Breast feeding problem

Importance of breast milk

Breast milk is nutritionally perfect for babies and contains enzymes that make it easy to digest, as well as substances that boost immunity and enhance growth. Nourishing your baby with breast milk alone for the first six months and continuing to breastfeed for at least six months protects against many infections. Breast-fed babies rarely develop gastroenteritis and are less likely to suffer from lung, ear, and urinary tract infections or to develop allergic conditions such as asthma and eczema. Breastfeeding may also reduce the risk of sudden infant death syndrome (SIDC), or cot death.

Diet

To maintain your energy level and ensure an adequate milk supply, increase your kilojoules intake by 2000 to 2500 kilojoules a day, concentrating on nutritious foods. You will need to maintain a calcium intake of about 1200 milligrams a day. Eat small amounts often, with a meal or snack between each feed. Drink at least eight glasses of caffeine-free fluids a day. Most substances you consume will be present in your breast milk, so you should avoid fizzy drinks or strong alcoholic drinks. Ask your doctor before taking any medications.

Everyday routine:

Your baby will need to feed frequently at first, so delegate other tasks whenever possible. Get as much rest as you require, especially during the first few weeks following the birth, when your milk supply is becoming established. Breastfeeding triggers the release of hormone-like substance called endorphins, as well as prolactin (a hormone that causes milk glands to produce milk), all of which can induce a feeling of calm and wellbeing.

Relaxation

Try to be relaxed when you feed your baby. If you feel anxious or tense, you may fail to release enough oxytocin, the hormone that triggers the initial flow of milk. Your hungry baby will then become frustrated, making you more tense. Simple measures such as sitting quietly with a warm drink or watching TV, may be enough to make you feel relaxed. If these do not work, you could try using the relaxation techniques, such as deep breathing exercises, that you learned in parental classes.

Treatment:

It is important to know how to tackle the common breast-feeding problems that can beset any mother. If you can’t solve a problem yourself, get advice from a trained breastfeeding counselor or other healthcare professional.

Engorged breast

When the mature milk comes in a few days after the birth, your breasts may feel tight, swollen and painful. This makes it difficult for your baby to ‘latch-on’ to take hold of the nipple and areola properly and this in turn can make the nipples sore. Breastfeed often, day and night, to stop too much milk from accumulating in your breasts. To relieve some of the engorgement and allow your baby to take the breast more easily, express a little milk before a feed, either by hand or with a breast pump. If your breasts are so full that expressing is impossible, bathe them in warm water for several minutes or place a warm compress on each breast before a feed to help the milk flow. Place a cold compress on each breast between feeds to reduce the discomfort.

Sore or cracked nipples

If your nipples hurt when your baby suckles, try the following:

1. Change the position in which you hold your baby at each feed to ensure that no one part of the nipple takes too much of the force of your baby’s sucking. Your counselor can advise you.
2. Treat any engorgement as soon as possible.
3. Encourage your milk to flow before you put your baby to the breast by relaxing and making yourself comfortable.
4. Feed your baby frequently, but if your nipples are very sore or cracked, limit the length of each feed for a day or two, and express any remaining.
5. Offer the less sore nipple first.
6. Don’t use soap on your nipples.
7.  After a feed, dry your nipples, then apply some breast milk or calendula (marigold) ointment.
8.  Allow your nipples to air dry as much as you can. Try to expose your nipples to sunlight for just few minutes each day, but avoid the hottest hours (generally 10 a.m. to 3 p.m.).
9.  If leakage is a problem, keep your nipples dry by wearing breast pads (not plastic-lined), changing them frequently.

Blocked ducts

A tender, red lump in your breast may be a sign of a clogged milk duct. Try to clear the duct as soon as possible to avoid infection. The following measures will help:

1. Empty your breasts thoroughly each time your baby feeds. Feed your baby from the affected breast first.
2. Feed your baby more often, and express between or after sessions, if necessary.
3. Vary your feeding position at each session.
4. Gently but firmly massage the lump towards the nipple during a feed.
5. In the bath or shower, soap the area of the affected duct and then gently run a wide-tooth comb over it to stimulate milk flow and help clear the blockage.

Do some arm-swinging exercise:

1. Ensure that your bra fits well and isn’t pressing too hard and causing the blockage.
2. To relieve pain, place a warm, wet compress or a covered hot water bottle on the breast every hour. Before a feed, splash the breast or immerse it in warm water for 5 to 10 minutes.
3. Increase your intake of vegetable oils. A supplement of vegetable lecithin may also help

Poor milk supply

1. Only rarely is a woman unable to produce a sufficient amount. Breastfeed frequently and for as long as your baby wants, since sucking stimulates the milk to flow.
2. To try to increase your milk supply, once or twice daily drink a cup of tea made from nettles, fennel, vervain, raspberry leaf, cinnamon or marshmallow. Caraway, coriander, cumin, sunflower, sesame, celery and fenugreek seeds are also said to be helpful.

Breast milk by bottle

There is no reason why breastfeeding your baby should restrict your independence. Invest in breast pump that allows you to express your milk into a bottle. This can then be given to your baby by your partner or a babysitter. If you will be expressing milk only at home, a full-size electric pump may be appropriate. These can often be rented. If you need to use pump outside the home, choose a smaller type either manual or electric. Remember to follow the instructions on sterilizing the breast pump and to use sterilized bottles or milk-collection bags (for freezing).