Costometic

Though mothers have been breast feeding for centuries, problems may crop up. A paediatrician can sort them out for you.

Your baby is born and you are looking forward to bonding with her. And of course, you want to start your baby on what’s best for her: your own milk. However, breast feeding doesn’t always work out easily. Some mothers may have a problem with breast feeding right from the start, while others may develop one after some time. You may be caught in that difficult choice between your own milk and formula, which ever doctor and parent wants to avoid. One of the most common reasons for the failure to initiate or maintain breast feeding is maternal anxiety and stress. Like most of our body functions, the milk moms produce too depends on having both a healthy body and a happy mind. Being aware of common breast feeding problems and their solutions will ensure that your baby gets a good feed each time.

You’re not making enough milk for the baby

If your body is not producing enough milk, your baby may not get the amount she needs for optimum growth.

An average newborn needs about 300 to 500 ml of milk daily. Though this cannot be measured when breast feeding, you can make out by the fact that your breasts are not completely full between feeds, your baby cries and is restless between feeds, your baby doesn’t pass enough pee and poop, and seems lethargic.

The possible causes of these problems are maternal anxiety, stress, a premature breast feed, lack of awareness about the right feeding techniques, fear and false beliefs that breast feeding will be bad for your figure, and the convenience of bottle feeding formula to your child may be a few of the causes of poor milk production and let-down.

Being aware of breast feeding during pregnancy itself can go a long way in having a normal milk supply. You can learn proper techniques and good latching positions for the baby from your paediatrician or neonatologist. Having someone to help with the breast feeding for the first few days, staying relaxed, eating balanced meals and sleeping enough will all help in having a good supply of your own milk for your baby.

You’re producing too much milk for your baby

Some mother produce so much milk that it tends to leak out in between feeds too.

Too much milk can make many babies struggle to handle the excess milk, and they often tend to choke. Since their swallowing mechanisms are weak, premature and low-birth-weight babies are more prone to choking than normal bewborns.

There is no one cause for this situation: its an individual variation.

What you can do: Use good breast feeding techniques: Hold and compress your breast to control the excessive flow, and keep the baby’s head higher than the rest of the body. Express excess milk between feeds and avoid feeding while lying down. As the baby grows older, the capacity to suckle and swallow large quantities of milk will improve, and the problem will go away within a few weeks.

Your nipples feel sore

Many mothers. especially those with babies who breast feed vigorously, complain of sore or cracked nipples. It can be quite painful and obstruct proper feeding.

As the baby feeds, many parts of the nipple which are stuck to the underlying tissues get stretched and stressed, resulting in blisters, cuts or soreness. In the case of open cuts, the baby tends to swallow a little blood along with the milk. Though not dangerous in itself, this can irritate the baby’s stomach, making her vomit the blood, which may frighten a new mother.

Most often, this is due to the tenderness of the skin in the nipple and breast area, along with the wetness, friction, and vigorous sucking action of the baby.

To avoid such a situation, keep the breasts and nipples as clean and dry as possible between feeds. Applying nontoxic nipple creams, which basically contain lanolin, between feeds helps to heal the soreness. Do wash off the cream before breast feeding or its taste may make your baby reject your milk. Applying breast milk to the sore nipples and letting it dry also helps. You could use a nipple shield, or express milk and feed it to your baby from a boggle or with a spoon. Using as breast pump helps to pull the nipples out gently.

You have ‘inverted nipples’ and find it hard to breast feed

In many women, nipples are not projecting, but flat; in some they turn inwards and are embedded in the breast tissue.

Your baby cannot get a grip on flat or inverted nipples and you struggle to breast feed. As the breast gets more and more filled up with milk, the nipples tend to get more buried in the breast. Some mothers may have one inverted and one normal nipple.

The possible causes: Its congenital: Many women are born and grow up with this condition. Using breat shells or caps during and after pregnancy helps to push back the breast tissue and release the nipples forward. Breast pumps and manual stimulation - by stretching the base of the nipples, or holding the nipples between the forefinger and thumb and pulling it out gently, or pulling the back of the breast tissue as the baby latches on - may help in varying degrees. In many cases, however, the nipples remain stubbornly embedded, and you may have to use a shield or a pump to express the milk. Luckily, many babies learn to take a big chunk of the breast in the mouth, rather than just the nipple.

You’re not sure what to eat while you’re breast feeding

One common question that nearly all mothers ask is - What should my diet be when I’m feeding my baby?

The anxiety that whatever you eat will mix up with your breast milk and find its way to your baby.

Most of the raw material that is needed for milk production has already been stored by the mother during the nine months of pregnancy. However, there are many myths and misconceptions about what the mother should and should not eat.

The simplest advice for the mother is that she should eat a normal balanced diet, without overeating or under eating any food. Very few foods are known to affect the baby adversely: The list includes an excess of coffee, tea, chocolates and colas besides alcohol. You should drink plenty of water and include enough calcium, iron and vitamins in your diet. Try not to eat out too often. The world over, the diets of mothers are very varied: there isn’t any single prescribed diet for the new mother.

You are uncertain about taking medication

Taking medication while breast feeding can make a new mother anxious, for fear that the medicine might be secreted in the breast milk while breast feeding.

Mothers who are sick either don’t take the necessary medicines and suffer, or they stop breast feeding for a while, assuming that it is dangerous for the baby. Mothers know that medicines are chemicals that can get secreted into the breast milk, causing temporary or permanent harm to their babies.

While most common medications that are used to treat colds, coughs, fever, stomach upsets, headaches and simple infections are harmless to the baby, its advisable to consult your paediatrician before taking them. Certain categories of medicines, like those used to treat severe infections like malaria or typhoid, should be strictly avoided.

Your breasts are engorged

It is the initial few days of breast feeding and your breasts feel swollen, tender, lumpy and uncomfortably full. Engorgement is the overfilling of the breast with milk. This is very common when you start or stop breast feeding - and it is painful. You may have temperature too. Sometimes the swelling extends all the way to the armpit. In rare cases, this can lead to mastitis, plugged ducts and abscess.

Engorgement is usually the result of an imbalance between how much milk the mother produces and how much of it the baby consumes. This normally occurs in the early days after birth, when the baby is not feeding well or emptying the breast well. It can also be because the baby is not latching on properly, or inverted nipples are preventing her from doing so. It can also happen if the baby is premature or low-birth-weight, or sick, and doesn’t suckle well. Waiting too long after the baby is born to breast feed, feeding incompletely, bottle-feeding between breast feeding or skipping feeds are common issues.

To avoid breast engorgement, once the baby is born, start breast feeding as soon as possible. The baby should be made to latch on well, and empty both breasts during feeding. If not, you should empty out the breasts in between feedings, either manually or with a pump. This is usually a temporary problem and once the baby is feeding frequently and effectively, it will pass. Warm packs, massaging and mild anti-inflammatory medicines help to prevent engorgement and the discomfort it causes.

Your breasts are inflamed

Mastitis is inflamation of the breast tissue and may quickly develop into an infection. It is common in the first two or three weeks after the baby is born.

Mothers with mastitis have heaviness, redness, swelling, and sever pain, usually in one breast and with an accompanying fever. The milk from the affected breast may become thicker, saltier, and may be stained or mixed with blood or pus, making it difficult for the baby to feed. Mastitis can also lead to the formation of a big pus pocket or abscess in the breast.

The most likely reson for this inflammation is plugged ducts or engorgement. Lack of local hygiene and cracked or sore ipples may be the starting point. Pressure from clothes, breast pads, nipple shields, sleeping in a prone position and infrequent feeding may all contribute to mastitis. In some cases the infection may be caused by bacteria.

To avoid breast inflammation, wear loose clothing and empty the breasts in between feeds, to prevent congestion. Consult a doctor at the first sign of redness or pain: Your doctor my prescribe painkillers, anti-inflammatory medicines, antibiotics or surgical intervention, depending on the severity of the condition. Using a hot compress or dipping the affected breast in a bowl of warm water and Epsom salt, and taking frequent hot showers will help. You can feed the baby, but it is likely to be very painful.

Your milk ducts are blocked

If you find a painful, swollen, hard lump in your breast, sometimes with a red and inflamed patch on the skin near the lump, it may be a plugged milk duct. That means a tube that carries the breast milk may be blocked.

A plugged milk duct may occur when a hole in the nipple or a tube deeper in the breast tissue gets blocked. With time, redness and pain can set in. The discomfort is at its worst before feeding and reduces on feeding. Occasionally, fever may develop; it might eventually end up in mastitis and a breast abscess. A plugged duct may lead to decreased milk output from the affected breast. It may also change the character of the milk due to pus formation and release of certain chemicals due to the inflammation.

Most often, a plugged duct results from engorgement, infrequent feeding, pressure from a nipple shield, tight clothing or sleeping in a prone position. Inflammations and infections of the skin around the nipple can also be a starting point for plugged ducts.

The treatment is similar to that for mastitis: Frequent feedings, hot compresses, soaks, massages, rest and in rare cases, anti-inflammatory medicines and antibiotics. Manual expression of excess milk also keeps the ducts open.

You have thrush

Thrush is a fungal or yeast infection in the breast that is passed on to the baby. This fungal infection of the breast and surrounding areas is caused by a fungus called Candida. It makes your nipples feel sore and itchy. Breast and nipple thrush may be a part of thrush in other areas of the body.

Fungal infections are common in tropical climates and when breast hygiene is poor. Heavy antibiotic usage by the mother during and after the baby is born ( true of C-sec deliveries) can also cause them. The use of breast pads, cups and tight clothing also aggravate them.

To avoid thrush, Take your doctor’s advice: The mother may need anti-fungal medicines and the baby too may need to be treated for oral thrush with child-safe anti-fungal lotions to prevent the spread of infection back and forth. Keep your breasts and nipples clean and dry. Vitamins and probiotic supplements may also help.