Please note: The information on this page is general and in no way replaces consultation with a health professional. Whereas every effort is made to ensure accuracy and relevance this in no way replaces seeing a Health Professional.
Please Contact Us to help us assist you.
Please Contact Us to help us assist you.
|
|
Breast Feeding: Common Problems
Generally Breastfeeding should not be painful, if it is and causes apprehension to feed baby, then that stress itself can further contribute to the difficulties you are experiencing by reducing milk supply. If you develop breast problems, You may need or wish to speak with your Dr. Petrina Duncan, and she will endeavour to assist you, this will commonly involve referring you to an experienced midwife, lactation consultant or other supportive professionals and voluntary groups such as La Leche league and the Australian Breastfeeding Association. Dr. Petrina would have already recommended approaching these support groups in the antenatal period of your care if you have expressed a desire to breastfeed. |
Breast discomfort and pain
Breasts can become swollen and cause discomfort. Typically engorgement of a breast occurs between 2-7 days when the milk "comes in". Prior to the milk coming in is the nutrient rich colostrum, which has been made whilst pregnant. If a breast is not stimulated by a baby and milk consumed then the milk production will eventually stop. This is not irreversible but is best avoided. The most sure way of minimising any discomfort is regular feeding of your baby. Some woman choose to express a small amount of milk from their breast to facilitate better attachment. Regular expressing in large quantities can however cause excessive engorgement and make worst already painful and swollen breast. Some woman benefit from analgesics such as paracetamol and Ibuprofen with this initial discomfort.
Dr Petrina welcomes any enquiry in these matters and also recommends contacting La Leche league and the Australian Breastfeeding Association.
Sore nipples
The most common cause is that your baby does not latch on optimally. Women who encounter soreness, should consider contacting a lactation consultant or one of the above support groups and have a full feed observed, for assistance with ensuring correct positioning and how to maintain it for the duration of the feed. If your baby is held so that just your nipple is just inside their mouth not at the back of their mouth then sore nipples are more likely to develop. The nipple is akin to the tube component of a dropper dispenser in that it simply delivers the milk to the back of the babies mouth. In this same analogy the bulbous squeezable component is within the breast tissue and the baby must compress this to eject the milk into the nipple to drop the milk (see diagram).
Breasts can become swollen and cause discomfort. Typically engorgement of a breast occurs between 2-7 days when the milk "comes in". Prior to the milk coming in is the nutrient rich colostrum, which has been made whilst pregnant. If a breast is not stimulated by a baby and milk consumed then the milk production will eventually stop. This is not irreversible but is best avoided. The most sure way of minimising any discomfort is regular feeding of your baby. Some woman choose to express a small amount of milk from their breast to facilitate better attachment. Regular expressing in large quantities can however cause excessive engorgement and make worst already painful and swollen breast. Some woman benefit from analgesics such as paracetamol and Ibuprofen with this initial discomfort.
Dr Petrina welcomes any enquiry in these matters and also recommends contacting La Leche league and the Australian Breastfeeding Association.
Sore nipples
The most common cause is that your baby does not latch on optimally. Women who encounter soreness, should consider contacting a lactation consultant or one of the above support groups and have a full feed observed, for assistance with ensuring correct positioning and how to maintain it for the duration of the feed. If your baby is held so that just your nipple is just inside their mouth not at the back of their mouth then sore nipples are more likely to develop. The nipple is akin to the tube component of a dropper dispenser in that it simply delivers the milk to the back of the babies mouth. In this same analogy the bulbous squeezable component is within the breast tissue and the baby must compress this to eject the milk into the nipple to drop the milk (see diagram).
No diagrams or written advice will replace support in person from a health professional, or experienced supporter. Ask for help.
Allowing breastmilk to dry after being expressed and rubbed over the surface of the nipple can promote healing. there is even mild antibiotic properties in breastmilk to assist with preventing infection
Sometimes a thrush infection of the breast or nipple is the cause. In this situation the nipple may become sore, red and cracked. Your doctor may then prescribe treatment, both for you and for your baby, for thrush.
Difficult Attachment or reluctance to Suck
Occasionally your baby may have a problem that makes it difficult for them to latch on or suck properly. The most common cause of this is tongue-tie (ankyloglossia), a problem which means that the tongue is more tightly
attached to the bottom of the mouth than normal. Most babies with a tongue-tie have no problems feeding.However, if your baby's tongue-tie does cause feeding problems, it may help to have the tie snipped (divided).
An abnormally shaped mouth, such as a cleft palate, may also affect a baby's ability to suck but breast-feeding is
still possible. However, your baby may need to be given expressed milk to begin with and you should be given
advice from a specialist breast-feeding counsellor.
Blocked Milk Duct or Ducts
A blocked milk duct can cause a painful swollen area in a breast. When you feed your baby, the pain may increase due to the pressure of milk building up behind the blocked duct. Make sure when feeding your baby that your bra or other clothing isn't pressing on your breast and avoid wearing an underwired bra.
A blocked milk duct will usually clear within 1-2 days and symptoms will then go. It may clear more quickly by
feeding the baby more often from the affected breast and gently massaging the breast whilst feeding. However, in
some cases a blocked milk duct becomes infected and develops into a mastitis (See Below).
Mastitis
Mastitis is a painful condition of the breast which becomes red, hot and sore (inflamed). It is usually caused by a
build-up of milk within the breast (a blocked duct or engorgement). Sometimes it can be caused by germs
(bacteria) that get into the milk ducts of the breast. This is often through a crack or sore in the nipple. If you develop any or all of these symptoms you should contact your chosen health professional to get the best advice for your particular symptoms and factors.
Breast abscess
This should go into uncommon problems but occurs with enough severity to dictate it being mentioned. As with all these problems if unsure, uncertain or concerned about anything to do with your health, please feel free to call Dr. Petrina and or your other health professionals.
An abscess may form inside an infected section of breast. An abscess is a collection of pus. This
causes a firm, red, tender lump. With an abscess, you may feel more generally unwell. As well as the breast
symptoms, you may feel flu-like or that you have a high temperature (are feverish). The pus in a breast abscess needs draining with a needle and syringe, or even with a small operation (called incision and drainage). You will probably need antibiotic medication as well. With a breast abscess you should not feed from the affected side; however you may benefit by expressing the milk and discarding. This expression will ease tenderness and ensure supply maintenance.
Jaundice
Jaundice is a medical sign with yellowing of the whites of the eyes and the skin. It is common in breast-fed babies and is often called breast milk jaundice. Jaundice in a newborn baby is called neonatal jaundice. About 6 in 10 full-term babies and 8 in 10 premature babies are jaundiced. This is called physiological jaundice and is due to changes in the baby's blood circulation and liver. It starts at 2-3 days of age and the baby remains well. Physiological jaundice is usually settling by the end of the first week and gone by about day 10.
Breast milk jaundice can be more prolonged, up to six weeks (occasionally a few months) but, again, is not
present immediately at birth. Babies with breast milk jaundice often do not need any treatment. Jaundice can be
worse if a baby is dehydrated, so it is important that they are feeding well.
Jaundice is more concerning when it is present at birth or within the first 24 hours of life. When jaundice presents this early it usually means that there is an underlying cause
Your baby will probably need further tests if they develop jaundice so early on. Blood tests may also be
needed if your baby is very strongly jaundiced. Some babies need treatment - for example, with ultraviolet (UV)
light treatment (phototherapy) - if the jaundice is severe. It is best to view recommendations for this treatment as being cautionary rather than to be alarmed, as the treatment is often more of an inconvenience than anything else and is usually very effective. Babies who present with jaundice require more frequent feeding. In some cases further treatments will be recommended. At all times you will be consulted and informed of recommendations, treatment and status.
Allowing breastmilk to dry after being expressed and rubbed over the surface of the nipple can promote healing. there is even mild antibiotic properties in breastmilk to assist with preventing infection
Sometimes a thrush infection of the breast or nipple is the cause. In this situation the nipple may become sore, red and cracked. Your doctor may then prescribe treatment, both for you and for your baby, for thrush.
Difficult Attachment or reluctance to Suck
Occasionally your baby may have a problem that makes it difficult for them to latch on or suck properly. The most common cause of this is tongue-tie (ankyloglossia), a problem which means that the tongue is more tightly
attached to the bottom of the mouth than normal. Most babies with a tongue-tie have no problems feeding.However, if your baby's tongue-tie does cause feeding problems, it may help to have the tie snipped (divided).
An abnormally shaped mouth, such as a cleft palate, may also affect a baby's ability to suck but breast-feeding is
still possible. However, your baby may need to be given expressed milk to begin with and you should be given
advice from a specialist breast-feeding counsellor.
Blocked Milk Duct or Ducts
A blocked milk duct can cause a painful swollen area in a breast. When you feed your baby, the pain may increase due to the pressure of milk building up behind the blocked duct. Make sure when feeding your baby that your bra or other clothing isn't pressing on your breast and avoid wearing an underwired bra.
A blocked milk duct will usually clear within 1-2 days and symptoms will then go. It may clear more quickly by
feeding the baby more often from the affected breast and gently massaging the breast whilst feeding. However, in
some cases a blocked milk duct becomes infected and develops into a mastitis (See Below).
Mastitis
Mastitis is a painful condition of the breast which becomes red, hot and sore (inflamed). It is usually caused by a
build-up of milk within the breast (a blocked duct or engorgement). Sometimes it can be caused by germs
(bacteria) that get into the milk ducts of the breast. This is often through a crack or sore in the nipple. If you develop any or all of these symptoms you should contact your chosen health professional to get the best advice for your particular symptoms and factors.
Breast abscess
This should go into uncommon problems but occurs with enough severity to dictate it being mentioned. As with all these problems if unsure, uncertain or concerned about anything to do with your health, please feel free to call Dr. Petrina and or your other health professionals.
An abscess may form inside an infected section of breast. An abscess is a collection of pus. This
causes a firm, red, tender lump. With an abscess, you may feel more generally unwell. As well as the breast
symptoms, you may feel flu-like or that you have a high temperature (are feverish). The pus in a breast abscess needs draining with a needle and syringe, or even with a small operation (called incision and drainage). You will probably need antibiotic medication as well. With a breast abscess you should not feed from the affected side; however you may benefit by expressing the milk and discarding. This expression will ease tenderness and ensure supply maintenance.
Jaundice
Jaundice is a medical sign with yellowing of the whites of the eyes and the skin. It is common in breast-fed babies and is often called breast milk jaundice. Jaundice in a newborn baby is called neonatal jaundice. About 6 in 10 full-term babies and 8 in 10 premature babies are jaundiced. This is called physiological jaundice and is due to changes in the baby's blood circulation and liver. It starts at 2-3 days of age and the baby remains well. Physiological jaundice is usually settling by the end of the first week and gone by about day 10.
Breast milk jaundice can be more prolonged, up to six weeks (occasionally a few months) but, again, is not
present immediately at birth. Babies with breast milk jaundice often do not need any treatment. Jaundice can be
worse if a baby is dehydrated, so it is important that they are feeding well.
Jaundice is more concerning when it is present at birth or within the first 24 hours of life. When jaundice presents this early it usually means that there is an underlying cause
Your baby will probably need further tests if they develop jaundice so early on. Blood tests may also be
needed if your baby is very strongly jaundiced. Some babies need treatment - for example, with ultraviolet (UV)
light treatment (phototherapy) - if the jaundice is severe. It is best to view recommendations for this treatment as being cautionary rather than to be alarmed, as the treatment is often more of an inconvenience than anything else and is usually very effective. Babies who present with jaundice require more frequent feeding. In some cases further treatments will be recommended. At all times you will be consulted and informed of recommendations, treatment and status.
