Common Problems in the first weeks of Breast Feeding
A fissure also
may be very slow to heal, especially if it is complicated by thrush infection. It may be
necessary to stop putting the baby to the breast and to express the milk manually instead.
Usually the milk volume decreases when you do this, but will increase again when the
nipples have healed and the baby can suck frequently again. It is reasonable to apply an
antiseptic cream as soon as you suspect a fissure, with the hope that it may reduce the
chances of bacterial infection making the condition worse.
Another thing that may help is to use a
nipple shield (of rubber, or glass and rubber) temporarily. This should reduce the pain
and also protect the nipple.
of the nipple.
the nipple is a condition, in which the nipple looks red and sore, and the mother feels
pain all the time while the baby is at the breast, not just in the beginning
(as in sore nipples). The nipple is tender even if you touch it with the back of the hand.
This may be an allergic reaction to
something which the woman has applied to her nipple: an ointment, detergents used for
washing her brassieres or pads that are in contact with the nipple. The treatment consists
primarily of removing and avoiding the irritating substance, if you can identify it. You
can apply a steroid-containing cream, for instance non-greasy hydrocortisome cream (0.5 %)
for a few days (never more than a week). Make sure that you wash off the cream
carefully with lukewarm water before each feed, even if you are expressing the milk
manually. This is to prevent the powerful steroid hormone from reaching your baby. If the
diagnosis is right, this treatment is very effective.
been described as occurring when a mother consciously or unconsciously associates breasts
or breast-feeding with some unhappy memory or feeling, for instance in connection with
uncertainty of her own feelings about motherhood.
Typically, on inspection, usually one or
both nipples turn pale and then suddenly blush and then turn pale again. The mother feels
pain in the nipple when she feeds the baby and all the time that the baby is at the
Treatment consists of finding the cause of
the mothers anxiety, and then discussing it with her. Sometimes, when a woman
understands her own problems, her fears decrease and her nipples no longer feel sore. At
other times the problem is too great to resolve quickly enough, and may prevent her from
This is an
uncommon and trivial condition. Milk gets under the superficial layers of the skin of the
nipple, and you see a small white blister. It usually cures itself after a few days and
the skin which covers the blister lifts off. While it lasts, feeding from the nipple may
In most instances, even very sore nipples
can be treated successfully. Occasionally, however, the condition is resistant to
treatment, or recurs at short intervals. This most commonly happens with a nipple of very
poor protractability. In these rare cases, it may be better to stop breast-feeding instead
of going through many painful attempts and failures (provided that artificial feeding can
be done safely).
Sore nipples always test a mothers
motivation for breast-feeding. If bottle-feeding is feasible, it is up to the mother to
decide how much trouble she is willing to take to continue breast-feeding.
I find my breasts leaking milk. Why does this happen and what do I do? Also, I feel that I
am losing a lot of milk, will this make my child weak?
Specialized muscles having sphincteric
action surround the ducts in the breast, which cause the milk to flow, when the baby
suckles. In some mothers lack of tone of these sphincter muscles causes a continuous
leakage. Using pieces of clean cloth in the brassiere is the obvious
solution. These must be changed frequently. Don't worry about wasting a lot of milk.
Although you are losing enough to stain and smell, the volume is very small. Comparing the
amount with the total daily output may be a consolation. Since the reflex affects both
breasts at the same time, while the baby is feeding at one breast, milk also flows from
the other. A mother can press one finger over the unsuckled nipple, this will considerably
reduce the leaking from the unsuckled breast. Leaking usually lessens as time passes.
baby is 6 months old, and I have yet to start my periods. Do we practice contraception
even though I haven't started menstruating? How long may I have to wait for periods?
Some women start menstruating as early as
six weeks after delivery. But in some women who breast-feed, menstruation is usually
delayed longer than that sometimes for as much as 18 months. Menstruation stops
because ovulation (egg production) stops. And a woman who does not ovulate does not get
So, breast-feeding, because it delays
ovulation, helps to space children. But this effect wears off, and menstruation often
starts again, long before you stop breast-feeding. Once menstruation starts after the
delivery, you are as fertile as before. But the first ovulation occurs two weeks before
the periods start so you can conceive before menstruation
reappears. So breast-feeding is not a reliable way for you to prevent pregnancy
even if you haven't started menstruating. There is no way of knowing exactly when you will
begin to ovulate again whether it will be two, six, twelve, or eighteen months. You
should therefore use some form of contraception unless you want another child in a
have been exclusively breastfeeding my 4-month-old son, and want to commence
bottle-feeding. My mother- in-law says, if I bottle-feed him, he will refuse to breast
feed again. Is this true?
What is easier for the baby, to
bottle-feed or breast-feed?
An infant who is used to sucking
from a bottle may have difficulty sucking from a breast. Both the sucking techniques
employed in fact are quite different. It is explained thus: The bottle receiving
mouth technique consists of rounding the lips, expecting the food to come from straight in
front, and holding the tongue high and close to the palate. It is as if the baby were
guarding against having something thrust too far into his mouth, whereas the baby taking
the breast needs to use a small indrawing action to pull the nipple into a widely opened
mouth. Once the babys technique has been adjusted to taking a bottle, it becomes
much harder to get him to take the breast, but competition from the bottle does not
matter, the baby becomes skilled with both.
Thus, since you have been breastfeeding him
regularly till now, the baby should have no problem adjusting to both.
I train my child on demand feed schedule? Or should I feed him looking at the clock,
irrespective of his need? Also tell me, should I feed him more during the day or at night?
There is no set rule that a child should be
fed only on demand, or only when the clock indicates feeding time. As such, a child
demands milk when he is hungry and should be fed then. . Generally, a clock schedule
should be prepared as a guideline for feeding the child and not just to be followed to the
tee. The clock schedule can work as an indicator as to whether the babys daily needs
are met. But, if your baby has 6 wet diapers a day and youre not giving extra water,
he is getting enough. If youre nursing as needed, 7-11 times in 24 hours, your baby
is getting enough. If the mother feels that the child does not demand milk often enough
during the day, she can feed him more according to the clock.
Does the infant have the right
to demand feed at night? Discussion on the topic seems endless. If an infant is hungry,
however, he has, we think, the right to be fed. This is a rule with some exceptions.
For the first weeks and months of life, the
infant certainly needs round the clock service. But as he becomes older, he
has to learn that in spite of what it may have been led to believe it is not the center of
the world. It must wait its turn, at times. The mother may, astonishingly enough, have
other things to do as well as look after it. The infant must accept a compromise between
its own, overwhelming demands, and what is possible for the mother this is part of
the socialization process.
For mothers who sleep with their infants at
night, feeding may not even be a problem at all. In fact, the number of night feeds for
the first three months has been shown to be almost equal to the number of feeds given
through the day. But if the mother does find it a problem, she may try to persuade her
infant to forget about it, by pretending not to hear the cries of hunger for a couple of
nights. Some mothers can bear to leave their babies to cry, others cannot bear it! Some
infants are particularly hungry or particularly persistent and some mothers are
softer than others are.
All that can be said is that a compromise
between mother and child has to be made as in the case of many other of these
questions. No one has yet shown that any lasting harm (or benefit) results whoever ends up
dominating the compromise! But from a purely nutritional point of view, a normal child,
fed on demand during the day, does not need to be fed during an 8-hour night interval
at least not after the first three months.
After the age of 3 months, if the baby
wakes up at odd hours at night after being fed satisfactorily according to the schedule
during the day, warm water (20 30 ml) with ½ teaspoon sugar can be fed to the baby
in a sterilized bottle so that he sleeps off. In this way, the baby will slowly adjust to
no milk feeds at night. Also, the baby will slowly get used to bottle feeding. But,
cows milk should not be introduced through bottlefeeding at least till 4 months of
Some children turn the clock
i.e. they feed in the morning, then they may sleep for 6-7 hours in the middle of
the day. During the night they are fresh and happy and want their parents to be the same.
In this case you have to try to turn the clock back. The mother should wake the child
several times during the day, and she may be able to teach it that the consensus of the
rest of the humanity is to sleep at night and wake by day.
Hence, as time goes on, each mother sees
for herself that breast-feeding is possible and that it is not a fragile and haphazard
process but a simple function, which she herself can control. This increases her
self-confidence, which makes uncomplicated breast-feeding even easier. As time passes,
breast-feeding becomes more of an everyday routine.