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FEEDING YOUR BABY

Breastfeeding problems

An NCT breastfeeding counsellor (ring 0870 444 8708), or your midwife or health visitor will be able to help you if you are having any feeding difficulties.

Here's some information to help explain causes and cures:

1. Baby wants to feed all the time
2. Sore/cracked/bleeding nipples
3. Sore nipples with white marks on them that don't heal
4. Full, hard, lumpy breasts, or flat nipples
5. Small lump in your breast, which is tender
6. Red, inflamed areas on breasts; flu-like symptoms
7. Baby won't take the breast

1. Baby wants to feed all the time

Caused by

Poor positioning (baby not properly latched on) or a delay in your supply building up.

What to do

In the early weeks, your baby may simply be the kind who draws enormous comfort from the breast and wants to be there, sucking, all the time. If this is a change of pattern, though, your baby may be building up your milk supply. They should settle again in 24-48 hours. Let them feed on demand.

If you are sore as well, your baby may not be positioned correctly. Ask your midwife to check that they are latched on properly.

2. Sore/cracked/bleeding nipples

Caused by

Poor positioning, or the baby sucking on your nipple rather than your breast.

What to do

Take the baby off (breaking grip with little finger first), and try again, making sure that the baby's mouth is wide open when they go on. Ask someone to check the positioning for you.

Also try different positions, such as holding him or her under your arm, or with you lying down to feed. To relieve soreness, express a little milk and spread around your nipples. Feed from the least sore side first

3. Sore nipples, with white marks on them that don't heal

Your baby may have white spots in their mouth and nappy rash; deep breast pain after feeds.

Caused by

Thrush, which can sometimes occur after either you or your baby has a course of antibiotics, or something that may come out of the blue.

What to do

You should both be treated with an anti-fungal cream. Occasionally systemic medication (tablets) are needed.

4. Full, hard, lumpy breasts, or flat nipples

Caused by

Primary engorgement, which often takes place when your milk first 'comes in' on the third or fourth day. Secondary engorgement, which happens when your baby drops a feed, perhaps when he or she first starts sleeping longer through the night. Your body will adjust to this quickly.

What to do

Use warm flannels to help the milk to flow, or get into a bath or shower before feeding. Express a little milk before offering your baby the breast, so that it is easier for them to latch on.

Feed your baby frequently to reduce fullness.

Put chilled savoy cabbage leaves inside your bra (yes, seriously) to draw away the swelling.

5. Small lump in your breast, which is tender

Caused by

A blocked duct: something that has stopped the milk from flowing freely. This can happen if a bra is too tight, if you have sat for some hours with a seat belt across your breasts, or even if you have slept awkwardly.

What to do

Use massage and warmth to help the milk to flow and disperse the lump. Let your baby feed by positioning him or her with their lower jaw nearest to the lump if possible so that the strong action of their jaw can 'feed it away'. Feed from the sore side first. Massage and express after a feed if your breast still feels full and lumpy.

6. Red, inflamed areas on breasts; flu-like symptoms: aching, temperature, weepy; full, sore breast

Caused by

Mastitis: an inflammation of the breast, which happens when breastmilk leaks into breast tissue.

What to do

Go to bed and rest.
Continue to feed your baby, offering the sore side first.
Feed frequently.
Ask your midwife to recommend a painkiller.
Use warm and cold compresses to reduce swelling.
If you are worried, or don't feel better after a few hours, contact your doctor, who will probably prescribe antibiotics.

7. Baby won't take the breast

Caused by

Change of taste of the breastmilk, caused by change in diet, or a course of tablets.
Use of a nipple cream.
Stopping using nipple shields.
Periods starting/dental treatment/even hard exercise!

What to do

Don't give up!
Try fooling your baby. Try feeding standing up, in the bath, when your baby is half-asleep, or when the lights are dim.

If you want to stop using a nipple shield, trim it down with scissors - snipping out the centre first. Cut off a little more each day.

If breast refusal continues, you may need to express milk to keep up your milk supply.

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