Executive summary about breastfeeding problems by Paula Ford-Martin and Teresa G. Odle
The term "breastfeeding problems" is used to describe a variety of physical, behavioral, and emotional difficulties with nursing an infant. Breastfeeding, is the practice of nourishing an infant with the milk in the human breast. At first, babies feed on a nutrient-rich substance known as colostrum, which is produced by the breast before milk production begins. New mothers will experience engorgement in the days following the birth of their babies, where breast milk "comes in" and engorges the breasts. After this time, regular feedings and proper breastfeeding techniques usually ensure a healthy milk supply for most babies until it is time to wean. However, breastfeeding can be a complex process and in many cases, there is a problem with the infant's suckling technique, the mother's milk supply, and breastfeeding problems result.
Inadequate weight gain and a failure to thrive in nursing infants is the most obvious sign that there is a breastfeeding problem. A number of factors may interfere with successful breastfeeding. Proper treatment for breastfeeding difficulties depends on the cause of the problem.
1. Milk supply problems. Milk production is largely a supply and demand process. Pumped breast milk can be bottled, and fed by bottle to the baby at a later time, although if milk production is a problem the mother will probably want to put the baby to the breast at every opportunity. Milk thistle is sometimes prescribed to promote increased breast milk secretion. If the baby does not completely empty a breast, the job can be finished with the aid of a breast pump. The next time the mother nurses, she should start the child on the opposite breast.
2. Latching problems. Some babies, particularly preterm infants, have difficulty suckling. If the baby has a structural problem in his mouth, such as a cleft palate, a breast pump may be required to keep milk production going. In some cases where suckling does not improve, feeding with a supplementary nutrition system may be required. The system consists of a feeding bottle containing the mother's own breast-pumped milk, and two tubes that run down from the bottle and attach to the nipples. Both baby and mother can still maintain closeness while providing the baby with adequate milk flow.
3. Scheduling problems. Breastfed infants should be nursed at least once every three hours during the day, and should go no more than five hours at night between feedings. Women who have returned to work can use a portable breast pump at least once during the work day to encourage sustained milk flow and to store milk for their babies to eat during their time away from home.
4. Nipple and breast problems. Cracked and sore nipples and breast infections can make nursing painful. Liquid vitamin E applied regularly to sore or cracked nipples can soothe the pain and help the healing process.
5. Retained placenta. If a woman's milk has not "come in" and she continues to experience abnormal bleeding after delivery, she may still be retaining pieces of the placenta within her uterus. Minor surgery known as a dilatation and curettage is usually required to remove pieces of placenta that were retained by the uterus.
6. Stress and fatigue. New mothers need proper rest in order to produce an adequate milk supply. The ability to relax is also fundamental to proper breastfeeding. Women who are stressed can have difficulty achieving milk "let-down," the sensation of the mammary glands releasing milk. Women should establish a quiet, restful environment for nursing. Warm compresses to the breast may also assist in milk let down.
7. Psychological issues. Some women are unable to breastfeed because of preconceived notions about the practice, or ideas instilled by their parents and peers, that have put up a psychological barrier for them. Many hospitals offer mothers and their spouses classes on breastfeeding techniques and nursing issues. Women who have negative feelings about breastfeeding may find classes helpful in overcoming these issues.
In most cases, treatment for breastfeeding problems is successful and mother and baby do well. Breastfeeding incidence and duration are both associated with reduced breast cancer risk in women, according to a large international study released in 2002.
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