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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 the areola in a “C” shape, about an inch from the bottom of the nipple, and gently press your thumb and forefinger together. Your nipple should stick out. If your nipple pulls back into your breast or remains flat, seek advice from your doctor, a certified lactation consultant, or a La Leche League leader.
Wearing plastic cups during the last months of pregnancy can help your nipples stick out. However, some authorities suggest that a baby who is properly attached to the breast will nurse effectively regardless of the size or shape of the mother’s nipples. Either way, it helps to understand proper positioning and discuss the issue with a lactation consultant or healthcare provider before your baby is born.
Uncomfortable breast fullness, which can make your breasts feel hard, hot and painful, can occur because the baby is not removing enough milk. To remove this congestion, breastfeed your baby more often or use a breast pump. Pumping until you’re comfortable, or pumping for just a few minutes, just long enough to make your breasts feel comfortable, won’t induce excess milk. Applying cold compresses between feedings and/or warm compresses and circular massage just before and during feeding may also be helpful.
Sore nipples are a common complaint at first. This may be a new experience for you and may indicate that your baby is not properly positioned at the breast. If the pain subsides within a minute and you are satisfied with the rest of the breastfeeding, there is nothing to worry about. If not, call a lactation consultant or La Leche League leader for suggestions.
Causes of sore nipples include:
- The baby sucks too close to the nipple and does not receive enough areolar tissue.
- The baby’s lower lip is tucked in instead of pulled out.
- The baby tucks the nipple into his mouth instead of opening wide to receive the breast.
- When coming down from the breast, the baby’s gums rub against the nipple.
- The baby puts stress on the tissues and causes pain by trying to pull out inverted or flat nipples during the first days/weeks of breastfeeding.
- Moisture stays on the inverted nipple for a longer time.
Too much milk left in the breast can cause the duct to become blocked. This can happen for a variety of reasons and can result in a sore spot on the breast that is red and slightly warm to the touch.
Measures to treat clogged pipes include:
- Wear loose clothing and a bra that doesn’t bind.
- Enough rest.
- Breastfeed as often as the baby will cooperate and/or pump between feeds.
- Breastfeeding the baby 8-12 times every 24 hours.
- Apply moist or dry heat to the sore area before nursing.
- Begin each feeding on the breast with the sore spot.
- Position the child so that his chin is level with the painful area.
- Massaging the sore spot while breastfeeding.
If you develop other symptoms such as fever, chills, soreness, or breast tenderness that is generalized instead of one spot, you may have a breast infection, also known as mastitis. Contact a certified lactation consultant, La Leche League leader, or health care provider. Some breast infections go away with the same treatment you would use for a blocked duct.
If your symptoms persist or you have a high fever, you may need an antibiotic prescribed by your healthcare provider. Most antibiotics are safe to use while breastfeeding, but to be sure, talk to your healthcare provider about this issue.
Is the baby getting enough milk?
Weight gain is the most accurate way to tell if your baby is getting enough milk, so weigh your baby. Normal weight gain is approximately four to eight ounces per week. As your baby gets a little older, the weight gain will become more noticeable. If you are concerned 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 only have one or two wet diapers a day. After your milk production increases, baby should have five to seven wet diapers (six to eight if you use cloth diapers) and three to five stools each day. Some babies may have a small stool with each diaper change.
The first bowel movements will be dark black, with a tarry consistency. Both color and consistency will change within a day or two of increasing milk production. The color of breast milk stool is most often mustard yellow, but it can vary from brown to yellow to yellow-green. The consistency is loose and seedy and will remain so as long as your baby receives only human milk. Also, while breastfeeding, your baby should be swallowing after every couple of feeds, so listen for them to swallow. Other indicators include that your breasts feel softer after nursing, your baby’s skin is smooth and firm, and baby seems content after nursing.
However, if your child shows any of the following symptoms, contact your healthcare provider immediately:
- A weak cry
- Skin with no resistance (stays clenched when clenched)
- Dry mouth and dry eyes
- Less than usual amount of tears
- Minimal urine output (less than two wet diapers in 24 hours)
- The fontanel (soft spot) on the baby’s head is sunken or sunken
Be sure to tell your healthcare provider if you’ve had breast surgery in the past. Many mothers were able to fully breastfeed their babies after breast surgery. However, it is important that your health care provider knows about your medical history and past breast surgeries so that you and your baby can be closely monitored to make sure your milk production is good and your baby is gaining weight.
Increase your milk supply
The amount of milk you produce depends on how much and how often milk is removed from your breasts. As your baby’s demand increases, your body will increase its supply, but if you’re concerned about your milk supply, the following recommendations may help:
- Feed the baby on both breasts each time you breastfeed.
- At each feeding, breastfeed the baby twice on each breast.
- Use the prone position occasionally to relax while nursing.
- Nurse at the first impulses of the child.
- Drink plenty of fluids (based on your individual needs).
- Use a breast pump between feedings.
- A certified lactation consultant will provide you with a complete assessment of breastfeeding.
The child constantly wakes up at night
There are many reasons why a child wakes up at night. You may have a newborn who is a light sleeper and wakes easily. Plus, human milk digests twice as fast as formula, so breastfed babies are hungry more often than bottle-fed babies.
The child is always sleepy
Some medications used during labor can make the baby extremely sleepy. If the baby sleeps all the time in the first week, it is important to wake him up to breastfeed so that the milk supply stabilizes and the baby grows and gains weight normally. Try to breastfeed often at night when it is quiet. Talk to another mom or a lactation consultant for advice on how to wake up a sleeping baby.
Breastfeeding and maternal medications
Most antibiotics and pain relievers are compatible with breastfeeding. However, you should always discuss any medications with your healthcare provider or pharmacist.
The potential risks of the drug, whether prescription or over-the-counter, should be weighed against the risks of weaning and providing formula.
When to ask for help with breastfeeding
Seek help when:
- Your newborn has fewer than five to seven really wet diapers or three to five bowel movements each day, even after your milk production increases during the first week.
- The child’s urine is dark in color or has a strong odor.
- Nipple or breast pain worsens and persists between breastfeeding sessions.
- Breastfeeding becomes painful. (A little soreness at first is normal, but should go away once your baby learns to breastfeed.)
The child seems full of gas You may have heard that babies react to foods in their mothers’ diets, but this is relatively rare. Infant formula is much more likely to cause some type of problem rather than a reaction to the mother’s diet.
Infant massage often helps calm a baby who seems gassy, so you can read books on baby massage to find a technique that your baby likes. You can also try the colic hold to see if it helps the baby to be more comfortable. Flip your baby face down over your forearm with his head in the crook of your elbow, your hand supporting his midsection and his legs hanging down.
Accessories and artificial nipples
Water or formula feeds in the first few weeks of breastfeeding can contribute to poor milk supply, prolonged feeding, jaundice, or an allergy or intolerance to cow’s milk for you and your baby.
Avoid artificial nipples and pacifiers as they can confuse your baby when learning to breastfeed. A baby uses their mouth and tongue differently when taking a bottle or pacifier than a human breast. Among other things, artificial nipples are firmer than your breasts and the baby holds them in the front of the mouth. If the baby does the same while breastfeeding, he may not pump enough and not get as much milk.
Your nipples may hurt during this. Some very sensitive babies even refuse to breastfeed after using artificial nipples.
Since there’s no way to know in advance whether your baby will be able to switch back and forth easily, it’s best to avoid artificial nipples until your baby has been nursing well for at least three or four weeks and the chances of confusion are reduced. . If you need to feed your baby other than at the breast, use an alternative to bottles such as a spoon, dropper or small feeding cup. Talk to a knowledgeable lactation consultant about these options.
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