Difficulties in Breastfeeding

Preparing the mother for breastfeeding

The pregnant mother should be encouraged for breastfeeding. Any breast related issues like inverted nipple has to addressed in the last trimester of pregnancy. Antenatal counselling individually or in groups organised by maternity facility should deliver messages of breastfeeding and harm of formula feeding/Top feeding. The main aim is to prime the would-be mother for successful breastfeeding.Some of the difficulties in breastfeeding are

1. Inverted nipple

   In this the nipple doesn’t protract. Expecting mother with inverted nipple may be helped with the syringe method.

   1. Cut the nozzle end of a disposable syringe (10-20 ml)
   2. Insert the piston through the cut end side.
   3. The mother should apply the smooth end of the syringe over the nipple and gently pull at the piston and let her wait for a minute.
   4. Nipple would then protrude into the syringe. The mother should slowly release the suction. At this time it helps the nipple to erect out.
   5. The nipple may retract back but doing it each times over a period of few days will solve the problem.
2. Sore Nipple/Cracked Nipple

   Frequent washing of the nipple with soap and water should be avoided. Bathing once a day is enough for a breastfeeding mother. Improper attachment of the baby to the breast causes a sore nipple and the most common cause of sore nipple is bottle feeding a baby. A baby sucks the nipple of the bottle while a breast has to be grasp. Due to “nipple confusion” a bottle fed baby sucks vigorously and the bite at the nipple making it sore. Candida infection may also be one of the reasons of sore nipple.

   Treatment- no bottle feeding, no frequent washing of breast with soap water, proper positioning and attachment while breast feeding. Hind milk or emollient cream can be applied to the nipple after a feed. The nipple should be allowed to aired and heal in between feeds.

3. Engorgement of breast

   After 2nd and 3rd day of delivery, breast milk production increases. If a mother delay feed or feeds infrequently, the milk accumulates and exceeds the capacity of the alveoli to store it. Hence breast is swollen, hard, warm and painful which is called an engorged breast.

   Treatment- Early and frequent initiation of breastfeeding, manual expression of the milk. Application of local warm water packs. If not relieved analgesics is prescribed to the mother.

4. Breast abscess

   Delay in treatment of an engorged breast or a cracked nipple will result in infected breast segment which may result in breast abscess. The breast becomes swollen, red and tender. The mother may have fever.

   Treatment- Manual expression of milk, pain killer and antibiotics. Sometimes it has to be incised and drain. Breastfeeding must be continued.