We all know breast is best and when breastfeeding goes smoothly there is no easier, more convenient or healthy way to nourish your baby. However, it's not always problem-free, so here we take a look at the difficulties some mothers may have to overcome...
The most common reason for sore nipples is incorrect positioning which means that your baby isn't latched on properly so she is sucking on the nipples rather than the surrounding areola.
Soreness can also occur if your baby is taken off the breast without the suction being broken first. Sometimes nipple pain is caused by thrush however, this is more common if your baby has had antibiotics.
Other causes include:
Make sure your baby is well attached; line up the nipple with your baby's nose or top lip so she can reach the nipple easily. She should automatically tilt her head towards the breast and open her mouth wide. Make sure she takes in big mouthful of breast including the area around the nipple.
To detach her from the breast, gently put your clean little finger in the side of her mouth to break the suction.
If you are having trouble you can get help and support from your doctor, nurse orbreastfeeding counsellor or contact dedicated breastfeeding organisations for support such as la leche league of india, cappa india or breastfeeding promotion network of india.
Nipples bleeding through a small crack or sore in the skin can result from untreated sore nipples.
Common causes include poor positioning, a reaction to soaps that dry the skin, reattaching your bra while the nipples are still wet or using a damp breast pad.
Although they are referred to as blocked ducts, these are more usually a lump in the breast which develops when the tissue around it becomes swollen and presses on the milk duct.
The swelling is caused by a build-up of milk in the breast, often through missing a feed or if the breast isn't being emptied fully.
The milk gets forced out of the duct and into the tissue which causes the swelling and makes the breast feel hot and painful.
Mastitis is a condition that causes the breast tissue to become painful and inflamed. It usually only affects one breast and can also include flu-like symptoms such as a fever, chills and aches.
There are two types of mastitis: infectious (usually caused by bacteria) and non-infectious (usually caused by a blocked milk duct or problems with breastfeeding).
An abscess can occur if an infection like mastitis goes untreated. A breast abscess feels like a painful, swollen lump in the breast and can also be red, feel hot and can cause a fever.
Seek medical help help straight away if you experience the symptoms
An abscess can be treated with antibiotics
If more serious, it can be drained with a needle and syringe or by making an incision to let the pus escape.
If you suddenly get sore, cracked nipples after you've been feeding without problems for a while, you may have an infection known as thrush.
Your baby has thrush if you can see patches of yellow or cream-coloured, like cottage cheese in her mouth which doesn't go away between feeds.
It is very easy to give thrush to each other so if your baby has it in their mouth it can easily spread to your nipples and vica versa. Thrush can give rise to sore itchy nipples and will require treatment with cream and sometimes oral anti-fungal tablets. Seek advice from your doctor.
If your doctor decides that your baby needs treatment, they will probably prescribe an anti-fungal medicine which can be given as a gel to apply, or an oral suspension which kills the fungus in your baby's mouth.
Oral thrush may not bother your baby but if her mouth is sore she may be reluctant to feed. Babies rarely have oral thrush in their first week of life. It is most common in babies around four weeks old. Older babies can get it too, but this is less common.
Make an appointment with your doctor straight away and, if it is a yeast infection, both you and your baby will need treatment.
Sore, itchy nipples will require treatment with cream and sometimes oral anti-fungal tablets.
If your baby needs treatment, an anti-fungal medicine will be prescribed which can be given as a gel to apply, or an oral suspension.
Some babies are born with a tongue-tie which is when there is a tight piece of skin between the underside of their tongue and the floor of their mouth.
This can affect feeding by making it hard for your baby to attach effectively to the breast. It can also cause nipple soreness as your baby is unable to latch on properly.
The good news is that doctors can easily fix the condition with a minor surgical procedure and your baby can then feed properly. If you think your baby might be tongue-tied, contact your doctor or a lactation consultant immediately.
It is fine to breastfeed after a caesarean and getting into a comfortable position while you are doing it is the key to successful feeding.
Tuck your baby’s body under your arm and support her head with your hand, using a couple of cushions for support to avoid her pressing down on your tummy.
If sitting up is too painful or difficult, feed her by lying on your side with your baby facing you
A doctor or nurse will be on hand to help you get into the right position. Any drugs you are having for pain relief will only pass to your baby in tiny proportions and the most important thing is you are without pain and able to feed your baby as soon as possible.
Poor positioning so that the baby is not latched on properly or infrequent feeding is more often to blame for an inability to produce enough milk. The signs your baby is not getting enough milk are:
Generally, the more you feed your baby, the more milk your body produces so if you feel you are not making enough, aim for 8 to 12 feeds in a day and possibly use a breast pump between feeds for further stimulation if this is advised. It's also important to drink plenty of water when breastfeeding.
With these measures it is very likely that your milk supply will improve. Always consult your doctor or a lactation consultant if you are concerned about your milk supply.
If your breast fed baby is given a dummy or bottle of expressed milk before six weeks of age there is a chance that he may become confused. The methods require completely different tongue and mouth movements and swallowing skills.
During breastfeeding your baby uses his jaw and lips to pump the milk from the breast and he can regulate the amount
Artificial teats are firm and do not fill the baby’s mouth. Babies often find that drinking from them is easier and that the milk flows more rapidly.
Nipple confusion can be avoided by avoiding the use of bottles and dummies until breastfeeding has been established.