111. Coping With Feeding Challenges

Breast fullness is normal in the first weeks. After each feeding, your breasts will be soft. Engorgement occurs when the milk does not flow easily from the breast. Your breasts may be hard, swollen, painful and/or reddened. Your baby may have trouble latching.

How to prevent engorgement:

• Position and latch your baby correctly.
• Breastfeed your baby often during the day and night (8 to 12 times in 24 hours)
• Breastfeed for as long as your baby wants
• Do not miss feedings
• If you are not able to breastfeed, use an electric pump.

If your breasts are very full, try the tips listed below.

You should notice a decrease in the swelling and pain within 24 hours. If there is no improvement, call a health care professional who is knowledgeable about breastfeeding.

Blocked milk ducts occur when a milk duct is not draining properly and has become inflamed. Pressure can build up behind the duct, causing inflammation in the surrounding tissues. These localized areas may be tender and lumpy, reddened and sore.

Continue to breastfeed often, starting on the affected side. Try massaging the breast before and during feeding to stimulate the milk flow. Change your baby’s position to help the milk flow from all areas of your breast. The baby drains the milk best from the area where his chin is. Plugged ducts usually improve within 24 to 48 hours.

Mastitis is in inflammation of the breast, often accompanied by localized breast tenderness, areas of the breast are inflamed, red and have a painful, hard swelling. Mastitis can progress to an infection. Flu-like symptoms such as fever and chills can develop suddenly. Mastitis usually clears up quickly with treatment.

• Position and latch your baby correctly. Get help if your nipples are sore and not improving
• Breastfeed your baby often, using different feeding positions. This will help to drain all the milk ducts
• If you have lumpy areas on your breast, using your fingertips gently massage from behind the area all the way to the nipple to clear the duct before, and during breastfeeding
• Avoid suddenly decreasing how often you breastfeed. Avoid the use of soothers or bottles to feed, as they cause your baby to miss or delay a feeding
• Be careful not to restrict milk flow while breastfeeding or pumping. Gently support your breast while breastfeeding or pumping. Gently position the breast shield on your breast while pumping
• Wear a well-fitted (but not tight) bra and comfortable clothing. Avoid underwire bras and wearing a bra to bed unless necessary
• Avoid carrying heavy diaper bags or purses with shoulder straps as they can put pressure on your breasts
• Sleep when your baby sleeps. Ask family members for help with other children and household tasks

• Continue to breastfeed often to keep your milk flowing
• Place warm cloths on your breasts 5 – 10 minutes before breastfeeding to help milk drainage
• Using your fingertips, gently massage from behind the tender area all the way to the nipple before, and during, breastfeeding
• Have your baby breastfeed on your tender breast first. Continue to nurse on both breasts. Breastfeed frequently
• Position and latch so that you baby’s chin is close to the tender area. The baby drains the milk best from the area where his or her chin is
• Stay in bed. Ask your family and friends to help you at home
• Drink plenty of fluids
• You may need to take a milk pain medication to relieve your discomfort. Antibiotics may also be necessary, if the mastitis is caused by an infection. See your doctor if the mastitis does not improve within 24 hours
• If your baby is unable to breastfeed, you will need to express your breastmilk regularly to keep your breasts drained