Breastfeeding is an essential practice for at least the first few months of a baby’s life. While many women opt not to breastfeed either due to career obligations or for cosmetic reasons, some women are unable to breastfeed despite the willingness to do so. A number of problems with breastfeeding may either discourage a women or make breastfeeding impractical and this is more likely to arise in first time mothers. However many of these breastfeeding problems can be treated or resolved with proper advice and guidance as well as patience.
Common Breastfeeding Problems
Discomfort or pain in the breast may arise due to the following conditions :
- Letdown reflex
- As milk is let down during breastfeeding, slight discomfort or pain may be felt in the breasts. With time, this sensation usually becomes eases.
- Breast engorgement
- This may occur due to excessive milk production or insufficient milk expression from the breasts if the baby does not suck properly. The breasts look swollen and tense and may become painful. This is most common in the first few days of delivery and usually resolves within a few days as the baby learns to latch on properly and the sucking reflex is initiated successfully.
- Frequent removal of milk from the breasts (by manual expression or breast pump) may help to relieve engorgement. Expression of a small quantity of milk before starting to breastfeed may make the breasts less tense and much easier for the baby to latch on. Feeding the baby on demand is often sufficient to prevent breast engorgement.
- Mastitis is inflammation of the breast most commonly due to an infection. The breast becomes swollen, red, warm and painful. There may be accompanied byg fever, rigor and malaise.
- Pain relievers and antibiotics are usually recommended. Breastfeeding should not be stopped.
- Breast abscess
- Mastitis, if not treated quickly and effectively, can develop into a breast abscess. The signs and symptoms may be similar to mastitis.
- White areas on the tongue or palate of the baby may be a sign of fungal (yeast) infection or oral thrush. It may spread to the skin on or around the nipples causing red itchy patches, which may lead to painful sores on the nipples.
- Some babies may bite while breastfeeding. This usually occurs at the time of teething.
Sore, Cracked Nipples
Nipple tenderness is one of the most common problems of breastfeeding. Sore, cracked, bleeding nipples should always be investigated by a medical professional and the appropriate treatment should be commenced as soon as possible.
Some of the causes of sore and/or cracked nipples includes :
- Improper latching on by the baby
- Dry skin
- Breastfeeding while pregnant
Proper breastfeeding technique so that the baby latches on properly can often help to prevent this condition. Applying lanolin cream or ointment may also provide some relief.
Difficulty Latching On
The baby may experience difficulty latching onto the nipple thereby preventing proper expulsion of the milk. This may occur due to many causes, the most common being improper breastfeeding technique, often due to inexperience of the mother (first time mothers). Other causes that may lead to difficulties with latching on includes :
- Breast engorgement
- Flat or inverted nipples (refer to Abnormal Nipples)
- Tongue tie
- Cleft lip and/or palate
Leaking of milk from the breasts may be embarrassing at times but is quite a common occurrence. It tends to occur more frequently in the first few weeks after childbirth, although it may continue till much later. Excessive milk flow is usually the cause. It is common for leaking of milk to occur from one breast while a woman is feeding her baby on the other. Leaking breasts are not a problem that is indicative of any disease or disorder.
Blocked Milk Duct (Plugged Ducts)
Although called a blocked milk duct, in most cases it is not actually blocked but is pressed upon and closed by the surrounding tissue and produces symptoms similar to mastitis. In rare cases, the opening of the duct is blocked by skin growing over it and may look like a tiny white spot on the nipple.
Low Milk Supply
A common problem while breastfeeding is low or inadequate milk supply. It is important to differentiate actual low milk supply from that as perceived by the mother.
If the milk supply is adequate the baby will :
- gain adequate weight,
- look healthy and alert,
- wet 5 to 8 diapers a day.
This is discussed in detail under Low Breast Milk Supply.
Baby Refusing to Breastfeed
This could occur if the baby has difficulty latching on to the breast. The baby may then prefer to bottle-feed and preferably milk expressed from the breast should be used. Other causes that may lead to a baby refusing to breastfeed includes :
- Baby may be suffering from an infection in the mouth such as thrush.
- Baby suffering from cold or blocked nose.
- Baby has an ear infection.
- Baby is teething.
- Low breast milk supply.
- Baby easily distracted by noise or other activity in the vicinity.
- Change in routine.
- Change in the taste of breast milk caused by certain foods or drugs.
Sometimes a baby will refuse to feed on one breast despite being hungry after completely emptying the other breast. This may be due to :
- A blocked nose aggravated by lying on one side
- Ear infection and pain on one side
- Infection of a single breast
- Low milk supply in one breast
Breastfeeding Not Advisable
Breastfeeding is always advised due to the nutritional and immune benefits as well as the bonding factor between baby and mother. Therefore breastfeeding has both physical and emotional benefits. However, there are some instances where breastfeeding is not advisable.
Breastfeeding should be avoided, after speaking to a medical doctor, in cases where :
- Baby is suffering from galactosemia, a rare genetic metabolic disorder.
- Mother is suffering from HIV/AIDS.
- Mother is using antiretroviral medication.
- Mother is infected with the human T-cell lymphotropic virus type 1 or type 2.
- Mother has untreated active tuberculosis.
- Mother is using illegal drugs such as amphetamine, cocaine, marijuana, heroin or phencyclidine.
- Mother is taking any medication that is contraindicated during breastfeeding.
- Mother is on chemotherapy or radiotherapy for cancer treatment.
- Mother has infected lesions on the breasts such as boils or herpes.