I remember the early days of breastfeeding so clearly. I’d imagined sitting peacefully on a park bench, feeding my sweet little baby, then pushing him as he lay contentedly in the pram as I took in the sunshine and flowers while he napped. The birds would sing and everything would be grand. As if.
The reality was that I was scared, exhausted, confused and isolated. And I was convinced that my baby was broken. He never seemed content after a feed and therefore wanted to feed constantly, he hated being put down and hardly slept. It hurt. I hurt all over. And I was desperate for things to get easier.
We’ve compiled a few tips and tricks for getting through some of the most difficult parts of breastfeeding (except latch - that’s a separate post called Getting Started with Breastfeeding). These are things we wished we knew at the time, but we didn’t have a clue!
Normal Pain vs. Abnormal Pain
So some people tell you that if breastfeeding hurts you are doing it wrong. That's kind of not exactly true or helpful advice. It can be painful if you are nipple feeding (see our blog about feeding positions) but there is also what we at the Bshirt call 'normal pain'. Normal pain comes from the tissues that exist inside your nipple being stretched. You might have had pretty cute delicate nipples before, but after breastfeeding those puppies will be permanently at attention! They get pulled out. (yikes) Flat nipples get really pulled out. And inverted nipples may need surgical intervention before you can even attempt to breastfeed (they basically cut the ligaments that are abnormally shorten inverted nipples to allow them to get pulled out). And if you have ever broken in a pair of new shoes you know that eventually calluses form from the friction but that it takes time.
The key difference is that normal pain (if you experience it) hurts like the dickens at the start of the feed then eases after about 30-90 seconds. Abnormal pain lasts through the WHOLE FEED and sometimes lingers afterwards. If you experience normal pain there are products that can help - Organic Babies Nipple Balm will save your life. If you have abnormal pain you could have one of the following: a baby with tongue tie; mastitis; a spaghetti feeder (poor latch) ; or inverted nipples. Seek medical/professional help for this - see Where to Get Help at the bottom of this post.
Blocked ducts are milk ducts that get blocked. This can happen if anything (ANYTHING) presses against your breast while milk is being let down:
- Are you holding your boob too tightly? Pressure from your fingers can block a duct.
- Are you wearing a bra that’s too tight or something with tight elastic? That can block a duct.
- Are you wearing underwires? That can block a duct.
If your blocked duct develops an infection (called mastitis) you will need antibiotics from the doctor.
Signs that you have a blocked duct are:
- It feels tender, like a bruise, in a specific location on the breast. Just in one spot.
- Swelling in a particular spot.
- Your breast feels warm or slightly hot in one spot
- It’s harder for your baby to feed from one side because the milk doesn’t flow freely.
- A small white dot may appear on the nipple called a milk bleb.
Ways to prevent getting blocked milk ducts:
- Breastfeed regularly and do not allow yourself to become engorged. This means do not skip a feed or make your baby wait out the clock. If you’ve got milk, and they’re hungry - feed them. If you’ve got milk, and they’re not hungry - express it out.
- Keep pressure off of your breasts. So avoid tight clothing and underwear.
- Change your nursing positions to allow the baby to drain milk from all areas of the breast equally. Try the football hold once a day on each side. It will clear the ducts from a different position to ensure you don’t get blocked.
Treating blocked ducts before they become infected:
If you suspect that you have a blocked duct try these remedies. You can unblock it yourself. However, if you aren’t aware you have a blocked duct, or if you leave it to get better on its own, you may get mastitis.
- Gently massage the breast towards the nipple during the feed to help the let-down and clear the blockage while the baby is feeding.
- Use a warm shower water to help you massage away a blocked duct. Don’t massage too hard otherwise you’ll get a bruise and you won’t know if the duct has cleared up!
How to feed a sleepy baby
How to latch on a baby who's too sleepy to feed - the answer here is (you guessed it) skin to skin. Do not put them in a bassinet. Ok, if you've had a particularly long labour and you need some sleep then by all means put the baby down. Not all babies are born hungry. But eventually, after 3-4 hours after they are born, get that naked baby on your naked chest and initiate those instincts!
How to feed a screaming baby
How to calm a baby who's too confused/upset to latch on - that's easy: skin to skin. Whip it off. Both of you. Engage those instincts! Let the baby smell the milk. Hand express colostrum if you need to. The milk smells like the baby's utero environment and it will seek it out. Skin to skin is like pressing the 'reset' button. If you experience problems at any point on your breastfeeding journey, go back to the basics of skin to skin - it always helps.
How to read your baby
Have you ever skipped a meal? Become really hungry? Think about the process you go through: You feel a pang. You lick your lips. You smell your favourite food. You turn your head. You start looking around for it. You’re getting hungry now. Where's the food! Somebody better feed me! I'm gonna get hangry! If your baby gets hangry you WILL NOT BE ABLE TO LATCH THEM ON. They will be too cross to realise you are trying to feed them. Little babies (under 2 months old) are really dense about this. It takes them a while to catch on. What you need to do is feed them when they start licking their lips. Which means ...
You Need to Know your Baby's Feeding Cues. Whenever someone we know has a new baby we always write in their card 'enjoy getting to know your new baby'. This is because babies are FIERCELY individual. They just know exactly what they want. No one ever asks a small person ‘what would you like’ and they don’t have an answer. They always know what they want. We should all be so lucky as adults (knowing our own mind somehow gets trained out of us). But babies are also really easy to read - after all it’s their only communication tool. But you have to observe them. Does your baby stop giving eye contact before they get cranky? Then don't try and re-engage them or they will get overtired and fight sleep. Does your baby make a funny face after they finish feeding? Then try burping before it gets trapped. Does your baby lick their lips or suck their hands when they are peckish? Then try latching them on. If you miss these cues you will have to first calm your baby down before you can address the tiredness/hunger issue. That can be very time consuming, demoralizing and exhausting for you both.
If you feed on demand, you should have enough milk. You also need to drink water and rest. Unless you have a medical condition, that is literally it! If you feed on a schedule this can impact your milk supply.
Your body releases hormones every time you breastfeed. They make milk for now, and milk for tomorrow. It takes 3 days for your body to catch up if your baby suddenly changes its feeding habits - ie if it has a growth spurt, which happens frequently. 3 days can seem like a long time with a fussy, hungry baby.
It's like this - someone comes to your house for brunch unexpectedly. You might be able to offer them toast. They aren't impressed but they deal with it. The next day they again turn up unexpectedly for brunch. What! You again? You have nothing in the cupboards because they cleaned you out yesterday! So you find some stale crackers. They cope. The third day you've caught on and you’ve been shopping. It's avacado toast for brunch on the third day and you've redeemed yourself. That's what your body does. It will not devote resources (your calories and fats and vitamins that you need to live which make up your milk) unnecessarily. So your body only makes enough milk as it thinks your baby needs. But as your baby grows, it needs more milk. If you feed on demand these hormones get released and within 3 days your milk is bountiful. But if you say ' the book says the baby should wait 3 hours between feeds' then your body never gets the chemical signals it needs (that's what hormones are) to know how much milk to make for your baby.
If you panic and supplement with formula because you have a cranky hungry baby you interfere further with the chemical signaling and end up on a downward spiral. Feeding on demand - which means when your baby wants milk no matter how long ago their last feed was - ensures you have a sufficient supply. It can mean that at times your milk needs to catch up with your baby. But it will.