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Breastfeeding Questions and Concerns Every New Mom Should Know
Before the baby is born, check the breasts for flat or twisted nipples. Place your thumb and index finger around the areola in a “C” shape, about one inch from the base of the nipple, and gently press your thumb and index finger together. Your nipple should stick out. If your nipple pulls back into your breast or remains flat, seek advice from your doctor, a certified lactation consultant, or a La Leche League leader.
Wearing plastic breast cups during the last months of pregnancy can help your nipples stick out. However, some experts suggest that a baby who is properly attached to the breast will nurse effectively regardless of the size or shape of the mother’s nipples. Either way, it will be helpful to understand proper positioning and talk to a lactation consultant or health professional about this issue before your baby is born.
Uncomfortable breast fullness, which can cause your breasts to feel hard, hot and painful, can occur because the baby is not getting enough milk. To eliminate this bloating, breastfeed your baby more often or use a breast pump. Expressing until you’re comfortable or just for a few minutes, long enough for your breasts to feel comfortable, will not produce too much milk. Applying cold compresses between feedings and/or warm compresses and circular massage before and during feedings can also be helpful.
Sore nipples are a common complaint at first. This may be a new experience for you and may mean that your baby is not properly latched onto the breast. If the pain disappears in a minute and you feel comfortable until the end of breastfeeding, there is nothing to worry about. If not, call a lactation consultant or La Leche League leader for suggestions.
Causes of sore nipples include:
- The baby latches too close to the nipple, not taking enough areolar tissue.
- The baby’s lower lip is pulled in instead of pulled out.
- The baby pulls the nipple into his mouth instead of opening wide to accept the breast.
- The baby’s gums rub against the nipple when it is separated from the breast.
- The baby puts stress on the tissues and causes pain trying to pull out twisted or flat nipples during the first days/weeks of breastfeeding.
- Moisture stays on the curled nipple for a long time.
Too much milk in the breast can cause the ducts to become blocked. This can happen for a variety of reasons and can result in a sore spot on the breast that is red and slightly warm to the touch.
Treatment measures for a blocked duct include:
- Wearing loose clothing and bras that don’t bind.
- Rest a lot.
- Breastfeed as often as the baby will cooperate and/or pump between feeds.
- Breastfeeding the baby 8-12 times every 24 hours.
- Application of moist or dry heat to the painful area before milking.
- Starting each feeding on the breast with a sore spot.
- Position the baby so that his chin is level with the sore point.
- Massaging the painful area during breastfeeding.
If you develop other symptoms, such as fever, chills, pain, or breast pain that is generalized instead of in one place, you may have a breast infection, also known as mastitis. Contact a certified lactation consultant, La Leche League leader, or health care provider for advice. Some breast infections will go away with the same treatment you would apply to a blocked duct.
If your symptoms persist or if you have a high fever, you may need an antibiotic prescribed by your doctor. Most antibiotics are safe to take while breastfeeding, but discuss this issue with your doctor to be sure.
Is the baby getting enough milk?
Weight gain is the most accurate way to determine if your baby is getting enough milk, so weigh your baby. Normal weight gain is about four to eight ounces per week. As your baby gets a little older, weight gain will become more apparent. If you are concerned about your baby, talk to your doctor or lactation consultant.
Also, monitor your baby’s diaper changes because what goes in must come out. At first, your baby will only have one or two wet diapers a day. Once your milk supply has increased, baby should have five to seven wet diapers (six to eight if using cloth diapers) and three to five bowel movements a day. Some babies may have a small bowel movement with each diaper change.
The first bowel movement will be dark black, with a tarry consistency. Both the color and consistency will change within a day or two of increasing the amount of milk. The color of mother’s milk stool is most often mustard-yellow, but it can vary from yellow to yellow-green. The consistency is loose and will remain so as long as your baby receives only human milk. Additionally, while you’re breastfeeding, your baby should be swallowing after every few sucklings, so listen for swallowing. Other indicators include your breasts becoming softer after feeding, making baby’s skin smooth and firm, and baby looking content after feeding.
However, if your baby shows any of the following signs, contact your doctor immediately:
- A weak cry
- Skin without elasticity (when compressed, remains compressed)
- Dry mouth and dry eyes
- Less than the usual amount of tears
- Minimal urine output (less than two wet diapers in 24 hours)
- The fontanel (soft spot) on the baby’s head is indented or indented
If you have previously had breast surgery, be sure to tell your doctor. Many mothers have been able to fully breastfeed their babies after breast surgery. However, it is important that your doctor is aware of your history and past breast surgery(s) so they can monitor you and your baby closely to make sure your milk production is good and your baby is gaining weight.
Increase the amount of milk
The amount of milk you produce depends on how much and how often milk is removed from your breasts. As your baby’s demand increases, your body will increase its supply, but the following suggestions may help if you’re worried about your milk supply:
- Feed your baby on both breasts at each feeding.
- Feed your baby twice on each breast at each feed.
- Use the lying position occasionally to rest while the baby is nursing.
- Nurse at the baby’s earliest signs.
- Drink plenty of fluids (based on your individual needs).
- Use a breast pump between feedings.
- See a certified lactation consultant for a complete breastfeeding evaluation.
The baby constantly wakes up at night
There are many reasons why a baby wakes up at night. You may have a newborn who sleeps poorly and wakes up easily. In addition, human milk is digested twice as fast as formula, so breastfed babies get hungry more often than bottle-fed babies.
The baby is always sleepy
Some medications used during labor can cause the baby to become extremely sleepy. If the baby is constantly sleeping in the first week, it is important to wake him up to nurse so that your milk supply is restored and the baby grows and gains weight normally. Try to breastfeed often at night when it’s quieter. Ask another mother or a lactation consultant for advice on waking a sleeping baby.
Breastfeeding and medicines for the mother
Most antibiotics and pain relievers are compatible with breastfeeding. However, you should always discuss all medications with your doctor or pharmacist.
The possible risks of drugs, whether they are prescribed or bought over the counter, should be weighed against the risks of weaning from breastfeeding and giving artificial milk.
When to ask for breastfeeding help
Seek help when:
- Your newborn has fewer than five to seven really wet diapers or three to five bowel movements each day, even after the milk supply increases in the first week.
- The baby’s urine is dark in color or has a strong smell.
- Nipple or breast pain worsens and persists between feedings.
- Breastfeeding becomes painful. (A little soreness at first is normal, but should go away as the baby learns to nurse.)
The baby looks gassy You may have heard that babies react to foods in their mothers’ diets, but this is quite rare. Infant formula is far more likely to cause some sort of problem than a reaction to the mother’s diet.
Infant massage often helps soothe a baby who seems gassy, so you might want to read books on infant massage to find a technique that your baby likes. You can also try the anti-colic position to see if it helps the baby feel more comfortable. Place the baby face down over your forearm with his head in the crook of your elbow, your hand supporting his midsection and his legs hanging down.
Dietary supplements and artificial nipples
Additions to water or artificial milk (formula) in the first weeks of breastfeeding can contribute to poor milk supply, prolonged bloating, jaundice or an allergy or intolerance to cow’s milk – problems for both you and your baby.
Avoid artificial nipples and pacifiers as they can confuse your baby while learning to breastfeed. A baby uses its mouth and tongue differently when taking a bottle or pacifier compared to a human breast. Among other things, artificial nipples are firmer than your breast, and the child holds them in the front of the mouth. If the baby is doing the same thing while nursing, he may not be using enough suction and not getting as much milk.
Your nipples may become sore during the process. Some very sensitive babies even refuse to breastfeed after using artificial nipples.
Since there’s no way to tell in advance if your baby will be able to switch back and forth easily, it’s best to avoid artificial nipples until your baby has been sucking well for at least three or four weeks and the likelihood of confusion has decreased. If you need to feed your baby in a way other than the breast, use an alternative to bottles, such as a spoon, dropper or small feeding cup. Consult a lactation consultant about these options.
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