Breast Feeding Discomfort

Throughout your pregnancy, you probably fantasized about the wonderful experience breast-feeding would be for both you and your baby. All you could think about was looking down into that tiny, trusting face and feeling the closeness between you and this new little being. So naturally, when it finally came time to put baby to breast, you were excited. But now, you’re in agony. Your nipples are sore, cracked, and bleeding. If your milk has already come in, your breasts may be painfully swollen. The milk may not flow when you need it to and may seem to flow uncontrol lably when you most wish it wouldn’t (like when you’re standing in line at the grocery store or sitting at a dinner party). So where are those tender, happy moments you’ve seen in the magazine and television advertisements?

Well, hang in there. Those moments do actually exist, just not right off the bat. The problem is, many mothers give up breast-feeding in frustration because they don’t realize that things will get better with time. They also don’t realize that there are things they can do to decrease breast-feeding discomfort.

As far as what causes breast-feeding pain, it depends on what part of the breast you are talking about. Nipple pain is most often caused by the baby latching on to the nipple incorrectly. “If the baby doesn’t latch on in a way that allows the nipple to get adjusted correctly in his palate, it can be very traumatic for the breast,” says Phyllis Frey, A.R.N.P., a nurse practitioner with Bellegrove OB­GYN, Inc., in Bellevue, Washington. In addition, she notes, “American women tend to experience more nipple discomfort than foreign women because we always wear bras to protect that sensi­tive skin. Foreign women, however, go braless more often and sunbathe topless, which toughens the nipples.” Pre-existing conditions, such as inverted nipples or nipple sensitivity that developed during the pregnancy, can also cause problems.

Pain in the fleshy part of the breast is most often caused by engorgement of the breast with milk when the milk first comes in. Engorgement may also make the breasts feel sore in between feedings. While you can’t escape all initial discomfort from breast-feeding, there are some tips and techniques you can use to prevent or alleviate much of the pain.

Make sure the baby latches on correctly. Despite what you may have been told, breast-feeding is a learned skill, and it takes time and practice to perfect. “If the baby is latching on at the very end of the nipple, he is really mashing his gums against that tender skin,” says Raven Fox, R.N., I.B.C.L.C., a registered nurse and lactation consultant/educator at Evergreen Hospital Medical Center in Kirkland, Washington. “If this motion persists, the nipples can start to crack, bleed, and blister, all of which leaves them more vulnerable to infection,” she continues. The key is to get the baby’s mouth open wide, lift your breast from underneath, and pun the baby in close as quickly as possible. “You wan to get the baby to close down on the areola (the darkened area around the nipple), rather than on the nipple itself. And if you bring him in too slowly, he will clamp down as soon as his lips touch the nipple,” Fox explains. When the baby does close directly on the nipple, you’ll know it. “You may feel a general tenderness when the baby first latches on, or you may experience a real sharp pain, almost as if someone had pinched you,” she warns.

Use a prop. Place the baby on a pillow on your lap when breast-feeding. “Doing so lifts the baby up a little higher so that once on, he isn’t further
irritating the nipple area by tugging down on it,” says Frey.

Go easy at first. “It’s so exciting initially to breast­feed your baby, and you often feel you don’t want to interrupt him when he’s finally latched on and gulping away,” says Frey. “But you will pay later,” she warns. She recommends limiting the breast­feeding time for the first five days of breast­feeding. Try five minutes on each breast at first. If you don’t notice yourself getting tender, you can increase that time rather quickly.

Then, nurse, nurse, nurse. Once your milk comes in, let the baby nurse as long as he or she wants to. “Babies go through a marathon nursing period right as their mother’s milk is coming in, and we recommend letting the baby nurse constantly during this 12- to 24-hour period. Just get it into your head that this will be your sole job for the next 24 hours,” advises Fox. “We’re finding that women who resign themselves to doing this are totally missing that initial engorgement period because the baby is helping to siphon off all of the excess milk the body initially produces.” After all, the body automatically makes enough milk for twins; it then gradually lowers its milk production to meet one baby’s needs if there is no twin. Fox. goes on to say that if you trap yourself into feeding the baby every three to four hours and letting the baby sleep as long as he or she wants, your milk will come in and make your breasts look and feel as if they’re going to explode. “The engorgement period should only last 36 to 48 hours, but the pain makes it seem like five years,” she says.

Don’t reach for the pump. If you do get engorged, resist the urge to express milk with a manual or electric breast pump. Unfortunately, the body doesn’t know the difference between a pump and baby’s mouth. Whenever milk is drawn from the body thinks it’s being used by the baby and makes more to compensate for that loss. So , the more you pump, the more milk your body produces. “In essence, using a breast pump introduces a twin to your body,” says Fox. The only time this advice wouldn’t apply is when you on a trip away from your baby and want to (continue nursing regularly when you return, or when your baby is ill and his or her appetite is temporarily down. In these instances, you would want to pump at the baby’s normal feeding times keep up your milk supply.

Air them out. Try to expose your nipples to air whenever possible to help toughen them up. “If you finish nursing and immediately put your bra back on with a nursing pad in it, you’re likely to it some milk leakage that will wet the pad and keep moisture against the nipple,” says Frey. “This rather softens the nipple, which is not what you want.” Instead, she suggests keeping your bra flaps open (on a nursing bra) or going braless under a It T-shirt for at least 15 minutes after feeding. If you were planning to nap after a feeding, you might consider napping braless, as well.

Stand in a warm shower. This causes some milk to drip from the breasts, which can relieve some of the pressure, according to Frey. But unlike pumping the breast, this technique doesn’t cause the body to produce more milk. It just provides welcome relief as long as the water is hitting directly on the breasts. “Another way to get similar Ilief is to fill the sink with warm water, take your bra off , lean over the sink, and splash the water up over your breasts,” says Fox.

Try “cold storage.” Between feedings, pack your breasts in ice, and wear a bra to hold the ice in ,. !lace. “My favorite way to do this is to freeze four Ziploc bags of unpopped popcorn. The popcorn holds the cold much longer than the frozen peas and carrots many people use, and it doesn’t get mushy. It also molds to the shape of your breasts so that you don’t have big, bulky ice cubes lying on you,” says Fox. “Usually, engorgement in between feedings lasts no more than seven to ten days after the baby’s birth. This is because the mother’s milk production and the baby’s milk consumption are still balancing out,” explains Harold Zimmer, M.D., an obstetrician and gynecologist in private practice in Bellevue, Washington.

Warm up for feedings. Fifteen minutes before feeding your baby, warm up your breasts. “Soak a bath towel in hot water, wring it out, and place it across your breasts with a plastic garbage bag over it to maintain the heat a little longer,” advises Fox. Then take it off and massage the breast from the fleshy part down to the nipple to encourage the release of milk into the nipple. “Latching your baby onto an empty nipple can hurt so much more than if there is milk in the nipple,” says Frey.

Try the “burp and switch” strategy. Always begin a feeding on the sorest breast or the one that seems fullest. “Once the baby is latched on, let him nurse for five minutes, and then burp him and switch him to the other side for five minutes. Continue switching him every five minutes until he is finished eating,” recommends Fox. This method ensures that the baby drains both breasts sufficiently, rather than tanking up on one and leaving the other ready to explode.

Try some tea. Placing warm tea bags on your nipples a few times a day is one of the best home remedies around for nipple discomfort, according to Zimmer. Fox stresses that it has to be black tea, as opposed to chamomile or yellow tea, because black tea contains tannin, and the tannic acid is what soothes and toughens up the nipples. Soak the tea bags in warm water for a few minutes, squeeze them out, and place them on the nipples for ten minutes.

Massage the nipples with an ice cube. “This will numb the painful area and give you some temporary relief,” says Zimmer. But he goes on to say that once the numbness wears off, the nipples will be just as painful as before. “It is not a healing remedy as much as it is a relief mechanism,” he explains.

Wear a well-supporting bra. “You want to avoid as much additional trauma to the breasts as possible and this is one way to protect them somewhat,” says Zimmer.

Take acetaminophen if you develop a fever. It is very common to develop a low-grade fever as high as 100.2 to 100.6 degrees Fahrenheit, according to Fox. Acetaminophen should help to lower it and make you feel a little better. Be sure to check with your doctor, however, before taking any medication while you are nursing.

Take ibuprofen if you feel achy. “It is also not uncommon to feel as if a truck has run over you,” warns Fox. If this is the case, ibuprofen should help relieve some of the aches and discomfort. Once again, however, check with your doctor before taking any medications.



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