Special Problems of Breast Feeding in Early Infancy

A new mother, inexperienced at breast feeding might be faced with numerous problems, stemming specially from the fact that an infant’s behavior patterns keep changing in the early days, complicating the nursing mother’s job, often driving her to insanity.

In the earlier stages of infancy, the baby is too small to know how to suck properly, as a result, she tires easily and falls off to sleep exhausted by the effort only to wake up again within a few minutes of being put down, because she is still hungry. This picking up, feeding and putting down routine, can really tire the mother who herself is exhausted.

Babies generally consume sufficient milk during the first five minutes of proper breast feed. It is therefore important to help the baby get a sufficient amount initially, so she sleeps with her tummy full.

The more tensed the mother gets, the more difficult it is to let the milk down, thus relaxation is the key to good breast feeding. However, there are some other common problems new mothers might face while breast feeding. Some of them are listed below.

Retracted Nipples
This is a common condition seen in new mothers, where the nipples are often drawn back into the breast by the supporting tissue. This makes it difficult to make the small baby, to get to suck at the breast, irritating the hungry infant as she seeks for the nipple but is unable to find it.

What to do-
• Try drawing the nipple out with your fingers, by pressing it.
• Use a nipple shield to let the baby suck and it will also draw out the nipple in a while.
• Calm down the cranky baby, do not tense up, and take your time.

Painful Nursing
One of the unknown facts of nursing/breast feeding is, that nursing causes the uterusdefine to contract, as a result of which, the mother might feel cramps in her lower abdomendefine, during the initial few days, when she is feeding the baby. These however, go away in a few days.

Unwell Mother
It is possible that the mother falls sick after delivery, generally the reason is a viral infection or fever. There is risk that the baby also might get the infection through the milk, but doctors advise continuing to breast feed as it is possible otherwise also, because the baby has to stay with the mother. Therefore unless very serious, breast feeding need not be stopped.

Baby Biting Nipple
Often when babies start teething they get itchy off and on, and tend to bite the nipples if it happens while they are feeding. This can be very painful for the mother and should be stopped immediately with a stern reaction and withdrawing the breast. Once this is done a few times, babies normally get the message that they are not to repeat the act.

Incase the baby goes on biting, the feeding can be stopped as the baby has developed teeth and can take solids now in addition to top feed.

Cracked Nipples
When the baby is not feeding properly, and is taking only the nipple in her mouth to suck on, instead of the whole areoladefine, it can often lead to cracked nipples, which pain badly.

What to do -
• Stop feeding from that breast immediately for 24-48 hours.
• Express milk manually from time to time to avoid engorgement of that breast.
• Dry the nipples properly before covering after each feed.
• Consult your doctor for a nipple cream.
• Resume feeding if nipple is better.
• If still sore, use a nipple shield for a few days.

Breast engorgement
Breast engorgement is a condition when the breast gets overfull or over distended with milk, causing a painfully uncomfortable condition for the mother, which makes feeding difficult, and further worsening the problem.
Breasts can get engorged in three ways –

Areolar engorgement happens when the storage spaces behind the areola get filled with milk, making the areola so firm and flat that the baby is not able to suck on it properly.

What to do -
• Manual expression of milk is the best solution in this case.
• Spending 3-5 minutes on each breast would be sufficient to make the areola soft enough for the baby to hold onto.
• While feeding the mother should hold the areolar region between her index and middle finger to avoid this in future.
• This kind of engorgement is seen only during the first few days of feeding and generally does not reoccur.

Peripheral engorgementhappens when the whole breast in addition to the areola is over distended. The condition makes the breast overly hard, painful and sensitive.

What to do -
• Feeding the baby provides immediate relief.
• Hot water bags and ice packs too might help.
• Manual expression after mild massage is also an answer.
• Wearing a bra which offers support from below and does not press the breast too hard is very important.
• Sometimes medicines also might be needed.

Breast Abscessis the kind of engorgement confined to a segment of the breast and can be treated similarly as in case of total engorgement.