Wednesday, February 5, 2014

Breastfeeding Challenges

     When we see moms nursing their babies with such ease and expertise, we think that breastfeeding looks easy and simple enough. But what we don’t know is the difficulty and challenges most mothers face especially when breastfeeding a newborn begins. And these inconveniences don’t end as our infants become nursing toddlers.
     I’ve had my own share of these breastfeeding nuisances from time to time but I am happy to say that these problems do have solutions (as most problems do).
     My most common nuisance is clogged milk ducts. I encountered this with both Audrey and Natalie, and let me just say that dealing with it is no walk in the park. I am so glad though that I found ways to address it through tips from friends, my lactation consultant and by reading The Breastfeeding Book by Dr. William Sears.

     If you experience Clogged Milk Ducts, the following suggestions will prove to be helpful to you (as they have been very helpful to me too).

      What to Do:

a.     Massage

·        You may seek the help of a lactation consultant, especially if you are a new mom, to learn how to massage the areas on your breast that have these clogged milk ducts (hard lumps that are painful when pressed and cause blockages on your nipples – ouch!)
·        Soften these lumps of milk using a circular motion and push the milk towards the nipple as baby feeds so she can help you get it out
·        If baby is done feeding and the lump is still there, try massaging it out and into a clean and sterilized storage container. I find that it is easier to hand express milk into an Avent Via Cup storage container than into a plastic storage bag (because the milk is easier to catch and it doesn’t fold like the plastic bag does)
·        If baby is done feeding and the milk lump is still there, you can also try to pump it out while massaging the affected area (but note that if you are direct feeding your baby, to avoid pumping until after one month so as not to interfere with your normal milk flow – this was a recommendation from my lactation consultant and it was very helpful because the first month of breastfeeding is usually when we encounter getting engorged the most because our milk supply is still getting established). Hand expressing is the way to go if you are trying to get rid of a milk lump or clogged milk ducts.

b.     Hot Shower

·        You can massage these lumps while taking a hot shower to help soften them and relax you as well. Push out the milk to loosen it up and therefore relieve you of the pain of the lump (I know this means that you will be wasting some milk - but believe me, when it gets really painful, saving some milk will be the last thing on your mind and more often than not, you really don't have the luxury of time)

c.     Hot and Cold Compress

·        While books normally recommend you to put a warm compress on your breast when you experience clogged milk ducts and lumps, my lactation consultant taught me to do a combination of Hot and Cold Compress application. This has worked well for me because the hot compress basically helps soften the lump while the cold compress (which can actually just be a face towel dipped into ice cold water) reduces the swelling of the affected area, especially after massaging it several times. This works best when you are trying to massage the hardened lumps of milk out and aiming to clear milk blockages in your nipples.*

* For milk blockages (the enemy!), which I encountered twice with Audrey and a couple of times with Natalie, I consulted a mommy friend and The Breastfeeding Book on what to do. These blockages sometimes don't disappear on their own and need to be... get ready --- pricked out of existence! I had to sterilize a stainless steel dressmaker's pin (dipping it in freshly boiled and very hot water and then pouring alcohol - yes I wanted to make sure it was safe! hehe) so I could pop the blockage and let the hardened milk out. This was painful yes, but even more painful is leaving the blockage there where it could potentially cause an infection and make each feeding very uncomfortable and excruciating. Sometimes a little pain is necessary for greater comfort.
         Another interesting thing about breastmilk is its antibacterial properties. I just put breastmilk in the affected area afterwards and let it dry. I haven't had any infections so far so this really seems to be an effective and natural way to protect the area where the blockage used to be. My lactation consultant also recommends doing this to prevent sore nipples especially during extended feedings. (I also use Lansinoh nipple cream for soreness, especially in the first few weeks but have gone the route of applying breastmilk in the following months. Both worked well for me).
        For all of you moms to be, I hope I didn't scare you or discourage you from breastfeeding --- these things are minor setbacks compared to the benefits that come with breastfeeding your baby. Mothers were made to be tough on the outside and soft on the inside so if you have been blessed with a baby, this is something that you can definitely handle. (Nine months of carrying your baby is already a feat in itself! If you were able to do that, then you can definitely overcome breastfeeding setbacks like this one!).

d.     Rest and Relaxation

·    Clogged milk ducts aren’t always the result of improper positioning while feeding, not alternating breastfeeding positions enough or not feeding your baby as often as you should - this too can be caused by stress and not getting adequate rest. Now it’s not as if new moms actually get a lot of sleep – but not resting when you should (i.e. sneaking in work while baby is asleep instead of sleeping too, or cleaning the house and getting yourself tired when you should be resting), contributes to the stress that your body is already experiencing. I can say this with certainty because those times that I got these clogged milk ducts often happened after I worked until the wee hours of the morning and didn’t get enough sleep. And this didn’t just occur during my baby’s first few months – it would happen even when Natalie was already way past six months which is when I thought my milk supply was basically steady and breastfeeding was more or less smooth sailing.

e.     Get the help of a Lactation Consultant

·        For new mothers, I recommend that you seek the help of a good lactation consultant. She will teach you all the basics and give you tips on successful breastfeeding. I was very happy with Lita Nery, the lactation consultant that my friend recommended because she went to visit me at home at the time that was convenient to me, and fit me into her very busy schedule when I had breastfeeding ‘emergencies’ (translation: I cannot massage the milk out on my own no matter how hard I tried and I’m stuck with a really really painful lump!). So yes, when all of the above solutions failed me, I called for help. Lita will give you a lactation massage (and back massage) during her visit, to relax you and help with the milk flow. She will also teach you breastfeeding positions with your baby which you probably just read about in books or saw in videos. I did learn a lot from her with only about 3-4 visits (for Audrey), because when Natalie came, I applied the same principles and tips from her and was able to do them on my own. 

If you want to prevent getting Clogged Milk Ducts, here are some suggestions:

What to Avoid:

a. Wearing Tight Underwear

·       Choose the right nursing bra. Don't go for ones that are underwired or have tight garters. These contribute to clogged milk ducts and can form lumps.

b. Lying on your breasts

·      Avoid lying on or pressing on your breasts while sleeping or exercising. This causes lumps to form. And if you plan to get a back massage, make sure you place two pillows parallel to each other and place your breasts in the space between so that it doesn't get pressed or pushed down directly (that would be very uncomfy!)

c. Stress and Lack of Sleep

·       This is supposed to be something we already know but fail to acknowledge - stress and lack of sleep is bad for our health and for breastfeeding as well.

    Do read The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning as your guide to common breastfeeding questions, concerns and problems.

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