Even though it is widely acknowledged that breastfeeding is the healthiest option for mothers and babies, many women who begin breastfeeding do not continue past the advised minimum of six months of exclusive breastfeeding. Fortunately, most women can overcome these challenges with the right support and medical care.
INADEQUATE MILK INTAKE
A true inadequate supply can occur if the infant is unable to extract milk well or if the mother doesn’t produce enough milk. Unfortunately, determining whether a mother has enough milk and, if not, why not, can be challenging. The most common reason women stop breastfeeding is that they believe their infant is not getting enough milk, but in many cases, the mother has an adequate supply.
Insufficient milk production — A mother may not produce enough milk for a variety of reasons, such as:
She may not have enough glandular tissue, which produces milk, causing her breasts to underdevelop during pregnancy.
Prior to this, she underwent radiation therapy or breast surgery.
Her hormones are out of balance.
Some of the medications she takes prevent her from producing enough milk.
Poor milk extraction — The most common reasons infants have trouble getting enough milk are:
They don’t receive enough frequent feedings, which can result in decreased or ceased milk production.
They are unable to properly latch on.
Insufficient time is spent with their mother.
â—ŹThey are fed formula.
During the first few days after birth, many babies are sleepy and difficult to keep awake, which can prevent the baby from eating enough; other babies can have difficulty controlling the muscles involved in sucking, which makes it difficult for them to extract milk; and many mothers judge adequacy of feeding by lack of crying, which can be misleading if the baby is not getting enough milk and is not getting enough food.
Diagnosis of inadequate intake
â—ŹNumber of feeding sessions the mother reports having– Nursing frequency typically drops to 7 to 9 times per day four weeks after delivery in mothers of term infants (i.e., those who are not premature) during the first week of life.
â—ŹAmount of urine and stool the baby makes– By the fifth day of life, infants who are receiving enough milk urinate six to eight times daily and pass three or more stools (the infant’s stool should be pale yellow and seedy once the mother’s milk comes in).
â—ŹWeight of the baby– Term infants typically regain their birth weight within one to two weeks after losing an average of 7% of it in the first three to five days of life. Once a mother’s breasts have filled with milk (by days three to five), an infant should stop losing weight. If an infant loses 10% of his or her weight or does not regain their birth weight as expected, health care professionals begin to investigate potential problems.
NIPPLE AND BREAST PAIN
Nipple or breast pain is the second most typical cause of early breastfeeding cessation.
The following are some causes of breast and nipple pain:
A breast pump or the baby could have caused a nipple injury.
Engorgement, or an excessive enlargement of the breasts
â—ŹPlugged milk ducts
â—ŹNipple and breast infections
â—ŹExcessive milk supply
Skin conditions that affect the nipple, like psoriasis or dermatitis
Nipple vasoconstriction refers to the tightening of the blood vessels in the nipple, which prevents enough blood from passing through.
Causes of breast or nipple pain:
Ankyloglossia, also known as tongue-tie, is a condition in which the tongue of a newborn cannot move as freely as it should, making it difficult for the infant to effectively suckle.
Torticollis, in which the infant’s neck is twisted and makes it difficult for the infant to comfortably nurse from both breasts
birth flaws in a baby’s mouth shape that make it difficult for the infant to latch on
When a baby’s tongue is not moved in the proper rhythm to suck up milk, it is known as an “uncoordinated suck.”
Nipple pain— Pain due to nipple injury needs to be distinguished from nipple sensitivity, which typically increases during pregnancy and peaks about four days after giving birth. Sore nipples are one of the most common complaints from new mothers.
Normal sensitivity usually goes away 30 seconds after suckling starts, diminishes on the fourth day after giving birth, and disappears completely when the baby is about one week old. Nipple pain caused by trauma, on the other hand, lasts or worsens after suckling starts.
Normal nipple sensitivityIf you find the “pins and needles” sensation of milk let-down to be uncomfortable, rest assured that this discomfort also resolves in the first weeks of breastfeeding. If needed, take acetaminophen (brand name Tylenol) to ease your discomfort. If you have some discomfort related to normal nipple sensitivity, keep in mind that this sensitivity usually goes away after the first few suckles of a feeding and stops happening after the first week or two of nursing.
Nipple injury— The most common cause of nipple injury is improper breastfeeding technique, particularly poor position or latch-on. — Harsh breast cleansing, the use of potentially irritating products, and older infant biting can all exacerbate the pain from nipple injury.
Prevention:
After feedings, let your nipples air dry and make an effort to keep them dry.
On breasts, avoid using abrasive soaps or cleaners.
Avoid using or abusing plastic-backed breast pads excessively.
For example, if your baby has tongue-tie, surgery to release the tongue will make it easier for the baby to latch on properly. If your baby’s mouth has any abnormalities, make sure to have them addressed as soon as possible.
If your baby bites you, put your finger between your nipple and the baby’s mouth during feedings to make it harder for the baby to bite, and firmly say “no” every time the baby bites you. The baby will eventually stop biting you if you do these things.
Here are some things you can do to promote healing if your nipples are already injured:
Use the breast without the injury to begin nursing at all times.
If you think your nipple is infected or you have a rash, see your doctor. If your nipple is cracked or raw, you can apply expressed breast milk or an ointment to them, such as purified lanolin (if you are not allergic), and cover them with a nonstick pad.
When it seems to help, apply cool or warm compresses; stay away from ice.
Before eating, take a mild painkiller like acetaminophen (brand name Tylenol) or ibuprofen (brand names Advil and Motrin).
The milk you remove can be used to feed your baby if nipple pain prevents your baby from emptying your breasts naturally.
Vitamin E oil may be toxic to your unborn child at high concentrations, so avoid using it on your nipples.
Nipple vasoconstrictionMothers with this condition may experience pain, burning, or numbness in their nipples in response to cold, nursing, or injury. The nipples may also turn white or blue and then pink when the blood returns. Nipple vasoconstriction is when the blood vessels in the nipple tighten and do not let enough blood through.
In contrast to other causes of nipple pain, nipple vasoconstriction can be predictably brought on by cold. This is one way to distinguish it from other types of pain.
Avoiding nicotine and caffeine, which can exacerbate the condition, may also be helpful in managing nipple vasoconstriction. Other tips for managing the condition include keeping your entire body warm, dressing warmly, breastfeeding in warm environments, and keeping your whole body warm.
EngorgementEngorgement is the medical term for when the breasts become overfilled with milk. Engorgement can make your breast feel full and firm, can cause pain and tenderness, and can occasionally make it difficult for the baby to latch. When the baby is unable to latch, engorgement is made worse because the baby cannot then empty the breast.
Prevention:
You can use your hand to present your nipple in a way that is easier for the baby to latch on to and to help get milk out for the baby if the engorgement makes it difficult for the baby to latch on.
Using a breast pump excessively will cause your breast to produce even more milk, which will worsen engorgement. You can use a breast pump to help soften your breast before a feeding, but be careful not to do it too much.
Before a feeding, use warm compresses or a warm shower to improve let-down and possibly make it simpler to express milk.
Take a non-addictive pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil and Motrin).
Plugged ductsIf the nipple is clogged, a white dot or bleb can develop at the end of the nipple, and a plugged milk duct can result in a tender or painful lump forming on the breast.
Poor feeding technique, donning tight clothing or a bra that is too small, stopping feeding suddenly, engorgement, and infections are all factors that can result in a plugged milk duct.
Galactoceles— A milk-filled cyst known as a galactocele may occasionally form as a result of a blocked milk duct; unless infected, galactoceles are usually painless, but they can grow quite large; if necessary, a healthcare professional may recommend surgery if the issue is severe.
BREAST INFECTIONS
Mastitis, an inflammation of the breast, can occur at any point during lactation, but it is most common in the first six weeks following delivery. Mastitis is not always caused by an infection, but most people associate it with infection. It is frequently accompanied by fever (which may be concealed by painkillers), muscle and breast pain, and redness.
To avoid and treat mastitis, it’s critical to address issues with the nipples, the breasts, or both. Mastitis frequently results from issues with the nipples, the breasts, or both.
Symptoms:
A firm, sensitive, and red breast area
Fever over 101°F (38.5°C),
Muscle aches, chills, fatigue, or symptoms similar to the flu
Yeast infectionHowever, yeast infections of the nipple or breast (also known as candidal infection) are poorly understood, and researchers are unsure what role they play in nipple pain. — Yeast infections of the nipple or breast (also known as candidal infection) are frequently diagnosed in women who are breastfeeding based on their symptoms (primarily nipple pain).
Diagnosis:
Breast pain that is excessive compared to the source of the pain
An infant with a history of yeast infections like thrush or diaper rash, or a history of vaginal yeast infections
On the affected nipple, shiny or flaky skin
â—ŹCandidabreast milk culture was discovered to contain (if this test is performed)
BLOODY NIPPLE DISCHARGE
During the first days to weeks of lactation, some women experience bloody nipple discharge, which has been referred to as rusty pipe syndrome. The color of the milk can range from pink to red, and the condition usually goes away within a few days. Women who experience bloody discharge for longer than a week should see a healthcare professional.
MILK OVERSUPPLY
The problem starts early in lactation and is most prevalent in mothers having their first child. Normally, the production of milk is determined by the infant’s demand, but in this case, the supply exceeds demand, which paradoxically can make breastfeeding challenging.
Infants whose mothers make too much milk can either gain weight quickly or gain too little weight because they cannot handle the flow of milk or because they do not get the last of the milk in the breast, which has the most calories. In women with an oversupply of milk, the rush of the milk can be so strong that it causes the infant to choke and cough and have difficulty feeding, or even to bite down to clamp the nipple.
Don’t worry if you have an overproduction issue because they usually go away on their own, but let your doctor know so they can see if you have any hormonal imbalances or are taking any medications that might exacerbate the issue.
HOMOEOPATHIC TREATMENT
Agnus castus– A treatment for depression and milk suppression.
Belladonna– For the initial symptoms of mastitis, the mother experiences extreme breast tenderness and pain that is hot, red, and throbbing.
Bryonia– May be used if the breast is pale in color as opposed to red and hard, swollen, and hot.
Borax– An effective treatment for newborns with thrush, who have distinct white patches on their tongues and cheeks. These infants are also used for mothers who are suffering from postpartum depression because they are so sensitive and will wake up at the slightest sound even when they are fast asleep.
Calcarea carbonica– It encourages the production of milk.
Causticum-Helped rheumatoid arthritis patients produce more breast milk
Dulcamara-Use it if you’re feeling cold and not producing enough milk.
Nat murThere is a stoic sadness or grief, often only experienced in private, with little to no crying.
Phytolacca-Can be applied to sore, cracked nipples caused by mastitis, which hurt when the infant nurses, as well as to painful lumps in the breast caused by mastitis, which is an infection of the breast.
PulsatillaUsed if you are overproducing milk. Also used for a milk supply that is erratic, meaning that it is good, then it is low, then it is adequate again. -When the person is depressed and tearful. She may weep while breastfeeding and needs a lot of support and company.
Ricinus communisCastor oil should never be administered to a pregnant woman to induce labor or to treat constipation at any point during pregnancy. – For non-appearance of milk or to increase breast milk; it also increases breast milk flow in nursing women.
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