If Breastfeeding Isn't Going Well

Some babies don’t seem interested in feeding when they are first born. Don’t panic, this is usually because they need a bit more time to recover from the birth and almost all will eventually start feeding at the breast.

The best way to help your baby is to have lots of skin contact and to give your baby lots of drops of colostrum [the first milk produced in your breasts]. Ask your midwife to show you how to hand express your colostrum. You can also hand express your colostrum into your baby’s mouth as this may encourage them to start to feed.

Sometimes mothers worry that their baby won’t be getting enough milk. If your baby is born after 37 weeks and is well then colostrum is all your baby needs for the first few days. Baby born after 37 weeks of pregnancy have fat stores that they use in the first few days and so frequent [every one - two hours] small feeds of colostrum is all they need.

Please try and avoid giving your baby a bottle in these early days so that your baby can get used to latching on to your breast.

For more information visit www.nhs.uk/conditions/pregnancy-and-baby/expressing-storing-breast-milk

It isn’t unusual for breastfeeding to feel a bit uncomfortable or strange to start with. Pain usually means that something isn’t right. You may find that it feels painful when your baby first latched onto your breast but then after a few seconds the pain eases. This is a positive sign. If the pain continues or gets worse this suggests that your baby isn’t latched onto your breast well enough. Please ask your midwifery team to watch your baby latch.

Most mothers are very tired in the first few days and it can be difficult to concentrate on getting a good latch every time. We would encourage you to ask for help as much as possible when you are in hospital so that you can feel more confident with feeding.

If you baby doesn’t latch well you may get some damage to your nipple. If this happens please talk to your midwife as soon as possible.

If your nipples are cracked, blistered or bleeding we would suggest you try the following to help them heal:

• Get help with latching your baby from your midwifery team or a support group
• When your baby has finished feeding, express a few drops of milk and gently, with your finger, wipe this around your nipple
• Let your nipple get as much air as possible, don’t rush to put your bra back on
• Before you put your bra on, put a lot of petroleum jelly (or similar ointment) on your nipple to stop your breast pad and bra sticking to your nipple.

Sometimes on day three or four when the volume of milk increases your breasts can become very full and tender. This is called being engorged. This usually happens because baby has not been feeding very frequently and so the milk is not being removed from the breast. Sometimes it can happen because a mother has a very large milk supply. If your breasts are engorged it can become difficult for your baby to latch to the breast. Engorgement is a temporary problem and once your baby is feeding well at the breast it should ease.

Please ask your midwifery team for support.

The way to stop engorgement is for your baby to feed frequently at the breast at least eight - 12 times in 24 hours. It may help to soften your breasts a little bit to make it easier for your baby to latch. You can do some gentle hand expressing before your baby latches. If your breast is so full that you are struggling to hand express then you can try some “reverse pressure softening” before expressing.

Reverse pressure softening:

• Rest yourself back in a comfortable position
• Place two fingers from each hand either side of the nipple, or cross your fingers over each other surrounding the nipple
• Push back into your breast and hold for two - three minutes
• This will help to soften the area around the nipple and milk should start to flow
• The try gentle hand expressing or latch baby to breast.

Mastitis is inflammation of breast tissue which can lead to infection. Mastitis usually develops because your baby has not been effectively removing the milk from your breast. This may be because the baby is not well latched to your breast. Sometimes this can be due to a Tongue tie. The first sign of mastitis is usually a red area on your breast.

Please contact your midwife if you think you have mastitis.

If an infection develops you may have flu like symptoms; feverish, sweaty, pain. If you feel that you have a high temperature please contact your GP for an urgent appointment as you may need antibiotics.

The following leaflet will give you helpful information about how to manage mastitis and prevent further episodes www.breastfeedingnetwork.org.uk