6 Common breastfeeding problems and how to overcome them

For something so natural, breastfeeding sure can be complicated. These solutions can help you get past the common problems many new nursing parents face.

If you’re trying or planning to breastfeed, you’ve likely heard the message that “breast is best.” Research suggests that infants who are breastfed have a lower risk of health concerns like asthma, obesity, and Type 1 diabetes, compared with formula-fed babies. That is why it’s recommended that you breastfeed exclusively for the first 6 months.

Although almost 84% of new parents start out nursing, by 6 months that number drops down to 56%. And only about a quarter of them are still nursing exclusively by then, according to the Centers for Disease Control and Prevention.

Why the decline? Experts say there are a lot of obstacles. “There’s a misconception among many women that after delivery, their baby will latch on and everything will be just fine,” says Deedee Franke, R.N. Franke is a certified lactation consultant at Mercy Medical Center in Baltimore. “But there can be rough bumps in the road. Throw in things like sore nipples and sleep deprivation and it can make even the most committed mother throw in the towel. But I tell my clients breastfeeding is like learning new dance moves: Most women take 4 to 6 weeks to hit their mojo.”

Here’s a look at some of the most common breastfeeding problems — and expert advice on how to fix them.

1. Vasospasms

Have you felt a deep stabbing or burning pain deep in your breast or nipple? Does the nipple look white and shaped like a lipstick after a feeding? It could be a vasospasm. Almost a quarter of all new nursing parents have this within the first 8 weeks of delivery.

“A vasospasm occurs when the blood supply to the breast and nipple is being restricted as the blood vessels tighten and cause pain,” says Mindy Cockeram. Cockeram is a certified lactation educator in Redlands, California, and author of Breastfeeding Doesn’t Have to Suck: Tips, Tricks & Knowledge for a Great Experience.

Vasospasms can be caused by a bite or shallow latch. But even something as harmless as a cool breeze can kick-start pain. So can anything else that constricts blood vessels. For instance:

  • Caffeine.
  • Smoking.
  • Stress.
  • Medications like over-the-counter (OTC) cold remedies.

The fix: Try to keep warm before and during feeds. And try not to feed your baby during a vasospasm, says Cockeram. Avoid nicotine and caffeine. They can make the problem worse. You can also talk to your doctor about certain supplements that might help. A few to ask about:

  • Omega fatty acids.
  • Lecithin.
  • Vitamin B6.

Many health plans offer postpartum support and recovery programs for their members. To learn how to get the most out of your health benefits, ask your health plan if you’re eligible for Wellframe.

2. Sore Nipples

This is one of the most common breastfeeding problems for new breastfeeding parents. It’s normal to have some nipple sensitivity in the first couple weeks of nursing. But this should get better during feeds and fade after a few days. If it continues, or if it really hurts? It may be due to problems with breastfeeding, particularly the baby’s ability to latch, says Franke.

The fix: The best treatment is to teach your baby how to latch on properly. A lactation consultant can help, says Franke. In the meantime, allow your nipples to heal. Begin nursing with the breast that doesn’t have a sore nipple (or isn’t as sore). Let your nipples air dry after feeding. Then dab on an ointment like lanolin. Finally, cover them with a nonstick pad. You can also talk to your doctor about taking an OTC pain reliever such as acetaminophen or ibuprofen before feeding. Don’t use vitamin E on your nipples. It could be toxic to your baby.

3. Low Milk Supply

The good news is that this happens less often than you might think, says Franke. “A lot of moms don’t realize that newborns eat so frequently. So they just assume they’re not making enough milk,” Franke says. (The average newborn nurses 8 to 12 times in 24 hours. That’s roughly every 2 to 3 hours.) But if you panic and think your baby isn’t getting enough nourishment, you may decide to feed them formula. That will tamp down your milk supply, since your baby will be less hungry when they nurse.

The fix: You can figure out whether your baby is getting enough milk by paying close attention to their diaper. By their fifth day, they should have 6 to 8 wet diapers a day and at least 3 bowel movements a day. And they should be back to their birth weight by 2 weeks. If they aren’t, your pediatrician can refer you to a lactation consultant. They can make sure your baby is latching correctly, says Franke.

If latching isn’t the issue, you can try to feed baby more often to stimulate milk production. Make sure you’re feeding your baby on demand, rather than following a strict schedule. You can also pump between feedings. This stimulates more milk production. As a last resort, your physician may prescribe medications called galactagogues (or lactagogues). But these drugs haven’t been shown to be that effective.

4. Too Much Milk

Yes, you can have too much of a good thing. Some people make too much milk, which makes breastfeeding harder. “It’s like trying to get a baby to drink off of a fire hose,” says Franke. It’s seen more commonly in people nursing their first child.

Some babies whose parents have an oversupply simply plump up quickly. But others struggle to gain weight. For them, feeding may be too difficult. Also, they don’t get the hindmilk. That is the last part of the milk in the breast. It has the most calories.

The fix: Oftentimes, the problem resolves on its own. Your body will adjust to your baby’s demands. Other things to try:

  • Hold your baby upright to nurse. This helps them have better control of the milk flow.
  • Press your breast with the heel of your hand. This helps to slow down the flow.
  • Limit pumping. It can stimulate even more milk production.

5. Breast Infections

If you notice breast pain and redness that comes with a fever, you may have mastitis. This occurs when a milk duct gets clogged and the trapped breast milk gets infected with bacteria from your baby’s mouth. It’s most common within the first 6 weeks of delivery. Nipple pain along with red, shiny, flaky skin may point to a yeast infection, says Franke.

The fix: If you notice mastitis-like symptoms, call your doctor. They will put you on an antibiotic. You should continue to nurse even during treatment. You can help prevent infections from recurring by making sure you empty your breast thoroughly, says Cockeram. (If you’re not sure, you can manually massage your breasts to get rid of excess milk.) You can use cold compresses or ice packs to ease discomfort. And take an OTC pain reliever. If you have a yeast infection, your doctor can prescribe a topical antifungal cream or gel. Just be sure to wipe off any medication before nursing.

6. D-MER

You probably expect to feel only warm and fuzzy feelings as you nurse. But that doesn’t always happen. “Occasionally during letdown, women experience negative feelings such as hopelessness, depression, panic, or agitation,” says Cockeram. (Letdown is when your brain releases the hormone oxytocin. This in turn stimulates the milk ejection reflex at the beginning of a feed.) This condition can last for at least 30 seconds. It’s known as D-MER (dysphoric milk ejection reflex). It’s thought to be connected to rapidly dropping dopamine levels during letdown, Cockeram adds.

The fix: While many doctors and lactation consultants are aware of D-MER, it’s still hard to treat, says Cockeram. Some nursing parents are prescribed a dopamine reuptake inhibitor called bupropion. “Just recognizing the condition seems like the first step in helping women deal with the emotional aspect of the syndrome,” says Cockeram.

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