Some of the most common difficulties moms may experience while breastfeeding include:
- Delayed milk production
- Low milk production
- Sore nipples
- Plugged milk ducts
Delayed Breast Milk Production
For the first 3 to 5 days after your baby is born, you will make a small amount of colostrum. Colostrum is a thick, rich milk that is high in nutrients. Around day 3 through 5, your milk will come in.
Infrequent or insufficient breastfeeding is the most common reason for a delay in milk coming in. This is also a common reason that women may experience a drop in milk production. If you are having difficulties with delayed milk production or a decrease in the amount of milk, a review of the number and length of breast feedings should be the first thing to evaluate. It is also important to make certain the baby can latch on and is able to transfer milk from the breast.
Other causes of a delay in breast milk production include:
- Severe stress
- Cesarean delivery
- Bleeding after birth
- Infection or illness with fever
- Thyroid conditions
If you have a delay in your milk coming in, do not feel discouraged. Continue to express milk using a breast pump or by hand. Do not wait to get help if milk supply is ever a concern.
Low Breast Milk Production
Sometimes a delay in the time when milk comes in turns into an ongoing problem with low milk production. Other times a mother has been producing sufficient amounts of milk and then milk production slowly, or quite suddenly, decreases.
Your certified lactation professionals may recommend any of the following to help increase your breast milk production:
- Increase the number of feeding’s or breast pumping sessions to 10 to 12 times per day.
- Have more of skin-to-skin contact with your baby. Take off your shirt and baby’s shirt and place your baby on your chest with a sheet or shirt over both of you.
- Pump your breasts for several minutes after breastfeeding.
- Consider renting a hospital-grade breast pump if you think you’ll need to pump for a prolonged period.
- A medication, such as galactogogue, found to have a positive effect on milk production.
- Think positive. Although insufficient milk production usually can be reversed, any amount of breast milk you produce is valuable for your baby.
Sore nipples are probably the most common difficulty mothers have when breastfeeding. Sore nipples may be caused by a variety of factors and determining the cause of sore nipples can be difficult. Talk with your lactation professional for suggestions on how to resolve the problem.
Breastfeeding should not hurt and the skin on your nipple should not break down any more than the skin anywhere on your body should break down. However, mild tenderness is fairly common for the first week or two of breastfeeding. Then it should go away.
If your nipples feel painfully sore or the nipples or areola feel bruised, it is more likely that it is related to an improper latch-on process or ineffective sucking. Suspect a difficulty with baby’s latch or sucking if your nipples become very red, raw, blistered, or cracked. A latch or sucking difficulty or a structural variation in the baby’s mouth might result in nipples that look creased or blanched (turn white) at the end of feedings. Get help from lactation professional.
Mastitis is often used interchangeably with the term breast infection, but mastitis may also be due to an inflammation. Often a reddened area is noted on the breast. Inflammatory or infectious mastitis may develop for reasons like those for plugged duct development.
With mastitis it is especially important to keep the affected breast empty through frequent breastfeeding or breast pumping at regular intervals. It is also very important to rest and keep hydrated by drinking a lot of clear fluids.
Plugged Milk Ducts
A plugged milk duct feels like a tender lump in the breast. Some mothers seem to be more prone to developing them, but usually they occur when a mother goes too long without emptying her breasts, or if insufficient milk is removed during breastfeeding. Use a baby feeding log to review your baby’s feeding routine and see if the time between feedings has recently changed. Sometimes, a mother gets busy again with a task and does not realize feedings are being delayed.
Ineffective sucking may also contribute to plugged milk ducts. Also, check that the material of nursing bras or clothing bunched during feedings is not putting pressure on milk ducts in a certain area of the breast.
If you develop a plugged milk duct, be sure to breastfeed or remove milk often and alternate different feeding positions. It often helps to apply warm compresses to the area or soak the breast in warm water. Massage above and then over the affected area when breastfeeding and after application of warm compresses.
If the lump does not go away over the course of a couple of days, contact your lactation professional. If you feel ill or develop a fever or chills, contact your doctor immediately. This could be a sign that you have an infection and might need to take antibiotics. If your doctor prescribes an antibiotic, be sure you take the entire course of the medication or you may experience a recurrence.