Breasts behaving badly? Here are some sensible solutions for common nursing problems
The most common breastfeeding battles you’re likely to face – and how you can nip them in the bud.
The lowdown on latching and other need to knows about common nursing problems. (LWA/Dann Tardif/Getty Images)
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Seasoned breastfeeding moms say that while nursing isn't rocket science, it certainly feels like it when something goes wrong.

Here are some of the most common breastfeeding battles you're likely to face – and solutions to nip them in the bud.

PROBLEM: Cracked or painful nipples

Nipples are extremely delicate, so cracks, soreness and pain may occur, particularly in the early days of breastfeeding. The most common reason is incorrect latching. Sort this out, and the nipples heal quite rapidly.

Symptoms include redness, inflammation, cracking or pain when touched.

CURE: First, get help with latching

Babies must have a large portion of the breast in their mouths and not just the nipple, which is painfully pinched between the baby's tongue and mouth if latched incorrectly.

Use a small amount of protective cream – which does not need to be washed off – before and after feeds.

Do not use soap and only wash your nipples with warm water, allowing them to air dry. Rub breast milk into the area and also allow to air dry.

While the area is healing, you can take a safe pain reliever prescribed by your pharmacist or doctor.

PROBLEM: Engorged breasts

There's nothing more uncomfortable – or downright frightening – than waking up with leaking, party balloon-sized breasts.

Engorgement is especially common among moms who have newborns.

CURE: Your baby needs to empty your breasts

Insufficient emptying means you'll build up too much milk, leading to engorgement. Never time feed or feed on a schedule.

Cue feeding means nursing your baby whenever she seems hungry and for as long as she wants. This could mean a marathon nursing session around the clock or a bout of "cluster feeding" in the early evening.

Use cabbage leaves to help relieve swelling. Dip two leaves in very hot water, shake off the excess moisture and put them inside your bra.

You can also express extra milk by hand, gently massaging blocked milk down towards the nipple. Alternating between warm and cold facecloth compresses also helps.

PROBLEM: Thrush

How will you know if you and your baby are suffering from thrush?

Symptoms include tender, sore nipples, often accompanied by shooting pain in the breast during or after feeding and white patches inside your baby's cheeks.

Several factors contribute towards thrush, including antibiotics, diet, the contraceptive pill, pregnancy, diabetes, clothing that are too tight, perfumed deodorants and creams, and weakened immunity.

CURE: See your doctor for diagnosis and treatment

Both you and your baby will need to be treated with medication, as you pass it on to each other easily. Eat live culture yoghurt and take supplements containing lactobacillus acidophilus.

Also try to avoid tight clothes, douching and antibiotics. If you must take antibiotics, take a good quality probiotic between antibiotic doses each day.

Other top tips include washing your nipples frequently with warm water, wearing cotton underwear, wiping from front to back after urinating and avoiding perfumed creams, bath products and soaps.

PROBLEM: Painful lumps

Those mystery lumps and bumps are usually blocked milk ducts, although sometimes they indicate infection. 

CURE: Empty your breasts frequently

Engorgement is usually the culprit if you have lumps and it must be treated promptly to avoid an infection, which may cause mastitis or an abscess.

Empty your breasts frequently by feeding your baby on cue, not on a schedule, and hand or pump express milk between feeds.

Although it may be painful, massage the lumps to unplug ducts and alternate between warm and cold compresses. 

PROBLEM: Mastitis

This is an infection of the breast that requires urgent treatment. Look out for red, shiny or hot, sore breasts, fever, nausea, chills, fatigue or an isolated red patch on the skin.

Not treating mastitis can lead to an abscess, which you may recognise as a closed, pus-containing lump, accompanied by tenderness, red skin in the affected area and pain.

The causes of mastitis usually include engorgement, blocked milk ducts or broken, damaged skin in the nipple area.

CURE: Don't time feed!

Breastfeed often and get engorgement and blocked ducts under control to prevent mastitis from developing. Antibiotics may be prescribed to treat your infection.

Try feeding from the non-infected breast first until you have let down (milk ejection reflex) and then switch to the infected breast.

This can be very painful, but soldier on and get a safe pain reliever from your doctor or pharmacist to help you cope. 

The lowdown on latching

  • Wear a button-down top with your nursing bra.
  • The rooting reflex causes baby to literally root around, looking for the nipple. Touch or tickle the lips and cheek at your breast to guide rooting.
  • Your baby's bottom lip curls and the mouth opens wide. Cradle your baby's head and gently hold her mouth against the nipple. 
  • Gently push the chin down a little if the mouth isn't wide enough. 
  • Often, you'll be told to jam baby's head onto the breast, but any pressure may cause her to resist – and you'll see that as rejection! Many mums call this "fighting me" or "fighting at the breast". It's usually better to hold her body via bottom and shoulders and use a finger to create a "safety net" for her head. 
  • When babies self-attach, they typically bob their heads and gradually "home" onto the nipple. If the chin lands up below the nipple, they will open wide and attach effectively often without any help at all.
  • Make sure the mouth is deeply attached, taking much more breast inside than you think possible! Imagine your nipple dangling freely at the back of baby's throat – it can't get quite that far, but the further it gets, the less friction on the nipple, the less chance of any pain.  If any areola is visible outside baby’s mouth, there should be more to see under her nose than chin.
  • Pain after the first few sucks generally means incorrect latching or the wrong position, so try again until it feels more comfortable. 
  • To de-latch baby, simply put your little finger in the corner of her mouth to break the suction. 
  • A good latch creates movement right up to baby's temples, and your breast will be pulled deeper into the mouth with each suck. 
  • A bad latch results in baby's cheeks drawing inwards. 


Sources:

Beth Cooper is the author of The Greatest Breastfeeding Tips in the World (2012).

La Leche League International has branches virtually everywhere. Their book The Womanly Art of Breastfeeding is most useful and encouraging. 


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