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Breastfeeding Questions and Concerns Every New Mom Should Know
Before your baby is born, check your breasts for flat or inverted nipples. Place your thumb and forefinger around your areola in a “C” shape, about an inch from the base of your nipple, and gently press your thumb and forefinger together. Your nipple should stick out. If your nipple returns to the breast or remains flat, seek advice from your doctor, a certified lactation consultant, or a La Leche League leader.
Wearing plastic breast cups during the last months of pregnancy can help your nipples stick out. However, some authorities suggest that a properly latched infant will nurse successfully regardless of the size or shape of the mother’s nipples. Either way, it will be helpful for you to understand the right position and talk to a lactation consultant or healthcare provider about the matter before your baby is born.
Uncomfortable breast engorgement, which can cause your breasts to feel hard, hot, and sore, can be caused by the baby not getting enough milk. To relieve this engorgement, breastfeed your baby regularly or use a breast pump. Pumping for comfort or pumping for only a few minutes, long enough to relax your breasts, will not produce excess milk. Using cold compresses between feedings and/or warm compresses and circular massages just before and during feedings can also be helpful.
Sore nipples are a common complaint at first. This may be a new experience for you, and it may indicate that your child is not properly placed in the bras. If the pain subsides in a minute and you are comfortable in the breastfeeding session, there is nothing to worry about. If not, call a lactation consultant or La Leche League leader for advice.
Causes of sore nipples include:
- The baby attaches too close to the nipple, not taking up enough of the areolar tissue.
- The baby’s lower lip is tucked in instead of protruding.
- The baby puts the nipple into the mouth instead of opening it wide to accept the breast.
- The baby’s gums rub against the nipple when they come off the breast.
- The baby puts pressure on the tissues and causes pain by trying to push out the curved or flat nipples during the first days/weeks of breastfeeding.
- Wetness stays on the inverted nipple for a long time.
Too much milk left in the breast can cause the duct to become strained. This can happen for a variety of reasons and can cause a sore spot in your breast that is red and slightly warm to the touch.
Treatment steps for a pulled duct include:
- Wearing loose clothing and a loose fitting bra.
- Enough rest.
- Nursing often as the baby will interact and/or pump between feedings.
- A baby nurses 8-12 times every 24 hours.
- Applying moist or dry heat to the sore area before breastfeeding.
- Starting every breastfeeding session with a sore spot.
- Positioning the child so that his chin rests on the painful area.
- Massage the painful area during breastfeeding.
If you develop other symptoms, such as fever, chills, soreness, or breast tenderness that is widespread instead of localized, you may have a breast infection, also called mastitis. Contact a certified lactation consultant, La Leche League leader, or health care provider for advice. Other breast infections will go with the same treatment as you would for a pulled duct.
If your symptoms persist, or if you have a high fever, you may need an antibiotic prescribed by your healthcare provider. Most antibiotics are safe to take while breastfeeding, but discuss this with your healthcare provider to be sure.
Is the baby getting enough milk?
Body weight is the most accurate way to tell if your baby is getting enough milk, so measure your baby. Normal weight gain is about four to eight ounces per week. As your child gets older, weight gain will become more noticeable. If you have concerns about your baby, talk to your health care provider or lactation consultant.
Also, keep track of your baby’s diaper changes because what goes in must come out. At first your baby will have one or two wet diapers a day. After your milk supply has increased, the baby should have five to seven wet diapers (six to eight when using cloth diapers) and three to five bowel movements every day. Some babies may have little bowel movements and diaper changes.
The first bowel movements will be dark brown, with a tarry consistency. Both the color and consistency will change within a day or two of your milk supply. The color of breast milk stool is usually mustard yellow, but can vary from tan to yellow to yellow-green. The consistency is loose and seedy and will remain so if your baby is getting only human milk. Additionally, while breastfeeding, your baby needs to swallow after every second feed, so listen to the swallowing. Other signs include that your breasts feel soft after a feed, your baby’s skin feels smooth and firm, and the baby seems satisfied after a feed.
However, if your child shows any of the following symptoms, contact your healthcare provider immediately:
- A weak cry
- Skin that is not resistant (when squeezed it is always dry looking)
- Dry mouth and dry eyes
- Less than normal amount of tears
- Low urine output (less than two wet diapers in 24 hours)
- The Fontanel (soft spot) on the baby’s head is low or depressed
If you’ve had breast surgery in the past, be sure to tell your healthcare provider. Many mothers are able to fully breastfeed their babies after breast surgery. However, it is important that your health care provider understands your history and previous breast surgeries so that you and your baby can be monitored closely to ensure that your milk supply is healthy and that the baby is growing.
Increasing Your Milk Supply
The amount of milk you produce depends on how much and how often your breasts express milk. As the baby’s demand increases, your body will increase its supply, but you may find the following tips helpful if you are concerned about your milk supply:
- Baby nurses on both breasts for each nursing session.
- Nurse baby twice on each breast for each nursing session.
- Use the crib occasionally to rest while the baby is nursing.
- The nurse at the first signs of the child.
- Drink plenty of fluids (based on your individual needs).
- Use a breast pump between feedings.
- See a certified lactation consultant for a full breastfeeding evaluation.
The child often wakes up at night
There are many reasons why a child wakes up at night. You may have a newborn who sleeps easily and wakes easily. Plus, human milk is digested twice as fast as formula, so breastfed babies are hungry more often than bottle-fed babies.
The Baby Is Always Asleep
Some medications used during labor and delivery can cause the baby to be too full. If the baby sleeps regularly in the first week, it is important to wake him up to feed him so that your milk supply will be strengthened and the baby will grow and gain weight normally. Try to nurse every night when it’s quiet. Consult another mother or a lactation consultant for advice on waking a sleeping baby.
Breastfeeding and Mother’s Medicines
Most antibiotics and pain medications are compatible with breastfeeding. However, you should always discuss any medications with your healthcare provider or pharmacist.
The potential risks of medication, whether prescription or over-the-counter, must be weighed against the risks of weaning and artificial milk supply.
When to Ask for Help with Breastfeeding
Seek help when:
- Your newborn baby has fewer than five to seven wet diapers, or three to five bowel movements each day, even after your milk supply has increased in the first week.
- The baby’s urine is dark in color or has a strong smell.
- Nipple or breast pain gets worse and continues between feedings.
- Breastfeeding hurts. (A little pain at first is normal, but should go away as your baby learns to breastfeed.)
The child appears gassy You may have heard that babies react to their mothers’ food but this is rare. Infant formula is more likely to cause some type of problem than to respond to the mother’s diet.
Massaging a baby can often help soothe a gassy baby, so you can read books on baby massaging to find a technique your baby likes. You can try holding the colic to see if it helps the baby to be more comfortable. Tuck your baby face down under your arm with his head in the crook of your elbow, your hand supporting his midsection, and his legs hanging down.
Additions and artificial nipples
Supplements of water or artificial milk (formula) in the first weeks of breastfeeding can contribute to poor milk supply, prolonged constipation, jaundice, or cow’s milk allergy or intolerance problems for you and your baby.
Avoid artificial nipples and pacifiers because they can confuse your baby when learning to breastfeed. A baby uses the mouth and tongue differently when taking a bottle or pacifier versus a human breast. Among other things, artificial nipples are stronger than your breast, and the baby holds them in front of his mouth. If the baby does the same thing while breastfeeding, he may not use enough and will not get as much milk.
Your nipples may be sore during this process. Some very sensitive children even refuse to breastfeed after using artificial nipples.
Since there is no way to tell in advance if your baby will be able to switch back and forth easily, it is best to avoid artificial nipples until your baby has been breastfeeding well for at least three or four weeks and the chances of confusion are reduced. . If you want to feed your baby without breastfeeding, use an alternative to bottle feeding, such as a spoon, eyedropper, or small feeding cup. Consult a lactation consultant who is knowledgeable about this option.
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