Despite what we often hear or see depicted on TV or in the movies, breastfeeding doesn't always come naturally or easily for all women. It is much more common to have problems with breastfeeding than not. After delivery, moms are often exhausted and need a lot of help getting the baby to latch onto the breast. And while infants often nurse well during the first several hours after delivery, they frequently become sleepy during the following days, so keeping them awake for feedings can be challenging. Thankfully nurses in the hospital are usually very helpful at getting babies to latch and feed, so problems often only arise once moms are finally home with their newborns.
One of the most common problems that arise with breastfeeding is sore nipples, which can develop for a multitude of reasons and is usually short-lived. Some sore nipples are expected at the beginning of breastfeeding as your body is getting acquainted with stimulation in a sensitive area frequently throughout the day. This type of sore nipple usually only lasts a few days and should occur with the initial latch and quickly subside over the next 30 to 60 seconds. Often, sore or cracked nipples are caused by an incorrect latch at the breast, which frequently occurs during those first couple of days while in the hospital due to tired moms and sleepy babies. As long as the latch is corrected, nipples should heal pretty quickly. When sore nipples last longer than a few days after delivery, seeing a certified lactation counselor is always best to ensure that mom and baby get a proper latch.
Engorgement is another common problem that contributes to breastfeeding not coming so naturally. Engorgement is a swelling or fullness in the breasts as the milk "comes in" and most often occurs 2-5 days after delivery. This swelling can sometimes be painful or uncomfortable but usually subsides over 1-2 days. In the meantime, it can often make the initial latch more difficult, which may require extra patience and persistence. This engorgement may also cause a newborn not to latch correctly, which could also contribute to sore nipples as well. A certified lactation counselor can always talk about other ways to help during this time if needed.
Babies who don't latch properly are another common problem with breastfeeding. While babies have certain breastfeeding instincts, they do not often go to the breast "naturally" and usually need guidance in the first days to weeks after delivery. Breastfeeding is not a skill that always comes easily, so sometimes we need a little time while mom and baby both navigate feeding and learn together. Sometimes the problem with the latch occurs because of something the mom is doing incorrectly, but there are also times when the baby cannot latch properly. A tongue tie (or lingual frenulum - an unusually short, thick or tight band of tissue tethers the bottom of the tongue's tip to the floor of the mouth) is one of the more common reasons this might happen, but there are many others. If you are ever concerned that your baby may have a tongue tie, you should address this issue with your pediatrician.
Not having enough milk supply is another one of the more common reasons that breastfeeding doesn't always come naturally. Sometimes there is indeed a low milk supply, but other times this thought process is just a concern for parents when they see their baby lose weight over the first several days of life. We expect babies to lose weight after delivery, which does not mean that moms are not producing what they need for their babies. Our bodies don't just make milk because we have a baby. Milk supply is stimulated by a hormonal process that takes several days, which is also why engorgement usually occurs 2-5 days after delivery. This process can be interfered with in various ways, and sometimes finding out the reason is the key to fixing a milk supply issue. If you or your baby's pediatrician are worried your baby is not getting enough milk at the breast, a certified lactation counselor may be able to identify the cause and help you increase milk production.
Sometimes no matter what resources are available, there are times when breastfeeding doesn't work for a mom and their baby. In rare cases, some moms cannot produce enough milk for their babies, no matter what interventions they try. Sometimes babies struggle with latching to the breasts or transferring enough milk for weight gain, and moms may need to pump milk exclusively. Moms may find it difficult if their breastfeeding journey goes differently than planned or does not work. Ultimately the goal is to feed your baby, and sometimes it doesn't work out how we thought it would. Finding support resources from a certified lactation counselor within the community or online can be very helpful.
Stormy Walker, Nurse Practitioner, Lactation Counselor, Lexington Pediatric Practice
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