Breast problems while breastfeeding. Stone chest when feeding. You can also add to these actions

Between the third and fourth days after giving birth, when colostrum begins to turn into mother's milk, your breasts will become fuller and heavier. Along with the increase in milk production, in the process of adjusting to this, excess blood and lymph will accumulate in your breasts. The best way to avoid full breasts with blood is to feed your baby more often (every two or three hours). If he doesn't feed often enough or long enough at each breast, normal fullness can develop into engorgement.

If you immediately begin to resist this state of affairs, engorgement usually resolves after 24-48 hours. A good supportive bra is recommended for such a case, but make sure it is not too tight around the chest. Counteracting this overflowing is more frequent feedings, increased attention to suction and the position of the baby. When he feeds, it is recommended to gently massage the chest. If your baby is unable to suckle well due to fullness around the halo, rubbing or pressure long enough to soften the halo may help. After feeding, you can apply cold compresses for 15-20 minutes. Avoid pumping unless there is a need to soften the halo or if your baby refuses to feed from the second breast. Remember that milk production is based on the principle of supply and demand, and your body will gradually get used to it.

Mother's milk is the best food for a baby. It not only saturates the baby, but gives him a lot of other benefits. However, the process of breastfeeding is often not as easy and natural for a young mother as she expected.

If you manage to overcome the accompanying difficulties, you will bring a huge benefit to the child: he will receive from you all the vitamins and nutrients he needs in the first months of life. Breast milk contains elements that help fight diseases, in particular antibodies that form the baby's immune system and protect his health.

Typical complaints

Child anxiety

If the baby is worried directly during and also after feeding, then he is likely to take the breast incorrectly, which limits the flow of milk. Ask a health visitor where they can teach you how to take the correct position and bring the baby to the chest correctly so that he is full of food.

Painful or cracked nipples

If your nipple hurts, take the baby off the breast and try a different way of putting it on. To pull away, gently slide your finger into the corner of his mouth and hold until he removes his tongue. Don't tolerate the pain: it usually comes from the fact that the baby failed to take the breast. In this case, the milk will not flow to him as it should. If you try again and the discomfort doesn't stop, or if your nipples start to crack or bleed, have a professional help you figure out what you're doing wrong. Be sure to seek support because pain when feeding is not normal.

Breast pain, blocked milk ducts, mastitis

Chest pain or blockage of the duct should be treated as soon as possible. If you do not see a doctor in a timely manner, mastitis (inflammation of the breast) may develop. Its occurrence is indicated by the presence of two or more of the following signs:

• hot and painful chest;
• a red spot on the skin that hurts to touch;
• general malaise, as with the flu;
• soreness, fatigue, tendency to cry;
• increase in body temperature.

Symptoms of mastitis often occur quite unexpectedly, the disease can develop rapidly. It is important to continue to feed: this will speed up your recovery.

Do you know?

Raw cabbage helps with hardening of the mammary gland: apply clean, chilled inner leaves to the breast, changing them about every two hours or as they fade.

sore nipples

As mentioned above, it is quite normal for some softening of the nipples to appear in the first two weeks of feeding. It can occur during sucking and during the first sucking movements due to stretching of the nipples and halos. But if this softening turns into irritation and inflammation, it is very important to understand and eliminate the cause of this. If the pain is stronger than the feeling of simple softness or becomes unbearable, you should seek the advice of a doctor. In addition, you should make sure that your baby is positioned correctly and sucks well at each feed. The following measures may be helpful.

• Ice on nipples before suction. Acetaminophen half an hour to an hour before feeding.
• Shorter but more frequent feedings (every hour or three for ten minutes on each side).
• At the end of each feed squeeze out some milk, rub it on your nipples and let them air dry.
• Between feedings, breast shells can be worn inside the bra to prevent rubbing of the nipples on the fabric and to ensure free access of air to them.
• If you wear nursing pads, change them frequently. Avoid linings with plastic trim.
• Avoid breast shields (thin silicone or latex nipples that are placed over the nipples when feeding a baby) completely. They only increase the inflammation of the nipples and can drastically limit the flow of milk.

Seek immediate medical attention if these measures do not help. Call your doctor without hesitation.

sleepy baby

Babies tend to be sleepy in the first few days after birth for a number of reasons. This is usually associated with the recovery of strength after childbirth, or possibly with drugs that were given to the mother during labor. You need to wake your baby every two to three hours during the day until he wakes up on his own.

First, swaddle your baby. You can undress him. Hold the baby in a sitting position on your knee. Gently rub his back or "run" your fingers up and down his spine. Try to change his sheet. If the baby falls asleep after sucking, wake him up, stimulate him and let him suck again. Keep trying like this. If nothing works, try again every thirty minutes. Avoid pacifiers and their substitutes! If the child cannot be awakened within five to six hours of such attempts, contact your child's doctor.

Is the baby getting enough nutrition?

The amount of milk a mother produces depends on her baby's suckling efficiency and how often he feeds. There are ways to monitor your baby to make sure he is getting enough breast milk. On the third or fourth day after birth, your baby should wet six to eight diapers a day. Urine should be pale, not concentrated. After all the meconium (baby's first stool) has passed, which usually happens within the first three to four days, the stool will change in color and consistency. Its color will turn yellow or yellow-green. Most babies have it two to five times a day for the first four to six weeks. Your baby should put on 180-240 grams of weight every week. A newborn usually loses five to ten percent of his birth weight, but he should regain his original weight by the end of the second week. The baby should be fed at least 8-10 times a day. Listen while feeding to his swallowing movements. In addition, after feeding, you should feel that your breasts have become softer. Watching the baby grow, enjoying feeding it is the biggest reward for a nursing mother.

That said, it's important to add that your baby will go through growth spurts roughly every two weeks for the first three months. At such a time, he will feed every hour or every two hours. It will seem that the baby is constantly hungry. However, he also stimulates your breasts to produce enough milk to meet his increased needs. Growth spikes usually last from 24 to 48 hours, because in the normal state of affairs, this is the time it takes for the amount of milk produced by the mother to increase. Avoid supplements at this time. Your milk production will increase in response to the increased stimulation that comes with your baby's sucking movements.

Work and breastfeeding

Currently, most mothers consider it necessary to return to work after the birth of a child. For mothers who want to continue breastfeeding with good planning and with little extra effort, there are a number of opportunities to successfully combine feeding and work. It is better, however, to try to stay at home for at least six weeks. Experts agree that by extending the mother's leave, there is less difficulty in maintaining sufficient milk production.

However, as soon as you decide to go to work, you will need to think through everything in advance and use every opportunity to continue feeding. First of all, and this is very important, you need to decide how you will express breast milk. It's best to check with your doctor and then choose a breast pump or other method that works for you. The book Maternal Feeding Companion by Kathleen Huggins provides an excellent overview of different types of pumping aids.

It is recommended that you wait at least three to four weeks after giving birth before giving your baby a bottle. This is important to establish good milk production and a good relationship between the baby and the mother during breastfeeding. It is also usually better for someone other than the mother to give the baby a bottle.

Pumping or pumping by hand requires practice. You can start pumping about three to four weeks after your baby is born and start using a bottle around that time. You will have more milk in the morning than in the evening, so it is best to start collecting milk in the morning.

If you manage to slightly change the schedule of the working day when you return to work, or even organize a “substitution” for yourself, this will help to significantly extend the period of breastfeeding and the need for pumping will disappear.

The process of expressing milk usually takes 15 to 30 minutes. It is best to collect breast milk in plastic bags designed specifically for this. Label each bag with the date and time of pumping, then tie each bag with tape about an inch above the milk level. This will allow the milk to expand if it freezes. Collect sixty to one hundred grams of milk to avoid wasting it.

Your freshly expressed milk can be safely stored at room temperature for about 6-8 hours; in the refrigerator, it can stand up to five days. If you slide it into the depth of the freezer, then such milk can be stored for 4-6 months, and even longer when completely frozen. In order to melt or warm milk, you can place the bag or bottle in the coffee maker or substitute it in cool and then warm water so that it warms up to at least room temperature. Never freeze melted milk again. Do not heat stored milk in the microwave. Hot spots can destroy some of the valuable ingredients in breast milk.

When adding fresh breast milk to already frozen milk, the fresh milk must be cooled so that it does not cause the frozen milk to melt. You can mix refrigerated milk, but you should mix cold milk with cold milk, not warm milk with cold milk.

Expressing breastmilk twice or pumping both breasts at the same time is the quickest and most effective way for working mothers. It is good to rent a quality electric breast pump for a few weeks so that pumping is fast and efficient.

If you are pumping milk first from one breast and then from the other, it is best to move the pump from breast to breast every five minutes, keeping a total pumping time of fifteen minutes per breast.

Breastfeeding is an act that provides an intimate bond between a mother and her baby. The feelings of warmth and intimacy that arise from this are incomparable. A breastfeeding mother cherishes those precious, beautiful, loving moments for years to come, and she gives her child the best possible start in life.

Behind pregnancy and childbirth is a difficult test for all systems and organs of a woman. Now the body is tuned to a new process - breastfeeding. Tatyana Oboskalova, an obstetrician-gynecologist with 30 years of experience, answers the questions that women in labor have.

• The chest is very swollen and sore. How to reduce pain?
• Do I need to use breast pumps? How often?
• Cracks formed on the nipples, when feeding it hurts to tears. What to do?

Needless to say, it is difficult for a young mother in most cases. A child is happiness, but reality makes its own adjustments to joyful experiences. To live in obedience to the needs of a tiny creature is difficult. Especially when unpleasant painful sensations are wedged into a heap of worries.

In the first days after childbirth, the breasts may swell and hurt - this is due to the appearance of milk. If the chest is hard and sore, then this is usually due to the fact that the mammary gland has produced too much milk, and its stagnation has occurred. Such breast problems can occur both immediately after childbirth and during the first months of breastfeeding. The best medicine in this case will be the child himself, who will suck the breast better than any breast pumps. The more often you put the baby to the breast, the less painful swelling occurs. Over time, the flow of milk begins to coincide with the baby's need for attachment to the breast. But it also happens that the child tries to suck out the milk, but nothing works out for him, he becomes restless and starts to cry. In this case, you need to lightly massage the breast and express the milk yourself - with your hands or with the help of a breast pump. However, modern breastfeeding experts believe that the cause of various problems with the mammary glands is improper attachment of the child to the breast.

Recall that the correct latch on the nipple is when the nipple touches the palate. In this case, the breast should “look” with the nipple not into the child’s mouth, but into the palate, which will allow the baby to capture a much larger part of the breast from below than from above. The baby's mouth should be wide open, and the tongue should lie on the lower gum and protrude freely from the mouth. The areola of the nipple is almost completely in the baby's mouth, while the baby's chin touches his chest.

A special case is a short frenulum, which can cause painful latch on the nipple due to the strong compression of the baby's gums. In this case, it makes sense to consult with the pediatrician about the optimal approach to attaching the baby to the breast.

Warm compresses, cabbage leaves and burdock do not need to be applied to the mammary glands. A warm compress will only increase the flow of milk, and there will be no effect from cabbage and burdock.

In case of lactostasis (the so-called stagnation of milk in the breast), you need to apply an ice pack for 20-30 minutes, repeat the procedure several times with an interval of 30-40 minutes. Women, and especially their mothers, believe that this way you can "chill" the chest, but this is not so.

Cold will narrow the lumen of the blood vessels that feed the breast lobules, which will lead to a decrease in milk production. In addition, favorable conditions are created in the congestive mammary gland for the development of microbes, which can cause inflammation of the mammary gland - mastitis. Cold is used at all times to limit the inflammatory process in any organ. Therefore, do not be afraid to use ice within reasonable limits.

If you still have to resort to any method of emptying the mammary gland, then preference should be given to a high-quality breast pump, which is designed in such a way that it imitates the capture of the areola and nipple, as a child does.

If there is no breast pump, and you express your breasts, you need to do this with absolutely clean hands in a clean dish, pressing your fingers not on the areola or nipple, but on the area near the areola, since it is here that milk accumulates in peculiar reservoirs - lacunae - and it is from here along the ducts enters the nipple. Some women are so zealous that they rub abrasions on the skin of the mammary glands, which is very undesirable, since abrasions on the skin are the way for infection to penetrate deep into the mammary gland.

Another fairly common problem is cracked nipples. Proper attachment to the breast is the prevention of this unpleasant problem. The reason for the appearance of cracks can also be illiterate care of the mammary glands, including their "disinfection" with alcohol-containing substances. Another reason is the lack of vitamins in the body of a young mother, which are necessary to maintain the elasticity of the skin, its resistance to infections, as well as for the rapid healing of microtraumas - we are talking about vitamins A, B, C, D and E. However, the occurrence of cracks is possible even in the case of proper attachment to the breast and competent care. But with very delicate and receptive skin of the nipple, as a rule, this happens in the initial period of breastfeeding (later the skin becomes coarser and the cracks disappear).

To treat cracked nipples, gels and ointments containing vitamin B can be used after each feeding. Moisturizers containing pure lanolin are suitable, which will help restore the elasticity of the skin of the nipple. But the crack will not heal in one day, and the baby needs to be fed, so you can use special nipple covers that completely repeat their shape, are made of elastic and hygienic material, and allow the baby to perform full sucking movements without causing additional trauma to the mother. Such adaptations help to avoid unreasonable refusal of women from breastfeeding.

For the hygiene of the mammary glands, it is more expedient to use special gels for nursing mothers, and exclude soap for the time being, in any case, make sure that it does not fall on tender nipples. Air baths, light massage, that is, those measures that were used in the prenatal period to train the nipples, are also suitable now, but already to prevent the formation of cracks. Bras should be purchased specifically for nursing women, as they are made of hygienic materials that allow the skin to "breathe", have wide straps and voluminous cups that do not compress blood vessels and gland tissue. It is advisable to change the bra daily, otherwise you can infect both yourself and the child.

During the next visit to the pediatrician, ask him a question related to the condition of your breasts. Surely you will be provided with timely assistance, and you will be able to cope with the painful condition.

"Mom's well-being in the postpartum period", from the book

Discussion

Cabbage leaf only helped from stagnation and pain. An ice pack is not needed. It is enough to attach a towel soaked in cold water

05/09/2018 00:41:43, light

Well, the bra does not need to be changed daily, there are special hygienic discs that are inserted into it. They need to be changed more often. You don't have to wear a bra all the time either.

Thanks for the advice. As I remember myself after giving birth, I think why I didn’t come across this article earlier.

At first, I struggled with feeding for a very long time. The chest hurt, cracks appeared. Even managed to earn mastitis due to inexperience. A very useful article for young mothers.

thanks to your becoming with feeding now there are less problems and pain))

The baby helped me with the stagnation of milk.

"It is advisable to change the bra daily, otherwise you can infect both yourself and the child." If you consider how much such a bra costs, then you can go broke, well, or wash it every day :)

Some feeling after reading the article remained - if you have lactostasis or a lot of milk, or cracks in the nipples - it's your own fault ... The young mother is already in a stressful situation. About underwear for feeding - I agree, it is convenient. But the cabbage leaf really helps to cope with pain and stagnation of milk. Even if the author of the article does not believe in it, you should not be so categorical.

Comment on the article "Starting breastfeeding: the most common problems"

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Didn't find what you were looking for? See other discussions on the topic "Breast pain when breastfeeding": how often do you change breasts?

Sore chest after weaning. Weaning. Breast-feeding. Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. At first, she associated soreness of the chest with them, but the pain is growing. I put the child to the sore chest - it sucks, but I have sparks from my eyes from pain.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Section: Problems with lactation (breast swollen milk does not leave). It helped me to express the most problematic places - where there is a stone, i.e. ...

Help. Chest pain Temperature!. Problems with lactation. Breast-feeding. Help. Chest pain Temperature! We are 1 month old on Friday, we are at GV. This morning I suddenly had a terrible pain in one of my breasts.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. I have been breastfeeding for three years. Now for the third cycle in a row, the nipples begin to hurt when seized a couple of days before ovulation and this continues until the very menstruation ...

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. A sick mother must spend time and energy pumping. If the mother is ill... Starting breastfeeding: the most common problems.

Remove the pacifier - in general? Starting breastfeeding: the most common problems. Another fairly common problem is cracked nipples. Proper attachment to the breast is the prevention of this unpleasant problem. Breast preparation for lactation.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Section: Problems with lactation (if the chest is empty in the evening during breastfeeding). Starting breastfeeding: the most common problems.

The story of breastfeeding. Breastfeeding is a big separate story. When I endured and gave birth to my Start of breastfeeding: the most common problems. But with very delicate and receptive skin of the nipple, as a rule, this happens in ...

Girls, my friend's chest hurts alone, but it is not hard, it hurts below, as if in the lower lobes. A small bruise of the chest, microtrauma. Stressful situation, overwork - of course, breastfeeding is not such an easy process, so no need for Mastitis?

tantrums at the beginning of feeding. Our problems:(. Breastfeeding. Try to calm down, try to change positions (lying, sitting, from under the armpit, hanging), apply more often, etc. Gradually, the tummy will pass, and such behavior at the chest will also pass.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Section: Problems with lactation (on the 8th day milk suddenly disappeared). Starting breastfeeding: the most common problems.

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Exactly one week after weaning, my chest began to hurt. Moreover, weaned at a respectable age - 2.2. Those. didn't have to pump, milk...

But it continues to hurt, and the lower lobules hurt (ie, it hurts under the breast). It is not clear with the temperature - I feel it (aches in the joints, fever), but in the elbow - 36.7. A Medicines for breastfeeding. How to make taking medications while breastfeeding safe?

Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. Breastfeeding: so that the chest does not hurt. Practical advice for breastfeeding mothers. Starting breastfeeding: the most common problems.

Chest hurts. Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning. All boobs became bruised, hurt, and then suffered for almost a week, that my child was malnourished .. pain during a rush of milk.

chest hardened. Increased lactation. Breast-feeding. Starting breastfeeding: the most common problems. However, modern breastfeeding experts believe that the cause of various In the event of lactostasis (so ...

Chest hurts. Increased lactation. Breast-feeding. Breastfeeding: tips for increasing lactation, feeding on demand, long-term breastfeeding, weaning.

Starting breastfeeding: the most common problems. See other discussions: Starting breastfeeding: the most common problems. And as soon as I got pregnant, it immediately became difficult to walk in heels, although my stomach was not yet visible.

Pediatricians all over the world recommend feeding the baby with breast milk, which helps the baby grow up healthy, getting all the necessary nutrients, trace elements and vitamins, contributing to the development of all organs and systems in the newborn and infant. It is always fresh, warm and sterile, but natural feeding requires certain conditions:

• mother must constantly be with the baby and feed him on demand;
• nutrition of a nursing mother should be complete, hypoallergenic and balanced;
• at first, relatives should help the mother, due to the fact that it takes a lot of time and effort to express the remaining milk. In the future, with the stabilization of lactation and adaptation to breastfeeding, both the mother and the baby are almost completely sucked out from one breast and partial from the other mammary gland and pumping is not considered necessary;
• also, because of household chores, it is practically impossible to rest, which is very necessary for a nursing mother;
• at the same time, an important factor is the great desire of the mother and the mood for breastfeeding, despite any problems.

All pregnant women dream of breastfeeding, read a lot on this topic and believe that they will cope with any difficulties - this attitude must be maintained before childbirth and after the birth of the baby. Today, there is a trend that the most stubborn mothers feed for a long time. Indeed, even a large amount of milk (“milk” mothers) in the early days is more of a problem than an advantage.

Currently, the key to successful breastfeeding is the ability to quickly cope with all problems. At the same time, it is important to rely on the qualified advice of a specialist (district pediatrician, family doctor, obstetrician-gynecologist) for lactostasis or hypogalactia, nipple cracks or professional help for mastitis (gynecologist or surgeon), and not self-medication or dubious recipes of grandmothers or girlfriends. It is important to remember that it is necessary, first of all, to establish the cause of any difficulties in feeding the baby, especially in the first months after childbirth. You can not miss the time when you can eliminate all problems and not lose the opportunity to breastfeed your baby for a long time, while receiving complete satisfaction.

In order to prepare a pregnant woman for the upcoming breastfeeding and to solve problems that arise in the process of breastfeeding, classes are held by a breastfeeding specialist in each antenatal clinic. Therefore, by the time of childbirth, every woman should be able to properly apply the baby to the breast, express milk, have knowledge about the nutrition and drinking regimen of a nursing mother.

The first problem is lactostasis

Lactostasis is the accumulation and stagnation of breast milk in the lobes of the mammary gland (in the milk ducts) during lactation and in most cases occurs:

• with insufficient emptying of the mammary glands;
• with the narrowness of the milk ducts;
• with active production of breast milk.

Clinical manifestations of breast milk stagnation are:

• bursting and compaction of one or two mammary glands;
• soreness of the mammary gland, both at rest and during feeding and palpation;
• expansion of the saphenous veins of the area of ​​​​stagnation of breast milk;
• general weakness and malaise with an increase in body temperature to high rates or subfebrile numbers.

When examining the mammary gland, painful areas (area) of compaction with local hyperemia at the site of lactostasis are palpated.

Etiological factors of lactostasis

The main causal factors in the development of lactostasis are considered to be a violation of the processes of both the inflow and / or outflow of breast milk, in connection with which there is a clamping of the milk ducts and blockage of the lobules in the mammary gland.

In most cases, this can happen:

• in case of incorrect attachment of the child to the breast and / or premature weaning of the child from the breast;
• when squeezing the mammary gland with tight underwear or sleeping on the stomach;
• with insufficiently active sucking of the baby (in premature babies, with intrauterine malnutrition and pathology of the central nervous system);
• with long intervals between feedings;
• in the presence of anomalies in the development of the nipples (inverted or flat);
• with congenital narrowness or atresia of the milk ducts;
• with large mammary glands;
• with injuries and bruises of the chest;
• with stress, overwork, excessive physical exertion;
• with excessive or insufficient drinking regimen of a nursing mother (liquid intake).

Complications of stagnant breast milk

The main complication of lactostasis is the attachment of a bacterial infection with acute inflammation of the mammary gland (mastitis), which is provoked by overheating (compresses, hot baths) or hypothermia of the mammary gland. This pathological process needs long-term treatment and the use of medications, and improper treatment or late referral to a specialist can lead to a breast abscess and surgical intervention.

Treatment of lactostasis

With the development of the first signs of stagnation of breast milk in the milk ducts, a nursing mother should consult with a general practitioner, gynecologist and local pediatrician as soon as possible to determine the etiological factor that led to lactostasis and its prompt elimination.

Often, one consultation with a specialist is enough to eliminate the incorrect technique of applying the baby to the breast and frequent feeding of the baby (for the duration of the elimination of signs of lactostasis) or frequent pumping (once an hour). It is better to feed the child in a position that allows you to most effectively empty the problem area of ​​​​the mammary gland, and start feeding from the breast with stagnant milk. Also, in addition, immediately after feeding the baby, you need to carry out a light massage of the mammary gland and pumping.

With insufficiently active sucking of the baby due to intrauterine infections, prematurity, with organic lesions of the central nervous system and malnutrition, it is necessary to supplement the child with expressed breast milk.

If it is impossible to properly attach the child to the breast due to anomalies of the nipples, the infant is fed using special nipple pads.

Also an important factor is to ensure maximum emptying of the mammary gland with relaxation of the milk ducts by moderate warming (compresses) followed by massage of the affected mammary gland.

The likelihood of developing reflex stasis increases with inadequate rest, the presence of stress, wearing loose underwear. Sleep on the back or stomach also provokes the occurrence of lactostasis, so a nursing mother needs to sleep on her side in the first months.

Before feeding the baby and pumping, the breast should be kept warm, and to facilitate the outflow of milk (immediately before feeding), the mother needs to warm the mammary gland (by applying a warm diaper ironed with an iron) or take a warm shower. It is important to remember that excessive, prolonged or abrupt warming of the breast (hot bath) is strongly discouraged due to the risk of infection and active massage, leading to mechanical damage to the milk ducts and lobules with the appearance of new areas of stagnation.

The use of folk remedies and self-medication without consulting a doctor can contribute to:

• the development of complications (lactational mastitis or breast abscesses);
• a decrease in the quality and quantity of breast milk with a complete cessation of lactation (with prolonged stagnation), which is associated with incorrect tactics for the treatment of lactostasis (without timely elimination of the cause of lactostasis), especially in young nursing mothers with lactation for the first time.

Effective additional methods of treating breast milk stagnation are physiotherapy procedures prescribed by the attending physician (depending on the etiological factor):

• magnetotherapy;
• light therapy;
• ultrasonic massage;
• laser therapy;
• electrical neurostimulation.

The second problem is the development of hypogalactia

Also, lactostasis can lead to hypogalactia - a decrease in milk production, which is associated with secretory insufficiency of the mammary glands. But this is not the only reason for the occurrence of absolute or relative hypogalactia.

Causes and forms of hypogalactia

Allocate primary and secondary, as well as early or late hypogalactia.

The primary form of this pathology is due to the underdevelopment of the mammary glands and / or the reproductive system of a woman with insufficient production of hormones (prolactin). Also, the etiological factors causing the development of primary hypogalactia is a pronounced hormonal imbalance caused by severe toxicosis (especially in the second half of pregnancy), bleeding, surgical interventions in childbirth or their hormonal stimulation. As a rule, early hypogalactia develops, which occurs immediately after childbirth.

Late or secondary hypogalactia develops with late attachment to the breast, violation of the technique of feeding the baby with insufficient emptying of the mammary glands, or with indiscriminate feeding of the baby, due to stress, overwork.

It is important to know that there is the concept of physiological hypogalactia (temporary insufficient secretory activity), which develops in young women who have given birth for the first time in the first days after childbirth (2-4 days). With proper care of the mammary glands, normalization of the diet and drinking regimen of a nursing mother, the correct technique of feeding the baby, lactation rapidly increases to physiological norms.

According to pediatricians, secondary hypogalactia is one of the main reasons for the refusal of both women and babies from breastfeeding. But with the development of this pathological condition, it is necessary to be patient and follow the basic recommendations of the attending physician, mainly the local pediatrician or obstetrician-gynecologist. Usually, herbal preparations are prescribed that increase lactation, less often drugs (prolactin in primary hypogalactia), an individual feeding regimen is established, milk residues are expressed, and the technique of breastfeeding is normalized.

Often hypogalactia is "imaginary", and the lack of milk is associated with the development of lactostasis, insufficient expression of milk or improper feeding technique.

It is also important to know that smoking, drinking alcoholic beverages, drugs containing caffeine, codeine, seduxen, laxatives, magnesium sulfate and other drugs can lead to a decrease in lactation. Therefore, before taking any medication, you should consult with your doctor.

The third reason is cracked nipples

Cracks in the nipples appear in nursing women and appear as small painful tears with a violation of the integrity of the skin in the areola and nipples.

The main reasons for their occurrence are:

• improper feeding technique;
• insufficient preparation of the mammary glands during pregnancy against the background of a weakening of the protective forces of the female body, hypovitaminosis and improper hygienic care of the mammary glands.

The development of nipple cracks occurs as a result of improper feeding of the baby due to excessive negative pressure in the baby's oral cavity or the capture of the nipple without the areola.

Crack prevention is considered:

• compliance with the feeding technique;
• prolonged sucking of the baby is contraindicated (in the first days after childbirth);
• nipple anomalies;
• lactostasis.

In this case, the nipples are traumatized with the subsequent development of abrasions and microcracks with a pronounced inflammatory reaction, which is only aggravated with each subsequent application of the baby to the breast.

In women who have congenital anomalies of the nipples (inverted or flat), correction before childbirth is not effective, but in most cases the shape of the nipples improves by childbirth, and with their constant stimulation in the postpartum period with the fingertips before feeding the baby or pulling out with a breast pump, a noticeable improving their form. Also, the pharmacy network currently offers a wide range of special pads for flat or inverted nipples, which greatly facilitates sucking and at the same time prevents the formation of nipple cracks.

Of particular importance is the prenatal preparation of the mammary glands and nipples for feeding the child. These are hardening procedures, in the form of daily air and sunbaths of the mammary glands with a light massage of the nipples, washing the mammary glands first with warm water, gradually lowering the water to room temperature, followed by gentle rubbing of the nipples with a waffle or terry towel. These procedures help to increase the resistance of the nipples and areola to various mechanical damage.

An important etiological factor in the formation of nipple cracks is lactostasis. If the outflow of milk is difficult, the baby makes more efforts to suck, excess negative pressure is created in the oral cavity, and the baby spends a longer time near the breast.

Prevention of milk stagnation is the expression of the first tight streams, a light massage of the mammary glands before feeding and / or thermal procedures - a warm shower or warm compresses (oil or water) on the mammary gland, especially when the first symptoms of lactostasis appear - pain and / or a feeling of fullness in certain areas of the gland.

It is important to remember that the combination of milk stagnation and nipple cracks is considered the main reason for the addition of an infectious-inflammatory process with the development of mastitis.

Treatment of nipple cracks

Juice cracks are the cause of severe discomfort in a nursing mother, which is associated with severe pain. With the development of small cracks, feeding of the baby is not stopped, but feeding is carried out through special silicone pads of European companies Medela Contact, Avent, Lindo, which are freely sold in pharmacies. In between feedings, it is recommended to use various wound-healing, anti-inflammatory, drying and bactericidal ointments and gels. You can not use local medicines that have a pronounced odor or hormonal ointments.

The most effective preparations are - ointment and cream "Bepanten", "Kornergel", spray "Panthenol", creams and ointments containing sea buckthorn oil, spray "Olazol" or solcoseryl ointment. Methods of applying sterile wipes with sea buckthorn or rosehip oil, lotions with decoctions of medicinal herbs (calendula, sage, plantain and chamomile) on the nipples are widely used in between feedings.

With the development of pronounced cracks, breastfeeding of the baby becomes impossible due to severe pain, so it is necessary to temporarily stop feeding the child without stopping the expression of milk. The baby is fed from a nipple or spoon until the cracks are completely healed and feeding is resumed as soon as possible after recovery.

For the treatment of painful cracks, which are accompanied by severe swelling of the nipple, the anti-inflammatory ointment "Traumeel" or "Arnica", synthomycin emulsion, chlorphyllipt solution, and the previously listed drugs are used. Do not use products with persistent drying and / or irritating effects that reduce the elasticity of the skin around the nipple and can provoke the progression of the inflammatory process (alcohol, brilliant green). Also, bactericidal and disinfectants are used for nipple cracks - a solution of furacillin, chlorphyllipt, Kalanchoe juice.

Important additional factors in the treatment of nipple cracks are:

• rational nutrition and prevention of hypovitaminosis of a nursing mother;
• strengthening the immune system;
• favorable psycho-emotional situation in the family;
• stress prevention;
• walks in the open air;
• air baths and proper hygienic care of the mammary glands.

All this activates the treatment of nipple cracks and is considered an effective prevention of complications - the addition of a purulent infection, eczema, and the development of mastitis.

Since women cannot estimate how much milk a baby receives during breastfeeding, they often worry that he is not full or that they do not have enough milk.

It is necessary to explain to a young mother that the child gets enough if:

• 6-8 gauze diapers are consumed per day (if the diapers are disposable, it will be more difficult to estimate);
• his height and head circumference increase;
• he has a soft stool;
• during the day he is cheerful and contented;
• weight gain averages 500 g per month;
• he has good skin color and muscle tone.

What breastfeeding problems might the doctor face?

Most women decide whether they will breastfeed or not before giving birth. Although breastfeeding begins in the maternity hospital, many women manage to be discharged before the arrival of milk (3-5 days after birth). Due to the trend towards early discharge after childbirth, the physician has to deal with a number of difficulties associated with breastfeeding.

What are the causes of nipple pain?

In most cases, women experience some pain in the nipple area in the first week after giving birth, but over time it decreases. If this does not happen, it is likely that the baby is not latching on to the nipple correctly when feeding. Less commonly, pain is caused by candidiasis of the nipples. Sore and cracked nipples can be caused by improper suckling position, improper nipple latch, and skin conditions such as eczema or psoriasis.

The best way to assess whether a woman is making feeding mistakes is to ask her to feed her baby in front of a doctor.
Common breastfeeding problems

• Chest pain
  • Stagnant milk.
  • Mastitis.
  • Blockage of the milk duct.
• Pain in the nipples
  • Incorrect feeding technique.
  • Candidiasis of the nipples.
• Other
  • Flat or inverted nipples.
  • Suppression of lactation.
  • Weaning.

By observing the feeding, the doctor can assess whether a woman does not make mistakes with breastfeeding.

1. The woman should sit in a comfortable position with back support, not leaning back or slouching.
2. The child should be turned to the mother (whole body). You need to keep it at chest level, bringing your hand under the neck and shoulders (not the head) and pressing it to you. The head should be slightly retracted.
3. Gently touch your nipple to your baby's lips, encouraging him to open his mouth wide. The tongue should be over the lower gums, but in the lower part of the mouth.
4. Move the baby towards the breast (not the breast towards the baby), making sure the baby has the entire nipple and areola in place. The lips should fit snugly against the skin, bordering the nipple, and not wrapped inward.
5. The child's chin should be pressed to the chest, and the nose should be free. The chest should not change shape either in appearance or in sensations.
6. When a baby suckles normally, his jaws, facial muscles, and the tips of his ears move. You can often hear him swallow.
7. The child's cheeks should not retract and the tongue should not click. If the fit deteriorates or pain occurs during feeding, carefully wean the baby by pushing the baby's chin down and start again.

Topical medications to relieve nipple pain are available in abundance, but a recent systematic review found none of them to be particularly effective. The best remedy for nipple pain is to teach women proper breastfeeding technique and latch on.

Incorrect breastfeeding and violation of breastfeeding technique are the main causes of nipple pain during feeding.

The use of pacifiers and bottle feeding only exacerbate the problem, as the baby gets used to sucking incorrectly (not the way he suckles at the breast). It is best to avoid them, at least until the habit of normal latch on is established.

Causes of pain in the nipples

• Incorrect position when feeding.
• Improper latch on the nipple by the baby.
• Short frenulum of the tongue.
• Candidiasis of the nipples.
• Improper use of the breast pump.
• Incorrect termination of feeding (for this, it is best to push the baby's chin down or insert the little finger into the corner of the mouth; do not pull the nipple out of the baby's mouth).
• Incorrect use of nipple shields.
• Hypersensitivity to creams and ointments.
• Prolonged contact with a wet bra pad.
• Use of pacifiers or bottle-feeding (this helps reinforce poor sucking technique).
• Contact dermatitis, psoriasis or eczema of the nipples.

Signs of good nipple latch and successful feeding

• Signs of correct posture and good grip
  • The baby's mouth is wide open.
  • Under the chin, a smaller part of the areola is visible than above the nipple.
  • The child's chin is pressed to the chest, the lower lip is protruded, the nose is free.
  • Absence of pain.
• Signs of good feeding on the part of the child
  • Swallowing is visible and audible.
  • Mouth moist.
  • Constant rhythmic sucking.
  • Wet diapers need to be changed regularly.
  • The arms are relaxed.
• Signs of good feeding on the part of a woman
  • The chest becomes soft.
  • The woman is relaxed and wants to sleep.
  • At the end of feeding, the nipple is not squeezed.

How to understand that the cause of pain in the nipple is candidiasis?

With nipple kaididosis, women experience burning and shooting pain, which radiates to the areola and the mammary gland itself. Pain occurs during feeding, persists after it and causes great suffering.

In women with these symptoms, when sowing a smear from the nipples, fungi of the genus Candida grow much more often than in other lactating women. But a nipple swab is not the best method for diagnosing candidiasis, because. its sensitivity is very low. In addition to pain, candidiasis can be manifested by a rash and itching of the nipples and areolas.

Sore nipples can be caused by nipple candidiasis, which is difficult to diagnose.

For the treatment of candidiasis, a child is given a quarter teaspoon of miconazole in the form of a gel or nystatin drops for oral administration 4 times a day. It is better not to use pacifiers. And if the child really asks, boil it daily and change it to a new one weekly. A woman is prescribed miconazole in the form of a gel or nystatin in the form of an ointment - the drug is applied to the nipples 4 times a day after feeding. The liners need to be changed after each feeding, and the bra itself - every day. The bra should be washed in hot water. Treatment continues for another week after the symptoms disappear.

Unfortunately, often candidiasis is not amenable to local treatment, which is explained by the penetration of fungi into the milk ducts. In some cases, treatment is longer.

With candidiasis of the nipples, treatment is necessary for both the mother and the child.

What are the causes of chest pain?

A recent UK study found that chest pain is the second most common reason for not breastfeeding in the first 2 weeks. after childbirth. The main causes of chest pain are milk stasis, blockage of the milk duct and mastitis.

Comparison of different causes of chest pain

Why does milk stasis occur?

In the first week after childbirth, when milk production rises, a woman experiences a feeling of fullness, warmth and heaviness in her breasts. But some women may initially have more milk than the baby needs. Because of this, the chest becomes tense, swollen, hot and even painful. If no action is taken, milk-filled ducts compress the surrounding tissues, leading to swelling and symptoms of milk stasis.

Congestion occurs when more milk is produced than the baby needs. To avoid this, you need not to delay the onset of breastfeeding, feed in the correct position and not limit the baby in the amount of milk.

What to do with stagnation of milk?

Several ways have been proposed to alleviate the condition with stagnation of milk. These include massage, topical application of heat or, conversely, cold, medicines, application of cold cabbage leaves, more frequent feeding until the congestion passes. A Cochrane review of the effectiveness of these methods found that cabbage leaves work just as well as cold gel packs. And since the cabbage extract and the placebo cream were equally effective, other measures, such as massage, seemed to provide relief. The effectiveness of ultrasound is probably due to thermal radiation and massage. Of the drugs, oxytocin did not give a noticeable effect, unlike Danzen (serrapeptase) with anti-inflammatory action and bromelain in combination with trypsin (it is rarely used in clinical practice), which significantly improved the condition with milk stagnation.

In conclusion, we note that milk stagnation is better to prevent than to treat. If it does occur, current recommendations include frequent, unrestricted feeding, including prolonged feeding from the affected breast, as well as massage and, if necessary, manual pumping and analgesia.

Most often, stagnation occurs between 5 and 7 days after birth, and then disappears.
Blockage of the duct is usually manifested by a seal in the chest on one side without disturbing the general well-being and fever. Warm compresses and massage of the compaction area towards the areola are applied - this helps to eliminate the “plug” and remove milk from the lobule. Feeding is continued so that there is no stagnation of milk.

Blockage of the duct differs from mastitis in the absence of signs of a violation of the general condition.

How to treat mastitis?

Mastitis is caused by milk stasis and Staphylococcus aureus infection. With mastitis, the mammary gland or part of it swells, turns red, takes a wedge-shaped shape, pain occurs, and the woman's body temperature rises. For mastitis, penicillinase-resistant antibiotics are prescribed, for example:

• dicloxacillin or flucloxacillin, or
• cephalexin, or
• (if allergic to penicillins) erythromycin. You need to take antibiotics for 10 days. With phlegmon, they are prescribed in / in.

For mastitis, penicillinase-resistant antibiotics are given and the woman is encouraged to feed on the affected breast so that it does not become congested.

Drinking plenty of fluids, paracetamol and, if necessary, bed rest are also recommended. If you do not feed the affected mammary gland or empty it completely during feeding, mastitis can be complicated by an abscess. Simple abscesses can be emptied under ultrasound guidance, sometimes this procedure is performed several times. If the abscess is multi-chamber, it may require surgical intervention to empty it.

What advice would you give to a woman who wants to express milk so she can return to work?

If a breastfeeding woman wants to go to work, she needs to think about how to deal with breastfeeding. There are several options:

1. express milk so that the baby can suck from the bottle;
2. use the nursery at the workplace to come and feed the baby on demand;
3. breastfeed only at home, and prepare mixtures for the child during work;
4. suppress lactation and switch to the mixture completely.

But, alas, these options look convenient only on paper, and in most cases it is the child who decides whether the alternation of breast milk and formula suits him.

Expressing milk can be very tiring, and a woman may feel that the amount of milk is decreasing each time. Here's what your doctor might suggest about pumping:

• You need to express at the same time that feeding usually takes place.
• The normal amount of milk per day is approximately 150 ml/kg. So for a child weighing 6 kg, who eats 6 times a day, of which 3 - while the mother is at work, you will need to express 450 ml of milk.
• If you express often (every 1-2 hours), each time the portion will decrease; on the other hand, this will lead to an increase in milk production in the next 1-2 days.
• You can pump manually or with an electric or mechanical breast pump.

How to manually express breast milk

• Place your index and thumb on both sides of the areola
• Gently press these fingers against the skin of your chest.
• Press the index and thumb fingers towards each other and repeat these movements rhythmically until the reflex is triggered and the milk begins to flow.
• When the trickle is depleted, move to another area of ​​the chest, and so on, around the areola

When a woman gets used to feeding, at the right time she will feel a surge of milk, and during the day, pumping will give 600-700 ml. Fatigue and anxiety can disturb this.

Freshly expressed milk must be cooled before being mixed with previous chilled or frozen portions. You can store expressed breast milk:

• in the refrigerator 3-5 days;
• in the freezer (if it is inside the refrigerator) for 2 weeks;
• in the freezer (if it has a separate door from the refrigerator) for 3 months;
• when deep frozen 6-12 months.

When feeding with expressed breast milk, the following rules must be observed:

• keep expressed breast milk frozen until needed;
• thaw expressed breast milk with cool or warm water;
• Shake expressed breast milk before feeding if it has separated into layers.
• do not refreeze expressed breast milk;
• throw away defrosted expressed breast milk if the baby has not eaten it within 24 hours;
• do not use the microwave oven to heat expressed breast milk.

How to increase the amount of milk, if it seems to a woman that the child is not full?

Non-drug methods include rest, drinking enough fluids, increasing the frequency of feedings (every 2-3 hours - only 8 feedings per day, sometimes you have to wake the child for feeding). In addition, it is recommended to offer each breast twice per feeding and to express the remaining milk after feeding.

Domperidone is a dopamine receptor blocker that is prescribed for nausea and vomiting. Unlike metoclopramide, it does not penetrate well into the brain, but has several CNS side effects. Domperidone increases the level of prolactin, which contributes to the production of breast milk. This drug can be used when the amount of milk does not increase despite all measures. It is especially effective in mothers of premature newborns, seriously ill newborns and foster mothers.

The first step is to take domperidone. The maintenance dose is usually 20 mg 3 times a day - the drug is taken until milk production improves. This may take 2-4 weeks. Then the dose is reduced to 10 mg 3 times a day and the drug is taken for another week, after which it is completely canceled. Possible side effects such as headache (most common), abdominal pain, dry mouth, rash, sleep disturbances. Rarely, restlessness and muscle spasms may also occur. Very small amounts of domperidone pass into breast milk.

Domperidone may prolong the QT interval. As already noted, minimal amounts of the drug pass into breast milk, and breastfeeding specialists do not consider this warning to be important when taking domperidone to increase milk production. However, it should be kept in mind in women at risk for cardiovascular disease (those who take strong CYP34A inhibitors such as ketoconazole and erythromycin and who enjoy grapefruit juice). Thus, cardiovascular risk in breastfeeding mothers should not be underestimated.

A recent review on the use of lactation inducers to increase breast milk production states that there is little evidence to support medications and that if mothers are taught proper feeding techniques based on physiological principles, then lactation inducers will not be needed or will be minimally effective.

How to suppress lactation?

It may be necessary to suppress lactation when further breastfeeding is not expected (when a newborn dies, when a child is placed for adoption) or when the mother is seriously ill or too weak to feed. In such cases, prescribe bromocriptine - a drug that suppresses the production of prolactin. Bromocriptine can cause orthostatic hypotension. Recently, cabergoline has been used for this purpose for a single dose at a dose of 1 mg - it has fewer side effects.

Cabergoline at a dose of 1 mg (single dose) suppresses lactation no worse than bromocriptine, but, unlike the latter, is characterized by fewer side effects.

What advice would you give to a woman who wants to wean her baby?

During the entire period of breastfeeding her child, a mother may face a variety of problems in this area. In this article, we will look at the most common options.

Baby's refusal to breastfeed

Possible reasons:

• use of breast substitutes (nipple, bottle);
• lack of attachment from the mother when the child asks for it;
• incorrect application;
• too slow flow of milk;
• too fast flow of milk;
• mom has hard nipples;
• gastroesophageal reflux, which causes pain during feeding;
• pain after an injury, medical procedure, injection;
• pain in the mouth during teething, thrush injury to the mouth;
• reaction to cosmetic products: deodorants, lotion, perfumes;
• stress, disorder;
• feeding according to the regimen or frequent interruption of feeding;
• the child is left crying for a long time;
• many changes in the daily routine of the child - for example, travel, the return of the mother to work;
• disputes and excited communication during feeding;
• a strong reaction of the mother during the biting of the breast by the child;
• unusually long separation;
• the child has a short frenulum of the tongue or unusual movements of the tongue;
• mother has inverted nipples;
• the baby was born prematurely and cannot suckle effectively or cannot remain on the breast.

If the baby refuses only one breast, the reason may be:

• difference in nipples;
• different amount of milk in the breast;
• breast density.

It is necessary to look for the reason for this behavior of the child during feeding. If the cause is found, it is usually not difficult to eliminate it. If no cause is found, general advice may help.

What should I do if my baby refuses to breastfeed?

1. Improve the technique of attachment to the chest.

2. Spend as much time as possible with the baby in a calm state, stroke him, hold him in your arms, provide skin-to-skin contact if the baby does not mind. This calms both mother and baby, and the oxytocin released during contact makes the interaction more open.

3. Offer your baby the breast when the baby is half asleep or sleepy. Some babies breastfeed more easily when they are relaxed or asleep.

4. Experiment with feeding positions.

5. Try rocking your baby to feed.

6. Try using thin silicone pads. In some situations, silicone pads can be a device that will keep 

lactation mastitis

Lactational mastitis is an inflammatory process in the mammary gland during breastfeeding as a result of milk stagnation.

There are 3 stages of such mastitis: serous, infiltrative and purulent.

Symptoms of lactational mastitis

serous stage

• increase in body temperature;
• chest pain;
• chills;
• redness of the skin at the site of the lesion.

Infiltrative stage

• weakness, similar to a flu-like condition;
• enlarged lymph nodes in the armpits, their soreness;
• compaction on the affected area of ​​​​the chest;
• poor outflow of milk;
• pain during feeding.

Purulent stage

• swelling and soreness in the chest;
• chills, fever up to 40 degrees;
• the formation of a purulent area at the site of inflammation of a bright red or cyanotic color;
• there is purulent discharge in the milk.

Possible causes of lactational mastitis

• local infection (against the background of lactostasis, a general decrease in immunity or got through cracks in the nipples);
• tight underwear;
• poor hygiene (either insufficient or too frequent washing with soap);
• injury.

What to do with lactational mastitis?

1. Complete breast pumping.

2. Seek help from a specialist.

3. Massage.

lactostasis

lactostasis- this is the stagnation of milk in the milk ducts of the breast.

Symptoms of lactostasis

• pain in the chest, incl. when feeding or pumping;
• seals;
• redness (not always);
• an increase in body temperature (not always).

Possible causes of lactostasis

• insufficient emptying of the breast;
• tight underwear, underwire bra;
• blockage of the duct associated with improper breastfeeding during feeding;
• squeezing the duct by a baby or mother during feeding;
• a large amount of milk with little need for the baby, associated with unreasonable pumping;
• dehydration;
• injury;
• stress;
• hypothermia.

What to do with lactostasis?

1. Regular massage from the periphery to the center.

2. Enough drinking.

3. Regular correct attachment of the baby to the breast.

4. Cold compresses after feeding or pumping.

5. Expression of a sick breast before feeding.

6. Timely seeking help from a specialist.

Hyperlactation

Hyperlactation- an excess of breast milk in a nursing mother.
In the first weeks of breastfeeding, increased milk production is normal.

This problem is solved by itself over time, the body adapts to the needs of a particular child and begins to produce milk, taking into account the needs of the baby.

If this does not happen and the volume of milk continues to exceed the needs of the child, then it is time to look for ways to overcome the problem.

Symptoms of hyperlactation

• bursting of the mammary glands;
• involuntary release of milk from the breast;
• when the baby is attached, milk floods the baby's mouth, causing discomfort and rejection of the breast.

Possible causes of hyperlactation

The most likely cause of a hyperlactation problem is breast pumping after feeding.

What to do with hyperlactation?

1. Feed your baby from one breast several times in a row, pumping a little from the other for relief. This will allow the baby to extract more fat milk from the breast and reduce the stimulation in the other breast to produce milk.

2. Avoid hot drinks, hot showers and baths before feedings.

3. Do cold compresses on the chest for 10-15 minutes. 2-3 times a day.

4. Drink a decoction of sage 1-2 times a day until lactation returns to normal.

5. Feed the baby lying on his side or back, laying him on his stomach.

6. If the baby is very difficult to suck due to excess milk, it is allowed to express a little before feeding.

Cracks in the nipples

Cracks in the nipples- this is a mechanical damage to the nipples that occurs during the period of breastfeeding as a result of violations of the technique of attaching the child to the breast.

Possible causes of cracked nipples

• improper grip on the chest;
• infections (fungal or staphylococcal);
• incorrect breast care (frequent washing, the use of soap with each wash, treatment with alcohol-containing antiseptics, a rare change of breast pads);
• traumatic removal of the breast from the baby's mouth;
• improper use of the breast pump.

Sometimes these problems can be combined with each other.

What to do with cracked nipples?

1. Only use manual pumping if necessary.

2. Do not take long breaks between feedings, this will increase the baby's appetite, which will lead to more aggressive suckling.

3. Provide damaged breasts with air baths (let's take a break from the bra, use protective shells for the breasts).

4. If the wounds are very painful, use breast pads for the duration of recovery.

5. If only one breast is injured, give it a break, expressing gently with your hands if necessary.

6. If only one breast is injured, offer the baby to start feeding on the other, and after that, when he is a little satiated, start feeding from the damaged one.

Lactation crisis and critical periods in breastfeeding

lactation crisis- a decrease in milk production within 3-7 days, associated with a physiological or external cause in the life of the mother.

Critical period- increased nutritional needs of the growing child. Often critical periods appear at 3-5-7 months and last from 5 to 14 days.

3 months - the chest becomes soft, hot flashes (if any) are already felt less often or do not occur at all. This is due to the fact that breast milk is not produced in advance, but in response to the baby's sucking, including during feeding. Mom thinks that the baby does not have enough breast milk, but in fact everything is in order.

6-7 months - a decrease in the amount of milk may be associated with the introduction of complementary foods and, as a result, a decrease in the number of attachments. The baby gorges on solid food, not milk. Milk has really become less, but this is a temporary lack of milk, which disappears when the feeding regime is changed.

9-10 months - the rate of weight gain decreases. This is due to an increase in the child's motor activity, and it may seem to the mother that the growth rate has slowed down because the milk has disappeared or it has become very small.

There may also be the following reasons leading to a temporary decrease in the amount of breast milk:

• the introduction of early or excess complementary foods, supplements or supplements;
• use of pacifiers and baby bottles for feeding instead of attachments;
• insufficient or rare application, long interval between applications, limitation of application time;
• separation of mother and baby during the day;
• mom's diet change.

What to do with a lactation crisis?

• frequent applications;
• alternate pumping of one or the other breast for half an hour;
• hot drink 10-15 minutes before feeding;
• herbal collection or homeopathic preparation;
• breast massage;
• ways of relaxation (aroma oils, bath, music, breathing exercises);
• lactogone preparations (in extreme cases).

It is very important to ensure that there are no too long breaks between feedings (3-3.5 hours during the day and 4-4.5 hours at night are acceptable).

Remember that the more often the breast is emptied, the more it fills. Don't be afraid to wake your baby up to offer him the breast, especially if there is a serious weight loss in the baby.

Check if the baby swallows milk, newborns have problems with this.

If in doubt about this, it is best to contact a breastfeeding specialist.

Literature and sources

Book "Breastfeeding answers made simple"
Instagram: @i_irina

Verified by experts:

Maksimov Andrey Vladimirovich - Head of the Pediatric Department, Deputy Chief Physician, Pediatrician of the highest category

The largest private medical company in Russia