Breastfeeding is a unique experience that offers important benefits, providing a natural food that is always available; indeed, the World Health Organization (WHO) recommends exclusive breastfeeding until the 6th month of life.
It does happen, however, that some women encounter temporary difficulties that can be resolved by improving how they are managed, with competent help and support.
In this article we will look at the most common problems, how to recognize them and what solutions to adopt to overcome them, always referring to breastfeeding experts such as the midwife and the pediatrician.
Breast engorgement
Breast engorgement is one of the most common problems, especially in the early period.
Between the third and fifth day after birth, the milk comes in: the mammary gland begins secreting milk, and its buildup makes the breast swollen and heavy; if it is not drained, the breast can become hard, hot and painful, with the skin taut, shiny and reddened, and fever and exhaustion may occur.
The cause is linked to inadequate emptying of the breast throughout the breastfeeding period, due to intervals between feeds that are too long or to suckling that is not effective or prolonged enough.
Management and solutions
- It helps to start with prevention: leave the breast free or wear comfortable bras that are not too tight, to avoid milk stagnation
- The best solution is to empty the breast often by feeding the baby, especially when they ask for it, or by using a breast pump
- Apply warm, moist compresses before feeding, using cloths soaked in hot water, hot water bottles, soaking the breast in a basin or sink, or taking a warm shower; this should be done for two to three minutes, after which you can proceed to feed the baby or use the breast pump
- Change the baby's latch position often to allow every part of the breast to be emptied, and favor forward-leaning positions to take advantage of gravity, which helps the milk flow more easily
- Massage the breast and stimulate the nipples by rolling them between thumb and index finger to trigger the milk let-down reflex
- Between feeds, apply cold compresses to the breast to relieve pain and tension
Homeopathic remedies
As for homeopathy, Lac caninum 30 CH pellets can be used for breast engorgement when the breast is tense and painful (5 pellets at each feed). It can be helpful to add Apis 15 CH pellets, 3 to 4 times a day, when relief is obtained from cold applications on the breasts. Phytolacca decandra, again at 30 CH pellets, when the lumps, besides being painful, begin to turn red.
Nipple shape
Nipples come in various shapes and sizes, and all of them are suited to breastfeeding; they are usually protruding outward, but in some cases they can be:
- Flat, barely protruding outward
- Inverted, drawn inward toward the chest
- Long and/or large, very protruding and wide
These variations can affect one or both breasts, causing difficulties especially in the first weeks, when the newborn has not yet refined their suckling ability, which is still not very vigorous, or when their mouth is small and they struggle to latch on and maintain the hold.
Management and solutions
- Correct the baby's position and latch
- Latch the newborn on frequently so they can get used to it and practice
- Stimulate the nipple to protrude before starting the feed, either manually by rolling it between thumb and index finger, or by using the «modified syringe» method, which should be requested from a breastfeeding consultant, or by using a breast pump
- If none of these measures seem to resolve the difficulties, resort temporarily to a nipple shield for short periods; choose a silicone one, as it is thinner and adapts better to the shape of the breast, and consult an expert who can explain how to put it on and how to gradually stop using it
It is important to see a doctor if the initial discomfort does not resolve on its own within a short time or tends to get worse. The onset of fever is always an important sign that may lead to antibiotic treatment being prescribed.