Breastfeeding is a learned skill and without help from experienced breastfeeding supporters it can be easy to develop problems where your baby is unable to attach properly at your breast. This can lead to damage of your nipple and breast, which is painful and can mean that your baby doesn’t get a good feed.
It’s really important in the early days of establishing breastfeeding to get the best advice available to you. This might come from your midwife, someone on your delivery ward, local drop-in breastfeeding clinics or breastfeeding peer supporters.
Get help from the beginning to ensure your baby is latching on properly and getting a good mouthful of breast in the mouth.
Sore or cracked nipples
If your baby has a poor latch, your nipple will rub on the roof of his mouth (rather than be resting right back in his soft palate) and the friction will make your nipples very sore. By improving the way your baby latches on to your breast you can protect your nipples from damage.
A sign of a poor latch is if your nipple looks like a new lipstick after a feed, with a pinched side and pale colour due to lack of blood circulation in the nipple. Get help quickly to make sure your nipples are getting safely to the back of your baby’s mouth during a feed.
A tongue-tie describes a baby’s tongue that is attached from the tip to the underside of your baby’s mouth. Tongue-tied babies often find it difficult to shape their tongue and get a good mouthful of breast in their mouth.
If you suspect a tongue-tie ask your breastfeeding supporter to take a look in your baby’s mouth. If a tongue-tie is diagnosed your baby can quickly be booked in to have the tie ‘cut’ to release the tip of the tongue from the base of the mouth.
This quick procedure is done without a general anaesthetic, and you will be encouraged to offer your baby a comforting breastfeed straight away.
Engorged breasts occur when the milk in your breasts isn’t being emptied. This can happen in the early days with your baby when your milk comes in. If your baby doesn’t have a good latch onto your breast, the milk will not be drunk and the breasts will stay full and feel very uncomfortable.
It’s important to get help to make sure your baby is getting a good mouthful of breast and emptying all the milk there. This will give her a good feed, empty your breast and stimulate your milk production.
If engorged breasts aren’t emptied, your breasts get a message to produce less milk next time. It’s really important to maintain your milk supply and help your baby to stimulate your milk supply by taking a good efficient feed.
One of the side effects of engorged breasts can be mastitis. This is when milk overfills the breast and gets pushed into the breast tissue. This can set up a painful inflammation response and sometimes leads to infection.
Symptoms of mastitis include pain in the breast, and red triangles or lumps in the breast where a duct or lobe is blocked. You will feel very ill, with flu-like symptoms and sometimes a fever.
Sometimes a baby will refuse to breastfeed. This is obviously a very stressful situation, and it is important to rule out any signs of illness such as thrush, reflux or a more urgent medical problem such as meningitis.
If you are able to rule out illness, you might notice that your baby is spluttering at the breast and pulling away – this might be due to a fast let down response of your milk. They might not be latched on properly and are getting tired and hungry from not being able to feed.
In these situations it is really important to seek out urgent expert breastfeeding support to help you and your baby to be able to feed in a comfortable way. During a breast strike you should keep expressing milk to keep up your supply on the advice of your breastfeeding supporter.
How can I stop my baby favouring one breast?
Sometimes a baby will prefer one breast to feed from and refuse to feed on one side. This can sometimes be because it is uncomfortable for her to turn her head in a certain direction, for example – if she has had a difficult birth she might still be experiencing pain in certain positions.
If your baby isn’t able to feed from your left breast in the traditional cradle position you can often use the rugby hold so that your baby will have her head turned in the same way as if she were feeding at the right breast but is in fact feeding from the left breast. This is often easier to do if your baby is sleepy.