Issues with breast feeding


The biggest mistake made in the past was seperating a healthy mother and infant after birth. A babies impulse to suckle is at its peak in those first few hours after birth, the strong suckle reflex - if not stimulated - decreases as time passes.
Most problems occur due to initial incorrect breast feeding practices, and majority of these are due to well-intentioned but inaccurate advice in those first vulnerable days.

One of these well intentioned practices which is still quite common in hospitals is seperatign mom and baby at birth with no true medical reason for it. Research has shown that those mothers that choose for baby to room-in are twice as likely to succeed. Most birthing facilities are returning to the practice of baby rooming-in with mother.

The second major contributor to problems is the encouragement to schedule feed & to time feeds – this approach with breast feeding does NOT work and causes a snowball of feeding related problems to occur!  The only way to ensure trouble-free breast-feeding is to feed on demand and feed on one side till baby is finished (or milk and then swap sides).

 

Problems experienced:

Insufficient milk supply

This is one of the most common ‘problems’ experienced - the perception of insufficient milk. We use the term perception as this as a physical problem is very rare. Due to mis-education, most women give up in the first 2-3 weeks of breast feeding, which is still in the initial build-up phase where feeds can occur anything between every ½hr to 3hrs.

There is a miraculous bond between mother and child - it takes team-work over weeks between yourself and baby till your milk supply is established.
Solution:
  • Drink whenever you are thirsty (drinking more than you require can have the opposite effect, suppressing your milk production).
  • Feed baby more often – his drinking stimulates the milk flow i.e. the more he drinks the more you will produce. Even if he drinks every ½ hour, remember it is only temporary and a means to an end. Do not let negative reactions and shocked comments on you not having enough milk get you down. All mothers go through this - it is just a matter of perseverance and patience.
  • Do not diet while breast feeding, you will in actual fact need an additional 2000 kilojoules per day (can easily be made up by an piece of fruit, slice of bread with cheese and a glass of milk extra).
  • Ensure baby latches properly as if he does not, he cannot stimulate the breast in the correct places and this will hamper milk production from the start. This also results in many follow-on complications (hungry baby, painful breasts, insufficient milk).
  • Get lots of rest – mothers often find the morning feed the best and easiest, this is due to the release of prolactin (hormone stimulating milk production). The release of prolactin works best when mother is well rested and relaxed, for this same reason you may notice a lower milk supply for the last feed for the day. Adrenalin produced when you are tense, inhibits the effects of oxytocin (hormone stimulating the let-down reflex), so also affecting your milk supply.
  • Ensure you drink your vitamins and supplements. Your health is essential for milk supply.

 

Nipple confusion

The sucking motion for getting milk from a breast and a bottle teat differ, therefore if supplementary bottle feeding is started too early baby may suffer confusion resulting in reduced suckling capability. The same applies for dummies.

Solution:

Do not give baby a bottle in the first few weeks. Use a dummy only after 3-6 weeks, and purely for settling after a feed. If you need to give expressed milk (or top up feeds) rather give these off of a teaspoon or from a feeding cup.

 

Leaking Breasts

Most women leak milk between feeds. This can happen even at the sound, sight or thought of your baby. While baby is feeding on one breast, the opposite one will generally leak.

Solution:

In most cases the leaking will stop once milk supply and natural feeding patterns are established (after about 6 weeks – varies per woman) – though even then it may still occur at intervals. Use breast pads and change them regularly as required. You get washable (reusable) pads and disposable pads (some of them contain an absorbent gel much like the nappies).

 

Nipples: Sore / Cracked

The main cause of tenderness and broken skin (with or without bleeding) of nipples is poor positioning. Other causes are:

  • Overly vigorous cleaning and use of soap that can cause dry skin.
  • An excessively hungry baby who ‘attacks’ the breast.
  • Incorrect latching.
  • Friction from baby’s tongue and gums.
  • Very full breasts resulting in hard, difficult to latch on to nipples.
  • Thrush passed on from mother to baby.
  • Wet nipples (inferior breast pads or insufficient changing thereof).
  • Do not push breast back to allow space for babies nose, this can cause painful nipples. Babies noses are specifically wider and softer to allow for them to breathe while feeding - this is a ‘problem’ nature has provided for!
Solution:
  • Adjust latching and positioning when necessary (if it hurts, make adjustments, do not try get ‘through’ the pain).
  • Do not use substances that will result in the skin of your breasts drying out.
  • Feed baby before he becomes overly hungry and so feeds ‘aggressively’. Do not wait till he cries from hunger offer him the breast earlier than you usually would. Offer the least sensitive breast first.
  • Express (hand or pump) to soften breasts.
  • Treat Thrush, reat both yourself and baby with antifungal ointment if thrush is suspected (consult your caregiver).
  • Use breathable bra’s and breast pads, not those with a solid plastic lining.
  • Coat nipples and areolas with nipple cream or simply breast milk (nature’s ideal nipple cream). Allow to air-dry.
  • Use Rooibos - Make yourself a cup of rooibos tea. Air-dry nipples then place the tea bag over your nipple till next feed.

 

Blocked ducts

This is a painful area in the breast (which may have a lump), caused by:

  • Milk reserved in breast (skipping feeds, feeding only on one side, one position or repeatedly not ensuring baby finishes milk on one side).
  • Wearing incorrectly fitting or underwire bras.
  • Sleeping in a position that places pressure on a duct.
Solution:
  • If baby only drinks a little from a side before being full, start him on that breast with the next feed, (instead of starting on the opposite side).
  • Feed frequently (every 2-3 hours daily and every 4 hours at night)
  • Wear a well-fitting, supportive bra.
  • Change sleeping positions often.
  • If it occurs, drink fluids when thirsty, get enough rest, apply warm cloths for relief and continue to breastfeed. Try if possible to use both breasts at each feed (alternatively express).

 

Mastitis

Painful lumpy area in breast, causing fever, chills and general flu symptoms. Triggered by:

  • Blocked ducts.
  • Infection from cracked nipples.
  • A mother who is run-down, exhausted and not well nourished.
Solution:
  • Contact your caregiver.
  • See solutions for blocked ducts and sore nipples.
  • Get more rest, relaxation and ensure a balanced diet.
  • Take baby and put yourself to bed.
  • Take pain-relief (paracetamol – Panado) if you are experiencing pain, fever, headaches or stiffness.
  • Continue to feed from both breasts (unless the nipple is infected). If there is pus at the nipple, feed from the non-infected side or express milk and throw it out until you have been treated with antibiotics.

 

Engorged breasts

If the engorgement is not relieved it can lead to mastitis (painful breasts which are very hard, swollen, red and hot to the touch).
This is caused by:

  • Muscle spasm due to over-full breasts, which are not tended to.
  • Congestion from milk ‘coming in’ on day 3, when mother has not yet fed often or long enough in the first few days.
  • Anxiety and stress can inhibit the let-down reflex.
  • Long intervals between feeds (another reason to rather demand feed than schedule feed).
  • Sudden weaning.
Solution:
  • Feed a.s.a.p. after birth and as often and as long as baby requires (do not time or miss feeds).
  • Express milk to a level of comfort if baby cannot feed (do not drain too much milk).
  • Let baby feed for longer from each side.
  • Avoid giving, complementary, supplementary feeds or water unless on medical orders.
  • See solution for blocked ducts.
  • If weaning, do so gradually to avoid problems.
  • Use a hot compress (warm face cloth to soften breast) before a feed and a cold compress between or after (brings relief).
  • Place cooled cabbage leaves in bra between feeds as they draw fluid from the breast (do not sleep with them in your bra!).
  • Take a warm bath shower and massage breasts.
Flat or inverted nipples

Protrusion of the nipple is not essential, as baby should take part of the areola in his mouth; not only the nipple and massaging of the areola by his lips and tongue are what stimulate milk flow. However there are measures you can take to improve this.

Solution:
  • Hoffman’s exercise (this also improves elasticity of the areola):
You can apply Vaseline or a nipple cream if you like but it is not necessary.
Using thumb and forefinger place one above and one below the nipple.
Press firmly (towards the chest), and gently pull areola away from the nipple (fingers in opposite directions), first in a vertical and then a horizontal direction. Work in a circle around the nipple. Repeat 5-10 times, at least 3 times a day.
  • You may need the help of a nipple shield, though the shields must be used with prudence, remove once the nipple is drawn out, as the shield can interfere milk flow and correct latching.
  • Seek advice from a lactation consultant.
  • Don’t give up too soon, IT IS WORTH PERSEVERING!

 

Breastfeeding and colic

It is often said (by Moms and care-givers), that colic is a result of baby having wind / discomfort from what a Mom eats. 
Though this does have an influence along with, baby’s formula and how baby feeds, of the bigger influencing factors are stress cycles, babies personality and miscommunication (between parents and baby).

There are obvious food-colic connections and then others less so. If every time you eat a certain thing, you notice baby has digestive irritation exclude (or minimise) that item from your diet.

NB. Don’t start off by excluding certain things from your diet as this in its self can create problems; rather eat a wide variety in moderation. Remember baby has developed in an environment of what you ate in pregnancy, making sudden changes to this can aggravate colic.

If it causes you discomfort it will more than likely affect baby too.
Beans, cabbage, cauliflower and onions - are some of the obvious foods that can cause bloating and stomach discomfort – e.g..
Caffeine, carbonated drinks and even fruit juices can over stimulate baby causing overtiredness and crying, rather try drinking water, herbal teas and decaf coffee. (see our Meadowsweet products for some Organic Herbal Teas).

If you are experiencing any particular problems please contact us at admin@earthbabies.co.za and we will give you information specific to that difficulty, alternatively we will give you the contact details of some-one in your area who will be able to give you the help and advice you need!

article by Earth babies.

 

Comments  

 
0 #1 Xtra Booster 2015-09-12 03:21
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Quote
 

What I Do

I am living my dream while working with mums and babies. I see mums when they are 34 weeks pregnant and then go to their homes once they go into labour. I stay for the full duration of the labour and after the birth I assist them with breast feeding. I do another visit after the birth to see that all is well and to help where I can.  Mums are always welcome to call me in the event that they have any questions, whether before or after the birth. I am passionate about my work as a doula and I care and love all the families with which I work. Once you have been present at a birth you feel part of the family and it’s wonderful to hear news of the new baby’s life as he or she grows.

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