BREASTFEEDING BASICS
Breastfeeding challenges and solutions

Caring for your breasts  |  Flat nipples  |  Sore nipples   Engorgement  |  Sleepy baby  |  Fussy high-demand baby

Caring for your breasts

• Wash your breast during your normal daily shower or bath.

• Additional soaps, creams, lotions or ointments are not necessary.

• Rub the colostrum or breast milk into your nipple area after your feed your baby. This will help condition it.

• Leave your nipples exposed and let them air dry after breastfeeding.

• Use 100 percent cotton or disposable breast pads without plastic liners. Change them as often as necessary to keep your breasts and nipples dry.

• If breast pads stick to your nipples, moisten the pads with warm water before removing.

• If your nipples are sore, apply medical-grade lanolin (i.e., Lansinoh, Purlan). Ask your lactation consultant or health care provider for more information.

• You may want to wear a bra while sleeping for comfort and support.

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Flat nipples
You will be able to breastfeed, but you should avoid the use of artificial nipples until nursing is well established.

• Don't use pacifiers.

• Early attachment is important. Do not use bottles until baby has successfully latched on.

• Wearing breast shells/cups inside your bra between feedings may help form nipples.

• Roll nipples between your fingers or pump before feeding to help shape nipples and make them easier to grasp.

• After birth, room-in with your baby so you can feed frequently to prevent/minimize engorgement.

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Sore nipples
Nipple tenderness is normal and usually goes away with time. However, pain is a warning that something is wrong. Proper positioning, latch-on and removal from the breast may help.

• Feed baby before he begins to cry.

• Wait until your baby's mouth is wide open to feed him. Do not allow slurping or nibbling, and do not stuff your nipple into baby’s mouth.

• Re-examine your latch-on and positioning techniques; you may need an adjustment.

• Remember this saying: “tummy to tummy, chest to chest, the chin and nose should touch the breast.”

• Remove baby from the breast by breaking suction first.

• Keep baby positioned upon the breast; don’t allow dragging off the breast or stretching and pulling the nipple.

• Avoid pushing/pulling the breast away from the baby’s nose; instead, adjust his position slightly until a nostril is visible.

• Apply warm moist compresses after breastfeeding.

• Express a little milk and massage into your nipple.

• If your nipples are cracked, bleeding or damaged, talk to a lactation consultant or your health care provider.

• Avoid breast pads.

• Wear plastic breast shells to promote air circulation, speed healing and keep bra from touching nipples.

• Apply warm saline solution (1/4 teaspoon salt to 1 cup water) with cotton balls.

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Engorgement
This swelling of the breasts may be brought on by onset of heavy milk production. Engorgement may last from one to 10 days.

Symptoms are:

• Tight, full, heavy breasts that are warm to the touch.

• Difficulty with latch on due to flattened nipple and swelling.

To alleviate engorgement:

• Breastfeed or pump your breasts at regular intervals.

• Apply warm, moist packs to your breasts for five minutes. This helps open ducts and encourages milk flow. Longer application may increase swelling.

• Massage your breasts with gentle circles to encourage milk flow.

• Pump or express milk to soften areola; then nurse your baby.

• After nursing or pumping, wrap ice in a towel and place it on your breast for 10 to 15 minutes to provide pain relief and reduce swelling.

• For severe engorgement, apply ice first to reduce swelling, then heat for five to 10 minutes and massage, then nurse or pump.

• Use analgesic/anti-inflammatory medications. Be sure to talk to a lactation consultant or your health care provider so you know which medications are safe to take while breastfeeding.

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Baby-related breastfeeding challenges

Sleepy baby

Some babies are difficult to arouse for feedings. Don't force feed, but try some of the following tips. To wake your baby:

• Change his diaper

• Hold him skin-to-skin

• Rub his back

• Tickle his feet

• Wash his face

• Unwrap blankets from around him

Other methods to try include:

• Express a few of drops of colostrum and allow your baby to suck it off your little finger.

• Avoid bottles and pacifiers between feedings.

• Attempt to breastfeed for 10 minutes. If you're not able to arouse your baby, place him skin-to-skin on your chest and try again in 30 to 60 minutes.

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Fussy high-demand baby

Some babies have periods of frantic, fussy behavior when it is difficult to get them to breastfeed.

• Learn to anticipate when your baby is ready to breastfeed but is not fully awake and/or frantic.

• Dim the lights and turn off the television and telephone.

• Be patient and don't take it personally. Your baby is not rejecting your milk.

• Remember: sometimes babies are just fussy - it's no one's fault if this happens.

• If you're feeling overwhelmed, put your baby in crib and take a break.

To calm your baby:

• Swaddle or hold him snugly.

• Let him suck on your little finger.

• Avoid pushing on the back of baby’s head or forcing him onto your breast.