Overcoming Common Breastfeeding Conditions

                Breastfeeding certainly comes with its benefits, but sometimes there are issues that develop that need managing. As baby’s needs grow and change, so does your milk supply. Making sure you empty your breasts with each feeding will help prevent many issues, but sometimes they occur regardless. I hope you find some help to whatever you may be dealing with right now, so you can get back to comfortably breastfeeding. There are a variety of remedies that can be used for breastfeeding issues, so you can find out what works best for you.

Engorgement

               Engorgement is something you will indeed deal with at some point in your breastfeeding journey. Your milk supply will not be completely regulated until baby is about 4-6 weeks old. Even after this period you can still experience engorgement, which just means a very full breast. Your first solution should be to feed your baby. If baby is not interested in feeding, but it is time to feed, you can pump and give this to baby when he is ready. If you have just fed baby, but he is satisfied and does not want to feed any longer, you will want to forego the pumping. This will only increase your supply, making your body think it needs to make more milk, thus furthering your engorgement. Hand express just enough for comfort, take a warm shower and hand express in the shower, or use ice packs to help with soreness caused by the engorgement. Cold cabbage leaves work wonders for engorgement, and can be kept in the refrigerator. Click here for an awesome hand expression tutorial.

Bleb

A bleb is a plug that occurs at the surface of the skin on the nipple that may appear white in color. It is caused by milk, oil, or skin cells that clog up one of your nipple pores. You may not be able to see this bleb at first, but it will prevent milk from exiting from that pore, which will mimic the feeling of a plugged duct. This will feel like a hard lump in the shape of a petal on your breast. If this occurs, carefully inspect your nipple for a white or yellow dot. You may need to spread the skin on your nipple to expose your pores. Once you’ve located the bleb you can rub it (gently) with an olive oil soaked cotton ball to break the bleb free. Sometimes you can pull the bleb out, and it may be stringy-this is totally normal. Using a salt water soak (see below) can help free the bleb, as well as nursing your baby.

Plugged Duct

A plugged duct is just that. A plug in your milk duct typically caused from engorgement or swelling. If swelling is the cause you will need to bring down the swelling with cold therapy (an ice pack), followed by feeding your baby or pumping. Some women find it helpful to have baby’s chin and nose facing the area of the plug, and getting on all fours with baby below you to dangle feed. You can try adding heat and massage to your breasts prior to feeding to help your let down push through the clog. Your baby has a stronger suck than any pump, and will be best to relieve the plug, so if you can nurse over pumping you will have faster results. Salt water soaks (see below) can help with a plugged duct as well. To prevent plugged ducts, make sure you are feeding baby frequently, and emptying your breasts with each feeding. Plugged ducts can lead to mastitis, a breast infection accompanied by a fever, and need to be addressed asap with antibiotics.

Breast Refusal

It is hard to imagine that baby would refuse the breast, but it does, in fact, happen from time to time. This is temporary, and often caused by something “bad” that happened at the breast, an earache or illness, or stress. Maybe baby was offended that you told him to stop biting, or maybe he’s upset that you had to work all day. Continue offering the breast, and showing baby your love and attention, and everything should go back to normal eventually. In the meantime, nurse baby in his sleep when he doesn’t realize anything is going on, try a different position or room than what he is used to, or try doing some skin to skin to calm him. Continue to offer the breast for each feeding, and pump if he continues to refuse.

Oversupply

This may sound like you hit the jackpot, but not all women are happy with an oversupply. If you don’t mind having an oversupply, you can pump and store this milk in the freezer, but if your baby is struggling with your large amounts of milk pouring out you will need to regulate it. Some babies cannot handle a large amount of milk, and may spit up or sputter, pulling off the breast. If this happens you can try a couple different things. First, initiate a let down prior to latching baby, either through hand expression or pumping. This way the fast let down will be over when she is ready to eat. Try nursing in a laid back position where you are reclined back and baby is face down vertically on your breast. This will allow her to control the amount of milk coming in to her mouth against gravity. Nurse on one side only per feeding, or try block feeding where you only nurse from one side for a series of feeds. Just be sure to not let the other breast become too full and uncomfortable where it could lead to plugged ducts or mastitis.

Decreased Supply

Milk supply is based solely on supply and demand. The more milk that is removed, the more milk that will be made. So, if baby is not removing milk from the breast, milk will not be replaced. Make sure that baby has a proper latch to transfer milk from your breast, is gaining weight, and having adequate output. For a baby one week old and older, he should have 6-8 wet diapers per day. If your baby is meeting this criteria, while seeming satisfied after feedings, you do not need to worry about your supply. It is completely normal to feel like you don’t have milk when you really do. If you truly have a low supply you can try pumping after each feeding to increase your milk supply, and be sure to hand express after each pumping session. A pump will not fully empty your breast, so hand expressing will finish the job. Feed baby frequently; at least 8-12 times in a 24 hour period. Do not allow baby to sleep through the night, even though it may be tempting. You may need to wake baby for feeds during the day as well. Foods known as galactagogues have been known to boost milk supply, but are not a guarantee. Examples can include green leafy vegetables, oatmeal, and sweet potatoes. Herbals include fennel, fenugreek, blessed thistle, goat’s rue, and alfalfa. In contrast, some herbs can decrease supply such as thyme and sage, as well as medications with pseudophedrine, and hormonal contraceptives. Be sure to check over the counter medication ingredients, and choose a non-hormonal birth control method if you feel like your supply is dwindling. You can also find many recipes online for lactation cookies and brownies, as well as Mother’s Milk tea.

Breastfeeding your baby is a great achievement no matter how long it lasts. Make each moment comfortable, and never settle. If you continue to struggle, please get in touch with your local lactation consultant for assistance. Don’t give up, because help is out there!

*Salt Soaks for plugged ducts and blebs: 2 tablespoons of Epsom salt to 1 cup of warm water. Fill a cup or bowl big enough for your breast to fit in. Set the bowl below your breast, and lean over into the bowl. If you have a Haakaa, you can add this mixture in your Haakaa, and suction it on your breast. (Obviously, this mixture cannot be given to baby even though milk will be pulled from the breast).

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