Plugged milk ducts; Nipple soreness when breastfeeding; Breastfeeding - overcoming problems; Let-down reflex
Health experts agree that breastfeeding is the healthiest option for both mom and baby. They recommend that babies feed only on breast milk for the first 6 months, and then continue to have breast milk as a main part of their diet until they are at least 1 to 2 years old.
It is true that breastfeeding is not always easy for moms and babies. It can take a little time for you both to get the hang of it. It is important to know this up front, so that you can make sure you have all the support and commitment you need if a problem does come up.
Breastfeeding (nursing) your baby can be a good experience for both the mother and the baby. It takes time and practice to get comfortable with breastfeeding. Things you can do to help the process include:
Most women are able to breastfeed with no pain. Sometimes, breast tenderness and nipple soreness will occur in the first week. Getting help with a proper latch right away from a breastfeeding support person can help this go away more quickly.
Nipple soreness may be caused by many things, including:
For many women, there is no clear cause of nipple soreness. A simple change in your baby's position while feeding may ease soreness.
You might have sore nipples if your baby keeps sucking as they come off the breast. You can help your baby learn to let go by gently inserting a finger into the side of the mouth to break the suction.
Skin that is too dry or too moist can also cause nipple soreness.
Some babies chew or bite on the nipples when they start teething.
BREAST ENGORGEMENT OR BREAST FULLNESS
Breast fullness is the slow buildup of blood and milk in the breast a few days after birth. It is a sign that your milk is coming in. It will not prevent you from breastfeeding.
Breast engorgement is caused by back up in the blood vessels in the breast. The breasts are swollen, hard, and painful. The nipples may not stick out enough to allow the baby to latch on correctly.
The let-down reflex is a normal part of breastfeeding. Milk made in the milk glands is released into the milk ducts. Pain, stress, and anxiety can interfere with the reflex. As a result, milk will build up. Treatment includes:
Nursing often (8 times or more in 24 hours) and for at least 15 minutes at each feeding can also prevent engorgement.
Other ways to relieve breast engorgement:
NOT ENOUGH MILK FOR THE BABY'S NEEDS
Almost all women can produce enough milk for their babies. Though many women are very worried about this, it is quite rare that a mother will produce too little milk.
Making too little milk can happen for a few reasons, including using infant formula to feed your baby in addition to breastfeeding. If you are worried about how your baby is growing, you should talk with the baby's doctor right away before starting to supplement with formula.
The mother's supply is based on the baby's demand for milk. Frequent feedings, adequate rest, good nutrition, and drinking enough fluids can help maintain a good milk supply.
PLUGGED MILK DUCT
A milk duct can become plugged. This may happen if the baby does not feed well, if the mother skips feedings (common when the child is weaning), or if the mother's bra is too tight. Symptoms of a plugged milk duct include:
Sometimes, a tiny white dot can be seen at the opening of the duct on the nipple. Massaging the area and putting gentle pressure on it can help to remove the plug.
A breast infection (mastitis) causes aching muscles, fever, and a red, hot, tender area on one breast. Call your health care provider if you develop these symptoms.
Treatment often includes:
Continuing to nurse from the infected breast will help healing take place. Breast milk is safe for the baby, even when you have a breast infection. This will prevent further breast engorgement.
If nursing is too uncomfortable, you may try pumping or manual expression to move milk out of the breast. You can try offering the unaffected breast first until let-down occurs, to prevent discomfort. Talk to your provider about ways to manage the problem.
Thrush is a common yeast infection that can be passed between the mother and the baby during breastfeeding. The yeast (Candida albicans) thrives in warm, moist areas.
The baby's mouth and the mother's nipples are good places for this yeast to grow. Yeast infections often occur during or after antibiotic treatments.
Symptoms of yeast infection in the mother are deep-pink nipples that are tender or uncomfortable during, and right after, nursing. White patches and increased redness in the baby's mouth are symptoms of a yeast infection in the baby's mouth.
The baby may also have a diaper rash, a change in mood, and will want to suckle more frequently. Call your provider to get a prescription for an antifungal medicine for affected members of your family.
If you develop a fever or illness, contact your provider. You can safely continue breastfeeding during most illnesses. The baby is likely to benefit from your antibodies.
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Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 24.
Parks EP, Shaikhkhalil A, Groleau V, Wendel D, Stallings VA. Feeding healthy infants, children, and adolescents. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 45.
Review Date: 9/5/2017
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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