BREASTFEEDING WAS NEVER MEANT TO HURT
Some nipple tenderness at the beginning of a feed is normal in the first two to three days of breastfeeding. But nipple soreness can be minimised or avoided entirely if a mother has accurate and consistent breastfeeding information and support.
Research shows that good positioning will help prevent and heal sore nipples.
POSITIONING BABY AT THE BREAST
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Before getting started
make sure that you are comfortable and well supported - use pillows if
necessary. There are a number of ways to hold your baby while breastfeeding. Getting your baby started at the breast smoothly and easily will soon become second nature to you. Nursing a baby at the breast is actually much less involved than any description of the process. Many mothers have found the cradle hold described below, is a comfortable and effective nursing position. |
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Your baby should be lying on his side, completely facing
you, tummy to tummy. Your baby should be cradled in your arm on the same side as the breast he is taking, that is, when he is nursing from the right breast his head will rest on your right forearm with his feet at your left side. Use your other arm to support your breast, thumb on top and fingers underneath the breast, well back from the areola (the darker area around your nipple.) Baby's head should be slightly tilted back with your nipple opposite his nose so that he does not have to turn his head to reach the breast. |
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Encourage your baby to
open his mouth by brushing his lips lightly with the breast or nipple.
Repeat until your baby's mouth is open wide and his tongue is down. When baby opens his mouth wide, bring your baby to the breast, chin and lower lip first, then bring him in close to you so that he takes the breast deep into his mouth. |
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Your baby's top and
bottom lips both need to be curled out with his nose barely touching the
breast. If his nose seems blocked by the breast, gently pull his hips
and legs in close to you and angle out his nose. Make sure your baby has taken the breast deeply into his mouth with more of the areola showing above the baby's mouth than below. You will know that the baby is sucking well when after a period of quick sucking his suck deepens and you hear a regular swallowing. Then your baby will relax into a deep sucking pattern. |
| Many mothers experience immediate relief from nipple discomfort when they begin positioning the baby correctly. | |
If soreness persists, check for the following -
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Don't let baby draw in the nipple through pursed lips.
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Be sure that the baby has his mouth open really wide so that the nipple is far back in his mouth.
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If baby consistently clamps down as he starts to suck, use the index finger of the hand supporting the breast to press down on his chin.
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Some babies suck in their lower lip along with the nipple and areola. If this is happening it is best to break the suction, take baby off the breast and reposition, ensuring lower lip is not curled in.
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Your health professional or La Leche League Leader may want to check to see if baby's tongue is visible between lower lip and breast by gently easing down baby's lower lip during nursing. If baby's tongue is not visible he may be sucking it along with the nipple, which can be very sore. In this situation take the baby off the breast and start again. Some mothers find the "football hold" very helpful in ensuring baby's tongue is below the nipple when he latches on. (click here, or See WOMANLY ART OF BREASTFEEDING, available from La Leche League Groups).
Nursing early and often is one of the most important factors in getting breastfeeding off to a good start. frequent nursing will help prevent engorgement and reduce the likelihood of nipple soreness. Newborns need to nurse 10 to 12 times in a 24 hour period. The length of a breastfeed should be determined by the baby's interest and response. The baby will usually suck eagerly, swallowing often, for the first ten minutes or longer, until he starts to slow down or loose interest. After a burp or a nappy change, switch to the other breast for as long as you and the baby like - perhaps ten minutes, perhaps longer.
Avoid using nipple shields, (which are worn during feeds), as they will not prevent soreness. Their use almost always reduces your milk supply and may make it more difficult for the baby to nurse correctly.
Bottles and soothers can cause "nipple confusion" when babies are learning to nurse. These babies then suck differently at the breast, causing sore nipples and getting less milk for their efforts.
Bathing daily with clear water is all you need to keep breasts and nipples clean. here are many preparations sold for the treatment of sore nipples, some of which are ineffective and/or may be harmful to your baby. Avoid using soap, and ointments that contain antibiotics, or anaesthetic agents on your nipples. Read the label carefully and avoid any products which you have to remove before nursing.
Remember the healing properties of human milk can help to soothe your nipples. After baby has finished nursing, gently rub a few drops of your breastmilk onto your nipples. Allow your nipples to air dry after a feed, especially i the early days. There are some ointments, such as modified lanolin, which are safe for baby. You may want to use one of these in addition to your own milk or colostrum to help healing, if your nipple is very sore or cracked .
In a few very rare cases of extreme sore nipples which might occur if baby has been sucking incorrectly for some time, it may be necessary to discontinue breastfeeding temporarily. During this time the mother will need to express her milk and give it to the baby from a spoon or small cup. It would be best to avoid using bottles, especially if the baby already has a sucking difficulty. As soon as there is sufficient healing, breastfeeding can resume. It is essential that a mother in this situation seek expert help for herself and her baby.
If sore nipples persist however, or you suddenly get sore nipples after several weeks or months of comfortable nursing, you and/or your baby may have contracted thrush. If your nipples get itchy and the area around them is tender, or if the skin becomes pink and flaky, you may have thrush.
Thrush may appear as white spots on the inside of your baby's cheeks or on his gums or tongue. Your baby may also have a persistent nappy rash and you may have vaginal thrush. You may have thrush on your nipples even when there is no sign of it in the baby's mouth..
Thrush may take several weeks to cure but there is no reason to discontinue nursing. Your doctor can prescribe medication to be used in the baby's mouth an don your nipples.
The early weeks of breastfeeding are a time of learning for both you and your baby. Knowing how to treat or prevent sore nipples can make a tremendous difference to the experience and success of breastfeeding. You may need to contact someone for suggestions and encouragement so that you and your baby can continue to enjoy the advantages and pleasures of breastfeeding. Your health professional and your local La Leche League Leader will be happy to assist you.
Although babies come in both genders, in this leaflet we have referred to baby as "he", for clarity's sake, since mother is unquestionably "she".
You can get a copy of this and other La Leche League of Ireland leaflets from a La Leche League Leader or at any of our meetings. Click here to find your nearest Group.
Do get in touch, we look forward to meeting you!
ŠText and Illustration La Leche League of Ireland, December 2000
