Breastfeeding is universally recognized as the best way to feed an infant because it protects mother and infant from a variety of health problems. Even so, many women who start out breastfeeding stop before the recommended minimum of exclusive breastfeeding for six months. Often, women stop because common problems interfere with their ability to breastfeed. Luckily, with sound guidance and appropriate medical treatment, most women can overcome these obstacles and continue breastfeeding for longer periods.
INADEQUATE MILK INTAKE
The most common reason women stop breastfeeding is that they think their infant is not getting enough milk, but in many cases, the mother has an adequate supply. A true inadequate supply can happen if the infant is unable to extract milk well or if the mother does not make enough milk. Unfortunately, figuring out if a mother has enough milk and if not, why not, can be challenging.
Inadequate milk production — There are a number of reasons why a mother might not make enough milk, including:
●Her breasts did not develop sufficiently during pregnancy – This can happen if she does not have enough milk-producing tissue (called glandular tissue)
●She previously had breast surgery or radiation treatment
●She has a hormonal imbalance
●She takes certain medications that interfere with milk production
Poor milk extraction — The most common reasons infants have trouble getting enough milk are:
●They do not get fed frequently enough (which can cause milk production to slow or stop).
●They cannot latch on properly
●They are separated from their mother too much.
●They are fed formula.
Many babies are sleepy and difficult to keep awake during the first several days after birth. This can prevent the baby from getting enough to eat. Other babies can have trouble controlling the muscles involved in suckling, which makes it hard for them to extract milk. Feeding difficulty is especially common among premature and late preterm babies. Many mothers judge adequacy of feeding by lack of crying. This can be misleading if the baby is not getting enough milk and is overly sleepy.
Diagnosis of inadequate intake
●Number of feeding sessions the mother reports having – During the first week of life, mothers with term infants (meaning they are not premature) generally nurse 8 to 12 times in 24 hours. By four weeks after delivery, nursing usually decreases to 7 to 9 times per day.
●Amount of urine and stool the baby makes – By the fifth day of life, infants who are getting enough milk urinate six to eight times a day and have three or more stools a day. (Once a mother's milk comes in, her infant's stool should be pale yellow and seedy.)
●Weight of the baby – Term infants lose an average of 7 percent of their birth weight in the first three to five days of life. They typically get back to their birth weight within one to two weeks. Once a mother's breasts fill with milk (by day three to five), her infant should not keep losing weight. If an infant has lost 10 percent of his or her weight or fails to return to his or her birth weight when expected, health care providers start to explore potential problems. Household scales are not accurate enough to detect these small weight differences. If you are using a medical scale for infants, remember to weigh the infant with the same clothes and diaper before and after the feeding.
NIPPLE AND BREAST PAIN
The second most common reason mothers stop breastfeeding early is nipple or breast pain.
The causes of nipple and breast pain include:
●Nipple injury (caused by the baby or a breast pump)
●Engorgement, which means the breasts get overly full
●Plugged milk ducts
●Nipple and breast infections
●Excessive milk supply
●Skin disorders (such as dermatitis or psoriasis) affecting the nipple
●Nipple vasoconstriction, which means the blood vessels in the nipple tighten and do not let enough blood through
Causes of breast or nipple pain:
●Ankyloglossia (also called tongue-tie), which is when the baby's tongue cannot move as freely as it should, making it hard for the baby to suckle effectively
●Torticollis, which is when the baby's neck is twisted, making it hard for the baby to nurse from both breasts comfortably
●Birth defects in the shape of the baby's mouth that make it hard for the baby to latch on
●Uncoordinated suck, which is when the baby does not move his or her tongue in the correct rhythm to extract milk
Nipple pain — Sore nipples are one of the most common complaints by new mothers. Pain due to nipple injury needs to be distinguished from nipple sensitivity, which normally increases during pregnancy and peaks approximately four days after giving birth.
One can usually tell the difference between normal nipple sensitivity and pain caused by nipple injury based on when it happens and how it changes over time. Normal sensitivity typically subsides 30 seconds after suckling begins. It also diminishes on the fourth day after giving birth and completely resolves when the baby is approximately one week old. Nipple pain caused by trauma, on the other hand, persists or gets worse after suckling begins. Severe pain or pain that continues after the first week after birth is more likely to be due to nipple injury.
Normal nipple sensitivity — If one 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. If one 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.
Nipple injury — Nipple injury usually is due to incorrect breastfeeding technique, particularly poor position or latch-on. Other factors that can make pain caused by injury worse include harsh breast cleansing, use of potentially irritating products, and biting by an older infant.
PREVENTION OF LACTATION TROUBLE
●Try to keep nipples dry, and allow them to air-dry after feedings.
●Do not use harsh soaps or cleansers on breasts.
●Avoid use or overuse of breast pads that have plastic backing.
●If babies mouth has any abnormalities, make sure to have them addressed as soon as possible. For example, if baby has tongue-tie, surgery to release the tongue will make it easier for the baby to latch on properly.
●If baby is biting mother, position the baby so that his or her mouth is wide open during feedings. That will make it harder to bite. Also, stick their finger between nipple and the babies mouth any time he or she bites mother and firmly say "no." Then put the baby down in a safe place. The baby will learn not to bite mother.
Here are some things one can do to promote healing if their nipples are already injured:
●Always start nursing with the breast that does not have the injury.
●If nipples are cracked or raw,one can put expressed breast milk or an ointment on them(if you are not allergic) and cover them with a nonstick pad. This will keep the injured part of nipple from sticking to bra. If one think their nipple is infected or one have a rash,must consult with doctor.
- Use cool or warm compresses, if they seem to help. Avoid ice.
●If nipple pain prevents baby from emptying breasts, try using a pump or hand expression to empty breasts. This will give nipples a chance to heal and prevent engorgement. Use the milk one remove to feed their baby.
●Do NOT use vitamin E oil on nipples. At high levels, it could be toxic to your baby.
Nipple vasoconstriction — Nipple vasoconstriction is when the blood vessels in the nipple tighten and do not let enough blood through. Mothers with this problem can have pain, burning, or numbness in their nipples in response to cold, nursing, or injury. The nipples can also turn white or blue and then pink when the blood returns.
One way to tell nipple vasoconstriction apart from other causes of nipple pain is that it can be predictably triggered by cold, while other causes of pain cannot.
To manage nipple vasoconstriction, try to keep our whole body warm and dress warmly. Also, if possible, try to breastfeed in warm conditions. It might also help to avoid nicotine and caffeine as they can make the problem worse.
Engorgement — Engorgement is the medical term for when the breasts get too full of milk. It can make our breast feel full and firm and can cause pain and tenderness. Engorgement can sometimes impair the babies ability to latch, which makes engorgement worse because the baby cannot then empty the breast.
PREVENTION OF LACTATION TROUBLE
●If the engorgement makes it hard for our baby to latch on, manually express a small amount of milk before each feeding to soften our areola and make it easier for the baby to latch on . To do this, place thumb and forefingers well behind our areola (close to our chest) and then compress them together and toward our nipple in a rhythmic fashion. One can also use our hand to present our nipple in a way that is easier to latch on to and to help get milk out for the baby while the baby is suckling.
●One can use a breast pump to help soften our breast before a feeding, but be careful not to do it too much. Using a pump too much will stimulate our breast to make even more milk, which will make engorgement worse.
●Apply warm compresses or take a warm shower before a feeding. This can enhance let-down and may make it easier to get milk out.
●Take a mild pain reliever, such as acetaminophen (brand name Tylenol) or ibuprofen (brand names Advil and Motrin).
Plugged ducts — A plugged milk duct can cause a tender or painful lump to form on the breast. If the nipple itself is plugged, a white dot or bleb can form at the end of the nipple.
Things that can lead to a plugged milk duct include poor feeding technique, wearing tight clothing or an ill-fitting bra, abrupt decrease in feeding, engorgement, and infections.
Galactoceles — Sometimes a blocked milk duct can cause a milk-filled cyst called a galactocele to form. Unless they are infected, galactoceles are usually painless, but they can get quite large. If necessary, a health care provider can drain a galactocele using a needle or suggest surgery if the problem is severe.
Lactational mastitis — Mastitis is an inflammation of the breast that is often associated with fever (which might be masked by pain medications), muscle and breast pain, and redness. It is not always caused by an infection, but most people associate it with infection. Mastitis can happen at any time during lactation, but it is most common during the first six weeks after delivery.
Mastitis tends to occur if the nipples are damaged or the breasts stay engorged for too long or do not drain properly. To prevent and treat mastitis, it's important to get these problems under control.
SYMPTOMS OF LATATION TROUBLE
●A firm, red, and tender area of the breast
●Fever higher than 101°F or 38.5°C
●Muscle aches, chills, malaise, or flu-like symptoms=
Yeast infection — Many women who are breastfeeding are diagnosed with a yeast infection of the nipple or breast (also called candidal infection) based on their symptoms (primarily nipple pain). Even so, yeast infections of the nipple or breast are poorly understood, and researchers aren't sure what role they play in nipple pain.
DIAGNOSIS OF LACTATION TROUBLE
●Breast pain out of proportion to any apparent cause
●A history of vaginal yeast infections or an infant with a history of yeast infections such as thrush or diaper rash
●Shiny or flaky skin on the affected nipple
●Candida found in a culture of breast milk (if this test is done)
BLOODY NIPPLE DISCHARGE
Some women have bloody nipple discharge during the first days to weeks of lactation. This is more common with the first pregnancy and has been called rusty pipe syndrome. It is thought to be caused by the increased blood flow to the breasts and ducts that happens when the mother starts making milk. The color of the milk varies from pink to red and generally resolves within a few days. Women who have bloody discharge for more than a week should be seen by a health care provider.
Some mothers make too much milk, which paradoxically can make breastfeeding difficult. Generally, the production of milk is determined by the infant's demand, but in this case, the supply exceeds demand. The problem begins early in lactation and is most common among women having their first child.
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 trouble feeding, or even to bite down to clamp the nipple. 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.
If one have a problem with overproduction, don't worry. The problem usually goes away on its own. But tell our health care provider about it, so he or she can check whether you have any hormonal imbalances or take any medications that could make the problems worse.
HOMOEOPATHIC TREATMENT FOR LACTATION TROUBLE
Useful medicine for suppression of the milk accompanied with depression.
Useful medicine for the first signs of mastitis. The mother feels hot, red, throbbing. There is very intense and sudden onset with pain and extreme tenderness in the breast.
Useful for lactation trouble with hard, swollen and hot breast but pale in color, rather than red.
Very effective medicine for thrush in newborns. There is distinctive white patches on the tongue and cheeks of the body.Useful for extremely sensitive breast.Also useful for a mother with postpartum depression.
Useful in lactation trouble which helps to stimulate milk production.
Useful to successfully increase breast milk in rheumatic women
Useful for an oversupply of milk. There is a stoic sadness or grief with little or no crying and often only in private.
Useful for mastitis for sore, cracked nipples, which hurt when the baby nurses. It is also useful for breast infections (mastitis) where there are painful lumps in the breast.
Recommended when the person is depressed and tearful. She may weep while breastfeeding and needs a lot of support and company. Usefull when there is over production of milk. Also useful for a milk supply that is erratic, meaning that is good, then it is low, then it is adequate again.
Useful for non-appearance of milk or to increase breast milk.Also useful to increases its flow in nursing women.