What to do when breastfeeding becomes painful  

Breastfeeding or nursing is a delightful moment not only for the baby but the mother too. It is the most satisfying and safest source of nourishing the little ones.

However, at times, particularly during the first few weeks after birth, a mother may be faced with some problems that can make this period hectic. This is more specially for first time mothers who do not have experience in breastfeeding.

The good news is that most of these problems can be treated and resolved. Also as time goes by, the mother gets used to the practice and breastfeeding becomes more comfortable.

Dear doc,

I delivered my baby three weeks. My son feeds well but despite regular feeding, my breasts are very full and painful. What can I do to feel better?

Anita Musyoka

Dear Anita,

What you feel is normal for most women who have just delivered. Usually, when breasts start producing more milk, they become heavier, bigger, and also a little tender. At times this fullness can cause engorgement whereby the breasts become very hard and painful. Breasts may also swell, become tender, warm, sore and sometimes a mother may have a slight fever. Engorgement occurs because of milk buildup. It is usually common in the first few days after delivery, although it can occur any time in the course of breastfeeding. To help you feel better, feed the baby more often and as much as he is able to take in. Use hands or a breast pump to express excess milk (this milk can be frozen for future use). Massage the breast or place a cold or warm compress on the breast to help relieve the discomfort.

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Dear doc,

I am pregnant with my first baby. My problem is that my nipples are inverted and I am concerned about whether I will be able to breastfeed. Please advice on what to do. Thanks.

Wanja

Dear Wanja,

First, you are not alone in this. Some women have problems with their nipples either being inverted (turned inward), flat, or not protruding enough. However, keep in mind that breastfeeding does not rely on nipple alone for it to work.

The baby needs to latch on both the nipple and the breast for effective breastfeeding. Thus, even with inverted nipples, you will still be able to nurse your baby just fine. With time, as the baby keeps on sucking, inverted and flat nipples protrude more. Inverted nipples can be pulled out slowly using fingers. There are also gadgets devised to pull out nipples that are inverted or flattened.

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Dear doc,

I am a first time mother and my nipples are sore, painful and breastfeeding is become unbearable. What is causing this and what can I do to ease the discomfort?

Mama Vin

Dear Mama Vin,

It is normal for nipples to feel tender when breastfeeding begins. Women with sore nipples may experience a pinching or burning sensation when the baby sucks. Many things can cause sore nipples including poor care for nipples, improper nursing techniques, and wrong positioning of the baby during breastfeeding.

Most cases of nipple soreness are as a result of poor latch which is how the baby connects to the breast. A good latch is whereby the baby is able to take in a good amount of breast tissue hence the nipple ends up in the back of its mouth. This way, the baby has nothing to pinch on. But if the nipple sits in front of the baby’s mouth, you are going to feel the pinch hence soreness is likely to occur. You can also ease the pain by avoiding use of soaps on the breasts as they can make the nipple dry and irritated. Do not wear clothes or bras that are too tight as they place pressure on nipples thus increasing pain. Talk to a doctor about the use of some specific creams for nipple inflammation. Despite pain, do not delay feeding as this can interfere with milk supply or problems of engorgement which can cause even more pain.

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Dear doc,

What is mastitis and how can a nursing mother know they have the condition?

New mum

Dear New mum,

Mastitis is a common condition that occurs during the breastfeeding period. It is an inflammation of breast tissue that occurs due to a blocked milk duct. The buildup of milk in the blocked milk duct can spread to the neighboring breast tissue and cause inflammation. If there is a cracked nipple, bacteria can enter and grow in the inflamed tissues leading to an infection. Breast engorgement and not feeding enough to drain milk can also cause mastitis.  Mastitis causes symptoms such as redness, pain, breast engorgement, swelling, soreness, warmth of the breast and body aches. Some women may have fever, nausea or vomiting. A yellowish discharge may also come out through the nipple. If you have mastitis, keep breastfeeding the baby or pumping the breastmilk to help empty the blocked ducts and prevent engorgement. Avoiding to breastfeed the affected breast can worsen the condition. See a doctor if mastitis does not resolve after a few days.