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Breastfeeding problems such as sore nipples, skin problems, mastitis and nipple problems may hinder effective breastfeeding or cause discomfort to the mother. The following are some of the common breastfeeding problems, their causes and how to manage them.

Sore or cracked Nipples

Sore nipples can be seen as crack, wound, bleeding or pain of the nipples. It is due to the baby’s improper attachment while breastfeeding, position and other bacterial or fungal infection. This can be managed through the following steps:

1. Massage the breast from top to the nipple using coconut oil to soften the area or visible crack.
2. Wipe expressed breast milk from the nipple every 15 minutes.
3. Breastfeed your baby on the unaffected breast and make sure that the baby is properly attached to the breast.
4. Position your baby horizontally, bring him/her close to your body and carry or support the baby up to your breast.
5. Sit at a relaxed position while breastfeeding. Putting a pillow at the back may help support your lower back for comfort.
6. Gradually breastfeed your baby on the affected sore nipple because this is the only way for it to heal faster. Breast milk contains antibacterial substances which can hasten the healing process and fight against infection.
7. You may try other comfortable breastfeeding positions. Remember to continuously breastfeed your baby.

Bacterial or Fungal Infection and other skin conditions

Symptoms of possible bacterial or fungal infection of the breast are: redness, itchiness, shiny appearance of the breast, clumpy white discharge from mother or in baby’s mouth (Candidiasis) and pain during or after breastfeeding. If these symptoms are observed, consult your doctor for proper assessment and management. Other management you can do at home are:

1. Avoid wearing tight bras with wire or those made with polyester which may prevent air circulation around the nipples. Air dry the nipples to prevent excess moisture from triggering bacterial or fungal infections.
2. Continue breastfeeding.
3. Consult your doctor. They may prescribe antibiotics for bacterial infections or ointments for fungal infections.
4. Apply the ointment to your baby’s lips and to your nipple after breastfeeding.

Engorged Breasts

Engorged breasts are breasts that feel very full due to excess breastmilk. This happens when the breast milk is not expressed or consumed by the baby possibly due to improper attachment or when the baby is receiving formula milk, sugar water or using a pacifier. Other factors include mother breastfeeds less frequently due to stress, scheduling of breastfeeding, sudden stop in breastfeeding or when the baby sleeps more than usual. The management for engorged breasts that you could do at home is:

1. Soak a towel in warm water for 5 minutes. Squeeze the towel and lightly place it over the affected breast.
2. Now soak the towel in cold water, squeeze the towel and lightly place it on the affected breast.
3. Now dip both breasts in lukewarm water in a basin for 5 minutes. Remove then repeat many times.
4. Massage your breasts to soften it.
5. After massaging, manually express breastmilk by hand to relieve the pressure. oThis step is important to help the baby have proper attachment when breastfeeding.
6. Check for proper attachment of your baby when breastfeeding.
7. Let the baby breastfeed on demand.
8. Put the baby close to your breast to encourage breastfeeding.
9. Continue breastfeeding to prevent the build up of breast milk and breast engorgement.

 Mastitis

Mastitis is an infection of the breast due to prolonged untreated blockage of milk passageways inside the breast. It commonly affects only one breast or sometimes both breasts. Symptoms include redness, swelling and pain of the breasts and sometimes fever. If left untreated, the breast may have a pus or a whitish greenish material that oozes out of the nipple or wound. The causes of mastitis include:

• Blocked milk pathways that are left untreated
• Swelling of the breasts that is left untreated
• Tight bras or bras with wire
• Extreme tiredness
• Stress or anxiety
• Breast trauma or injury
• Excessive breast milk production
• Less frequent or inadequate breastfeeding
• Redness in some parts of the breast
• Bacterial infection of small wounds or cracks in the nipple

If you are experiencing these symptoms, consult your doctor for proper assessment and medical treatment of bacterial infection. The following are the management you can do at home:

• Drink fever and antibacterial medications as recommended by your doctor
• Do not breastfeed on the breast with pus. Breastfeed on the other healthy breast.
• Pus can be extracted from the breast by massaging and gentle squeezing of the affected breast.
• Put cold compress over the affected breast to reduce pain and swelling.

If you are experiencing breastfeeding problems, visit your nearest health center to receive guidance from our IYCF counsellors and to get proper medical treatment for breast problems.

/AET

References:

Department of Health (2012). Gabay sa Nanay sa Tamang Pagpapasuso.