Problems during breastfeeding
Breastfeeding is the most natural thing for every mother
and is an experience to be cherished. Sometimes, certain problems faced by
mothers result in stoppage of breastfeeding or giving of supplements of animal
milk/commercial infant formula to the baby. Problems include flat nipples,
inverted nipples, breast engorgement, swelling, sore nipples or not enough milk,
etc. These problems are preventable if care is taken from the pregnancy period
to prepare for breastfeeding.
Some of these problems relate to the shape
and size of the nipple and others are related to breast tissues as a whole. Here
are the problems.
- Flat nipple
The length of the resting nipple is not important
for breastfeeding. However, the areola embedded in the breast tissue beneath
should be able to be pulled out to form the teat. The nipple is just a guide to
show where the baby has to take the breast. Having flat nipples should not worry
- Inverted nipple
A nipple that does not come out erect and on
trying to pull out goes deeper into the breast is an inverted nipple.
Fortunately, true inverted nipples are very rare and usually during pregnancy
the nipple becomes normal. If they remain inverted, these can be treated in
consultation with a doctor.
- Long nipple
A long nipple may be a common problem as the baby
may suck on the nipple only and may not take enough of breast tissue into his
mouth. To help, the baby should be brought closer to the breast to enable him to
take more breast tissue into his mouth.
- Sore nipples and cracked nipples
The most common cause of
sore nipples in the first few days of feeding is the incorrect
position/attachment of the baby at the breast meaning that the baby sucks only
at the nipple. If feeding continues in the poor position, it may lead to cracked
nipple and later to mastitis and breast abscess.
Treatment: If it
pains during breastfeeding, the mother should wait until the baby releases the
breast, or put a finger gently into the baby's mouth to break the suction first,
so as to avoid injury at the nipple. Then, again start to breastfeed in a
correct position and if the child is attached properly it will not cause pain.
Breastfeeding should be continued on the affected breast as sore nipples usually
heal after correcting the suckling position. For cracked nipples, treatment
consists of feeding in correct position, washing the nipple once daily only with
water and exposure of nipple to air and sun as much as possible, and application
of a drop of your hind milk on the nipple after each feed. Medicated creams are
best avoided as they may worsen the soreness and draw away the attention from
the crucial issue.
- Fullness and engorgement of the breast
Fullness of the breast
is a frequent problem. Milk production is continuous and, if enough milk is not
removed, engorgement of breasts may result. The engorged breast is tight, shiny
and very painful.
The common causes of engorged breasts are:
Other feeds given before starting breastfeeding
- Delayed starting of
- Long intervals between feeds
- Early removal of the baby
from the breast while breastfeeding
- Bottle-feeding and any other
restrictions on breastfeeding
If breast is engorged the baby is unable
to take feed properly due to poor attachment, inadequate emptying, which further
leads to decreased production. Engorgement of the breast can be prevented by
avoiding other feeds being given before breastfeeding, keeping the baby with the
mother, unrestricted and exclusive breastfeeding on demand and feeding in the
- Blocked duct
If the baby does not suckle well on a
particular segment of the breast, the thick milk blocks the milk duct leading to
a painful hard swelling.
Treatment for this involves –
Improving suckling/position - the baby should be fed frequently on the affected
breast and in different suckling positions so as to improve the emptying.
Massaging the lump towards the nipple to promote emptying of the breast.
Rest and wearing loose clothes.
- Swelling of the breast.
blockage of the duct or engorgement continues, infection may supervene. The
breast becomes red, hot, tender and swollen. This is called mastitis. An abscess
may form or swelling may occur, associated with fever. The treatment
- Express the milk frequently and continue breastfeeding.
water fomentation may also help alleviate pain.
- Consult a doctor for pain.
Incision to drain the abscess may be necessary sometimes.
breastfeeding from the affected breast as soon as possible.
- Leakage of
milk from the breast
Milk leaking is usually the result of an active
ejection reflex during first few weeks of lactation. It commonly occurs when it
is time for a feed or when intervals between feeds are increased and when you
have loving thoughts about your baby. This is due to normal oxytocin reflex.
- Blood in the milk
Some mothers notice a little blood in the
milk, even in the absence of a nipple fissure. It is usually a harmless and
self-limiting condition. The mother should continue breastfeeding.