Breastfeeding problems

It's not uncommon to hear pregnant mothers say they plan to breastfeed If I can . However, it is worthwhile for every woman to assume that they will be able to breastfeed their baby. Having a positive attitude, where breastfeeding is normalised, goes a long way towards dealing with any issues if they come up. Most breastfeeding problems are best viewed as temporary interruptions, rather than a reason to stop breastfeeding.

Although breastfeeding is a normal process, it still involves a learned set of skills for both the mother and her baby. In the course of developing confidence, it can be easy to feel overwhelmed and confused. But it is worth remembering that breastfeeding is so beneficial to both mothers and their babies that it is generally worth persevering.

Common Breastfeeding Problems

Most women are able to breastfeed without experiencing any significant problems. After a few days of getting used to attaching the baby correctly, and for lactation to become established, breastfeeding becomes an easy and straightforward process.

Time, patience, confidence, support and importantly, an I can do this attitude, all combine to make breastfeeding a pleasurable experience for most women.

Colostrum is the first milk produced by the mother's breasts and this is replaced by more mature milk within the first few days after birth. Colostrum is high in antibodies and immune properties and is ideally suited a newborn baby's gut to digest. Early breastfeeds, as soon after birth as possible, even within the first half hour, help to initiate breastfeeding and lead to success. They also assist with early bonding and emotional attachment.

Most newborns have a very strong urge to suck and are hard-wired to seek the nipple and attach themselves. Where possible, midwives and maternity care providers encourage early breastfeeding and attachment by placing the newborn baby up onto the mother's chest or tummy immediately after birth. This skin-to-skin contact helps the baby to activate their inbuilt crawling and seeking responses.

Don t expect your breastmilk to look like cow's milk they are completely different. Breast milk can appear watery with a pale blue tint, but this is not a sign of it being too weak. The concentrations of nutrients, water, fat and antibodies in breast milk are always perfect for the individual baby. Breasts can differ in size and how much milk they produce. It is not uncommon for babies to prefer sucking on one breast than the other.

Some women experience a painful let-down during breastfeeds. The milk ejection reflex can be quite strong, especially if it has been a while since the baby last fed. Fortunately, let-down pain is usually temporary, as the nerves are activated. The hormones which are released during a let-down help the breasts to produce milk and for the milk to be squeezed out of the nipple. Deep breathing and trying to relax often helps with managing breastfeeding let-down pain.

Biting when breastfeeding

Once a baby starts teething, they may start to bite down on the mother's nipple when breastfeeding. Baby teeth can be very sharp and biting can understandably, cause intense pain. Managing baby biting can be challenging, especially as it's hard to predict when it will happen.

If your baby bites, break their suction and calmly finish the feed. Say clearly no biting , place your baby down gently and have a break before reoffering the breast. With time and repetition, your baby will learn to associate their biting behaviour with the outcome e.g., that feed has finished. In-between breastfeeds, offer your baby soft toys to bite down on and textured foods to chew.

Now I'll always have Problems!

Early breastfeeding problems are not a sign that breastfeeding will always be difficult. Most minor problems can be fixed with short term strategies and often don t recur. However, it's important to get professional help if you feel you need it. Early, specifically targeted solutions can often prevent complications from occurring. Speak with your midwife, child health nurse and/or a lactation consultant to get support and guidance.

Mothers often develop their own solutions, though just need a trusted person to clarify them. Support can range from a telephone conversation to a comprehensive consultation with someone experienced in lactation. Often the greatest support comes from those who have had similar experiences. Although they may not have professional expertise, empathy is an important factor.

Common Breastfeeding Problems for Mothers

• Difficulty attaching the baby correctly to the nipple.
• Low breast milk supply or alternately, a copious milk supply.
• Tender or painful nipples. Occasionally cracks, blisters and grazes occur as a result of incorrect attachment.
• Blocked milk ducts and mastitis.
• Confusion due to conflicting advice. Aim to find a couple of trusted sources of support and work out what applies to you and your baby. Do what seems and feels right.
• Low confidence. Any new set of skills seems foreign and strange at the beginning. Be kind to yourself as you and your baby progress through the learning stages of breastfeeding.
• Mothers who have had breast augmentation or reduction procedures may have problems with low breast milk supply. This does not prevent them from breastfeeding, but if their baby is not receiving sufficient breast milk to thrive, they may need formula or donated breast milk supplements.

Common Breastfeeding Problems for Babies

• Sleepy baby who is disinterested in sucking.
• Prematurity or illness which is impacting on the baby's ability to suck.
• An uncoordinated sucking and swallowing response.
• Fussiness and disinterest in breastfeeding. Sometimes the cause for this is unclear.
• Lack of opportunity to feed as frequently and for as long as they need to. Restricting breastfeeds does not support the supply and demand principles of successful breastfeeding.
• Confusion about effective sucking. This can happen when a baby is sucking on bottles and dummies as well as the breast.
• When a breastfed baby is offered formula milk, this can interrupt their hunger and willingness to attach and suck on the breast.

Where to Get Support

• Midwives. These nurses have training and expertise in caring for mothers. They work in maternity hospitals, community health centres and in private practice.
• Child health nurses who work in community health centres.
• Lactation consultants who work within community health or have their own independent practices. Check the Australian Lactation Consultant Association at www.alca.asn.au
• General Practitioners particularly those with a special interest in breastfeeding.
• Paediatricians.
• Australian Breastfeeding Association www.breastfeeding.asn.au
• Other mothers, friends, relatives and support groups who have had breastfeeding experience.

Edited and reviewed by Jane Barry, Midwife and Child Health Nurse July 2021.