World Breastfeeding Week: Common Questions, Challenges, and Solutions

This past week (the first week of August ) was World Breastfeeding Week, and August is Breastfeeding Awareness Month. For those of you who are breastfeeding or did for any period of time, I am so proud of you! You are amazing!! For those of you who couldn’t, know that you are still an amazing parent and I hope you received the support you needed. I think we’ve all heard the many, many reasons breastfeeding is beneficial for babies from complete nutrients to antibodies and more. But did you know it also benefits the breastfeeding parent? It is associated with a reduction in breast cancer and osteoporosis risk. Although many parents understand these amazing benefits, we also tend to worry about our ability to breastfeed successfully. I’ve noticed this boil down to two real issues: pain or discomfort and low supply (or perceived low supply). Luckily there are solutions to these problems. Let’s start by taking a look at discomfort.

Pain and Discomfort

The most common cause of nipple pain in breastfeeding is a poor latch. Bad latches can cause soreness, cracking, and bleeding. Luckily, there’s an easy solution to this. Fix the latch.

Tips for a good latch:

1. Bring baby’s belly to touch your belly

2. Tilt baby’s head back

3. Bring baby’s chin into your chest/breast below nipple

4. Release nipple into baby’s mouth, making sure their nose is free of the chest/breast

5. Make sure the entire nipple (and as much of the areola as possible) is in the mouth

If latch issues persist, check for a tongue or lip toe and be sure to consult an IBCLC.

Once the latch has been resolved, nipple pain can be addressed in a number of ways

Nipple Pain

1. Moisturize the skin (do not use lanolin)

2. Try a saline soak (not epsom salt)

3. Use hyrdrogel pads

4. Try a nipple shield for protection as the nipples heal

Besides latch issues, there are two other common causes of pain during breastfeeding that go hand in hand: engorgement and clogged ducts.

Engorgement

Until 6 weeks, breasts may feel engorged as the body begins to regulate to a supply and demand approach. This may also happen when you have gone longer than usual without breastfeeding or if you suddenly change your feeding frequency. Here are some tips to help you out:

1. Keep breasts cold between feedings

2. Warm the breast immediate before

   feeding

3. Cabbage leaves over the breast can

   soothe and reduce engorgement

4. Try breast massage

5. Try reverse pressure softening

6. DO NOT PUMP

Clogged Ducts

Clogged ducts, milk blisters, and other obstructions can be extremely painful and lead to serious infections such as mastitis. It is important to get them resolved and manage pain as early as possible. Here are some tips for clogged ducts:

1. Try a gentle breast massage

2. Apply warmth to the breast

3. Feed often so baby can help you remove the obstruction with their powerful suction

4. Try switching positions so gravity can do some of the work for you. Try laying overtop of baby and hanging the breast into their mouth.

5. Prevention tips: wear loose fitting clothes and don't go too long between feedings.

Supply Issues

Early issues

Many parents worry about breastfeeding because milk does not come in immediately. It is important to note that the first food for baby is just a few drops of nutrient dense colostrum, which helps build baby’s microbiome and prepare their body to digest milk.

Colostrum begins being produced at 20 weeks pregnant, and milk usually comes in between 3-5 days postpartum. For those who worry about supply, remember the average size of newborn feedings are:

- 1-1.4 teaspoons for 1 day old

- 0.75-1 oz for 3 day old

- 1.5-2 oz for 1 week old

- 2.5-5 oz for 1 month and beyond

Also- do keep in mind that most babies will lose weight the first week of life and gain it back in the second week. This is nothing to be concerned about. As long as baby is having enough dirty diapers and appears in a good mood and well nourished, they are fine!

Boosting Milk Supply

If you are having supply issues after the first couple of weeks there are some other important things to remember.

1. Let baby latch as much as possible. Breastfeeding is a supply and demand system so the more you practice, the more you will make!

2. Skin to skin: one of the hormonal drivers of breastfeeding is oxytocin which is produced when you and baby spend time with your bare skin on each other. Other things also stimulate oxytocin production such as seeing or smelling your baby. Spend time really bonding and enjoying them.

3. Nourish yourself. This means drinking half of your body weight in ounces of water per day and being sure to eat around 500 extra calories a day of healthy, high protein, high fat foods.

Remember- with enough support almost everyone can breastfeed. If you still have trouble after trying the tips in this post, or have other more serious concerns, contact an IBCLC. They are experts on breastfeeding and can help with all sorts of conditions.