A Lactation Consultant’s Guide to Breastfeeding

By Guest Blogger Megan Dunn, IBCLC, a board certified lactation consultant

When it comes to nourishing your baby, fed is always best. But if you choose breastfeeding, you’re bound to have questions along the way. With the right information and support, you can develop techniques and strategies that work best for you and your little one.

To help you on your journey, we spoke with Katie Maxey, a registered dietitian and board-certified lactation consultant at Atrium Health Wake Forest Baptist. Here’s what she says are the most common breastfeeding challenges new mothers face – and how to overcome them.

5 Common Breastfeeding Challenges (and how to overcome them)

By Katie Maxey, RD, IBCLC

1 – Breastfeeding Hurts

Breastfeeding can cause sensitivity, but it should never be painful. If you are experiencing pain, here are some things to try:

~ Check your baby’s latch.

The most common cause of breastfeeding pain is a shallow latch. Your baby should draw your nipple and much of your areola (the darker region around the nipple) into their mouth. With a shallow latch, your baby is only drawing your nipple into their mouth, which can cause you to experience pain.

You can achieve a deeper latch and increase comfort by fixing your baby’s positioning – this can also help your baby get more milk from the breast.

~ Try different positions.

To take pressure off the most sensitive or painful areas of your breast, try nursing in different positions to learn what works and feels best for you and your baby. Here are a few examples:

~ Keep your nipples clean and dry.

Infection flourishes in damp conditions, so air-dry your nipples or dab them dry with a very clean and soft muslin or flannel cloth. You can also use disposable or washable nursing pads to absorb any milk leakage – just remember to change them regularly.

~ Soothe your nipples.

Many mothers experience dry or sore nipples when they first start breastfeeding. For relief, gently apply a few drops of breast milk to tender areas. You can also use coconut oil or ultra-pure lanolin ointment, as long as you’re not allergic to wool. There’s no need to wipe it off before your next feed.

Another thing you can try is refrigerated hydrogel pads. These nipple pads are cool and provide instant relief, but be sure to wash them with soap and warm water and allow them to dry completely between uses.

2 – My Baby is Not Latching Correctly

At times, your newborn may struggle to find the right latch. This is usually just part of the learning process, but it can also happen if your baby was born early or if you have flat or inverted nipples. If you’re struggling to get your baby to latch:

~ Adjust your hold.

Your newborn needs to feel supported, comfortable and able to breathe during feedings. To help them feed properly, keep their body and bottom close to you, support them across their shoulders, and hold them firmly so they feel secure. Try not to hold or push your baby’s head to assist with latching, as this can affect their experience. (Refer to the breastfeeding position pictures above for examples.)

~ Use nipple shields.

If your baby still isn’t latching, nipple shields may provide a larger, firmer target for them to feed from – but only as a short-term solution.

3 – There’s Not Enough Milk.

If your milk doesn’t come in right after birth, try not to worry. Your milk supply grows gradually, just like your baby’s stomach, and it can take 3 or 4 days after giving birth for your “mature milk” to transition in.

In the meantime, your body was making something called colostrum during pregnancy. Also called “liquid gold,” colostrum is the first drops of milk present after birth and is full of antibodies and nutrition that are perfect for your newborn baby. As your milk comes in, here are some ways to build your supply:

~ Feed on demand.

If possible, avoid a scheduled feeding pattern. In the first week postpartum, your newborn will want and need to feed at least 8 times throughout the day and night, sometimes even more. This frequency will help boost your milk production, so allow them to go to the breast as often as they show hunger signs. The more your baby stimulates the breast and nipple after delivery, moving colostrum into their belly, the better your long-term milk supply will be.

~ Express milk yourself.

Whether you’re separated from your baby or struggling to latch, there may be times when direct breastfeeding isn’t an option. In these cases, hand expression and pumping can help stimulate your breasts, build your supply and move milk to your baby, without putting your baby to your breast.

~ Take good care of yourself.

While it’s not always easy with a newborn, try to get rest, eat well and accept help whenever possible with chores or caring for your other children. This will make it easier to focus on breastfeeding and building your milk supply.

4 – My Breasts are Full and Hard.

As your milk begins to transition from colostrum to mature milk – around days 3 and 4 postpartum – your breasts may become fuller and firmer. This should get better on its own, as your newborn begins feeding more frequently.

However, some women’s breasts become engorged, rock hard, and feel tender, uncomfortable and even painful. Although this is only temporary, engorgement can make it difficult for your baby to latch as your nipples may become flattened. If your breasts feel engorged, here’s what you can do to maintain healthy breastfeeding with your baby:

~ Feed your newborn often.

Aim to feed at least 8 to 12 times every 24 hours. Try to listen for swallowing – sustained sucking and audible swallowing are signs that your baby is feeding well and removing milk from your breasts.

~ Express milk to help latch.

If your breasts are so full that your baby cannot latch, hand express or use a pump to gently release some of the milk and soften the breast before latching.

5 –  One Area of My Breast is Super Tender.

In some cases, a sensitive area in one of your breasts may indicate a clogged duct, which happens when the breasts aren’t drained fully. If you have a clogged duct, the first step is always getting milk to the area. Here’s how:

~ Position your baby so their chin points toward the tender spot.

~ Massage the area while your newborn feeds.

However, if your condition gets worse, your nipples are cracked and damaged, or you develop a fever or redness in the breasts, contact your doctor right away. This could be a sign of a breast infection called mastitis, which requires medication to treat.

~ Help is here when you need it.

Although breastfeeding is natural and beneficial for your baby, it can take time and practice to get the hang of it.

One of the best ways to achieve breastfeeding success is to see an Atrium Health Wake Forest Baptist lactation consultant. They offer support in the hospital after delivery and even after you go home, helping you learn proper latch, overcome challenges and ensure your baby is feeding and gaining appropriately. To learn more about our lactation services or schedule an appointment, call 336-716-6212 or go online.

*Sponsored by Atrium Health Wake Forest Baptist