Maybe you are producing too much milk. Maybe there are issues with the “latch.” Maybe you have mastitis. Maybe your nipples are cracking and bleeding (fun!). Maybe you just don’t like it.

We know by now that things can go wrong with breastfeeding, and they can go wrong for anyone, even the healthiest, most natural-leaning people. Heidi really struggled with the issue of not making enough milk, and it brought up feelings of insecurity and inferiority that I just couldn’t relieve her of, no matter how much I tried. That broke my heart. But this happens to a lot of people from all ages and all walks of life. Breasts are “designed” for breastfeeding, theoretically, but the reality doesn’t always work out that way.

So should you grin and bear it? And how much is enough? Experts say that the first few weeks really are the hardest, as you get the hang of nursing. It does not come naturally to most women, contrary to what you might think.

But it is definitely good for your baby, and it also does good things for your body, so it’s definitely worth a good try. (It burns 300 to 600 calories a day!) Let’s go over some of the most common issues and discuss possible plans of attack.

Ineffective Latch

You’ll find plenty of information out there on the Internet, but rather than consulting Dr. Google, I honestly recommend a lactation consultant. There are so many factors to consider! I remember thinking our son was suffocating, when he was actually latching correctly. New moms tend to not put enough of the nipple in the baby’s mouth, and a hands-on demonstration (don’t be embarrassed) by a lactation consultant is worth a thousand words. Ask to have a lactation consultant visit you as soon as possible after the birth—most hospitals have them available—and keep asking for help while you’re in the hospital until you feel comfortable. After you get home, see if you can have your insurance cover the cost of a home visit; if not, attend a breastfeeding seminar for new moms. (Here is a website to help you find someone in your area: uslca.org/resources/find-an-ibclc) I highly recommend at least one session to help you and your little one work out the kinks—breastfeeding shouldn’t hurt, and if it does, you probably need further instruction. Once you get going, you’ll be amazed by how wonderful it feels and how close it helps you feel to your baby.

Mastitis

If you are wondering what this is, you obviously have not experienced it because you’d know. Mastitis is the swelling of the breasts because of a bacterial infection. Your breasts will get engorged, incredibly painful, and hard to the touch. You may also get a fever and feel like you’re getting the flu. The infection can happen when the milk ducts get plugged, or bacteria can get introduced from sore, cracked nipples. This is a serious medical condition and warrants an immediate call to your doctor. It’s likely he or she will put you on antibiotics. If the infection is caught early enough, it should clear up fairly quickly.

Mastitis can occur anytime you are breastfeeding, but it’s most common in the first month of your pregnancy, before you and your baby get the hang of nursing. Here are a few tips to help you avoid mastitis or manage it (should you get it) in conjunction with treatment from your doctor.

• Get rest. Mommies who are fatigued and stressed are more at risk.
• Make sure your latch is solid. Good breastfeeding techniques will help prevent sore or cracked nipples.
• Nurse or pump frequently to keep the milk flowing and your breasts empty.
• Drain your breasts thoroughly at each feed. If your breasts still have milk after your baby is done eating, be sure to use a pump to get the rest of the milk out.
• Apply wet heat and massage the affected breast to help get the milk out. Repeat throughout the day.
• Wear well-fitting nursing bras. Avoid those that are too small or have an underwire.
• Above all, keep going! Even if you have mastitis, continue to breastfeed. It will help empty the milk from your breasts, and it will not hurt the baby. (The only exception would be if your infant is in neonatal intensive care. That’s because mastitis can increase the amount of sodium in your milk, and it’s not recommended for little ones in neonatal intensive care. Otherwise it’s perfectly safe.)

Sore or Cracked Nipples

Ouch. In many cases, latch issues cause this because the baby is essentially gumming the end of the nipple instead of mouthing the whole nipple in a way that pushes the milk out. This is when a lactation specialist can be so helpful. Some people try nipple shields for this problem, but a nipple shield can cause latch problems, and most lactation specialists usually recommend against them. However, they have helped some women nurse who might not have nursed otherwise, so the verdict isn’t exactly in on these. Before you go that route, however, try applying a bit of breast milk to your nipples after every feed—freshly expressed breast milk can help heal cracked nipples because it offers antibacterial protection. It’s an old midwife’s trick that’s been proven to work!

Thrush

Thrush is basically an oral yeast infection that babies often get and pass on to their nursing moms. Then it can get passed back and forth so it is very hard to get rid of. Women who’ve had C-sections may be more susceptible to this due to the antibiotics prescribed after the surgery, which tend to let yeast overgrow. To help avoid this, I highly recommend taking probiotics and slipping some baby-appropriate probiotics into your little one’s bottle of pumped breast milk. BioGaia is a great brand that you can find nearly anywhere. Also, back off sugar in your diet, which feeds yeast. You can talk to your doctor about prescription nipple cream, but avoid the ones that can facilitate fungal growth (which is why prescription may be necessary—some over-the-counter brands will be counterproductive). You can also try coconut oil, which is a natural antifungal. If you already have a bad case of thrush, again, back off on the sugar, eat more foods with natural probiotics like yogurt, drink a lot of water, and air out your boobs when you can—thrush thrives in moist environments. If your baby has oral thrush (a sign is white cheesy-looking lesions in the mouth that look like curdled milk but don’t wipe away), your doctor or lactation consultant may recommend treatment, but often it goes away on its own in a couple of weeks.

Overzealous Pump

Your breast pump’s level of suction may be up too high and/or the flanges or breast shields may be too small for your nipples. Have your lactation consultant help you to make sure you get this just right.

Low Milk Production

I know this one can bring a lot of anxiety; I have witnessed it firsthand, and it is one of the main reasons why women stop breastfeeding. As I mentioned, Heidi was simply unable to make enough milk to feed our enormous 9-pound son. We had to supplement with formula, and he was happy and able to both breastfeed and be topped off with formula in a bottle. No stress, and no shame! Enough with the perfectionism around 100 percent breastfeeding! I’m telling you this personal tale so that you will not give up on your milk supply, no matter how modest or robust it turns out to be. Either way, it will all work itself out.

That said, there are some things you can do to boost milk supply:

• Nurse on demand. Nurse for as long as you can manage. Shoot for 8 to 10 minutes, so the baby gets the nutritious foremilk (the milk at the beginning of the nursing session) and the hydrating hindmilk (the more watery milk at the end of the nursing session). Also nurse as often as possible. I’m not going to lie—this one brought my sweet and exhausted Heidi to tears, so if you can’t do it, that’s okay! But if you can, it will help. As the amazing Dr. William Sears, a well-known pediatrician and author of many classic parenting books has said, the three Bs of breastfeeding are the breast, the baby, and the brain. Essentially, the baby needs to stimulate the breast more often to send signals to the brain to produce more milk. Basic supply and demand: Works in economics and the biology of breastfeeding.
• Hydrate. Some say this tip is overrated. I say it can’t hurt. You don’t need to guzzle gallons, but be sure to prevent yourself from getting dehydrated, which can inhibit milk production.
• Avoid alcohol. I know you have been teetotaling for months now. I hate even mentioning this to you. However, if you are having issues making enough milk, research has shown that after drinking one or two glasses of wine, women take longer to release their milk and produce less milk overall.10 So while you may have heard the old wives’ tales about beer enhancing milk production, research suggests the opposite. Be safe, and steer clear.
• Consider herbs. Many herbs are touted as having near magical powers when it comes to enhancing breast-milk production. Few have been scientifically tested and proven, but the following may help when taken in moderation while breastfeeding. (That said, always talk with your doctor before using any herbal supplement.) Asparagus racemosus, Chamomile, Fennel, Fenugreek seeds, Goat’s rue, Milk thistle, Motherwort, Red raspberry
• Stick to your healthy diet. An overall healthy diet will make a big difference, but the following foods can help boost milk production because they are believed to boost pituitary function and estrogen levels: Alfalfa, Almonds, Asparagus, Brewer’s yeast in supplement form (not in beer!), Carrots, Chickpeas or hummus, Coconut and/or olive oil, Flax, Garlic, Oats, Sesame seeds or tahini sauce, Spinach, Wild salmon

And let me reiterate one final breastfeeding fact: Should you need to pump and bottle-feed, supplement with formula, or even feed with formula only, despite all the propaganda, the world won’t end. While there are many benefits to breastfeeding, if you are simply unable to do it or choose not to, your child will be fine. My mom was unable to breastfeed me. I love and adore her. We are and have always been utterly bonded. And I am also pretty darn healthy. So try to cut yourself some slack, will ya?