If your baby is unsettled at the breast and doesn’t seem satisfied by feeds, it may be that they are sucking on the nipple alone. This may mean they are not getting enough milk. Ask for help to get your baby into a better feeding position.
Sore or cracked nipples
If your nipples hurt, take your baby off the breast and start again. If the pain continues or your nipples start to crack or bleed, ask for help getting your baby patched on comfortably.
It can sometimes take a while to sort out how to prevent the soreness, but it is important to get support as soon as possible.
The following suggestions might help:
- try squeezing out a few drops of milk at the end of a feed and gently rub them into your skin and let your nipples dry before covering them
- if you are using breast pads, they need to be changed after every feed
- avoid soap, as it dries out your skin
- wear a cotton bra so air can circulate
- some mothers treat any cracks or bleeding with a thin smear of soft paraffin or purified lanolin – put the ointment on the crack, rather than the whole nipple to help it heal
Tender breasts, blocked ducts and mastitis
Milk can build up in the ducts for a variety of reasons. The most common are wearing a bra that’s too tight, missing a feed, or a blow to the breast. It’s important that you deal with a blocked duct as soon as possible so that it doesn’t lead to mastitis (inflammation of the breast).
If you have mastitis, your breasts will feel hot and tender. You may see a red patch of skin which is painful to touch. You can feel quite ill, as if you have flu, and you may have a temperature.
This can happen very suddenly. It’s important to carry on feeding as this will help you get better.
If you think you might have mastitis or a blocked duct, try the following:
- take extra care to make sure your baby is attached well to your breast
- feed your baby more often
- let your baby feed on the tender breast first
- if your breasts feel tender after feeding or you baby cannot feed, massage your breasts and express your milk
- applying warmth to your breast, such as a warm flannel, before a feed can help milk flow and make you more comfortable
- while your baby is feeding, gently stroke the lumpy area towards your nipple, this will help the milk flow
- get lots of rest and catch up on your sleep whenever you can
- take a painkiller such as ibuprofen or paracetamol
- ask for help if you cannot get your baby latched on properly
Mastitis can also be a sign of infection. If there is no improvement within 12 to 24 hours, or you feel worse, contact your GP or healthcare professional. If necessary, they can prescribe antibiotics that are safe to use while breastfeeding.
If you suddenly get sore, bright pink nipples after you have been feeding without problems for a while, you might have an infection known as thrush. The pain may be felt right inside the breasts.
Ask for help to check that your baby is latched on properly and make an appointment with your GP.
You and your baby will both need treatment as you can easily give thrush to each other. If your baby has it in their mouth, they will need oral gel. You will still need some cream for your nipples to stop it spreading to you.
You can also ask your pharmacist for advice. Some antifungal creams can be bought over the counter from a pharmacy, but you need to be sure it is safe to use while breastfeeding.
Some babies are born with a tight piece of skin between the underside of their tongue and the floor of their mouth. This is known as tongue-tie. While it doesn’t always affect breastfeeding, it can make feeding painful as it is harder for your baby to attach to your breast.
Tongue-tie can be easily treated, so if you have any concerns talk to your midwife or health visitor.
Coping with allergies
If you think your baby might be allergic to formula milk, talk to your GP. They can prescribe formula feeds called extensively hydrolysed protein feeds.
Some formulas are labelled as hypoallergenic, but they are not suitable for babies with a diagnosed cow’s milk allergy.
Talk to your GP before using this milk. Always get their advice before using soya-based infant formulas too. Babies who are allergic to cows’ milk may also be allergic to soya.
Babies sometimes grow out of allergies and you may be able to introduce cows’ milk into your baby’s diet as they get older. Always ask your GP or health visitor for advice before making any changes to your baby’s diet.
Always stick to the recommended amount of infant formula. Using too much can make your baby constipated or thirsty.
Breastfed babies don’t usually get constipated. If your baby is under eight weeks old and has not passed a stool for a few days, talk to your health visitor or GP.