Tuesday, August 2, 2011

7 Breastfeeding Troubles & How I Overcame Them

In the spirit of this year's "Talk to me!" World Breastfeeding Week theme, today I'm sharing more about the parts of my breastfeeding journey that have not been easy. My hope is that my words here will be helpful to someone in a small way, even if just to know that you can work through all these things and still maintain a positive breastfeeding relationship.


I've been breastfeeding for fourteen months now, with no plans to wean my son any time soon. It's funny how one day I had never done it before, and the next day, I was nursing my son every hour or two around the clock. Experience like that makes a new mom an expert fast!

Still, I didn't grow up regularly seeing people breastfeeding, and there were definitely times when things haven't gone as smoothly in our breastfeeding relationship. In those moments, I've had to figure out what would work for us to get over whatever bump we had just encountered. Here are a few of the things Daniel and I have been through in this year plus as a nursing diad, and what I did to remedy the situations:

 

Engorgement


I experienced moderately severe engorgement, which started when my milk came in on day two postpartum and gradually decreased over the next few weeks (though, I was prone to bouts of engorgement for many months if I so much as delayed a nursing session). I had a home birth, so when the after-care nurse came to see me at home, she reminded me to be vigilant about taking care to relieve the engorgement and also about watching my breasts and body for signs of mastitis (red, hot spots, streaking, flu-like symptoms). I did have a bag of IV fluids later in the day after the birth, which may have contributed to the mastitis and swelling that I experienced later. So, what did I do?
  • I sent my partner out to the grocery store for a cabbage, which we then put in the freezer (two leaves at a time) for me to keep in my bra between nursing sessions. Cabbage seems to have magical engorgement-relieving powers that even research can't explain. I know it certainly helped me!
  • I nursed around the clock, following the "breast on request" (nursing "on demand" or "on cue") philosophy. 
  • I did reverse-pressure softening, a technique used to move interstitial fluid away from the nipple and areola to facilitate proper latch when there's a lot of swelling.
  • I hand-expressed milk when I was in the shower, and into a burp cloth or prefold diaper before nursing.
  • I pumped (just a little) to relieve the pressure and discomfort, and to make it easier for my son to latch.

Blisters


I had a couple of small blisters in the first week of nursing. I remember recognizing them and then working very hard to heal them before I ended up with broken skin. I was determined not to have any cracks or bleeding, because I knew it would take longer and would be more difficult to heal once they got to that point. How did I handle it?
  • I worked a lot with Daniel on a wide, asymmetrical latch. The blisters were definitely from not having a deep enough latch, so I had to be really intentional about getting him to open very wide and take a lot of breast into his mouth at each feeding. It was hard in the middle of the night when I was totally sleep-deprived during those first days to wake myself up enough to work on latch, but I'm really glad I did, because I think it saved me a lot more pain down the road.
  • I used lubrication, in the form of pure lanolin. I would apply lanolin before each and every nursing session, until my nipples were all healed up. This was annoying when I was nursing side-lying in bed in the middle of the night, but it was really helpful to relieve the friction that had caused the blisters.
  • I also used a healing herbal salve on my nipples between nursing sessions. (My midwife advised me about the timing of those two: lanolin before nursing, herbal salve after.)
  • I expressed a little extra breastmilk after my son was finished nursing, and rubbed it into my nipples. Breastmilk is effective (and convenient!) when it comes to healing over-worked nipples.

Oversupply and Forceful Letdown


Having a large milk supply and a forceful letdown often go hand-in-hand. I had a lot of milk. I made too much milk, in fact, for my baby to drink. I had so much milk that my son started to show signs of getting too much foremilk in relation to hindmilk. I also had a very strong letdown which resulted in my son coughing and gagging on milk, as well as pulling off the breast frequently during a nursing session (resulting in milk spraying everywhere). What did I do?
  • I used a lot of these techniques outlined by Kellymom: I nursed Daniel "uphill," nursed him when he was sleepy, I would pump or hand-express a little milk before each feeding to remove some of the extra milk so it wouldn't come out so forcefully.
  • I nursed on only one side per feeding. This helped Daniel to get more hindmilk and not have to deal with letdown on both sides. He was very full after nursing on only one side, so:
  • I would hand express or pump excess milk so to prevent engorgment. I took advantage of my abundant supply by donating my extra milk directly to other moms with babies who needed it.

Painful Letdown


I had a very painful letdown which started at five weeks postpartum and lasted until Daniel was around five months old. After being evaluated by my midwife for thrush, we determined that it was most likely a result of the oversupply issues mentioned above, or it was just how I was experiencing letdown, and it would work itself out. But still, I was in pain! Here's how I worked through the pain:
  • I breathed through it. I know that might sound trite, but it was my best coping mechanism. I took deep breaths and stared at my baby as the pain passed, and I thought about how much I adore him.
  • I took extra magnesium. I used a powdered magnesium supplement (called Calm) which I take sometimes to help relieve muscle pain. I figured that since the pain was from all those little ducts being stretched out and contracted, that taking something natural to help relax the muscles would help. And it did!
  • I treated myself gently. I didn't expect nursing by baby to be blissful every time, and it wasn't. Sometimes I was gritting my teeth through the pain of letdown. I gave myself permission to feel those physical sensations and emotions surrounding them without any guilt. That was probably the most helpful thing I did for myself.

Plugged Ducts


I've had plugged ducts off and on since the beginning. Early on, they seemed to be caused by the oversupply, but more recently, I had a badly plugged duct from wearing a very poorly-fitting bra. That one was totally my fault (though, to be fair, finding a bra in my size is not easy). Plugged ducts seem to be very common, and I've found them to be easy to treat in my body, if I catch them early. So, what did I do about them?
  • I used heat to encourage the duct to open. Usually I just get in the shower and let the warm water run over the area that's hard and painful. Sometimes using heat can further inflame plugged ducts, so you have to be careful.
  • I used a castor oil compress. Castor oil helps to relieve inflammation, and it will soak through the skin and help to encourage the duct to clear. I would just soak a disposable nursing pad in castor oil and let it sit on the affected area for a while. The only thing to keep in mind is to try to keep the castor oil away from your nipples, because the next time you nurse, your baby could ingest it and subsequently experience the laxative effects of the castor oil.
  • I expressed milk. I nursed a lot on the affected side, and then if that didn't work, I would hand express. For me, hand expression works better for relieving plugged ducts than does pumping, probably because I'm able to target a specific area. With my latest plugged duct, I cleared it almost entirely with hand expression, and it was probably the worst one I've had.

Biting


Now this one is one of the hardest ones for me, because it's about my son's behavior, and not just something that's going on with my body. I even asked the wise and wonderful mentors over at Natural Parents Network what I should do about my son biting me. I tried many things, but many of them didn't work for us. How did I handle it?
  • Troubleshoot the cause of the biting. Since babies can't come out and say, "Momma, my mouth hurts." or "Wow, that milk came out fast!" I've had to try to decipher the root cause when my son bites me. He started doing it before he had teeth, and he still bites every once in a while. Some of the main causes for us have been: teething pain, being scared or startled, trying to slow milk flow, and distraction.
  • Address the cause. Maybe it goes without saying, but when I figured out what was wrong, then I would take steps to fix the problem. For instance, if teething was the culprit, I would offer something that was alright for my son to bite, give him a teething remedy, etc. If the cause was distraction, I would ask him if he was still interested in nursing, and if not, I would give him something else to do.
  • Unlatch (and try again). Sometimes when Daniel bites me, I don't want to nurse him again right away. I think that's only natural when I'm in pain! I hand him to my partner and tell them both that I need a break, and then I take one. Other times, I'm willing to have a little chat with Daniel about biting, and then allow him to latch back on. He's old enough now to totally understand when he's hurt me, and often he cries if I tell him that he's done so. It's sad, but I think it's important to let our kids know when their actions hurt others, especially in this case.

 

Nursing Strike


This one was the hardest of any of the breastfeeding challenges I've faced, mostly because I felt totally out of control of the situation; I didn't know what to do. One day, my son just stopped nursing. He was nursing fine that morning, and he had never refused the breast before, but then all of a sudden, he didn't want to anymore. He still acted hungry, but then he wouldn't take the breast. I knew that babies don't usually self-wean suddenly, and that self-weaning before one year old is uncommon. What did I try?
  • Offer, offer, offer. I offered the breast often, and tried not to show my son that I was upset when he refused. I know he's sensitive to my emotions, and I didn't want him to think I was angry with him for declining. I just kept trying, and eventually (after almost three days) it worked.
  • Pump. Since I'm prone to engorgement and plugged ducts, I knew I couldn't go very long with full breasts without risking mastitis. I pumped and saved milk throughout the nursing strike, and I even offered it to my son both a bottle and a sippy cup, to see if he would take it (he wouldn't).
  • Treat the cause. Some nursing strikes are related to stress caused by sudden changes in the child's environment (a move, new sibling, visitors, etc.), some are because of physical discomfort due to illness or teething, or it could be for one of many other reasons. In our case, there were many of the possible contributing factors: we had just had company in town, Daniel had a bit of a cold, and he was teething. After talking to several other moms who have experienced this type of situation, I determined that the most likely cause for his refusal to nurse was pain. I had already tried several homeopathic and other natural remedies for teething pain, and decided to give Daniel some Ibuprofen. After a couple of doses, he was happily nursing again!
Well, after all of that, you might think that breastfeeding has been an arduous task for me. However, that has not been the case at all! These things have been only little hiccups in our breastfeeding relationship, and they've certainly not soured it yet. I'm looking forward to nursing Daniel until he weans on his own—hopefully at least another year or more!

Do you have a story about your experience breastfeeding through a bump in the road? Do you have any tips to share for overcoming specific breastfeeding challenges? Let me know in the comments!


Though I have a nursing license and I have completed some additional lactation-specific courses, this is not intended to be medical advice, but rather as a "been there" kind of account of my experiences. As always, when it comes to your health, please trust your own judgment and that of your healthcare provider.


Let's help communicate about breastfeeding for this year's WBW! Link up your breastfeeding posts below, and visit NPN to grab the code for your own blog. It will update automatically as posts are added!

6 comments:

  1. When my son bites me, I block his nose gently with my fingers. This forces him to unlatch to breathe, solving the pain immediately, and is uncomfortable for him without being painful or traumatizing. I might accompany it with a stern "no" and signing "naughty". He started biting me before he got teeth, and with these steps he learned to not do it before any teeth had come in.

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  2. What an awesome list of remedies for some common problems!! My main problem when Kieran was younger was nipple blisters - oh, ouch! We worked on latch, I used breastmilk, and I loved my heat packs.

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  3. Wonderful tips to share! I'd like to add one for blocked milk ducts. I've always laid my baby down flat (on the bed or floor) and then positioned myself so that her chin pointed toward the blocked duct. The blocked duct has almost invariably been in the top section of my breast, so it was a bit of an odd / rare position. If it was especially bad, I applied pressure / massage to it as baby nursed.

    This got me through 3½ years with Tyler and nearly 2 years (so far!) with Sasha. Thankfully, I'm not having as many blocked ducts this time around! (I've also used heat if it was painful or between nursing sessions.)

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  4. @Amy: I did try the blocking airflow trick for biting, but it didn't work for us. I hear it's usually very effective, though!

    @Dionna: Thanks! Blisters are tough to deal with, especially persistent/recurring ones.

    @Jorje: That's a great tip! I've not tried it quite the same, but I have used nursing on all fours (above the baby who is laying on his back) which uses gravity to aide in draining the duct while also relieving any pressure from clothing and such. Sometimes the funny positions are what really help! =)

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  5. It was interesting to read your post as I could only relate to only a few of the troubles. I had the opposite problem-- not having enough milk. I actually took a prescription (Reglan 10 mg tablets) that really helped my milk production. I've heard that with second babies, the milk comes in more quickly (with hopefully more quantity.) Now I have some good ideas on how to handle these problems if they arise with the next baby, thanks!

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  6. I found with biting, the best thing that i did was bring my daughter real close to my when she did it. It would make it so she would have to unlatch herself - so there was no pulling. I hope this helps!!

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