Health & Baby

Common Breastfeeding Problems

Engorged Breasts continued...

"Once milk starts to come into the ducts, there is also a flooding of lymph fluid and blood, which causes the tissue in the breast to swell," says Sterner.

Because that swollen tissue pushes down on the milk ducts, the ducts can sometimes clamp shut. When milk can't be expressed, it builds up inside the breast and engorgement occurs.

Sterner says your best solution is to place cold packs on the breast, along with clean washed cabbage leaves. Leave these on your skin for about 20 minutes. Both can help reduce the swelling and allow the ducts to open.

"Right before you are ready to nurse, put a warm pack on your nipples for a few minutes -- this will also help with the 'let down' [milk flow] and can encourage feeding," says Sterner.

Showers are not recommended when you have engorged breasts, warns Sterner. The warm, pounding water can dilate blood vessels, increasing the swelling and congestion in your breast.

"Most important is to keep on nursing," Huotari tells WebMD. "The more milk that is expressed, the less chance you have of engorgement."

Resources for Nursing Mothers

Nursing mothers are often surprised to discover how little their obstetrician or pediatrician knows about breastfeeding problems. Lactation consultant Katy Lebbing, IBCLC, says that as recently as the mid-1990s, a full 50% of medical schools were graduating doctors without a single day's training on breastfeeding.

In one study published in the American Journal of Preventative Medicine, the obstetrical staff of a California hospital answered just 53% of the questions correctly on a simple 15-minute quiz about breastfeeding. Only 14% of the doctors said they felt confidant about their knowledge on this subject.

If you have questions concerning any aspect of breastfeeding, including medical issues about your breast health, you'll often get the right answers fastest by contacting a lactation counselor.

Usually, the hospital where you delivered your baby will have at least one lactation counselor on staff. This counselor may have even visited you shortly after you gave birth to help you begin breastfeeding.

Most lactation counselors are also available for at-home consultations after you leave the hospital. If this isn't the case, they can suggest private practice lactation experts to help you.

Although many people experienced with childbirth, such as doulas and midwives, may be able to help you with breastfeeding, try to find lactation consultants with the initials IBCLC after their names. This stands for International Board of Certified Lactation Consultants.

An alternate credential is RLC -- for registered lactation counselor. Both credentials mean the counselor has received special training and has certified expertise in breastfeeding.

The following organizations can help you find a lactation counselor in your area:

• Le Leche League International. The oldest name in the breastfeeding arena, this worldwide organization has counselors and group leaders nationally and internationally. To access its huge database of experts, visit the web site: www.laleche.org. Or call (800) LALECHE.You can also try your local telephone directory under La Leche League, where you might find a local chapter.
  
  
• International Lactation Consultant Association. This group helps train lactation consultants worldwide and provides many of the guidelines and training materials used to teach breastfeeding counselors. Visit its web site, www.ILCA.org, to access a national database of experts. You can also email info@ilca.org or call (919) 861-5577.