Uniquely Fed: An Honest Look at the Realities of Breastfeeding, Part Two – Common Breastfeeding Issues
Breastfeeding is hard! Sure it might be natural (because our bodies were created to do it) but it doesn’t come naturally. You and your baby have to learn how to do it and as with anything learned in life, that takes time. There are a number of different complications that can arise throughout the course of breastfeeding and even the best breastfeeding relationships can experience setbacks or times when things are less than ideal between mama and baby. While this is by no means a comprehensive list, here are 6 of the more common issues you might encounter.
Please note that I am not a medical professional. The following information is not a diagnosis and should not be used as a substitute for real medical advice. If you are having pain or discomfort while nursing, or any other symptoms that concern you, I encourage you to see an International Board Certified Lactation Consultant (IBCLC) or your doctor.
Pain during nursing. When you first begin breastfeeding, you have to adjust to having a baby feeding every two hours. Nipples are a very sensitive area and it takes a bit to get used to the demands of a newborn. So a small amount of discomfort is to be expected in the beginning – especially as you and your baby both learn what you’re supposed to be doing. But pain can also be a symptom of an underlying problem requiring more investigation. If you are experiencing discomfort with every feeding that just seems to get worse (or makes you want to avoid nursing altogether), I encourage you to seek out the advice of an IBCLC who can help you determine the cause of your pain and will have a number of wonderful tips and suggestions. Your pain may simply be the result of an improper latch requiring nothing but a few adjustments to yours (or your baby’s) positioning. Or you may have extra sensitive nipples and getting a prescription for some all-purpose nipple ointment could also provide some relief. Be sure to ask at your visit if you can photograph or video the adjustments the IBCLC makes to your baby during a feeding to help you remember what to do when you’re on your own…I got that tip from my own fantastic IBCLC!
Cracked, bruised, or bleeding nipples. This problem often starts out as pain during nursing that doesn’t go away. I learned from my personal breastfeeding experience that nipple bruises or abrasions can look like brown or dark brown spots on the nipple (and not the familiar black and blue of a bruise on another part of your body.) Cracks will look just like they sound, crevices in the skin of your nipple that sometimes look deep. Bleeding nipples may not be immediately obvious to you since they may only bleed during nursing (when your nipple is not visible.) Your first sign may be a change in your baby’s poop or your pumped milk having a pink tinge to it. Cracked, bruised, or bleeding nipples are a big sign that there is an underlying problem that needs to be addressed. Your nipples will not have a chance to heal if the cause of the injury to them is not fixed. Again, a visit to your IBCLC will help you identify what is going on. It is important not to wait to address this issue as cracked nipples can lead to infections such as thrush or a bacterial infection like mastitis. Here is a good article from KellyMom with information on how to treat your nipples to get some relief while you are waiting to see your IBCLC (especially if you are reading this in the middle of the night 😉 )
Thrush. Thrush is a fungal infection caused by an overgrowth of yeast. Your baby will usually have white, furry patches in his/her mouth and your nipples may be itchy, bright pink, and cause pain (especially shooting pain) during nursing. Although you can get thrush without having cracked nipples, they are definitely a superhighway leading straight to it. Thrush is treated a number of different ways and, although I’ve never had it, I have learned from my friends who have that it can take a number of weeks to finally go away (so don’t get discouraged). You have to be very vigiliant about sterilizing anything that comes in contact with your breastmilk which includes pump parts, bottles, and even clothing and burp cloths, to keep the fungus from reinfecting you or your baby. And don’t forget that any milk pumped while you have thrush cannot be reused, even if it has been frozen! Your pediatrician and/or your OB/Gyn will be able to diagnose and prescribe medication to treat you. For particularly stubborn cases, a combination of both oral and topical medicines may be necessary. Don’t rule out gentian violet as a treatment option either. Though it stains everything it comes in contact with (and makes your baby look strange with such a deep purple mouth), it might be just what you need to get that fungus out of your life. Here’s a great article on thrush treatment.
Clogged Ducts or Milk Blisters. Clogged ducts feel like small, hard rocks in your breasts and can happen for any number of reasons. Perhaps you were stuck in a meeting at work and couldn’t pump or maybe your baby is not emptying your breasts during feedings. They can also be caused by milk blisters – which are skin flaps that grow over the openings in your nipple (sometimes seemingly instantaneously). Milk blisters can look just as their name suggests, a small, white, blister/bubble on your nipple. No matter their cause, it is important to remove the clog before it becomes infected and causes mastitis.
There is a PLETHORA of information online about how to deal with clogged ducts. And just about everyone you know will have a different suggestion for how to deal with them. Everyone’s body is different and will respond to different methods of releasing the clog. My advice to you is first and foremost, don’t panic!! I know this is MUCH easier said than done. When I was breastfeeding Dash, I got a clogged duct from a milk blister (which kept threatening to return – a common problem with milk blisters.) When I couldn’t get it to resolve, I took to the internet and quickly became overwhelmed by all the advice out there (and I definitely panicked). I tried a number of traditional clogged duct remedies such as laying the baby on the ground and nursing from all fours above him/her, massage, etc., but because my problem was a milk blister, none of those things worked. Here are the two most helpful articles I found on the topic: Clogged Ducts and Milk Blisters. However, as I said, there were so many paths to follow to treat my particular problem that my sleep-deprived and stressed mommy brain didn’t know where to begin. I decided to make the steps I would take as simple as possible and I’ll share them with you here to help give you a starting point.
About 15 minutes or so before your baby’s next feeding:
- Soak the offending boob in epsom salt. For me, this meant getting a large mixing bowl (I used ¼ cup epsom salt per 2 quarts of warm water) and leaning over it so that my breast could soak. This was neither easy nor comfortable so it only lasted about 5ish minutes.
- As soon as the soak is done, quickly rinse the breast with fresh water and put a warm compress on immediately. But don’t use the ol’ warm washcloth compress. Nope. Take a clean disposable diaper and fill it (you will be astonished by how much water this thing can hold!!) with warm water. Ring out the excess and bam! You’ve got a warm compress that stays warmer longer. And is easier to hold on the breast. I prepared this while soaking the breast because I was on my bathroom counter.
- Keep the warm compress on until you are literally ready to put your baby to breast. Then feed him/her while massaging the clogged ducts.
The soak and compress helped open the milk blister and the clog released. It was wonderful! My stress melted away and I could finally relax. I continued soaking my nipple in epsom salt before feedings for about a day but I used one of those mouthwash cups and just a teaspoon of epsom salt. That was far less cumbersome than leaning over a bowl.
No matter what has caused your clogged duct, I cannot recommend the disposable diaper warm compress enough. It is hands-down the BEST warm compress I have ever encountered (short of a heating pad)!
Should your clogged duct not clear up after a few days of trying your best, make an appointment with your OB/Gyn. That is the doctor that can best help you take care of this issue.
Mastitis. Mastitis is a bacterial infection of the mammary gland and can cause flu-like symptoms among other things. While there are a number of causes, cracked or bleeding nipples or unresolved clogged ducts are the usual culprits. Treatment can involve warm compresses, continuing to nurse baby (even through the pain), and antibiotics to clear up the infection. This problem can become severe very quickly so it is important to get treatment as soon as you suspect mastitis is developing. The article I shared earlier on clogged ducts also has good information about mastitis as does this one from La Leche League, though I would encourage you not to wait too long with self-treatment for an infection.
Tongue and/or Lip Ties. This is probably one of the most complex of the breastfeeding issues. Some babies have ties with little to no symptoms. Moms never feel the effects and therefore never know the ties even existed! But other times, the ties can cause an extremely painful and difficult breastfeeding relationship and can go on to cause other problems as the child grows such as difficulty eating solids, tooth gaps, tooth decay, and TMJ (just to name a few.)
I never knew anything about tongue or lip ties until I had Dash. You can read more about my personal breastfeeding journey here. Suffice it to say that we had just about every symptom in the book. Although the symptom list can be quite extensive, here is an infographic of the basic symptoms you might encounter:
(If you click on the image, it will take you to MommyPotamus’ full article which goes into more detail.)
In case you didn’t click on the image (for whatever reason), I want to add a couple of symptoms that don’t appear in this infographic that I think are important to note:
- Nipple compression – nipples look like a brand-new lipstick (flat on an angle on one side) after feeding.
- Nipple blanching – nipples appear white after feeding.
- Baby frequently falls asleep at the breast, leading to short, very frequent feedings.
I also found the following articles helpful as I was researching this issue for Dash and myself: Using the Murphy Maneuver to diagnose a tongue tie and Dr. Ghaheri’s information about the different lip tie classes/meanings (with pictures.) Dr. Ghaheri’s blog also has an incredible amount of information on this topic and he is widely regarded as one of the foremost experts on the subject.
It is important to note that Dash never experienced weight loss or improper weight gain and I never had problems with my milk supply. I am extremely grateful to have had a proactive and understanding pediatrician and lactation consultant that helped me identify the ties despite the absence of those issues and who directed me to a fantastic pediatric dentist in our area who specializes in laser frenectomies.
The pain I felt during breastfeeding was enough to make me question whether or not I could continue. If you suspect your baby has a tie, arm yourself with as much information as possible before visiting your pediatrician. Know the symptoms both you and your baby are experiencing. Even though awareness about ties is increasing, there are still a surprising number of medical practitioners who do not recognize the need for revision or who do not think there is a connection between ties and breastfeeding problems. I would encourage you not to stop or get discouraged if you experience roadblocks when you are seeking treatment. I found this Facebook group essential for information and support as I was going through this process!
As I mentioned before, this list is not exhaustive but I hope it gives you a good jumping off point if you are experiencing problems breastfeeding. Please know that you are not alone and none of these issues means the end of your breastfeeding journey in and of themselves. You can make it through!
If you have any go-to resources about common breastfeeding problems, please do share them in the comments below!
Be on the lookout for my next post in this series: Real Stories. It is one of the most important posts in my opinion. More than 20 women have shared their breastfeeding experiences and I know you will find them as heartwarming, encouraging, and enlightening as I have.
Read all the Uniquely Fed Series Posts!