Breastfeeding problems can be overcome

If you're having trouble breastfeeding, you're not alone. If so many women didn't have trouble breastfeeding, hospitals wouldn't have lactation experts. As natural as it is, breastfeeding can be difficult for new and even experienced moms and babies. Fortunately, many of these difficulties can be overcome.

Engorgement: When breasts are too full of milk

Slight engorgement is not a problem, but it can become painful. The American Academy of Pediatrics makes the following recommendations:

Nurse frequently with the baby in proper position.

Express some milk by hand or with a pump before breastfeeding.

Use cold compresses as you express milk and ice packs between feedings.

Try different feeding positions.

Massage the breast, moving from under your arm all the way to the nipple.

Don't take medications for pain without your healthcare provider's approval.

If you are engorged, try breastfeeding every 1 ½ to 2 hours and let the baby nurse as long as possible. The La Leche League recommends that you avoid wearing an underwire bra at this time.

Mastitis: Caused by blocked milk ducts

When milk ducts are blocked, milk pools and bacterial infection and inflammation set in. Symptoms of mastitis include reddening, warm, tender and lumpy breasts. You may feel sick and have a fever from mastitis, so call the doctor right away if you have symptoms.

Cracked or sore nipples

Nipple problems are not uncommon. They usually indicate that the baby isn't in the right position or hasn't latched on to the breast correctly.

Here are some ways to prevent and care for cracked or sore nipples:

Expose your nipples to air as much as possible.

Warm them for short periods with a hair dryer after breastfeeding.

Avoid nursing gear that holds moisture, such as plastic-lined nursing pads.

Avoid creams and lotions. These have to be removed before breastfeeding and can make cracked or sore nipples worse.

Vary feeding positions.

One of the most common causes of cracked or sore nipples is not having the baby facing your body. When using the cradle hold (the most common hold for nursing), be sure his body is almost horizontal across your body and his chest, head and belly turned to directly face you.

Another common problem is when the baby's mouth grasps only the nipple. This is almost guaranteed to make you sore. Even though your baby takes in so much breast, he or she will be able breathe just fine. Just be sure the area around the nipple is in his mouth, too. Get the baby to open his or her mouth wide and take in as much of the areola area around the nipple as possible.

Inverted nipples

Nipples that are drawn inward can make it hard to breastfeed. Often inverted nipples reverse themselves during pregnancy, resolving this condition. You can receive treatment for inverted nipples, so be sure and talk to your lactation expert or your healthcare provider.

Date last reviewed: October 2002.

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