9 Troubleshooting Tips for Breastfeeding

Breastfeeding has many benefits for both parent and baby. According to the American Academy of Pediatrics, breastfeeding helps protect against asthma, ear infection, obesity, and sudden infant death syndrome (SIDS). The practice may also help reduce the chances of developing diseases like type 2 diabetes, childhood leukemia, eczema, and lower respiratory tract infections.

Research also shows that breastfeeding may benefit new parents through a lower risk of both breast and ovarian cancers.

While the perks of breastfeeding are plentiful, that doesn’t mean it's without challenges. Here are some tips from Erin Young, MD, a primary care physician in Big Rapids, Michigan.

There are many myths about breastfeeding. The most common ones Dr. Young hears are:

• Because breastfeeding is natural, it should be easy.
• Breastfeeding is painless.
• You can't breastfeed when you go back to work.
• Formula-fed babies sleep better.
• If a breastfeeding baby seems hungry or eats more often, then you aren't making enough milk.

These myths lead to self-doubt and can limit the opportunities new parents have to create their own experiences. Be aware of them, and you'll be better prepared to handle setbacks if they occur.

A parent who is considering breastfeeding should be prepared to feel overwhelmed at times. This is because their responsibilities to the child may exceed others they have during this time.

“Breastfeeding places the sole responsibility of feeding the infant on the mother," explains Young. "This can be a heavy burden, especially in the first few weeks and months of motherhood. When only the mother can feed the infant, it can result in increased exhaustion as well as create personal and relationship stress.”

Prepare for these responsibilities by taking breaks and devising stress-reduction techniques beforehand. Having a partner or support person who can provide periods of rest is helpful, as well.

Similarly, the decision to breastfeed might require adjustments at work and within communities, from blocking out nursing time to designating a private location. “Mothers require means to either feed their infant directly by latching or expressing breastmilk,” Young says. "Expressing milk requires a pump, private location, refrigeration or ice to store the milk, and clothing which makes the breasts accessible."

Before returning to work, discuss your feeding options and breaks with your employer to help set expectations and make the transition smoother. Remember, the law is on your side.

Even experienced breastfeeders face challenges. Smooth sailing with the first child doesn’t mean there won’t be obstacles with the second. You can expect things to change from child to child.

Risk factors for breastfeeding problems vary with each newborn and can even range for the parent based on different pregnancies. For example, one newborn may be tongue-tied, a condition where the tongue is anchored to the floor of the mouth, whereas their sibling may not be. A parent may have a normal pregnancy and delivery with the first child but experience severe anemia with a subsequent delivery. "Both of these situations can affect breastfeeding," says Young.

In addition to your regular healthcare provider (HCP) and your OBGYN, the importance of hospital lactation consultants cannot be overstated. In the early days, they can help establish one of the most important aspects of any breastfeeding experience: a good latch.

"They are also a wealth of knowledge in regard to any breastfeeding concern, including pumping and returning to work,” says Young. "Insurance companies are mostly covering lactation consultation services."

Lactation consultants can provide feedback on where to find resources upon leaving the hospital, as well. Resources include Women, Infants, and Children (WIC) food assistance, pumps and equipment, and breastfeeding support groups like La Leche League, an organization aimed at providing information and encouragement that enables new parents to breastfeed. You may also find it helpful to keep track of feedings with a breastfeeding app or journal.

Nipple pain is natural for a few seconds at first, as you get the hang of breastfeeding. But if it persists, it may indicate breast pump issues, thrush, a nipple blister—or, most likely, a bad latch. Sometimes, changing your position is enough to fix the latch and alleviate some of that discomfort. Some positions, like leaning backwards with your baby on top of you or lying on your side with your baby next to you, may come easier. Pillows and footrests can help you stay in certain positions.

Other positions, like the football or the cross-cradle position, might require more practice. Call your OBGYN or lactation consultant or visit the La Leche League website for more information on positions. A lactation consultant can also help you prepare and recommend potentially helpful aids, such as a nipple shield, if your nipples are flat or inverted. In the meantime, nipple creams may alleviate pain by helping the skin retain moisture.

Breastmilk functions under a “demand and supply” system. In other words, the more you stimulate milk production, the more milk you will produce. But obstacles like clogged ducts can interfere. Clogged ducts occur for many reasons, including ineffective milk removal (which can be caused by a weak or poor latch), inconsistent feedings, or even oversupply.

Although breastfeeding is less comfortable with a clogged duct, it is recommended that you keep nursing to avoid developing mastitis, or inflammation of the breast. Applying heat, gently massaging the breasts, feeding frequently, and wearing loose clothing can all help with clogged ducts, as can taking nonsteroidal anti-inflammatory drugs (NSAIDs). Remember to speak with your HCP before trying any new medication, though.

After you've expressed milk, medication and cold compacts can help reduce pain. Chills, high fever, and pus or blood in milk are all signs to call your HCP to discuss treatment.

“It is extremely important to have a support system with any newborn, but especially with breastfeeding," says Young. She believes surrounding yourself with dedicated people will help you meet your breastfeeding goals. “I'm a firm believer that successful breastfeeding requires a team which includes medical professionals as well as a support system at home. The support system could include the new parent's mother, significant other, grandparent, friend, or coworker.”

If you know a nursing parent, try these tips to help support them:

• Ensure they have access to food. Even better, surprise them with meals.
• Offer to come by and help with things around the house so they can get adequate rest.
• Avoid shaming them or making jokes about breastfeeding.

If you would still like your child to experience the benefits of breastfeeding but are having trouble with production, you have options. One of these is donor milk.

Many neonatal intensive care units (NICUs) have donor milk on hand for babies in need. It's often available outside of the hospital from both for-profit and nonprofit organizations.

“Donor milk sources range from certified centers where the milk is screened for viruses, bacteria, or exposure to toxic substances, to friends and family who have an oversupply,” says Young. The American Academy of Pediatrics advises against sharing breast milk informally—without its being screened or pasteurized—and cautions mothers not to buy it over the internet.

If your local hospital cannot direct you to milk resources, state and citywide milk banks are a great place to start. Those linked with the Human Milk Banking Association of North America have high standards for processing and screening.

Deciding not to breastfeed does not make someone a bad parent. If nursing becomes a true problem, there is no shame in stopping.

“Reasons for discontinuing breastfeeding are person-dependent," Young says. "For example, working through poor latch may be enough for some women to give up, whereas others may have the resources available to work through it." Job issues and health problems are other perfectly reasonable reasons why some parents opt out.

And if you're undecided, not producing sufficient milk, or would like to begin tapering off of breastfeeding, supplementation (using formula and breast milk at the same time) can give you the best of both worlds. Speak to your OBGYN, pediatric HCP, or family practitioner for advice on how and when to begin.