Breastfeeding Problems

Sore nipples can be caused by many things when you are breastfeeding so here we provide some top tips to help sore nipples heal.

• Check positioning and attachment. Your baby should take a big mouthful of breast, with his tongue under your nipple. Varying positions can help, perhaps feeding lying down, or with your baby's feet out behind you.


• Feeding frequently can help. A new baby needs to feed 8-12 times in a 24-hour period. This means that your breasts will not get too full and it will be easier for your baby to latch on.


• Feed on the least sore side first, then when the milk is flowing, switch breasts.


• Make sure that your bra is not putting pressure on your breast. Some mothers find plastic tea strainers with the handles cut off worn inside their bra protect their sore nipples from pressure.


• Avoid breast pads with plastic backing which keeps the nipples wet. Expressing a little milk after a feed onto the nipples helps healing.


• Avoid using soaps on the nipple as these can be drying. Creams that need to be removed before nursing should also be avoided as extra rubbing may irritate already sore nipples.


• Moist wound healing is the preferred treatment for sore and cracked nipples, in conjunction with help to address the cause of the condition. Moist wound healing involves retaining the moisture already present in areolar skin, by applying a moisture barrier cream to the injured site. Internal moisture, retained within the skin, will return the skin to its normal healthy state, supple and soft rather than brittle and dry. When cracked tissue is rehydrated in this way from within, it will heal without the formation of a scab or crust.

As well as positioning which we looked at previously, there are other causes of sore nipples in the early days.

Engorgement
If your breasts are very full it may make it difficult for your baby to get a good attachment. Many mothers express a little milk before feeding to help relieve the fullness. Some women find it helps to wrap frozen peas in a cloth and hold it to their breasts, changing to a warm compress a few minutes before the next feed. Others find relief from cold Savoy cabbage leaves worn in their bra. Feeding at least every two hours with a longer gap at night helps avoid engorgement.

Flat or inverted nipples
This used to be considered a problem, but we now know that it is the amount of breast in the mouth that is important, not the shape of the nipple. By positioning your baby to enable him to take a large mouthful of breast, he can draw out your nipple in his mouth. Some mothers draw out the nipple in the early days by using a breast pump, or by wearing breast shells half an hour before a feed.

Nipple confusion
Some babies have difficulty distinguishing between the breast and artifical teats or dummies. These babies suck on the breast as if it is an artificial nipple, which is quite a different technique. This can give you sore nipples, as your breast will not be taken as deeply into your baby's mouth. Studies show that some babies cope better with this if they are not given artifical teats before four weeks of age.

Tongue-tie
The tongue is important as it is the motion of the tongue (and lower jaw) that milks the breast. Poor use of the tongue can allow suction to be broken with each suck, and cause inefficient milk removal, which can lead to slow weight gain. Tongue-ties can be treated, and it is advisable to consult a health professional.

Breaking suction
Removing your baby from your breast without breaking suction may make your nipples sore. Many mothers leave their babies on the breast until they are ready to come off, but if you need to take your baby off the breast, break the suction first by putting your finger between his gums.

Mastitis as a result of blocked milk ducts is a huge issue with various causes, symptoms and treatments and as such the next article will purely look at this issue.