Breastfeeding Matters Saskatoon


Breastfeeding Your Baby: Mothers' Milk, Babies' Choice

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Troubleshooting: Managing Problems with Breastfeeding

Here are some suggestions for dealing with breastfeeding concerns. A full assessment of mom and baby may be needed.

Contact your Public Health Nurse or Breastfeeding Centre (see Resources) or Sask. Health Line at 1-877-800-0002

Many women stop nursing before they want to because they feel they are having problems. This section provides suggestions for dealing with breastfeeding concerns. A full assessment of you and your baby may be needed. Contact your public health nurse or health care provider for extra help. (See Resources)

Concern
Possible Causes
Possible Solutions
Sleepy baby who doesn’t wake to feed
  • difficult birth, long labor or medication during labor
  • rubber nipples, bottle or soother given to baby
  • jaundice (yellow skin)
  • premature birth
  • unbundle baby, change diaper before feeding, undress the baby, hold skin-to-skin, between your breasts
  • walk your fingers up the baby’s spine to waken,
  • express milk onto your nipple for baby to smell and taste
  • hand express or pump if baby doesn’t nurse within 6 hours after birth, cup feed expressed colostrum
  • if skin-to-skin contact is delayed, then early nipple stimulation (rolling, touching) can trick the breast into making milk.
Baby fussy between feedings
  • baby not latched well
  • caregiver trying to schedule feeds
  • too much milk or not enough milk
  • growth spurt
  • colic
  • sometimes there may be no apparent cause
  • depending on cause, you may need to contact professional support to check latch and milk transfer; see “Not making enough milk?” and “Too much too fast”
  • bundle, walk, rock, sing, carry baby in a sling
  • offer skin to skin comfort, take a tub bath together
  • offer burps often
  • take cows’ milk and milk products out of your diet for a couple weeks (possible cause of colic)
Jaundice—Yellow, Sleepy Baby
  • not enough breastmilk; baby not pooping often enough in the first days
  • difficult delivery that affects baby
  • mom’s and baby’s blood types differ
  • check latch
  • nursing often moves the black poop out; the sooner the baby gets rid of this black “poop”, the less likely she is to get jaundice
Sore or Cracked Nipples
  • poor position and latch
  • too long between feedings
  • latch not deep enough on the breast
  • baby pulling nipple before letting go
  • thrush (yeast infection)
  • misuse of breast pump
  • soaps and creams on nipples
  • tongue too short); have a Public Health Nurse or doctor check
  • nurse on the less sore side first until milk is flowing
  • use pillows to support you both
  • hold your baby in different positions to nurse
  • express some milk onto nipple before nursing to soften skin and protect nipple (helps milk flow)
  • wait until baby’s mouth is open wide enough to take in the underside of the coloured skin around your nipple
  • rub breastmilk into nipple after feeding helps to heal
  • nurse more often so baby’s suck is not as strong
  • salt water compresses to heal nipples (1/2 tsp salt to 1 cup water)
Engorgement (Full and Painful Breasts)
  • sleepy baby
  • poor latch
  • long stretch between nursing
  • milk supply building
  • apply warm, moist towels for a few minutes and use pressure massage to move milk
  • express to soften areola (dark area around the nipple) so baby can latch
  • latch the baby, check latch and milk transfer
  • apply a bag of frozen peas or ice packs on the breast after feeds
  • feed frequently
Not Making Enough Milk?
  • baby missing feeds (sleeping or mom busy)
  • poor position and latch
  • weak suck (may nurse a lot but not seem content)
  • supplements are being used
  • drugs: cigarettes, birth control, allergy pills, alcohol
  • stress and feeling tired affects milk flow
  • correct position and latch
  • offer both breasts at each feed
  • nurse at least 10-12 times/24 hours - avoid bottles and soothers
  • ask about effects of drugs
  • get help around the house and with older children
  • sleep when your baby sleeps
  • eat well (see 7 Days to 6 Weeks)
  • you may need privacy to relax while nursing
  • contact Public Health if you feel concerned.

Too Much Milk Too Fast:

What baby does: Spits up. Lots of wet and poopy diapers, some greenish. Wants to nurse but then fusses. Coughs and sputters as milk starts to flow. Gains weight quickly or poorly.

milk flows too fast for the baby
  • express some milk until the flow slows down
  • nurse as soon as your baby shows interest (wakens, puts hand to mouth)
  • try different positions: lying down or with baby clutched around your side, in a baby carrier or sling
  • nurse with her head higher than her body so she can swallow more easily
  • stay on one breast at each nursing. You may need to express some milk from the other side until you feel comfortable. Some babies do better nursing as often as they want on the same breast over a period of several hours
Mother Feeling Tired or Sad:
  • doing too much too soon
  • feeling isolated and tied down
  • too much household and childcare work
  • not enough time for self-care, rest, eating or being outdoors
  • too many visitors
  • sleepiness is a normal response to the hormones of breastfeeding; rest when infant sleeps
  • use the time the baby sleeps for yourself
  • ask and expect to get help with household, shopping, and other children
  • find a mothers support group
  • you may want to contact a postpartum support group. See Resources.

Blocked or Plugged Milk Ducts:

What you would notice:
sore lump in your breast

  • poor or incorrect positioning and latch
  • too long between nursing (missed feeding)
  • tight bra
  • carrying bags, infant carriers
  • mom overtired or stressed
  • heat on breast (hot wet cloth, shower, hot water bottle)
  • check positioning - avoid positions that press your breast while you are holding your baby or sleeping
  • firm hand pressure on the lump during the feed
  • nurse the sore breast first
  • nurse with baby’s chin towards lump
  • nurse often (10-12 times in 24 hours)
  • rest, eat and drink well

Prevention:

  • if you wear a regular bra, flip it under your breast to nurse, not over the breast, or get a nursing bra
  • avoid tight fitting bras
  • rest

Breast Infections (Mastitis):

What you would notice:

  • fever, chills, and headache
  • feels like the flu
  • part of the breast is red, hot, tender, lumpy
  • plugged duct
  • cracked nipples
  • mother over-tired, e.g., special events such as wedding, household move, Christmas
  • follow remedies for blocked ducts
  • take medicine for fever
  • contact your doctor for assessment and for antibiotics
  • you can continue to nurse through an infection
  • if your nipples are too painful, you can hand express or pump and feed milk to baby. If baby spits up blood from cracked nipple, it will not harm baby. Blood may also be passed in the baby’s stool (poop).

Nipple Yeast and Thrush:

What you would notice:

  • sore nipples that don’t heal
  • nipples suddenly become sore
  • reddened nipple area, tiny cracks (like paper cuts) around the nipple
  • shooting and burning pain through the breast during and after nursing

Signs In Baby:

  • there may be no signs in baby
  • white patches in baby’s mouth that don’t come off
  • diaper rash
  • baby may fuss at the breast (pull off)
  • baby more gassy
  • antibiotic treatment for mom or baby
  • mom had vaginal yeast infection in pregnancy
  • mom has had contact with sexual partner who has yeast
  • see your doctor. Both you and baby (and possibly your partner) will need to be treated
  • symptoms may get worse for a short time
  • salt water compresses on nipple after feed (see “Sore nipples
  • wash your hands after changing baby’s diaper — consider using paper towels
  • yeast can live on cloth. Wash baby’s and your laundry in hot water. Boil breast pump parts daily
  • discard soother and toys that have been in baby’s mouth
  • eat yogurt daily. Buy yogurt that states “active culture” on the label

 


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