0-6 Months: Your New Baby and You - Breastfeeding Problems (part 1)

It can be frustrating
when little problems and annoyances raise their heads, making it seem
that breastfeeding isn’t the easiest option. The good news is that
almost all problems can be resolved, and after the first few weeks, you’ll find that you settle into a comfortable, pleasurable routine with your new baby.

I find I simply don’t have enough milk at some points during the day. What do you recommend?

It can take some time for your milk to become established, and
for “supply and demand” to kick in. Continue to allow your baby to
suckle, even if there doesn’t seem to be much milk coming out. This will
stimulate your body to produce more milk to meet your baby’s demands.
It may take a day or so for the milk supply to adjust to your baby’s
needs, and the only way to do this is to continue to try to feed her
when she is hungry. Make sure that you are relaxed when you feed her. If
you are tired and anxious, it might seem as though there is no milk, or
not enough. In reality, however, even if your breasts do not feel full
to bursting, there will be plenty there for your baby.

Take some time to
rest, and even retire to bed with your baby for a day or two, to divert
your energy toward making milk. Most new moms can use a break, and once
you’ve got your supply re-established, you’ll probably feel much better.

Make sure, too, that
you are getting enough to eat. You need plenty of energy to produce
milk, and an inadequate diet can most definitely affect your milk
supply. Eat three good meals a day, with plenty of healthy snacks in
between, such as whole-grain toast, fresh fruit, cheese, seeds, and nuts.

My nipples are sore and chapped, and latching on is becoming very painful; what can I do?

Breastfeeding in the early days can be quite painful as your
nipples adjust to regular feeding. It may be cold comfort, but things do
improve over time and the best thing you can do is persevere.

Make sure that your
baby is latching on properly. Her mouth needs to be open wide, with her
tongue down and forward, and your nipple should be aimed at the roof of
her mouth. When she is properly latched on, she should be drawing in all
of the nipple, and some breast tissue into her mouth. If you’re not
sure, ask your midwife, doctor, or breastfeeding counselor to watch you
feed.

After feeds, express a
little of the rich, fatty milk and rub it over your nipple to encourage
healing. Between feeds, keep your bra and T-shirt off for short
periods, to allow the air to get to your nipples. Try a good emollient
cream for sore nipples too.

My baby has started refusing my breast; what could be causing this?

First of all, make sure that you’re relaxed and in a quiet spot.
If you are feeling fraught or anxious, your baby may respond in kind and
become fussy or even reject your breast. Make sure that he’s latched on
properly, too (see My nipples are sore and chapped, and latching on is becoming very painful; what can I do?),
as he can become frustrated if he’s working hard to feed, and isn’t
getting much milk. You may find it helps to express a little milk first.
Sometimes your milk may flow too quickly, causing your baby to choke
and to cry after latching on. If this happens, try using a nipple
shield, which slows down the flow. Also, it may be possible that you’re
eating something that disagrees with your baby.

My baby often goes for hours between feeds, and my breasts become uncomfortable. What should I do?

Some babies do have an amazing capacity to last for hours between
feeds. While it may help to express some milk when your breasts are
uncomfortable, you don’t want to build up your supply to the extent that
you are siphoning off milk and storing it, as well as feeding your
baby, because it won’t solve the problem in the long-term. Try offering
your breast a little more often, even if he doesn’t seem to be
requesting a feed.

Also, some very young
babies have not yet developed the strength to wake up and demand to be
fed. Sometimes a premature or ill baby is too small and sleepy to cry,
instead focusing on conserving energy for growth and recovery. Waking a
baby in this situation to offer the breast is a good idea. If your baby
isn’t putting on much weight and seems tired and listless, see your
doctor or health professional.

My baby still seems hungry after feeds; how do I know that I am producing enough milk?

If your baby is growing and putting on weight normally, has at
least six wet diapers a day, as well as regular bowel movements, is
alert when she is awake, but also sleeps well, she is getting plenty of
milk.

Sometimes babies
have growth spurts that make them hungrier for short periods of time;
these often occur around three weeks, six weeks, three months, and six
months. You will need to feed her more frequently during these periods
to build up your milk supply to meet the new demands. It normally takes
only 24 to 48 hours for this to happen, so don’t panic.

Sometimes babies
vomit after feeding, leaving them very hungry. If your baby spits up
more than a tablespoon or so of milk after feeds, pay a visit to your
doctor to establish the cause.

Around the four or
five month mark, your baby may seem to need more and more milk and may
appear less satisfied after feeds. This may be a sign that she is almost
ready to start some solid foods.

In most cases, however, you simply need to feed your growing baby more often until things settle down.

My baby wakes continually throughout the night for feeds, and I’m becoming exhausted; what can I do?

First of all, make sure that he is getting plenty of milk during
the day, at regular intervals. Babies who develop the habit of snacking
tend to wake more frequently than those who have good feeds every three
hours or so, since their bodies have not become adjusted to increasing
gaps between feeds. If your baby does wake up at night, get him up,
change his diaper, and settle him down for a good, long feed. While it
does mean that you will have to wake up properly, it’s worth
considering—he’ll go for longer the next time and he’ll soon get used to
one good feed. If he wakes again, try to settle him without a feed, and
he’ll soon realize that waking and calling for you isn’t going to get
him another one.

My baby constantly falls asleep while feeding; should I wake her up?

Babies often fall asleep at the breast, because they are
comfortable and deeply relaxed. It’s perfectly acceptable to encourage
this, but only if they are getting a good feed before they drift off. If
your baby is getting only a little milk before she falls asleep, she is
likely to wake soon, demanding more—a process that can go on all day
and night! It’s best to gently nudge her, and switch positions, to
encourage her to keep suckling. Sit her up and talk to her, and when
she’s awake again, put her back on the breast. My mother tells me that
she used to tickle my feet to keep me awake. Also try to avoid “big
feeds” when she is very tired.

I have a real problem with leaking; could I be making too much milk?

Leaking seems to be a problem that occurs mainly in the first
weeks of breastfeeding. Before your supply has been “matched” to your
baby’s needs, you may produce more milk than your baby needs, causing
your breasts to leak and even spurt milk. Try feeding your baby before
your breasts become too full. Even if he takes only a little, it can
help to ease the flow. Over time, your breasts will respond to your
baby’s needs, and become less full. If your baby is ill, or if he has
slept longer than usual, you may experience very full, painful, leaking
breasts. Try expressing a little milk, and put it in the freezer for a
later date. Sometimes breasts leak when your let-down reflex suddenly
and unexpectedly kicks in. You may hear your baby—or even another
baby—cry, which gets things started. Try crossing your arms across your
breasts and hold them firmly for a few minutes, to stop the flow, and
keep a supply of breast pads on hand.

I don’t enjoy breastfeeding at all and want to give it up, but I feel incredibly guilty. Does it matter that much?

Breastfeeding should be a pleasurable experience for both mom and
baby, and if you don’t enjoy it, it can become negative for you both.
Breastfeeding for even a short time gives your baby the best start in
life, and you should feel proud that you have managed to give her that.
Sometimes it simply doesn’t work out, and there are a wide range of good
formulas on the market that will ensure your baby gets exactly what she
needs. Try not to feel guilty—you can make bottle-feeding sessions
warm, nurturing, and positive.

I would like to stop breastfeeding, but my baby refuses a bottle. What do you recommend?

First of all, experiment with some different bottle teats. Some
of the flatter ones are more similar to the nipple, and he may find this
less offensive. Start by offering him expressed milk in a bottle, which
he’ll find familiar and less distressing. Try dropping one feed at a
time, and offering the bottle when you know he’ll be hungry—perhaps
first thing in the morning. It can sometimes help to have someone else
offer the bottle, because if he’s near to you, and can smell your milk,
he may hold out for the real thing. Make sure the bottle-feeding
experience is cozy and nurturing .
It can be difficult, but persevere, and he’ll get there. If he’s
hungry, he’ll eventually give in, and one or two successful bottle feeds
will make things much easier in future.