Posted on May 19 2021
Breast pumps, such as this one from Hegen, can help boost your milk supply, and relieve you of blocked ducts and breast engorgement.
Breastfeeding is not easy, so kudos to all the mums who have tried, no matter how long or short your journey has been. Here are some of the problems and issues you might face when breastfeeding, and how to solve them.
1) Incorrect Latch
Your baby’s chin and nose tip should touch your breast, and her mouth should cover the nipple and the areola.
An improper latch can cause a few problems in breastfeeding, such as sore and cracked nipples and low supply. Ideally, your baby’s mouth should cover the nipple and most of the surrounding areola. Cradle your baby with her mouth close to your breast and hold the breast with your other hand. Your thumb should be above your nipple and areola, and your index finger at the spot where your baby’s chin touches the breast. Compress your breast like a sandwich, stroke her cheek, turn her mouth towards your breast, and tickle her lips with your nipple until she opens her mouth wide. Bring her to your breast so she puts the nipple and a good amount of your areola into her mouth. Your baby’s chin and tip of her nose should touch your breast, and her lips should be flanged out.
2) Low Supply
Every drop of milk is precious, especially when you have low supply, so collect milk with the Elvie Curve, which fits securely in your nursing bra.
Judge if your baby is getting enough milk by her bowel movements and urine, and weight gain. In the first four weeks, your baby should have about two bowel movements and six to eight heavy and wet diapers in 24 hours. Additionally, your baby should gain about 110 to 200g per week. If you have medical conditions like polycystic ovarian syndrome, diabetes, hormonal disorders or mammary hypoplasia, you may have low supply. First, a lactation consultant can help ensure your latch is correct.
Next, try to express or nurse around eight to 12 times a day, pumping after each feed for up to 15 minutes or power pumping once a day for an hour. Comfort nursing is a great way for your little one to fall asleep. Add galactagogues like oatmeal, brewer’s yeast and flaxseed to your diet via lactation cookies or nursing tea. You may also have to supplement with formula milk to clear your newborn’s jaundice and to ensure she’s getting enough nutrients. Just remember that your baby’s health and your own well-being are more important than how much breast milk you can produce.
3) Tongue and Lip Ties
If your baby has trouble latching and you hear a clicking sound, she may have a tongue tie. This means the band of tissue connecting the bottom of the tongue to the mouth’s floor, or the frenulum, is too short and tight, restricting your baby’s tongue movements. A paediatrician or ENT may clip the frenulum so your baby can freely move her tongue.
A less common condition is the lip-tie, a short and tight connective tissue attachment on the upper lip, which also affects your baby’s latch. Check to see if your baby’s upper lip is attached low on the gum, and a lactation consultant can help position your baby properly. Otherwise, your paediatrician can also revise the lip-tie.
With the Elvie Catch, your nursing bra can stay dry and you can collect any additional milk to add to your freezer stash.
Some indications you might have oversupply include your baby coughing and spluttering near the start of a feed. She is likely to clamp or bite down, or loosely hold your breast in her mouth. Additionally, she may spit up a lot and require frequent, gentle burping. With oversupply, your baby gets less high-fat milk, but plenty of lactose-rich breast milk, which can be hard to digest, as evidenced by her explosive, frothy green poop.
You may constantly feel engorged and overfull, have blocked ducts or repeated bouts of mastitis. Let your baby set the pace and feed her in a reclined or lying-down position, or hand express or pump to relieve the breasts. Bear in mind that each time you express milk, your breasts produce more, beneficial if you want to build a freezer stash. Stay dry with nursing pads and avoid lactation teas and supplements. Check with a lactation consultant or breastfeeding specialist to help you manage your milk supply or try block feeding. With block feeding, you’ll feed your baby from only one side for four hours, so the other side gets full and slows down production of new milk.
5) Blocked Ducts and Breast Engorgement
Use the Lansinoh TheraPearl hot or cold to help relieve engorgement, plugged ducts and mastitis.
Some causes of blocked ducts include inadequately removing milk, breast pressure, infrequent feedings, and abrupt weaning. Try, as much as possible, to get proper rest and nutrition to keep your milk flowing instead of developing a clogged duct.
Similarly, if you make more milk than your baby drinks, you might experience breast engorgement, where the breasts are firm and swollen. Other symptoms include flattened nipples, a slight fever and swollen and tender lymph nodes in your armpits. This usually occurs when your milk first comes in, if you suddenly stop nursing or your baby goes on a nursing strike. If you aren’t breastfeeding, or intend to wean your baby, pump just enough to make you feel more comfortable.
Ways to help breast engorgement and blocked ducts are to use a warm compress, hand express or pump a small amount of milk from your breasts. Try breastfeeding or pumping more frequently, making sure to empty your breast each time. Opt for supportive nursing bras ($44.91 to $71.91) that don’t put pressure on your breasts for a long time. For blocked ducts, massage the breasts or have a trained masseuse help you - just be warned it will hurt a lot. A cold compress or over-the-counter painkillers can also help.
If you have a fever, muscle and breast pain and redness, you may have mastitis, where your breast tissue is infected. This usually happens when the trapped breast milk in a clogged milk duct gets infected with bacteria from your baby’s mouth. Seek medical attention, and your doctor will likely prescribe antibiotics and pain relievers. As with breast engorgement and milk ducts, applying warm compresses can also help relieve pain. As far as possible, try to continue breastfeeding your little one.
7) Uneven Breasts
One of your breasts may under-produce, leading your baby to favour the other one, causing your breasts to look a little lopsided. Offer the less-favoured side first every feed to increase production, and the breasts should balance out once you wean.
8) Nipple Vasospasm
If you feel pain, burning or numbness in your nipples, you might have nipple vasospasm, where the nipples’ blood vessels tighten and constrict, restricting blood flow. Women with Raynaud’s disease, where blood vessels in the fingers and toes narrow when cold or stressed, may be more susceptible. Ensure you’re always warm, cover your nipple once you’re done feeding, and apply warm heat when the symptoms start. Help stimulate blood flow by massaging your areola with olive oil and stretching the muscles around your breasts a few times a day. Check with your doctor to make sure you’re not on any medication that may inadvertently cause this.
9) Sore or Cracked Nipples
Once you and your baby get the hang of nursing, your sore nipples should ease - otherwise, put a little milk on the nipple to lubricate it and let it air dry.
You might get these from incorrectly positioning your baby on your breast or using your breast pumps, or through an infection, dermatitis and a tongue-tie. Ease the pain of breastfeeding with sore nipples by gently massaging your breasts, applying warmth to get your milk flowing, and express some milk to lubricate the nipple. Offer the less painful side first, and ensure your baby is latching and positioned correctly. Try to feed her before she starts crying - look for smacking or licking lips, opening and closing her mouth and sucking on any items. Vary your feeding positions, or express for 12 - 24 hours, feeding your baby the milk in a cup. Smear a few drops of milk on your nipple, or use nipple cream ($9.90 to $19.90) to relieve the pain. Check with your doctor if you suspect a medical condition or if you need pain relief.
10) Milk Bleb or Blisters
When a milk duct gets clogged, your nipple pores might also become blocked, making your breast milk thick and hard. Look for a tiny white or yellow spot on your nipple, or red and inflamed skin around it. Try applying moist heat like a warm wet washcloth for about 10 to 15 minutes, then nurse your baby. As she suckles, she may open the blister. After about 48 hours, if the blister still persists, see a doctor, who will clear it out with a sterile needle.
KKH Lactation Service: Call 6225 5554 (Leave your contact details with the telephone operator and the Lactation Consultants will return your call)
Breastfeeding Mothers’ Support Group (Singapore): Call the hotline or Whatsapp +65 6339 3558
Joyful Parenting and Breastfeeding Hotline (by the Family Life Society): 6488 0286
Thomson ParentCraft Postnatal Helpline: 9119 3502
NUH Breastfeeding Helpline (8am - 8pm): 9722 0376
Valerie at Mums Fairy: WhatsApp or SMS her at 8157 5780
Leila at Leila & Co: WhatsApp her at 8200 8262
Sister Kang from Mount Alvernia Hospital: 9839 9477/6347 6641