Breastfeeding problems
Common breastfeeding problems can usually be resolved by getting the right information and assistance. If a mother requires assistance with problems not discussed here, seek further help
Low Supply/not enough milk | Sore and Damaged Nipples | Engorgement (full) breasts | Mastitis
Low supply/not enough milk
Many mothers think that they don’t have enough milk, and will stop breastfeeding. There are a number of reasons mothers may believe they have insufficient milk:
- the baby is unsettled
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the baby is constantly feeding
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the baby is not sleeping through the night
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the breast milk looks watery
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between 6-12 weeks after birth, breasts become softer, smaller and stop leaking
These can all be normal. Mothers can check their babies for signs they are getting enough milk.
Signs of good milk supply
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baby has at least 6-8 breastfeeds in 24 hours (sometimes this can be up to 12 feeds)
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baby has a settled period between feeds
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baby has 6 to 8 wet nappies every 24 hours
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weight gain in baby.
Signs of low milk supply
What causes low milk supply
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baby not attaching well to the breast
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baby not feeding often enough at the breast
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sometimes can be related to health conditions in mother
Management of low milk supply
Health care providers can provide assistance and advice. Mothers should:
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ensure baby is well attached to the breast and feeding at least 8 times per day
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encourage baby to feed well on the first breast before offering the second breast
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express milk after feeds
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rest when able to
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avoid herbal preparations to increase milk supply as their effectiveness and safety have not been established.
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Sore or damaged nipples
Breastfeeding can be a little sensitive at the beginning; this is partly to do with hormones. Breastfeeding should not be painful through a whole feed, or continue to be painful.
How to reduce the chance of pain when breastfeeding:
Cracked/Bleeding Nipples
Cracked or bleeding nipples are often a sign that the baby is not attaching well to the breast.
Some helpful hints are:
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Engorgement (full) breasts
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.
What causes engorgement?
How to treat engorgement
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across the counter pain medications
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express a small amount of milk before feeds to make breast softer
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cold packs on breast between feeds
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avoid wearing a tight bra
If symptoms continue, or worsen, seek assistance
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Mastitis
Mastitis is an inflammation and/or infection of the breast tissue. Mastitis can be caused by:
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a blocked milk duct
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ongoing nipple damage
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Signs of mastitis
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an area on the breast that is red and swollen
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breast feels hot
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skin on breast may look tight, shiny and red
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mother feels very unwell with flu type symptoms
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temperature greater than 38.5 ˚c
Management of mastitis
- Seek treatment from a doctor immediately.
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Breastfeeding (or expressing) needs to continue to avoid complications.
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Keep feeding on the side that is not infected, and offering the infected breast.
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If a mother cannot attach baby to the infected breast she should begin expressing that breast.
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If the milk is not removed from the infected breast a breast abscess may form - this will require hospitalisation and possibly surgical drainage.
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The milk from the affected breast is safe for baby.
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Antibiotics should be started.
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The breastmilk is safe for baby when the mother takes antibiotics.
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Mother should get plenty of rest and drink plenty of fluids.
If a mother decides she no longer wants to breastfeed, to reduce the risk of complications from the mastitis, it is recommended that she continue to express until the mastitis is gone, and then wean gradually.
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