You may sometimes doubt your ability to successfully breast-feed. It's common to have questions and struggles sometimes. You may notice that your baby is having problems. Or you may have problems during feeding or problems with your breasts. Remember, most breast-feeding issues are easily resolved when you know what to expect and have support from others, including your doctor, midwife, or lactation consultant.
Problems in babies
- Cold or flu. When your baby has a minor illness, such as a cold or the flu, continue breast-feeding. Breast milk is still the best nourishment.
- Digestive problems. Some foods may affect your breast milk and contribute to intestinal gas or other digestive problems. If you suspect that your baby's crying gets worse after a feeding of breast milk, keep a record of what you eat and how your baby acts, especially when crying episodes occur. Some babies develop a cow's milk sensitivity. If this occurs, stop including milk and dairy products in your diet, and talk to your doctor.
- Spitting up. Almost all babies spit up, especially newborns. Spitting up usually doesn't seem to cause the baby any discomfort. But if your baby spits up more often, cries, acts fussy, or has trouble eating, there may be a problem called gastroesophageal reflux.
If you have other concerns or aren't sure if you should see your baby's doctor, see When to Call a Doctor.
Feeding babies with special conditions
Some babies are born with problems that interfere with their ability to breast-feed right away. But many of these babies can be fed breast milk using special techniques, such as cup-feeding or a feeding device called a supplemental nursing system. Feeding a premature baby or a baby with cleft palate or cleft lip may be challenging. Your doctor or a lactation consultant can guide you on feeding techniques.
Problems during feeding
- Latching on. Sometimes it can be hard for your baby to latch on, but there are some techniques that can make latching on easier .
- Biting the nipple. When your baby's primary teeth start to come in, usually between 6 and 12 months of age, you both have to make a few adjustments. Your baby may have a temporary loss of appetite because his or her mouth is sore. Teething babies may bite the breast, not knowing that it causes pain. Usually, a firm "no" and a stern expression are enough to control this behavior. It may also help to stop breast-feeding when your baby is finished actively nursing and then give him or her cold teething items to chew on.
- Poor let-down . Practice some relaxation techniques, eat properly, and drink plenty of fluids. And try to breast-feed in comfortable, quiet, and familiar spots.
- Arousal during feeding. Some women notice that they become aroused during breast-feeding. Although this sensation is similar to a sexual response, it isn't sexually driven. It's your body's way of preparing for breast-feeding.
Problems in moms
- Being sick. You can keep breast-feeding when you have a minor illness (such as the flu or a cold). Try to rest as much as you can, and drink fluids. Talk to your doctor if you have any questions or concerns about breast-feeding when you are sick or if you need to take prescription or over-the-counter medicines for your symptoms.
- Feeling depressed. Breast-feeding problems can be exaggerated if you have postpartum depression. Many women have some feelings of depression in the first few weeks after childbirth. This is commonly known as the "baby blues," and it usually resolves on its own. But some women's bodies respond to changing postpartum hormone levels with a lasting depression that requires treatment. Talk to your doctor if your baby is more than a few weeks old and you continue to have trouble sleeping (insomnia) or concentrating, or if you often feel sad, tearful, anxious, hopeless, or irritable.
- Breast and nipple changes. Many women notice differences in how their breasts look and feel during breast-feeding. Early changes (such as larger breasts) are related to the body's preparation for milk production. Other changes, such as a darker color and increased size of the areola (the dark circle around the nipple) and more prominent nipples, are sometimes permanent. Some women may have inverted nipples and may need help from a lactation consultant to get started with breast-feeding.
- Sore or cracked nipplesSore or cracked nipples. You can help relieve the pain from sore or cracked nipples by rubbing a few drops of breast milk on the nipple and areola and letting it air dry. It may also help to apply pure lanolin cream on your nipples.
- Engorged breasts. You may have painful breasts and flattened nipples, making it hard for a baby to latch on for feeding. Gently massage your breasts and express or pump some milk to soften your nipple and areola before breast-feeding. This will help your baby latch deeper onto your breast, past your nipple and onto your areola. Wearing a supportive, well-fitting bra also may help. Applying cold compresses to your breasts now and then after breast-feeding may reduce swelling and pain. For more information, see the topic Breast Engorgement.
- Blocked milk ducts Blocked milk ducts. Blocked milk ducts may cause a painful lump in the breast. Untreated blocked milk ducts can lead to an infection, which will require a visit to your doctor. Massage the affected area toward the nipple before breast-feeding and during feeding. This simple measure can help release the milk plug. Also, this is one time you should always feed your baby on the affected side first. Your baby is usually more eager at the start of a feeding. The stronger sucking force helps empty the breast and unblock the duct.
Breast infections. These are treated with prescription medicines and home treatment. Infections that sometimes occur with breast-feeding include:
- A yeast infection, which may affect you and your baby. The baby often has white patches in his or her mouth (thrush) or a diaper rash, while your nipples may be extremely sore. You may also experience stabbing pains in your breast, especially as you start to breast-feed and in between feedings. You and your baby must both be treated with medicine, such as nystatin, for a yeast infection.
- Mastitis, which may cause a fever, flu-like symptoms, and pain in the breast with an inflamed, red, dimpled, or swollen area. An untreated infection may lead to an abscess, which can cause a firm, often painful mass in the breast. You may need to take an antibiotic medicine to treat the infection. For more information, see the topic Mastitis.
Most women can take acetaminophen (such as Tylenol) and ibuprofen (such as Advil) while breast-feeding to help relieve discomfort from some of these problems. But talk to your doctor before taking any medicine (prescription or nonprescription).
- Leaking breast milk. Your let-down reflex may be stimulated unintentionally. Be prepared by using absorbent pads that you change frequently. You can use washable or disposable pads, but don't use pads that have a plastic backing.
- Low milk supply . More frequent breast-feeding usually helps increase the milk supply within 48 hours. You can also try pumping both breasts for 10 to 15 minutes each after you have just fed your baby. You should notice an increase in your milk supply after 2 to 4 days of the extra pumping. Other things can affect milk production, but it's rare to have a true milk deficiency. Contact a lactation consultant if you think your milk supply is too low.
- RelactationRelactation. Relactation means stimulating your body to again produce breast milk and start breast-feeding or taking measures to stimulate your body to produce breast milk when you have not been pregnant recently (such as for an adopted baby).
If you have other concerns or aren't sure if you should see your doctor, see When to Call a Doctor. For problems related to technique or positioning, you also can talk to or visit a lactation consultant.