Nursing 101: Problems & Solutions

Breastfeeding may be natural, but as many moms can tell you, that doesn't always guarantee that it's easy. Thankfully, what is easy is getting the pro tips you need should a snag arise. Here are some of the most common nursing challenges that moms and babies alike may face during their breastfeeding journey.

A Painful Latch.

Let's be perfectly clear. That delicate little newborn of yours will be anything but delicate to your boobs. This can be a huge surprise to first-time moms! Expect to be a little sore when you get started. But if pain persists beyond the first few seconds of nursing, it may be that Baby has a bad latch.

Solution: To encourage a wide-open mouth, softly brush your nipple directly under Baby's nose. Because hungry babies instinctively root, giving them something to root toward opens their mouths nice and wide. Next, make sure their bottom lip is well below your nipple, not simply at the base of your nipple. Last, bring Baby toward you instead of putting the breast in her mouth. A good latch will show itself when Baby's chin rests directly on your breast, lips splayed out, with your nipple or lower areola covered by Baby's latch. Still struggling? Don't be afraid to reach out for help. Both your attending nurse or an on-call lactation consultant can assist you bedside during labor recovery. Still struggling after you've been discharged? Look into consulting with a lactation specialist or join a breastfeeding support group like La Leche.

Engorgement

Engorgement happens when your breasts overfill with milk, making them rock hard, tender to the touch, feeling as if they'll explode. Another culprit? The lymphatic fluid that tries to escape your body near your armpit while your body is simultaneously trying to produce milk can cause a fluid traffic jam. Though common, engorgement left untreated can result in more serious issues like clogged milk ducts or even mastitis. Most women experience engorgement a few days after giving birth when their bodies make the switch from producing nutrient-dense colostrum to mature milk, though it can happen throughout your nursing career as a result of over pumping or not fully draining the breasts with each feeding. Although engorgement is uncomfortable, moms can take heart that it is actually a sign their bodies are working properly. So long as a fever isn't involved, engorgement has nothing to do with infection and can be relieved immediately.

Solution: Because engorgement can make latching difficult initially, you might think using a pump will bring instant relief. But pumping will signal your body to produce more than you need to nurse, further exacerbating the issue. Try hand expressing to soften your nipple and then nurse on demand, making sure Baby drains your breasts fully. If you feel the need to nurse, and  Baby is sleeping or drowsy, don't be afraid to wake him to try.

Clogged Ducts & Mastitis

Clogged ducts can be the result of a number of things: engorgement, using the wrong-sized pump parts or wearing a poorly fitting, overly constricting bra. Some moms even find themselves naturally predisposed to getting clogged ducts for no rhyme or reason. Clogged ducts can be equally distressing to Baby, who may get frustrated at ineffective nursing. Mastitis, on the other hand, can result from clogged ducts that are left untreated, resulting in an infection that causes incredible pain throughout the entire breast, as well as flu-like symptoms such as fever, chills and body aches.

Solution: Clogged ducts can typically be tackled with home remedies. It's incredibly important to continue to nurse regularly, rest, stay hydrated, employ massage or the use of warm or cold compresses. Avoid sleeping on your stomach or wearing uncomfortable underwire bras for the first few weeks of nursing when your breasts are the most sensitive to constriction. If you find yourself in the uncomfortable situation of having a clogged duct for more than two days, reach out to your doctor as you will likely develop mastitis. As a bacterial infection, mastitis can only be treated with an antibiotic. Thankfully, the infection doesn't transfer to Baby, and appropriate medications are nursing-friendly. Nursing will actually relieve the problem with the added benefit of keeping your milk supply up. Too painful? Pump instead and offer bottles to Baby while the mastitis clears up (typically a two- or three-day process, though your doctor will recommend completing a full round of antibiotics).

Yeast Infection

Thrush is a yeast infection that begins in Baby's mouth and can ultimately transfer into your breast, causing deep shooting pain, itchiness and red, shiny nipples. It's the gift that keeps on giving ... only neither of you want it.

Solution: Your doctor will treat both you and your baby with an antifungal medication to ensure that fungi doesn't continue to persistently pass back and forth. It's important to sanitize all pumping parts well, along with anything else that comes into contact with your breasts (i.e., nursing bras, pads and clothing) in hot water and vinegar to kill the yeast spores.

Low Supply

According to Stephanie Nguyen, RN, a board certified lactation consultant and founder of Modern Milk, 90 percent of moms have the ability to produce enough milk for their babies, and the other 10 percent usually have some reason that can be remedied.

What are some reasons for low supply?

a) not feeding enough

b) having a preemie who struggles to nurse

c) using a pacifier to suppress hunger cues

d) drinking and/or smoking

e) advanced maternal age

d) pre-existing health conditions, such as PCOS or thyroid issues, or medications like contraceptives or decongestants

Solution: One of the simplest ways to boost supply is to relax, eat well and nurse often. Add in extra pumping sessions using a medical grade pump between nursing sessions to signal to your body to increase production. And fill up on nourishing foods such as oatmeal, flaxseed, brewer's yeast, fenugreek, and lactation tea. Trying to find ways to incorporate these superfoods into your diet? Try making lactation cookies (recipes abound online!). Tea and cookies, anyone?

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Susie Roth of Starting Point Dental suggests checking one other culprit for bad latch and low supply: mouth restrictions. “A lip or tongue tie can present a significant challenge to nursing mothers,” she cautions. “A thick frenum can restrict the babies tongue or lip movement creating decreased mobility and failure to latch or create the seal needed for successful feeding.” Consult with your doctor if you have any concerns.

Lauren Greenlee is a freelance writer and an Olathe mom of four who is thankful for the number of resources that abound in the KC metro that helped support her breastfeeding journeys.

As always, please consult your health care provider with any questions or concerns.