Below is information on the most common breast feeding challenges. 

Engorged breasts

The signs of engorged breasts are:

• Larger, heavier and tender breasts.
• Breasts hard and painful and warm to touch.
• Swelling of breasts.
• Firm nipples and areola.

What can be done about it?

• Feed your baby frequently at least 8 to 12 times per day.
• Wear a support bra 24 hours per day while breasts heavy.
• Apply a warm washer over each breast 3 to 5 minutes before feed.
• Warm showers and express milk in shower.
• Breast pump can help
• Apply a cold compress for 20 minutes after feeding.

Sore nipples & cracked nipples

The impact of sore nipples and cracked nipples is painful feeding resulting in you deciding to cease breast feeding sooner than planned and mastitis.

What can be done about it?

• Check your baby’s positioning and attachment.
• Air drying you nipples after each feed can help.
• Apply colostrum or milk over your nipple after air-drying.
• Avoid soap, alcohol and extra water on your nipples.
• Clean your nipples with water flowing over them in shower.
• Nipples shields can be a great help.

Flat nipples

Flat nipples is a common problem. In my experience it is more common in Caucasian than Asian women and more common in women with very large breasts. It is uncommon in small breasted women.

What can be done about it?

• Nipples shields are helpful until your baby’s suck is strong enough to draw them out.

Poor milk supply

Poor milk supply is a huge challenge when you want to breast feed.

What can be done about it?

• Motilium (Domperidone) stimulates prolactin production. You will need a script for this.
• Increase your fluid intake.
• Check attachment and positioning.
• Avoid using a dummy.
• Rest and avoid stress. Stress can result in reduction or even loss of your milk supply.
• Increase the number of feeds per day.
• Express 5 to 10 minutes after feeding. A breast pump can help. Fully emptying your breast stimulates more milk production.

Mastitis

Mastitis is a breast infection. It is usually related to cracked nipple and incomplete emptying of breasts with breast feeding. 

What can be done about it?

• You will need to contact me or see your doctor as you will need appropriate antibiotics.
• Empty your breast as much as possible. A warm washer can help.
• You may need a breast ultrasound scan to an exclude abscess.
• Hospital admission may be needed for intravenous antibiotics and abscess drainage (if present).

I have had 2 women there the “mastitis” was due to underlying breast cancer. So careful assessment is very important.