Common concern and challenges in breastfeeding

Maternal and Child Resource Initiative on Breastfeeding (MaCRIB) addresses common breastfeeding concerns:
I am not sure if my baby is getting any milk.
I don’t know if my baby is getting enough milk.
How often should my baby breastfeed?
Can I take medicines if I am breastfeeding?
Can I wake my sleeping baby?

1. Idemudia Shulammite
Omowunmi
[email protected]
[phone]
Presented at Agric. Lecture Theatre on the 22
nd
of October
2016 1

2. “The nature has
designed the provision
that infants be fed
upon their mother’s
milk. They find their
food and mother at
the same time. It’s a
complete nourishment
for them both for their
body and soul”
- Rabindranath Tagore
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3. Concerns about
breastfeeding
3

4. Breastfeeding Concerns
I am not sure if my baby is getting any milk
I don’t know if my baby is getting enough milk
How often should my baby breastfeed
Can I take medicines if I am breastfeeding
Can I Wake my sleeping baby
4

5. I am not sure if my baby is
getting any milk
When breastfeeding, listen closely for the
sound of swallowing
When breasts makes small amounts of early milk
(colostrum), baby swallow every 10 sucks
When breasts produces a lot more milk baby
swallows more loudly and with every suck
5

6. I don’t know if my baby is
getting enough milk
To find out, count wet and dirty diapers
Urine
Bowel Movement
Importantly, your baby’s weight is the key factor
that tells you that he/she is getting enough to eat
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7. How often should my
baby breastfeed
First week at least every 3 hours or sooner if your
baby acts hungry
at least 8 feedings in a 24-hour period
Watch for signs of hunger like mouth movements,
sucking, bringing hands to mouth etc
As baby gets older it will be easier to tell when they
needs to eat
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8. Can I take medicines if I am
breastfeeding
Medicines pass into your milk in small amount
Discuss any medicines you are using with your
doctor
Ask before you start using new medicines
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9. Can I Wake my sleeping baby
Most babies are sleepy for the first few days as they
adjust to life outside of mom’s body
 You may need to wake your baby so he or she will
nurse often enough to establish a good milk supply
Tips on waking up babies
Loosen your baby’s clothing or undress your baby so
that he has “skin to skin” contact with you.

10. Can I Wake my sleeping baby
Rub your nipple against baby’s upper lip to
stimulate baby to open his mouth
Express some breast milk onto baby’s lips
Change baby’s diaper
 Walk your fingers up baby’s spine; rub baby’s
hands, legs and feet
Wipe baby’s face with a lukewarm washcloth
With a clean finger, stroke baby’s cheeks, lips and
mouth
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11. Breastfeeding challenges
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12. Breastfeeding challenges
Breast engorgement
Sore nipples
Flat and inverted
Plugged ducts
Mastitis (Breast infection)
Poor milk production
Oversupply of milk
Nursing strike
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13. Breast Engorgement
Breasts feel full and heavy before a feeding, this is
normal
But pain, swelling and hardness of the breasts is
engorgement
It can happen if your baby doesn’t eat often enough
or long enough, or if you miss feedings
13

14. Engorgement
Prevention
●Allow the baby to feed as long as he or she likes
●Nurse often on demand. Build up to eight to 12
times every 24 hours
●Do not limit the baby’s time at the breast
●Nurse on each side of the breast at each feeding until
the baby is done or satisfied
14

15. Engorgement
Treatments
●Gentle massage to stimulate the let-down reflex
●Apply warm compresses to help the ejection of
the milk
●Manually express some milk before breastfeeding,
so that the areola gets soft enough
●Cold compresses in between feedings to help ease
pain
●Wear a well-fitting supportive bra that is not too
tight
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16. Sore nipple
Painful, red, cracked, bruised, blistered and
tender nipple
Improper positioning
Inappropriate latch-on
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17. Sore nipple
Treatments
Use a proper breastfeeding technique
Keep the nipples dry
Change the nursing pads used to prevent milk flow on
a regular basis
Avoid products that remove the natural protection
of nipples, such as soaps, alcohol or any drying agent
Offer the least affected breast first
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18. Sore nipple
Treatments
Express enough milk before breastfeeding to
stimulate the let-down reflex
Discontinue feeding, slip the index or little
finger into the infant mouth
Apply expressed breast milk on the nipple due
to it’s anti-infective properties
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19. Flat and Inverted nipple
do not stick outward from the breast
do not protrude out of the breast, but face inward
toward the body
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20. Remedy
hand express or use a breast
pump to pull your nipples
outward right before you
nurse you
If breast is engorged, try to
remove a little bit of breast
milk before you put your
baby to the breast baby
syringe can be use to pull
nipple out
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21. Plugged duct
Free flow of milk is blocked.
Tender and sore lump in the breast
It happens when a milk duct does not properly
drain andbecomes inflamed
Occurs in one breast at a time
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22. Plugged Duct
Causes
Delayed, incomplete or missed feedings
 local pressure, for instance, a very tight bra, or the
use of creams on the nipples
use of the same nursing position or incorrect
positioning of your hands on the breast
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23. Plugged Duct
Treatments
Apply moist heat to the area before nursing
Gently massage the plugged area after using moist
heat
During nursing, massage gently from the sore spot
toward the nipple
Begin feeding on the breast with the plugged duct
Position the baby’s chin toward the plug so his or
her tongue milks the affected area
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24. Plugged duct
Breastfeed more often (at least every two to three
hours) and long enough to relieve fullness
Make sure baby is latched on well to the breast
Hold baby in more than one position during
nursing to remove milk from all parts of the breast
Check that your bra and clothing are not too tight
Get extra sleep or relax with your feet up to help
speed healing
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25. Mastitis
Breast Infection
Infected area always red, hot, and
tender to the touch
Caused by
 Fatigue and stress
 Untreated plugged duct or
engorgement
 Cracks or fissures in the nipple
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26. Mastitis
Treatment:
Breastfeed often on the affected side, as
often as every two hours
Massage the area, starting behind the sore
spot
Apply heat to the sore area with a warm
compress
Wear a well-fitting supportive bra that is not
too tight
See a doctor
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27. Poor milk production
 Most mothers can make plenty of milk for their
babies
Pain, discomfort, stress, anxiety, fear and lack of
self-confidence may inhibit the let-down reflex,
hampering lactation
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28. Remedy
Increase the frequency of feeding
Offer both breasts in each breastfeeding
Allow the infant to empty the breasts completely
Alternate between breasts during the same
Feeding if the infant feels drowsy or if he/she is not
sucking vigorously
Avoid the use of bottles, pacifiers and nipple shields
Eat a balanced diet
Drink enough fluids
Take a rest

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29. Oversupply of milk
● Having an overfull breast
●Sometimes stressful and
uncomfortable
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30. Remedy
Breastfeed on one side for each feeding
Continue to offer that same side for at least two hours
until the next full feeding
Hand express for a few moments to relieve some of
the pressure
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31. Nursing strike
●Baby suddenly begins to refuse the
breast
Major causes
●mouth pain from teething, a fungal
infection
●ear infection, which causes pain while
sucking
●Pain from certain breastfeeding
positions
●Being upset about a long separation
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32. Remedy
●Try another feeding method temporarily to give baby
your milk, such as a cup, dropper and spoon
●Keep offering your breast to the baby
●If the baby is frustrated, stop and try again later
●Try various breastfeeding positions
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33. Remedy
Focus on the baby with all of your attention
Comfort him or her with extra touching and
cuddling
Try breastfeeding while rocking and in a quiet room
free of distractions
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