Potential problems in the first few days
The sleepy baby
Rather than being alert and eager to drink after birth some baby's tend to be sleepy and show little or no interest in feeding. Don't be put off trying, even a little drink is worth the effort.
You need to rely on the discretion of the nursing staff as to how long you should keep coaxing your baby.
Your baby might be tired, sleepy because of drugs you had during your labour, too hot or too cold.
In such instances your baby is probably better off being monitored in the nursery and brought back to you at a later stage.
You could however, express some colostrum on to a sterile teaspoon and give that to your baby. This often encourages your baby to wake up within 15 to 20 minutes for more.
It could be helpful to unwrap your baby and have skin to skin contact when feeding.
A wet facecloth on the forehead or tickling feet would encourage him to wake up.
The nursing staff will keep a close check on your baby and test his blood glucose levels if necessary so there is no need to be concerned. Your baby will wake up in due course and be more eager to take feeds.
Painful nipples
Most often sore or painful nipples can be avoided by applying the correct techniques, the most important of which is "a good latch."
When feeding your baby for the first time you'll probably be surprised at the strength of your baby's sucking action.
It might be sensitive but it should not be painful, if it is, it would then be better to re-latch your baby. Pain indicates that damage is being done.
How to avoid painful nipples
Positioning and latching when feeding
- Most mothers are more comfortable feeding in a chair rather than in bed.
- Use all the pillows you need to get you and your baby comfortable.
- The Madonna position (supporting your baby's head in the crook of your arm) is not the best position to use in the first few days.
- Most mothers prefer the football position when learning. As the name indicates you would hug your baby lets say, under your right arm on your right side with your baby's mouth slightly lower than your nipple.
- Be sure to have your baby's face, tummy and knees facing towards you.
- You would need a pillow under your right arm as support.
- Now support your baby's head in your right hand.
Once comfortable you are ready to stroke your nipples with your baby's lips to encourage her to open her mouth.
- Only when her mouth is wide open would you push her onto the breast.
- The best indication of a good latch is when it feels comfortable.
- Should you experience pain try again.
Taking the baby off the breast
- Babies often fall asleep at the breast but start sucking the moment you move to take them off.
- Taking your baby off the breast incorrectly even once can cause painful nipples.
- It is important to break the suction before taking your baby off the breast.
- Firmly insert a finger into your baby's mouth, you must get your finger between the gums and feel the suction breaking, leave your finger between the gums while taking your baby off.
The duration of feeds
- Leaving your baby on the breast for long stretches at a time could result in painful nipples.
- Most often you're supporting hand and arm tires then sags resulting in your baby pulling unnecessary on the nipple.
- Timing your baby's feeds must be avoided but when your baby's strong sucking action subsides he has had what he is going to get from that breast.
- You could leave him on the second side for a little longer if you wish to.
The frequency of feeds
For successful breast-feeding, demand feeding is encouraged. Remember that babies niggle and cry for reasons other than hunger.
Don't assume that your baby needs a feed every time he stirs or wakes up. Babies need lots of love and cuddling. You cannot spoil a young baby with too much love.
Be careful not to over-stimulate your baby.
Besides being unnecessary, feeding too often could also result in painful nipples.
When not really hungry your baby may not latch correctly and damage the nipples. These babies tend to use the nipple as a dummy when they are not hungry.
Feeds that are too far apart can be even more problematic. Hungry babies put far more stress on the nipples than babies that drink often.
Hygiene
Too much soap, cleaning or rubbing can damage the skin and cause it to become dry. It is not necessary to clean your nipples every time you feed your baby.
In fact it is preferable not to use soap on the nipples when having a bath or shower. Water only is sufficient.
On the other hand, it is important to dry the nipples after feeds and keep them dry between feeds.
Breast pads must be changed frequently and avoid plastic backed breast-pads.
Choose cotton bras and nighties to avoid unnecessary perspiration.
Full or engorged breasts
Full or engorged breasts could also result in painful nipples.
Your milk will come between day three to five. You might experience a tingling sensation and notice the colostrum becoming whiter.
It would be normal for the breasts to feel full and heavy.
After feeding your baby this would subside before filling for the next feed. This is all normal and to be expected.
It is possible that your baby might have difficulty in latching when the breast is full and the areolar difficult to grip. One would then need to express a little milk to soften the areolar area.
Cold cabbage leaves could be used inside the bra for relief.
However, your breasts are probably engorged if
- you experience severe lumps and discomfort
- the heaviness doesn't subside with feeds
- your nipples became painful
- your baby remain restless during and after feeds
Prevention
- The best way to prevent engorgement is to demand feed your baby, meaning that you would probably feed your baby every two to four hours.
- Should your baby have any difficulty in latching you may need to express a little to soften the area around the areolar - that includes the night-time feeds.
- Feeds would now last longer than before.
- Do not restrict your fluid intake.
- Wear comfortable bras
Treatment
- Treatment would be much the same as preventing the condition mentioned
- Alternating heat and cold offers relief, for example a hot shower followed by cold cabbage leaves inside the bra.
- It would be necessary to express some milk to soften the area around the areolar to enable your baby to latch correctly.
- Ultrasound treatment administered by a physiotherapist offers relief.
- In severe instances your doctor might prescribe medication. - Purity