You finally have your baby in your arms and they are rooting (looking for the breast). You have always planned to breastfeed but this is harder than you thought and your baby is having a hard time latching. Just remember it will get better with each feeding, with each day, and by the time your baby is a month old they will be nursing like a pro. Don’t give up!
Research has shown that mothers who have a lot of support or have had an immediate family member breastfeed are more likely to breastfeed for at least 6 months and in may cases 1 year or more [1]. Your midwife is here to support you every step of the way. Please, if you are having a hard time and your baby is not picking it up like you thought they would, call your midwife! She or he will give you resources and put you in contact with a nurse specialized in providing breastfeeding support. You can do it!
Your nipples will be sore at the beginning but once the baby learns how to latch effectively the soreness will disappear and breastfeeding will become second nature. Below are signs of a good latch
- Most of the areola will be inside the babies mouth (at least 1 inch radius)
- You will see your baby’s ear wiggle
- There is circular movement of the jaw rather than rapid chin movement
- Your babies cheeks will be rounded
- You will not hear clicking or smacking noises, instead you will hear swallowing
- Your baby’s chin is touching your breast
- When your baby comes off the breast, the nipple is not flattened or misshaped
- Any discomfort ends quickly after getting the baby latched on
- Milk should not leak between the corners of the baby’s mouth
- Your baby ends the feeding with signs of satisfaction
- Signs of satisfaction include your baby looking relaxed, falls off the breast, has open hands, or falls asleep after [1]
Another worry of nursing mothers is that their baby is not getting enough to eat. It’s important to remember that breast milk is denser than formula so the amount of breast milk will be less than the amount of formula. You will know baby is getting enough if they have 4-6 wet diapers a day and 2-3 yellow colored poopy diapers a day. The good news is breast milk is a natural laxative, so some babies will have a poopy diaper with each feeding [6].
Warning signs
Sometimes a mother can develop a clogged milk duct that can lead to a breast infection called “mastitis.” A clogged milk duct develops when milk flow is blocked in a small area of the breast. Usually it has a gradually onset and only happens to one side of the breast. Signs of a clogged milk duct include the following:
- You will notice a hard lump area of engorgement
- Your breast will be swollen, bright read, and warm to the touch
- You will notice pain or tenderness on the affected breast
- Your milk let down will be painful and nursing on that side will be painful
It’s important to continue to nurse on that side even if it is painful. A clogged milk duct is caused from restricted milk flow. You may have skipped a feeding or become engorged and your breast was not emptied. Putting pressure on the duct can also cause restrict milk flow—maybe from a tight bra, sleeping on your stomach, or pressure from a strap on a diaper bag. Try taking ibuprofen (800 mg) to help with inflammation, make sure you are drinking plenty of fluids, and getting an adequate amount of sleep.
Mastitis is another infection that can happen while nursing. This can be caused by an infection, milk obstruction, or an allergy. Sometimes this infection can start from a cracked nipple. You are also at higher risk of developing it if you have a previous history of mastitis. This infection is most common in the first 2-3 weeks after the birth of your baby but can happen at any time while you are nursing. Mastitis usually has a sudden onset. Signs are similar to a clogged milk duct and listed below.
- The first sign is flu like symptoms, body aches, fatigue, nausea
- You can experience a fever that is greater than or equal to 100.4 F
- Your breast will be very painful
- Your breast can be hot, bright red, and swollen
- In some cases you will notice a red streak extending outward from the affected area
Just like with a clogged milk duct it’s important to continue to nurse on the affected side, even if it is painful. Heat can also help with the pain and encourage emptying of the breast. Use a warm compress and gentle massage to your breast before you nurse. Ensure you are getting enough rest and drinking enough fluids. Most importantly, make sure you are emptying your breast often, continue to nurse frequently and if you need too, use a breast pump. If symptoms of mastitis are mild and have been present for less than 24 hours, consider effective milk removal and supportive measures like ibuprofen (800 mg), warm compresses, and rest. If symptoms are not improving within 12-24 hours or if you are acutely ill, antibiotics should be started [2]. Call your midwife if you have any questions and she can guide you through treatment.
Lastly, don’t forget to take care of yourself while you are breastfeeding. You might feel extra hungry while you are breastfeeding, this is because your body is working around the clock making that precious breast milk. During pregnancy it is recommended to increase your caloric intake by 300 calories….well during breastfeeding you should increase your caloric intake by 500 calories. Your body will let you know when you are hungry and try to choose healthy items. If you get an intense craving (cravings can still happen during breastfeeding) listen to your body and just remember those sugaring cravings are OK in moderation. Below are some additional resources to help you during your breastfeeding journey and don’t forget to call the midwife if you have any questions.
Resources
- https://www.cdc.gov/breastfeeding/pdf/BF-Guide-508.PDF
- http://www.bfmed.org/Resources/Protocols.aspx
- Got Mom: http://www.gotmom.org/
- Le Leche League: http://www.llli.org/
- International Lactation Consultation Association: http://www.ilca.org/
- Breastfeeding website: http://www.breastfeeding.com/
