Breastfeeding Problems
Breastfeeding Problems
Brush Up on Your Nursing Skills
Breastfeeding is as natural as walking. But nursing doesn't always come naturally for mother or child. A newborn doesn't always "get it" right away. Or perhaps your body doesn't seem to produce enough milk to satisfy your child. Or nursing leaves your breasts sore. Don't despair: Women doctors have plenty of helpful advice.
REMEDIES FOR COLIC AND FUSSINESS
Breast milk is ideal nutrition for babies, and breastfeeding can be part of an important emotional relationship between mother and infant, says Ruth Lawrence, M.D., professor of pediatrics in the Division of Neonatology at the University of Rochester School of Medicine and Dentistry. But successful nursing doesn't always come easily. "It is not a reflex, but a skill that must be learned," she says. Here are ways to deal with some of the challenges that can arise when you want to breastfeed, but your baby has other ideas.
Rest, rock, relax. Babies can and do sense any insecurity and tension in their moms, says Dr. Lawrence. "Colic in babies has been associated with maternal tension," she says. "It also interferes with letting down your milk--that is, release by your milk-producing glands." So find somewhere peaceful to feed your baby, somewhere with low lights and maybe some quiet music, especially during the first few weeks of nursing.
Sitting in a rocking chair can be a big help, adds Dr. Lawrence, because the structural design forces you to lean back and relax.
Nurse early, nurse often. Babies' appetites vary widely, says Susan Schulman, M.D., attending physician in the Department of Pediatrics at Maimonides Medical Center in Brooklyn. Little Jimmy may require 6 feedings a day, while Joey needs 16. Not to worry, she says: Frequent feedings actually keep Mom's milk flowing. So the more frequently your baby nurses, the more milk you produce. It's a common misconception that frequent nursing encourages overproduction of milk and a condi tion called engorgement, but that's not true, says Dr. Schulman. Frequent nursing improves drainage and a healthy flow of milk, she says.
When To See A Doctor
Breastfeeding shouldn't hurt, says Ruth Lawrence, M.D., professor of pediatrics in the Division of Neonatology at the University of Rochester School of Medicine and Dentistry. So if nothing you try seems to relieve pain and discomfort brought on by nursing, consult your doctor, especially if nursing leaves your breasts red, hot, swollen and painful. You may have mastitis, a breast infection that requires attention.
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Tilt and switch. Some babies are unsatisfied, because they nurse on just one breast, fall asleep, then wake up hungry an hour later, says Dr. Schulman. Try this: When you notice your baby drifting off to dreamland, gently tilt her up and down until her eyes open--to wake her--then switch her to your other breast. "Don't take no for an answer. Finish feeding on both sides," Dr. Schulman says.
At first, forgo all bottles. Babies who are bottle-fed part-time within the first couple of weeks get confused when prompted to breastfeed, says Dr. Schulman. "They start looking for a rubber nipple on their mother and are unhappy when they don't find it," she says. So wait until your baby is at least three weeks old before you introduce a bottle.
Desalt your milk. Some babies refuse to nurse right after mom has exercised, says Dr. Lawrence. To get rid of sodium that accumulates at your nipples when you work up a sweat, express and discard a teaspoon or two of milk and wash off your breasts after exercise and before nursing.
Drink a glass of water both before and after exercise. When you perspire, your breasts, which are actually modified sweat glands, use up water needed to produce milk, says Dr. Schulman. To stay hydrated, drink up.
PRIME THE PUMP
Sometimes you know you have milk, but it's not flowing. To help nature along, try these suggestions.
Massage yourself. A gentle breast massage stimulates milk flow, says Elaine Stillerman, a licensed massage therapist on the staff of the Swedish Institute of Massage in New York City and author of Mother- Massage. With your fingertips, circle around the base of one breast, then the other. Then place both hands flat on either side of one breast and slowly slide outward from the areola, the dark area surrounding the nipple. Repeat on your other breast.
Warm a clogged duct. It's not unusual for a milk duct to clog, preventing free flow of breast milk. A warm washcloth or shower and some gentle massaging helps unplug a clogged milk duct by increasing blood flow to the area, says Dr. Lawrence. After your breast softens, feed your baby or express excess milk.
Cool engorgement. Dr. Lawrence recommends an ancient folk remedy for tender, engorged breasts the first few days following birth: Place cool, fresh cabbage leaves on your breasts until they fully wilt. (The cabbage leaves, that is, not your breasts.) If you're fresh out of cabbage leaves or prefer a less exotic approach, a cool, moist washcloth may help: Applying a cold compress for 15 to 20 minutes at a time between feedings reduces blood flow and the overfilling of the breasts, says Dr. Lawrence. But don't apply just before feeding, as it will interfere with letdown of your milk.
Quit smoking. Smoking right before breastfeeding interferes with release of milk from milk glands, says Dr. Lawrence. So if you smoke and have been meaning to quit, breastfeeding is a good time to stop.
SORE BREASTS? DO THIS
If your baby is enthusiastic about nursing, but your breasts are the worse for wear, women doctors offer these strategies.
Change your position each time you nurse. Using a variety of positions encourages your baby's mouth to create pressure on different parts of your nipple, which helps prevent soreness as well as clogged ducts, says Dr. Schulman. Two tried-and-true positions include the regular cradle position, where you support your baby's head in the crook of your arm while nursing, or the lying down position, with your baby lying down in the bed next to you. Dr. Schulman also recommends the football position. Hold your baby's head in your hand, and allow her body and legs to rest on your hip, like carrying a football downfield.
Moisten up. If your nipples become dry and cracked--often the case if you live in a dry climate and you breastfeed, says Dr. Lawrence--try between-feeding applications of a form of purified lanolin such as Lansinoh, made especially for nursing mothers. Thoroughly wash off the lotion before baby's next feeding.
