Breastfeeding

Common breastfeeding issues

Many women experience some difficulties when establishing breastfeeding.

Most are minor and can be overcome by advice, assistance and support.

Your midwife or a lactation consultant will be happy to help.

For advice contact:

• 13 HEALTH (13 43 25 84)
• Australian Breastfeeding Association Breastfeeding Helpline: 1800 mum 2 mum (1800 686 268)

Engorgement

About three days after having a baby, many mothers will experience breast fullness as their milk 'comes in'. Occasionally a mother may need to express a small amount of milk to soften the breast before a feed. This fullness usually only lasts for 24 hours and is different to engorgement.

Signs of engorgement

• breasts full and painful, with swelling down to areola of breast
• baby may be unable to attach to breast because of fullness.
• limiting the time baby feeds at the breast
• using dummies to extend time between breastfeeds
• baby not being properly attached to the breast.
• massage and warm packs to breast prior to the feed
• express a small amount of milk before feeds to make breasts softer for baby to attach
• feed your baby frequently
• apply cold packs on breast between feeds
• avoid wearing a tight bra
• if symptoms continue, or worsen, seek assistance.

What causes engorgement?

• limiting the time baby feeds at the breast
• using dummies to extend time between breastfeeds
• baby not being properly attached to the breast.

How to treat engorgement

• massage and warm packs to breast prior to the feed
• express a small amount of milk before feeds to make breasts softer for baby to attach
• feed your baby frequently
• apply cold packs on breast between feeds
• avoid wearing a tight bra
• if symptoms continue, or worsen, seek assistance.

Concerns with milk supply

Building your milk supply

When it comes to breastfeeding, remember that supply equals demand. The more you feed your baby, the more milk your breasts will make.

Ways to increase or maintain a good milk supply include:

• respond to your baby’s feeding cues both day and night
• avoid giving any extra feeds from bottles – this reduces your baby’s need to suck at your breast and reduces your milk supply
• avoid the use of dummies until breastfeeding is established (four to six weeks)
• express milk in between feeds to increase your supply.

Sore, damaged nipples

Nipples can be sensitive in the beginning, but breastfeeding should not be painful through a whole feed or continue to be painful.

Helpful hints to avoid sore nipples:

• make sure your baby is well attached to the breast, not just to the nipple
• apply small amounts of expressed breast milk on the nipple after feeding and allow to dry
• replace damp breast pads frequently
• try different feeding positions
• if breastfeeding continues to hurt, or there is nipple damage, seek help.

Cracked/bleeding nipples:

• make sure baby is attached well
• apply small amounts of expressed breast milk on the nipple after feeding
• if there is a need to rest breasts, you should express breastmilk to keep up supply.

If your nipples are cracked or bleeding it is recommended that you seek help from a health care provider.

Mastitis

Mastitis is an inflammation and/or infection of the breast tissue.

Mastitis can be caused by:

• a blocked milk duct or nipple damage
• milk oversupply that is ongoing
• baby not being attached well to the breast
• mother’s stress, fatigue or poor nutrition.

Signs of mastitis

• an area on the breast that is red and swollen
• breast feels hot
• skin on breast may look tight, shiny and red
• mother feels very unwell with flu type symptoms and a temperature greater than 38.5^oC – if so, seek medical help immediately.

Management of mastitis

• seek treatment from a doctor immediately – antibiotics should be started
• continue to breastfeed or express to avoid complications
• keep feeding on the side that is not infected and also offer the infected breast (the milk from the affected breast is safe for baby)
• get plenty of rest and drink plenty of fluids.

More information:

• Australian Breastfeeding Association – Common concerns - mum
• Queensland Health – Queensland Milk Bank

In this guide:

1. Breastfeeding 101
2. In pregnancy – planning for breastfeeding
3. Breastfeeding – the first few days
4. Signs of hunger
5. Breastfeeding – the early weeks
6. Positioning and attachment
7. Signs of an effective attachment
8. Breastfeeding positions
9. Common breastfeeding questions and concerns
10. Common breastfeeding issues
11. Breastfeeding in the first year
12. Important points about breastfeeding

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