Breastfeeding is a natural process. However, the first two weeks of breastfeeding can be a difficult time especially if you are a first time mother. Here are a few common problems faced by some mothers:

• Breast engorgement
• Not enough milk
• Sore nipple

Breast engorgement

Causes

Breast engorgement is caused by a rapid increase in milk volume which causes congestion of the blood vessels in the breast. It is different from breast fullness. Breast fullness will still be compressible, soft and flexible.

Signs and symptoms

Signs of breast engorgement are:

• The breasts become hard and painful, and will look tight and shiny.
• The areola seems firm.

Complications

Breast engorgement can cause:

• Difficulty for baby to latch on to the breast.
• Difficulty to extract milk.

Treatment

Things that you can do to treat breast engorgement are :

• Do not stop breastfeeding.
• Check whether you are using a proper technique for positioning and attachment and correct it.
• Breastfeed your baby frequently.
• Before feeding, gently express some of the milk to soften the breast, so that your baby can attach.
• After feeding, if your breast is still hard, express the remaining milk.
• Apply warm and moist compresses to your breast to get milk flow.
• Use cold compresses in between feed to help relieve pain and reduce inflammation.

Prevention

Breast engorgement can be prevented by :

• Frequent feeding, at least 10 – 12 times a day
• Proper technique of breastfeeding

Sore nipple

Causes

• Improper positioning of baby
• Improper feeding techniques
• Improper nipple care
• Other factors
  • Nipple eczema : When eczema is present your nipples may be red, blacky, itching, oozing and/or inflamed.
  • Thrust : Fungal infection (due to Candida albicans) may also cause sore nipples. It will begin with nipple pain with burning sensationand itching. Your nipple will be slightly pink to red in color.

Treatment

• Do not stop breastfeeding.
• Check whether you are using a proper technique for positioning and attachment and correct it.
• Express a few drops of breast milk and apply on the nipple. This will help healing.
• No need to use any lotion or ointment.
• See a doctor if there is no improvement, to check for fungal infection or eczema.

Prevention

• Make sure you position and attach your baby with a proper technique
• Do not wear plastic breast shield that holds in moisture.
• Avoid wearing a bra made of synthetic fabric which increases sweating and hinders evaporation
• Wash your breasts only with water, not soap. Using soap or soapy solution will remove natural skin oils and can cause excessively dry skin.

Not enough milk

Not having enough milk is the most common reason given by mothers for stopping breastfeeding or giving supplements. But most of the time, this is not true. Your milk flow will diminish because of lack of stimulation due to the following:

• If you do not let your baby suckle as frequent and as long as he wants to.
• If your baby is not attached at the breast for effective suckling.
• If you stop night breastfeeds too early.
• If you start giving other food (apart from breast milk) to your baby too early or you bottle-feed.
• If you breastfeed from only one breast.
• If you lack confidence in your ability to breast feed.
• If you are emotionally stressed.

Here are a few solutions to overcome these problems:

• Feed your baby as frequent as you can and whenever he wants to.
• Try not to let more than two hours lapse between feeds.
• Make sure the baby is properly attached at the breast.
• Breastfeed from both breasts.
• Improve your diet. Eat more body building foods such as fish, chicken, meat, eggs, peas and beans; and protective foods such as fruits and vegetables.
• Have confidence in yourself. You can breastfeed.
• Rest as much as possible and try to relax during breastfeeds.

You can be sure that your baby is receiving sufficient breast milk by observing the signs below:

• He breastfeeds at least eight times in 24 hours.
• His suckling rhythm changes during feed; you can hear or see him swallowing.
• He is alert and is contented between feeds.
• He has good muscle tone and healthy skin.
• He has six or more pale yellow urine, and three to eight loose yellow stools in 24 hours.
• He shows a steady and consistent weight gain after the first week of age, and follows the growth curve.
• You may feel a sensation and leaking from the non-suckled breast or a change in fullness in your breasts.