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Breastfeeding > When to get Help
Breastfeeding is the natural,
normal way to feed an infant and moms and babies have to
learn together. This wonderful experience doesn’t
always come naturally and challenges can arise. It’s
always beneficial to know what is ‘normal’ and
what isn’t so that you can react early and seek help
as needed.
Breastfeeding shouldn’t hurt. Generations of mothers
have been breastfeeding and if it was a painful experience
it would have disappeared a long time ago! Sore nipples
are an indication that there is something wrong with the
latch. It could be a positional difficulty or could be a
physical anomaly relating to the baby. A poor latch will
prevent the baby from removing milk efficiently and so he
will be hungry more often – hence coming to you more
frequently, leading to more trauma to your nipples. If left
untreated, this inefficient latch can lead to a low milk
supply .Please don’t be tempted, or ill-advised, to
use a nipple shield. This will teach the baby how to latch
on to a nipple shield, which is a shallow latch and when
you are healed, the initial problem persists. The use of
a nipple shield itself can cause low milk supply because
you are not experiencing the same nipple stimulation which
is necessary to encourage milk flow. It is a very poor breastfeeding
tool to use when experiencing sore nipples.
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mothers have heard that breastfeeding hurts for the first
few weeks ‘”and then it gets better”’.
Don’t accept this, you may feel a little tugging or
it may feel a little strange to begin with but this is of
short duration and in no way painful. Those first few days
of frequent, untimed feeding are important in setting up
your milk supply and for the baby to learn how to latch
correctly.
After birth, most breastfed babies lose up to 10% of their
birth weight; this is normal. The transition to the outside
world is a complex process. Events that occur during labour
can also influence this initial weight loss. If pitocin
and/or epidural anesthesia were used during labour, the
fluids transferred to the mother can also travel across
the placenta to the baby. If a LOT of IV fluids were used,
mom can experience a puffiness in her legs and sometimes
in the breasts and the baby might not seem very interested
in nursing. Soon, the baby will start passing urine ( remember
that extra fluid) and lo and behold, the baby’s (inflated
) weight has dropped. Be cognizant of this. If you observe
that the baby is drinking well; you are seeing those deep
pauses in the chin, he is waking up to feed, is calm following
the feed and producing wet and soiled diapers according
to his age( See chart on ‘How to Know Your baby is
Getting Enough Breastmilk’) then don’t worry
but be aware and keep an eye on his progress and discuss
this with your lactation consultant or health care provider
This symptom may accompany other signs of poor milk transfer
such as a baby who is lethargic and not waking well to feed.
Or a baby who is not settling after feeds and is not gaining
weight well. If the baby is becoming dehydrated, you may
notice orange/red crystals in his diaper.
By this time, you should be seeing the normal breastfed
baby stool; yellow, liquid, seedy stool. The risk of jaundice
is increased if meconium is still present.
Sleep is very important to newborns. They are adjusting
to life outside the womb and are still developing and growing
at an incredible rate. They can only do this during deep
sleep. If the baby is not drinking enough milk at the breast,
he will not settle and so this impacts his quality of sleep.It
is normal for a new born to want to nurse frequently in
those first few days but he should sleep in between feeds,
taking longer breaks as he gets older.
Breastfed babies follow their appetite triggers, so your
baby may have the odd long break in between feeds. If you
know he had a good feed that last time you nursed him, then
let him be; sleep is important to him. If he becomes lethargic
and is consistently slow to rouse and you aren’t sure
about whether he has been drinking well, seek help. Other
symptoms may also be present such as weight loss, mom experiencing
sore nipples, baby not settling after a feed, low urine
output. At this point, you need to take your baby to the
nearest hospital
As described earlier, breastfeeding shouldn’t hurt.
If you have experienced painful nipples and suffered a crack
or small lesion in your nipple, try to keep the area clean
and protected. Applying small drops of breastmilk will help
with healing but if things don’t seem to be improving
you could be risking a bacterial or fungal infection. Candida,
the fungus responsible for thrush infections (often seen
in vaginal infections or feet) is a fungus that we need
in our bowel to stabilize the microflora in the gut. Sometimes
this can overgrow due to stress or use of antibiotics. If
you underwent a caesarian section, you would have received
antibiotics in the IV infusion following surgery, given
as a prophylactic measure. This can reduce the number of
‘good’ bacteria in your bowel as well as the
harmful ones. This enables candida to overgrow. 90% of babies
are colonized with candida within 6 hours of birth, so it
is in our environment. Once the baby unwittingly transfers
the candida to your nipple, into your breast via the lesion
or crack, the candida can multiply. This fungus likes warm,
dark, sweet environment s– the exact properties present
inside your breast. Breastmilk is high in lactose, natural
sugar. The pain felt from a candida infection is a sharp
shooting pain that travels through the breast towards the
back. It is usually present during the feed and stays after
the feed. It can also suddenly appear in between feeds.
Sometimes the nipples can look ‘red and angry’
and the breasts feel tender. Both mom and baby have to be
treated with a protocol that stops the fungus growing and
prevents cross infection between mother and baby
Sometimes, if an area of the breast has not been drained
well during nursing, milk can be left behind and develop
into a blocked duct. Blocked ducts are
not uncommon and easily treated through massage, warm compresses
and making sure the baby nurses well on that side for the
next feed. If a blocked duct remains untreated, it could
develop into a bacterial infection of the breast called
mastitis. The symptoms of mastitis are:
- A painful lump in the breast
- Reddened, warm area on breast
- Pain in the breast
- Fever
Go to bed and rest, take the
baby with you and nurse as usual on the affected side. A
heated pad placed on the area aids healing . Use the
Potato Protocol listed below.
Very often the infection resolves
itself within 24 hours but if the symptoms persist, you
should go to your doctor for antibiotic treatment.
Within the first 24 hours of symptoms, you may find that
applying raw potatoes to the breast, in slices, to be very
helpful in reducing the pain and the swelling and redness
of the infection. Many mothers have reported that this is
extremely effective, works quickly, and often eliminates
the need for further treatment.
- Cut 6-8 washed, raw potatoes
(preferably lengthwise) into thin slices, approximately
1/8” to ¼” thick. Place in a large
bowl of water (room temp.) and leave out.
- Apply wet potato slices
to breast and affected areas. Leave in place for 15-20
min.
- Remove and discard used
slices. They should feel hot and softened. Apply fresh
slices from bowl.
- Repeat process two more
times, totalling approximately 3 applications per hour.
Take a 20-30 minute break and then repeat procedure. Adapted
from Bridget Lynch, Community Midwives of Toronto.
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