Pain and Discomfort
Some pain and discomfort during breastfeeding, especially in the beginning, is normal. A common cause of pain that can be easily fixed is poor latch. Meet with a lactation counselor to make sure you are positioning your baby well and getting a good latch. If you have a good latch and your discomfort is not persistent, it should get better in a week or so.
If you begin experiencing actual pain and damage to your nipples, you need help from a lactation counselor. Your baby may not be latching correctly, or may have a more serious physiological issue that needs to be identified and addressed. The first step is to resolve the cause of cracked nipples.
Once you have addressed the cause of your cracked nipples, care for them is fairly basic. Let your nipples air dry as often as possible, and help them heal by rubbing some of your breast milk on them. Breast milk has amazing healing properties and none of the oiliness of lanolin. It may be tempting to give your nipples a "break" by lessening nursing while they heal, but in actuality, this may only cause more problems (except in the most extreme of cases). Know that once the problem that caused the damage is addressed, you will begin to heal quickly.
Engorgement is one of the most common problems new mothers experience. Especially in the beginning stages of breastfeeding, your breasts may become full and tender. This fullness alone does not qualify as engorgement, but can rapidly become so if your breasts stay full too long or too often. The most effective way to avoid engorgement is to breastfeed your new baby every two hours or more on demand, and make sure your baby is effectively draining your breasts (breasts should be softened at each feeding).
If you do become engorged, there are many effective methods to deal with it, which all serve the same purpose: to drain the breast effectively and frequently.
Treatments for engorgement:
v Before breastfeeding your baby, apply a warm compress or take a warm shower and let the water run on your breasts. The heat is not only relaxing but it will help stimulate your milk flow. Prolonged heat can encourage swelling, so use compresses only for a few minutes before feeding.
v While nursing, gently massage your breast from the chest wall down toward the nipple in a circular motion. This may help stimulate your let-down reflex, as well as help break up any possible clogs in your milk ducts. This is also a very good technique to combine with the warm shower described above.
v Make sure your baby is achieving an effective latch. Sometimes engorgement can cause the nipple to stretch so tightly that your baby may not be able to latch properly. If you experience this problem, hand express until your nipple is no longer stretched and is soft and pliable enough for your baby to get a good latch.
v Pump/hand express to comfort. Although we recommend mastering hand expression, if your baby has not nursed enough to relieve your discomfort, using a pump or hand expressing to drain your breast to the point where you are comfortable is completely acceptable. Please keep in mind though that frequently draining your breasts with a pump after your baby has fed is only going to create more milk, so use this tool sparingly and only as needed.
Thrush, or Candida Albicans, is a fungus that thrives in cool, dark environments, such as on your nipples, in the mouth, or in your baby's diaper. Symptoms of thrush are often sudden, persistent shooting pain in the nipple that lasts through a feeding and cannot be improved by adjusting your latch or positioning, shooting pain in the breast during or after feedings, or traces of white fungus in the folds of the nipple or breast. Symptoms in your baby can be white patches in the mouth that cannot be wiped off, diaper rash, a clicking sound while nursing, or baby repeatedly pulling off the breast during feedings or refusing to nurse because of mouth soreness. In some situations, a mother may be predisposed to thrush by having taken antibiotics for mastitis or having persistent cracked nipples.
If thrush is diagnosed on either mother or baby, both of them must be treated simultaneously. Thrush is very aggressive and will happily pass back and forth between you and your baby if not treated properly. One of the most popular treatment options is Gentian Violet, which is effective, but comes with its drawbacks: if used in high dosages for an extended amount of time it is carcinogenic, and it will stain everything it comes in contact with. Contact a lactation counselor for help on proper usage of Gentian Violet. There are also a large number of over-the-counter and prescription creams and ointments that can be used to combat the infection.
In order to effectively combat thrush, a mother must be vigilant in washing her hands frequently and boiling anything that may have come in contact with the baby's mouth once a day for twenty minutes until the infection has gone. Other tactics mothers can take for managing the infection can include taking grapefruit seed extract, reducing consumption of sugar and dairy products, drinking more water, and adding supplements to your diet such as garlic, zinc, and B vitamins.
Mastitis is a general term for inflammation of the breast. In its most common form, it is characterized by redness on the breasts (in serious conditions it will show as angry, shiny red streaks), painful swelling in the breasts (not necessarily a uniform swelling), and fever and/or flu-like symptoms. Many of the same treatments mentioned in the "engorgement" section can be utilized for treating mastitis as well. Because of the generalization of mastitis, it is best to contact your lactation specialist for assistance in treatment immediately. If left alone, mastitis will only get worse, so if you experience any of these symptoms, contact someone for advice. When mastitis has gotten too far out of hand, antibiotics need to be used to treat, which can open you up to the possibility of thrush, so it cannot be stressed enough that getting help and advice early can be the deciding factor in resolving mastitis effectively.
There are many solutions to any of the problems you may experience while breastfeeding. The best way to assess and treat any and all of them is to get in contact with a knowledgeable professional as quickly as possible. Always know that this too shall pass, and that even through the worst scenarios, you are doing the best for your baby, and yourself, by breastfeeding.