Vaccination remains the strongest defense against COVID-19. For more information about where you can schedule a vaccine, be tested for COVID-19 or learn more about the virus, visit https://www.bjc.org/coronavirus.

COVID-19 Information

Breastfeeding Difficulties for New Moms

Breastfeeding Difficulties for Mom

Some of the most common difficulties moms may experience while breastfeeding include:

Delayed milk production
Low milk production
Sore nipples
Flat or inverted nipples
Mastitis
Plugged milk ducts

Do not wait to get help if milk supply is ever a concern. The sooner you intervene, the better. Missouri Baptist offers breastfeeding support groups and breastfeeding classes for new mothers. Some expectant mothers may desire, or benefit, from a private, individualized lactation evaluation and consultation with a lactation consultant. These private consultations are available for a nominal fee. For more information, please call our Lactation Services at (314) 996-5747.

Delayed Breast Milk Production

For the first 3 to 5 days after your baby is born, you will make a small amount of colostrum. Colostrum is a thick, rich milk that is high in nutrients. Around day 3 through 5, your milk will come in.

Infrequent or insufficient breastfeeding is the most common reason for a delay in milk coming in. This is also a common reason that women may experience a drop in milk production. If you are having difficulties with delayed milk production or a decrease in the amount of milk, a review of the number and length of breast feedings should be the first thing to evaluate. It is also important to make certain the baby is able to latch on and is able to transfer milk from the breast.

Other causes of a delay in breast milk production include:

Severe stress
Cesarean delivery
Bleeding after birth
Maternal obesity
Infection or illness with fever
Diabetes
Thyroid conditions
Strict or prolonged bed rest during pregnancy

If you have a delay in your milk coming in, do not feel discouraged. Continue to express milk using a breast pump or by hand. Breastfeed frequently even if you are supplementing with formula for a few days.

Occasionally, a mother has a health condition that may temporarily delay the large increase in milk production. These mothers may not begin to produce large amounts of breast milk until 7 to 14 days after giving birth. If this happens to you, do not feel discouraged. Continue to breastfeed frequently even if you also must give your baby infant formula for a few days.

Low Breast Milk Production

Sometimes a delay in the time when milk comes in turns into an ongoing problem with low milk production. Other times a mother has been producing sufficient amounts of milk and then milk production slowly, or quite suddenly, decreases. Mothers with previous breast surgery that cut some of the nerves, milk-making tissue or milk ducts may experience difficulty producing enough milk to fully feed their baby.

Other factors that can lead to insufficient milk production include:

Maternal smoking.
Some medications and herbal preparations have a negative effect on the amount of milk produced.
Hormonal forms of birth control, especially any containing estrogen, have been found to have a big impact on milk production. However, some mothers report a drop in milk production after receiving or taking a progestin-only contraceptive during the first four to eight weeks after delivery.
Milk production may also decrease if you become pregnant again while nursing.

If insufficient milk production seems to be a problem, yet the baby seems to be sucking effectively, it is important to review your health history with your doctor or lactation consultant to discover if there may be a health condition, treatment or medication interfering with your milk production.

Your doctor or certified lactation consultant may recommend any of the following to help increase your breast milk production:

Increase the number of breastfeedings or breast pumping sessions to 10 to 12 times per day.
Have more of skin-to-skin contact with your baby. Take off your shirt and baby's shirt and place your baby on your chest with a sheet or shirt over both of you.
Pump your breasts for several minutes after breastfeeding.
Consider renting a hospital-grade breast pump if you think you'll need to pump for a prolonged period of time.
A medication, such as galactogogue, found to have a positive effect on milk production.

Think positive. Although insufficient milk production usually can be reversed, any amount of breast milk you produce is valuable for your baby.

If milk supply is ever a concern, the sooner you intervene, the better. Missouri Baptist offers breastfeeding support groups and breastfeeding classes for new mothers. Some expectant mothers may desire, or benefit, from a private, individualized lactation evaluation and consultation with a lactation consultant. These private consultations are available for a nominal fee. For more information, please call our Lactation Services at (314) 996-5747.

Sore Nipples

Sore nipples are probably the most common difficulty mothers have when breastfeeding. Sore nipples may be caused by a variety of factors and determining the cause of sore nipples can be difficult. Talk with your doctor or lactation consultant for suggestions on how to resolve the problem.

Breastfeeding should not hurt and the skin on your nipple should not break down any more than the skin anywhere on your body should break down. However, mild tenderness is fairly common for the first week or two of breastfeeding. Then it should go away.

If your nipples feel painfully sore or the nipples or areola feel bruised, it is more likely that it is related to an improper latch-on process or ineffective sucking. Suspect a difficulty with baby's latch or sucking if your nipples become very red, raw, blistered, or cracked. A latch or sucking difficulty or a structural variation in the baby's mouth might result in nipples that look creased or blanched (turn white) at the end of feedings. Certain creams or dressings may promote healing, but others can actually cause more damage.

When nipples become red and burn or feel extremely sore after weeks or months of pain-free breastfeeding, it may be due to a yeast infection, such as thrush. Yeast may appear as white patches in the baby's mouth or it may show up as a bright red diaper rash. Specific medications are needed to treat yeast infections. Contact your baby's doctor for more information and treatment.

Flat or Inverted Nipples

An effective breastfeeding baby usually has little trouble breastfeeding even if his mother's nipples appear to be flattened. A less effective breastfeeder may need some time to figure out how he or she can draw the nipple into the mouth with latch-on.

If you find that your nipples are flattened and causing problems when breastfeeding your baby, you can try:

Using a breast pump to draw the nipple out just prior to breastfeeding.
Breast shells worn in the bra between feedings. Breast shells exert a small amount of traction to help draw the nipple outward. Although the benefit of using hard plastic breast shells is not conclusive, some mothers find that they do help.

If nipples invert, first try the interventions mentioned above for flat nipples. Like breast shells, nipple eversion devices are also available. Occasionally, one or both nipples are severely inverted. If one breast is less affected, your baby can breastfeed on the less affected breast. Most women can produce enough milk in one breast to exclusively breastfeed their babies. If you only nurse on one breast, it is a good idea to pump the other breast so that your breasts will be approximately the same size. You can store the breast milk you pump in the freezer and use this milk for times when you are away from your baby.

Mastitis

Mastitis is often used interchangeably with the term breast infection, but mastitis may also be due to an inflammation. Often a reddened area is noted on the breast. Inflammatory or infectious mastitis may develop for reasons similar to those for plugged breast duct development.

With mastitis it is especially important to keep the affected breast empty through frequent breastfeeding or breast pumping at regular intervals. It is also very important to rest and keep hydrated by drinking a lot of clear fluids. You can take ibuprofen or acetaminophen for the discomfort. If you develop flu-like symptoms or your temperature increases to 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, call your doctor. If your doctor prescribes an antibiotic, be sure you take the entire course of the medication or you may experience a recurrence.

Plugged Milk Ducts

A plugged milk duct feels like a tender lump in the breast. Some mothers seem to be more prone to developing them, but usually they occur when a mother goes too long without emptying her breasts, or if insufficient milk is removed during breastfeedings. Use a baby feeding log to review your baby's feeding routine and see if the time between feedings has recently changed. Sometimes, a mother gets busy again with a task and does not realize feedings are being delayed.

Ineffective sucking may also contribute to plugged milk ducts. Also, check that the material of nursing bras or clothing bunched during feedings is not putting pressure on milk ducts in a certain area of the breast.

If you develop a plugged milk duct, be sure to breastfeed or remove milk often and alternate different feeding positions. It often helps to apply warm compresses to the area or soak the breast in warm water. Massage above and then over the affected area when breastfeeding and after application of warm compresses.

If the lump does not go away over the course of a couple of days, contact your doctor or lactation consultant. If you feel ill or develop a fever or chills, contact your doctor immediately. This could be a sign that you have an infection and might need to take antibiotics. If your doctor prescribes an antibiotic, be sure you take the entire course of the medication or you may experience a recurrence.

Breastfeeding Resources