You’d think after breastfeeding three babies, I’d have become some kind of expert. Yet when my fourth child arrived, it was like I’d met my Waterloo, and it took a month of hard work before we were able to find our feet as a nursing duo. Breastfeeding can sometimes feel like a war zone, but most problems can be overcome with a supportive partner, a little expert advice and a healthy dose of patience. Here’s how to get over the most common breastfeeding hurdles.
Some soreness and redness is to be expected as you work out the kinks—after all, for your nipples, starting to nurse is like running a marathon after years of inactivity. But sudden, shooting pain signals a problem, says Dr. Jack Newman, a Toronto-based pediatrician and breastfeeding authority. Whether your baby is three days or six months old, pain can mean plugged ducts, cracked nipples, thrush or an incorrect latch.
For typical start-up soreness, try manually expressing a little milk to begin letdown, nursing from the least sore breast first, and using ice packs between feedings. But if pain comes on fast and is accompanied by flu-like symptoms, speak to your doctor.
Usually the result of an incorrect latch, plugged ducts and cracked nipples, painful in their own right, can lead to a full-blown breast infection.
See a doctor to determine whether or not you require antibiotics, increase the frequency of feedings to keep your ducts drained (taking extra care to get the latch right) and apply heat. While breast shields can bring new problems, such as a reduced milk supply, they did the trick for Dr. Julie Desmeules, an emergency room physician and mom in Montreal. “Not every solution has to be permanent, and the shields got me past the pain so I could continue to breastfeed.”
Diane Selkirk, a Vancouver mom, says her month-early daughter’s mouth was too small to latch on properly. But size issues can affect any newborn in those early days, when it seems your breast is bigger than the baby’s head.
THE FIX If your baby has a small mouth, that doesn’t mean your breastfeeding dreams are over. Selkirk fed pumped breastmilk through a tube taped to her breast for the first month. “She didn’t have to work so hard and it kept her at the breast,” says Selkirk.
Megan Nodwell spent three weeks coping with long crying jags (hers and her son’s) before they both learned the mechanics of nursing. The Vancouver mom had read plenty of books, but still needed hands-on support.
It takes two people to breastfeed, says Nancy Klebaum, a board-certified lactation consultant in Saskatoon, and it’s rarely as easy as new moms hope. Nodwell says a lactation consultant repositioned her nipple in her baby’s mouth, and taught Nodwell how to watch and listen for swallowing. Visit a breastfeeding clinic, call your public health nurse or ask your doctor for help finding a private lactation consultant.
If your baby’s as attentive as a new lover, then suddenly jilts you, that’s called a nursing strike, says Dr. Newman. Babes who “strike” eat just enough to maintain a slow weight gain and, for most, it can be difficult to pinpoint why.
The good news is strikes are as normal as tantrums in the candy aisle. Your baby won’t starve (see your doctor if you’re concerned about your milk supply). Dr. Newman suggests some guerrilla warfare: take the baby to bed with you and sneak the breast in when he’s relaxed and doesn’t know he’s nursing. As long as he’s wetting diapers, pooping and gaining weight, it’s just a matter of waiting it out, says Dr. Newman.
Most newborns develop jaundice but some babies tolerate it better than others. Babies just turn a little yellowish and there’s no special treatment, says Klebaum. “It becomes a problem when the baby is so sleepy he’s not feeding effectively.”
Contented nursing doesn’t always equal a well-fed baby. “They may just be cuddling, nuzzling or hanging out, which are all important things, but the baby must be actively sucking to extract milk from the breast,” Klebaum says. Listen for sucking and swallowing, watch his jaw for the pause where the swallowing happens, and compare the weight of his used diaper to a dry one to ensure he’s peeing regularly. It’s easier to feel wetness with cloth diapers, but placing a square of toilet paper in a disposable can provide reassurance, too. Support is a huge piece of the puzzle and getting to know a La Leche League leader (groups.llc.ca) or other breastfeeding experts before giving birth means you’ll have someone to turn to when you have questions. Still not sure your baby’s getting enough? Take your baby for regular weigh-ins and stay in touch with your baby’s doctor—she’ll let you know if any further treatment is needed.