Breastfeeding - Challenges! - Breast Engorgement

Right after the child is born, in just few hours a mother starts to produce Colostrum. Colostrum is rich in antibodies, it has many white cells that fight against infection, it helps in clearing meconium, prevents jaundice, it is rich in Vitamin A and also helps the intestine of the babies to mature. So it is very important that the babies are breastfed right after they are born. The often the better... 

Only right when the mature milk starts coming in (usually after 3-4 days a child is born), does the mother have the possibility of facing Breast Engorgement. But don't worry Moms!! being a little meticulous you will sail through the initial few days very smoothly. The good news is, usually this condition does not happen once the feeding is well established (after 20-30 days).

Mommy Elephant and Baby Elephant bonding! 

This picture was taken in Dubare Elephant Camp, Near Madikeri, Karnataka. I just thought this picture would make this post more Jazzy!

Symptoms

• Breasts become extremely heavy, hard and painful. 
• Nipples become very tight that the baby has difficulty suckling. (The baby keeps crying by not being able to latch on to the areola despite all your effort trying to feed the baby)
• Breasts may look red
• Mother might run a temperature

Causes

• Abundant milk supply
• Poor latching mechanism
• Infrequent feeds
• Restricted length of feeds

Treatment 

• The moment you feel that your breasts are getting engorged or for that matter even full, you should try to feed the baby if the baby is able to suckle. 
• If the baby is not able to suckle, it is best to express the milk from the breasts right away. If you have a breast pump nothing like that, use it to express the milk NOW. If you do not have a breast pump, express the milk manually. Expressing out even few ml (10 - 20ml) of milk can make the nipple supple for the baby to suckle. And so the mother should be able to breast feed after the nipple becomes supple. 
• If the mother (with engorged breasts) has severe pain as she feeds/expresses, she can be recommended to have a warm shower or to have a warm compress on her breasts. It is not only very soothing but also enhances the feeling of let-down.
• If the fever persists beyond 24 hours along with chills, rush to the doctor immediately.  

The best way to avoid breast engorgement is to feed the baby every two hours during the day and every four hours during the night. The more the number of feeds, the more often the breasts will be emptied. Also, ensure that the baby empties the breast completely before she is put on the other breast (An empty breast is usually light and soft). During the initial few days your baby is still learning the art of suckling, so she could take a long time to get the milk out of the breast. Let her suckle as long as she 

wants to, say around 30-45 minutes, never more. And also as long as you hear her swallowing milk! 

More on breastfeeding challenges to follow...

Breastfeeding - Challenges! - Sore Nipples

For many women breastfeeding is very easily established without any hitches and for some it could be a great challenge. If breastfeeding seems challenging; it is all about taking the challenge up fighting it and winning it! At the end of the day, it is worth the fight as the mother gets a sense of FULFILLMENT breastfeeding the baby. 

Listed in this post and the next few posts that are to follow, are some of the common problems that many breast feeding women under go.

Sore Nipples

Many women do experience sore/cracked/bleeding nipples during first few days of breast
feeding. Sometimes nipples hurt so much that the mother just dreads the next feed the baby is due and wishes to just give up breast feeding... But mothers, don't give up yet...

Causes: 
First of all, check if you are holding the baby in the right position. Please refer this article in babycentre*.

Secondly, check if the baby is latching-on to most part of the aerola, not just the nipple. 

Thirdly, whenever the baby is done feeding, slowly insert the little finger between the baby's mouth and the aerola to unlatch the suction. Pulling out the baby's face from the breast will not release the suction and could result in severe sore nipples. 


Remedies:
a. Don't let them wilt!!
It is always a good idea to apply breast milk on the nipples and let it air dry after every feed. Also it is best to avoid direct application of soap on the nipples right from the third trimester of pregnancy to as long as you breast feed (as it takes away the natural moisture, resulting in cracks). 
Applying Lanolin cream (brand name Nipcare in India) to the nipples after every feed comes of great help too.  Use it sparingly, though!!

Despite having the right hold, right latch and unlatch methods and keeping the nipples moisturized (ONLY with the help of breast milk/lanolin, DO NOT use petroleum jelly or other creams, they could be harmful to the baby), if the soreness persists or worsens, it is always a good idea to make a trip to your doctor or to a lactation consultant. 
The doctor will evaluate the nipples and can recommend medicines and/or nipple shields*.

b. Guard the nipples!
If nipple shields are recommended it is wise to buy one that gives your baby maximum contact with the mother's aerola (the one on the left). 

 

(Image courtesy http://www.medelabreastfeedingus.com/tips-and-solutions/112/nipple-shields)

They could be more expensive than the regular ones but they are worth it!  It gives the baby a very close experience as that of direct breastfeeding. Sometimes nipple shields also help in enhancing the baby's latching technique. 


c. Extract it!
Severe sore nipples require a break once in a while. It is a good idea to feed the baby expressed breast milk, but hey! use ONLY cup and spoon. Introduction of feeding bottles during the initial few days could make the baby lazy to suckle from the breasts. Try expressing the milk using breast pumps, manual extraction could be even more painful!


Remember mothers, this is only a passing phase... with a tiny bit of endurance breast feeding will turn out to be a gratifying experience. Just like the first picture of this post, in the end, bright red roses will stay in the memory not prickly thorns...
* Click on the words that are star marked to know more about them