Hello, mamas! I’m Stephanie Weight Hadfield, BS, IBCLC. I’m a mom of 4 and a lactation consultant with Lactation Link. Today I’m talking about some of the most common breastfeeding concerns I see when I’m consulting with moms and babies.
Pain and Nipple Tenderness
Pain is one of the most common reasons mothers give for early weaning. While some nipple tenderness is normal at the beginning of feeds in the early postpartum period, severe pain and skin damage is NOT normal and should be seen as a sign that help is needed. How can you tell when you should be concerned? Use the “30 second” rule. If your pain disappears within 30 seconds after latching, you can safely ignore it. If your pain lasts longer than that, gently insert your finger into the corner of your baby’s mouth to break the suction and unlatch baby, then try again. If you’re not able to get a latch that is comfortable for the majority of feeding session, your pain is severe, and/or you notice any damage to the nipple, you should seek help right away.
Concerns over milk supply are right up there with nipple pain as a top cause of early weaning. Neither babies nor breasts come with full/empty gauges, so you might feel like it’s hard to know how much you’re making and how much baby is getting. However, there are some reliable signs that can clue you in if you know what to look for. You can be confident that your baby is getting just the right amount of your milk if he or she is growing and gaining well, and having plenty of wet and poopy diapers each day. After the first week, and for the first month or so, expect 5-6+ light colored and mild smelling wet diapers and 3-4+ poopy diapers. If your baby is gaining poorly and/or not having enough wet and dirty diapers, help from an IBCLC is a very good idea.
The best way to ensure that you’ll have an ample supply is to start breastfeeding within the first hour after birth and then whenever your baby shows feeding cues after that—generally 8-10 or more times per day. Milk volume works on a supply and demand principle—the more you demand it (by feeding or pumping), the more you’ll supply. Your breasts are always making milk. They’re never truly empty, so you don’t need to wait for them to feel full before you feed your baby. In fact, if you do, you might be telling your body to make less milk.
Medications While Breastfeeding
Breastfeeding mothers might worry that prescribed medications will pass through their milk and possibly hurt their babies. The Infant Risk Center at Texas Tech University Health Sciences Center is an excellent resource for information on the safety of medications in breastfeeding mothers. If you’re worried about a medication, or have been told that you can’t breastfeed while taking a medication, you can call their hotline 806-352-2519 or visit www.infantrisk.com for the most up-to-date information. If you have an ongoing medical issue requires medication and you have concerns about it and breastfeeding, we would love to talk with you on an eConsult or an in-person consultation if you are in our area. Making a personalized plan with one of our IBCLCs is a great way to bring some confidence into what could be a challenging situation.
Teething & Breastfeeding
Yes, you can continue to breastfeed through teething and beyond! Many teething babies will nurse better if they get to chew on something cold first. You can also talk to your doctor about pain relief options for your teething baby. If you’re worried about those new little teeth being right next to your nipples, relax. Most babies’ teeth cause no problems at all for their mamas. When a baby is actively drinking, the tongue comes forward over the lower gumline and gets in the way of biting. If your baby does bite though, he or she is usually trying to resolve the discomfort of teething, or simply experimenting with new ways to use his or her mouth. Your baby doesn’t realize that it hurts you. You can teach your baby that biting mama isn’t ok by ending the feeding session and calmly, but firmly saying “No, no, no.”
Concerns with breastfeeding older babies
Sometimes, breastfeeding problems can pop up with older babies after breastfeeding has been going really well for a while. This can be especially worrying if you don’t know other moms who have breastfed past early infancy and worked through these common bumps in the breastfeeding journey. Joining a local breastfeeding support group is a great way to help you gain confidence in nursing your older baby, and maybe even make some new friends at the same time.
Sometimes older babies will start to refuse to feed at the breast. It is unlikely that a baby younger than a year old is actually self-weaning from the breast. If you can protect your milk supply and be patient, you can be confident that the refusal is almost certainly temporary. Most nursing strikes only last a day or two, but some can last up to a week or more. If your baby starts to refuse the breast, keep offering gently. The trick is to act like you don’t care whether or not baby latches, even though you probably care very much! Lots of skin to skin cuddle time can be very helpful in these situations. You could try nursing baby when he or she is very sleepy, or in a new position– maybe even standing up and walking around.
If the refusal goes on more than a few hours, you’ll need to express your milk. You can give this milk to baby by cup, spoon, or bottle. Older babies who have never taken a bottle may do better with a straw sippy, or even frozen breastmilk cubes in a mesh feeder. Don’t be afraid to reach out for help from an IBCLC when having issues breastfeeding an older baby. We don’t just help newborns, we love helping moms breastfeed babies of all ages.
I hope these breastfeeding concerns and solutions have created some more confidence in yourself! What was the biggest snag you hit in breastfeeding? How did you overcome it? Share in the comments.
Thanks for stopping by,
Stephanie Weight Hadfield, BS, IBCLC
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Mohrbacher, N. (2010). Breastfeeding answers made simple: a guide for helping mothers. Amarillo, TX: Hale Publishing, L.P.