Sore, cracked or bleeding nipples
Sore, cracked or bleeding nipples are usually a sign that either your baby is not latched on properly, is positioned incorrectly, or you could be using a breast pump incorrectly.
Blocked ducts
There are two types of blocked duct.
- A small white spot at the end of your nipple: you can normally remove it with a clean fingernail when your skin is soft after feeding.
- A painful lump in your breast with inflamed skin around it. This kind of blockage could be an early sign of mastitis.
If you have an inflammation in your breast it’s important to speak to your health care professional as soon as possible to prevent mastitis from fully developing.
In the meantime:
- Feed as often as you can to drain the excess milk
- Make sure your baby is latching onto your breast correctly
- Try using a breast pump to drain your breasts fully to help relieve the pain. Gently massaging your breasts and applying warm flannels can help too.
Thrush
Thrush is a fungal infection that babies often get on their genitals and in their mouths. It can also spread to your breasts during feeding. If your baby has thrush you’ll notice the nipples may appear bright pink; the areola may be reddened, dry or flaky. Rarely a fine white rash may be seen. The most common symptom is nipple pain or breast pain that feels like a stabbing or aching sensation that radiates through the breast.
If you think you or your baby has thrush, see your health care professional. They may prescribe an oral fungal cream for your baby. Mum and baby need to be treated at the same time to prevent re-infection. You can still carry on breastfeeding, though it may be a little sore!
Engorged breasts
Two to three days after you give birth, your breasts may become full, tender and lumpy with flattened nipples. The swelling may even spread to your underarms and you might get a small fever. This happens when your milk ‘comes in’. It can be painful, but it’s quite harmless and usually goes away quickly.
Try applying hot, moist towels to your breasts for a few minutes or taking a hot shower before feeding baby. After using moist heat, gently massage your breasts with massage oil all over in small circular movements. Either hand express or use your pump to express some milk. This will help soften the areola and make it easier for baby to latch on to your breast. Apply cold compresses or ice packs to your breasts after the feeds. This will relieve discomfort and swelling.
Leaking breasts
Your breasts may leak if they are too full of milk, or your ‘let down reflex’ is triggered. Usually your breasts only release milk when your baby suckles, but sometimes just hearing a baby cry can trigger your breasts to ‘let down’ their milk!
The more regularly you feed, the less likely your breasts are to leak. Most mums wear breast pads inside their bras in case of any leaks. You’ll probably find that the problem disappears almost completely after about seven to ten weeks of breastfeeding.
Problems with your milk
Too little milk
The more milk your baby consumes the more your body will produce, so too little milk can be a sign that your baby isn’t latching on properly so your body produces less milk. If you’re worried your baby may not be getting enough milk, speak to your health care professional.
Too much milk
Producing too much milk is common in the first few days. Initially your body produces lots of milk to allow for a high volume of feeding, this settles down once your baby is feeding well and should regulate itself. If your baby isn’t latching on properly then this regulation doesn’t happen and you may find that you continue to produce extra milk, especially as they’ll need to feed more often. So make sure your baby is latched on properly.
Too much milk can also be down to an overactive let down reflex or an imbalance between the amount of foremilk and hind milk you’re producing.
If you’re still producing too much milk after your baby’s pattern has settled, you can express some and store it for later. Be sure not to express too much or in-between feeds though, as this will cause your body to produce more milk to fill the extra demand.
Milk spray
Some mums can produce a strong spray of milk either as a side effect of producing too much or as a problem on its own. This can be off-putting for your baby and can cause some babies to refuse the breast.
If this happens, it helps if you can express some excess milk before you let your baby feed. Or you can try letting them suckle to bring the milk down, and then capture the initial spray in a towel. When the flow has calmed a little let your baby latch on again.
Problems with your baby’s feeding habits
Breast refusal
If your baby is refusing your breast, it’s usually their way of telling you there’s something wrong. It might just be teething pain, or difficulty breathing from a cold.
If your baby’s gone on breast strike, try feeding them when they’re very sleepy, and keep the room quiet and distraction-free. You could also try different feeding positions, or even try feeding on the move as the rocking motion can be comforting to your baby.
It’s also a good idea to see your health care professional to make sure there’s nothing wrong, such as an ear-infection or thrush.
Feeding from one breast only
Sometimes babies develop a preference for one breast. It won’t harm them, but you want to give both your breasts the chance to produce equal amounts of milk.
If your baby’s being choosy, try feeding them on the breast they don’t favour in the same position as the one they do. So if you’re cradling your baby on your left breast, just move them across to the right one, instead of turning them around. You’ll find it more comfy if you put a pillow under your supporting arm.
Biting baby
A biting baby is not much fun! If your baby is teething, let them have a good chew on a cold teething toy to get it out of their system and numb their gums. And if they do bite, draw them close. This makes it difficult for your baby to breathe through their nose, forcing them to open their mouth and let go!
If your baby is biting because they think making mum yell is a great game, be firm, say ‘no!’ and place them gently on the floor for a minute.