COMMON BREASTFEEDING CHALLENGES

Worldwide, breastfeeding is recognised as the best way to feed an infant because it protects the mother and infant from a variety of health problems. Even so, many women who start out breastfeeding stop before the recommended minimum of exclusive breastfeeding of six months.

Often, women stop because of the common problems they encounter. With sound guidance and appropriate medical treatment, most of them can overcome these obstacles and continue breastfeeding for longer period.

Breast engorgement

Engorgement is a medical condition that breastfeeding mothers can experience. The breast milk will come in around 24 to 72 hours after birth. A degree of fullness may be experienced in the breasts at this time. After feeding, at least, one’s breast should feel soft and light (well drained). Engorgement is caused by a build-up of blood, milk and other fluids in the breast. It will occur if the baby is not feeding and attaching well and the breasts not drained well during feeding. Less commonly, it may occur if the body is making more milk than the baby needs.

Signs and symptoms

Engorgement results in full and often painful breasts.

Ensure your baby is attached well when breastfeeding. Feed the baby frequently at least eight to 12 times every 24 hours.

Do not limit the baby’s time at the breast. Express a small amount of milk before you feed to soften your breast and help the baby to attach. Use cool towel or clothe from the refrigerator (not freezer) for comfort.

Blocked milk ducts

A blocked duct causes tender or painful lumps because of milk building up in the breast behind a duct. Milk ducts are small tubes inside the breast that transport milk to the nipples.

Signs and symptoms

A painful red lump or swollen spot on the breast. One may also see a white spot on the nipple, which is a sign that a duct may be blocked. Blocked or plugged ducts are areas of the breast where the flow of milk is blocked. They can stretch the nearby breast tissue and cause a painful breast lump.

Management of blocked ducts: Feed frequently from the affected side first. Gently stroke the breast towards the nipple during feeding. This may assist the letdown reflex. For comfort and reduction of the swelling from excess fluid, apply a cold cloth or towel. Express after feeding and if there is a white spot on the nipple, soak the nipple with a warm moist cloth and the health worker rub or scratch off the spot with a sterile needle to allow the duct to open and the milk to flow again. Use paracetamol or anti-inflammatory tablets according to directions.

Prevention: Ensure correct positioning and attachment. For frequent drainage of the breast, alter your position during breastfeeding to include underarm position, cradle position or lying on your side. Check for a white ‘spot’ on the nipple, as this may be blocking the milk duct. Avoid sudden long gaps between breastfeeding periods.  Use tight or restrictive clothing such as a bra. You should avoid holding or pressing one area of the breast too tightly, especially close to the nipple.

Mastitis

Mastitis occurs when there is a blockage of milk in the milk duct. Some milk may leak out of the duct into the surrounding tissues causing inflammation and infection. Milk ducts are small tubes inside the breast that transport milk to the nipples.

Signs and symptoms

The breast has a red, painful area, an aching flu-like feeling such as a fever, feeling shivery and generally unwell. Seek medical help if fever lasts more than six hours.

Treatment of mastitis

Drain the breast frequently. Attach the baby to the affected side first. You may need antibiotics for 10 to 14 days. Keep the breast drained by expressing the affected breast after each feed. Cool cloths from refrigerator (not freezer) can relieve discomfort and pain. Anti-inflammatory medication such as ibuprofen will reduce the inflammation and pain. Paracetamol may be taken to ease discomfort.

Nipple pain, sores and cracks

Another common reason mothers stop breastfeeding early is nipple pain. Causes of nipple pain include nipple injury (caused by the baby or a breast pump), while sore nipples are one of the most common complaints by new mothers. If the nipples are cracked or raw, one can put expressed breast milk or a nipple cream, petroleum jelly, ointment on them, and cover them with a non-stick pad.

This will keep the injured part of the nipple from sticking to the bra nipple vasoconstriction, which means the blood vessels in the nipple tighten and do not let enough blood through. To determine the cause of your pain, your healthcare provider will examine you and your baby, and watch you breastfeed.

Are you having issues with establishing breastfeeding? Talk to lactation experts, doctors, gynaecologists, paediatricians, nurses and other health workers, who are highly skilled in breastfeeding issues. There are foods and medications called galactagogue that can help you to increase breast milk supply, this works best when a mother has low prolactin levels (i.e when there is a genuine, not a perceived, low milk supply issue), and after a mother has received support and education to improve her breastfeeding or expressing technique.

Source : Dr. Rotimi Adesanya.