Having Breastfeeding Problems?

There are many different problems that mothers can face while breastfeeding. Some of these problems include having a low milk supply, mastitis, a poor latch, sore nipples, plugged ducts, leaking milk, colic, baby refusing to nurse, biting, and engorgement. Even though these problems can be difficult to deal with their are many reasons for the mother to continue breastfeeding.

Benefits of Breastfeeding

Breastfeeding reduces infections in babies, boosts their immune system and prevents obesity. Breastfeeding may even help mothers by lowering the risk of developing diabetes, high blood pressure, cardiovascular disease and breast cancer as they age.

Mastitis and Clogged Ducts

Mastitis is a bacterial infection of the breast that usually occurs in breastfeeding mothers. However, it can occur in women who are not breastfeeding or pregnant, and can occur even in small babies, of either sex. Nobody knows exactly why some women get mastitis and others do not. Bacteria may gain access to the breast through a crack or sore in the nipple, but women without sore nipples also get mastitis. Mastitis should be differentiated from a plugged or blocked duct, because a plugged or blocked duct does not need treatment with antibiotics, whereas mastitis often requires treatment with antibiotics.

A blocked duct presents as a painful, swollen, firm mass in the breast. The skin overlying the blocked duct is often quite red, similar to what happens during mastitis, but less intense. Mastitis is usually also associated with fever and more intense pain as well. However, it is not always easy to distinguish between a mild mastitis and a severe blocked duct. A blocked duct can go on to become mastitis. A blocked duct will usually resolve in 24hrs if you continue to breastfeed. You should continue to try and breastfeed as much as possible from the breast that is affected to help the duct become unclogged.

Treatments For a Blocked Duct and Mastitis

Nurse frequently & empty the breasts thoroughly. Aim for nursing at least every 2 hrs. Keep the affected breast as empty as possible, but don’t neglect the other breast.
When unable to breastfeed, mom should express milk frequently and thoroughly (with a breast pump or by hand)
Use heat & gentle massaging before nursing. Try using a disposable diaper: fill the diaper with hot water (try the temperature on your wrist first to avoid burns), squeeze the diaper out a bit, then put the inside of the diaper toward the breast. This will stay warm much longer than a wet cloth, or fill sink or bowl with hot water and submerge breast in water while massaging the plugged area toward the nipple. Some report better results when epsom salts are added to the water — add a handful of epsom salts per 2 quarts (2 liters) of water. Rinse with fresh water before nursing, as baby may object to the taste. It can also be helpful to massage in the shower with a large-toothed comb. The comb should be drawn through a bar of soap until it is very soapy and then used to gently massage over the affected area in the direction of the nipple.
Loosen bra & any constrictive clothing to aid milk flow.
Nurse on the affected breast first; if it hurts too much to do this, switch to the affected breast directly after let-down.
Ensure good positioning & latch. Use whatever positioning is most comfortable.
Use breast compressions.
Massage gently but firmly from the plugged area toward the nipple.
Try nursing while leaning over baby (sometimes called “dangle feeding”) so that gravity aids in dislodging the plug.
Pump or hand express after nursing to aid milk drainage and speed healing.
Use cold compresses between feedings for pain & inflammation.

If pain remains after 12-24hrs and the mother has a fever or just continues to feel ill, then she most likely has mastitis. With mastitis an antibiotic may be necessary to overcome the infection. Talk to your doctor immediately if you have: Mastitis is in both breasts, if baby is less than 2 weeks old, you have recently been in the hospital, You have broken skin on the nipple with obvious signs of infection, Blood/pus is present in milk, Red streaking is present, Your temperature increases suddenly, Symptoms are sudden and severe, or if problems don’t start to resolve after 24hrs.

Lecithin has been recommended to combat recurrent plugged ducts. Lecithin is a very common food additive, and is found naturally in many other foods. There are no known contraindications to its use for breastfeeding mothers. Choline is a component of lecithin – the lecithin sold in health food stores is about 1-2% choline. B-complex, evening primrose oil and thyme have also been recommended for treating recurrent plugged ducts.

Increasing Breast Milk

The primary control of milk supply is related to the amount being taken from the breast. Anything that inhibits the amount that is being taken from the breast can inhibit supply. The most common causes of low milk supply are 1)when the baby is not latched deeply enough on the breast, and 2) babies who are not at the breast long enough or frequently enough.

Another common cause of low supply is supplementation with formula or solids. Since that will cause the baby to take less breast milk from the breast and ultimately the breast will produce less.

Most of the common causes of low supply can be fixed easily by fixing the cause such as improving the latch or increasing the frequency of breastfeeding.

True low milk supply, where the mom is truely unable to produce adequate milk is pretty rare. Hypothyroidism (low thyroid hormone), which can be corrected with medication, is another potential cause of low milk supply. Excessive loss of blood during the birth can cause low supply. Breast reductions and enhancements can also cause problems. Polycystic ovarian syndrome can also create low supply.

Fenugreek (Trigonella foenum-graecum L.) Is the herb that is most often used to increase milk supply. It is a great galactagogue, and has been used as such for centuries. In one study of ten women, “the use of fenugreek significantly increased volume of breastmilk” [Swafford 2000].

Mothers generally notice an increase in production 24-72 hours after starting the herb, but it can take two weeks for others to see a change.

Dosages of less than 6 capsules/day (approx 3500 mg/day) produce no effect in many women. If you’re having problems with any side effects, discontinue use and consider alternative methods for increasing milk supply.

Fenugreek can be used either short-term to boost milk supply or long-term to augment supply and/or pumping yields. There are no studies indicating problems with long-term usage. Per Kathleen Huggins “Most mothers have found that the herb can be discontinued once milk production is stimulated to an appropriate level. Adequate production is usually maintained as long as sufficient breast stimulation and emptying continues”