Maternal Breast-Feeding, Problems
During breast-feeding, especially during the most delicate early phases, the mother or the child may have different problems of a medical, psychological or social nature. These problems can make breast-feeding difficult or indeed prevent it. Often, some of these problems can be overcome, especially if the mother wishes to breast-feed and has the physical and psychological support of her partner, of the people who are close to her or of the health experts. The practical and specific supports available on the market can also help. In other cases, on the advice of a paediatrician, it may be necessary to change from breast-feeding only to mixed feeding or sometimes, to only formula feeding.
Maternal Difficulties
There Is No Milk Volume Increase
Cases of actual impossibility for the breast to produce milk are extremely rare. It may happen that the milk volume increase does not occur. In this case, and in the case that the production of milk stops or becomes insufficient for the needs of the baby, the paediatrician will advise the mother whether it is necessary to use formula milk.
The Use of Medicines
Because medicines can pass into maternal milk, even in very small quantities, it is recommended not to take medicines during the period of breast-feeding. If necessary, it is advisable to consult your doctor.
Raghades
Raghades often occur, especially in women who have recently started breast-feeding or have started for the first time. Raghades are small cuts, situated at the base, in the middle and at the tip of the nipple. They often cause bleeding and are very painful, especially during the sucking. The pain can become acute, to the point of discouraging the mother from latching the baby on to her breast. It is necessary to treat this immediately in order to avoid infection from germs commonly present on the skin and a consequent inflammation of the mammary glands (mastitis).
It is possible to prevent raghades effectively:
- Paying particular attention to the correct position of the baby during the feeding;
- Cleaning the nipple very thoroughly, before and after the feeding, avoiding the use of soaps or detergents;
- Keeping the nipples dry and allowing the free circulation of air around them;
- Frequently changing the nursing pads, preferably making use of breathable pads;
For treatment, it is advisable to:
- Use the specific Idrogel disks;
- Spread some drops of milk on the nipple, as this has sterilising, moisturising and healing properties;
Protect the nipples during feeding with the use of nipple shields.
Flat or Retracted Nipples
The erection of the nipples, which in most women occurs when the areola is stimulated, is, on the contrary, very weak in the case of flat nipples. Even rarer, is the situation in which the nipples not only fail to become erect, when stimulated, but also tend to retract inwards. These cases are known as retracted nipples.
Having flat or retracted nipples, does not mean that a mother is unable to breast-feed, as the baby does not take only the nipple but also all of the areola. Obviously, however, the baby will have difficulty in latching on to the breast and feeding will be more difficult. To make feeding easier, it is necessary to adopt some measures. It is advisable to use nipple correctors, which will stimulate the erection of the nipple. Naturally, they must be used on the advice of a gynaecologist or an obstetrician, and not prior to the fifth month of pregnancy. The nipple correctors can also be used after birth, immediately prior to the feeding. The rest will be done by the suction movement of the baby, which will ensure that the nipple is modelled in the best way. The use of nipple shields, in the presence of this problem, can also help breast-feeding.
Breast Congestion
This involves an important increase in the texture and tension of the breast, together with swelling, redness, pain and a rise in the local temperature following the presence of a residue of milk in the ducts and the mammary glands. In turn, this presence causes problems in the milk secretion cells and a consequent reduction in the production of milk. Breast congestion is a serious condition, as it can make a woman more vulnerable to the risk of mastitis (a breast infection), resulting also in high temperature. The primary cause of the problem is insufficient suction by the baby, which, as a result, is not sufficient to empty the breast. Breast-feeding on request can prevent this condition as can empting the breast manually or with a breast pump after every feeding.
The necessary measures to avoid this are:
- Breast-feeding more frequently (beginning with the more swollen breast);
- Gently squeezing the breast during feeding, leaning towards the baby to help the opening of the obstructed ducts. These actions "soften" the breast and therefore help the baby with the sucking;
- Placing hot-damp compresses locally to help the outflow of milk.
Mastitis
It is a serious inflammation caused by germs, which infect the skin - in particular, the Staphylococcus Aureus – which in certain temperature and humidity conditions, and helped by the nutritional substances contained in the maternal milk, reproduce in the mammary glands. The breast becomes very hot and painful, and fever and redness may appear. If you are worried that you have mastitis and if the above-mentioned symptoms do not improve after 6 hours, you should consult a doctor.
Treatment:
- Take antibiotics for at least ten days, as prescribed by your doctor;
- Rest as must as possible until you feel better;
- Continue with breast-feeding on request;
- Begin the feeding with the breast that is not inflamed;
- Have lukewarm showers before feeding;
- After each feeding, gently squeeze the milk from the painful breast, manually or with a breast pump, until it is completely empty;
- Apply cold compresses after the feeding.
An Abundance of Milk or the Need to Be Separated from the Baby
In these cases, the milk can be extracted and stored to be given to the baby when necessary. After use, all the parts of the breast pump that come into contact with the maternal breast and with the milk must be disassembled, washed and rinsed thoroughly. They must be sterilised after every use, at least until the baby has reached five months of age.
 Ask your obstetrician to show you the ways to manually squeeze the milk or make use of a breast pump, which is practical and quick. It is better to have a breast pump equipped with a suction intensity adjustment mechanism, which makes the pump more delicate. It is advisable to ensure that the milk flows directly into the specific containers, which can be sterilised and closed hermetically.
If it is necessary to store the milk, it is advisable to fill the container with a quantity of milk sufficient for only a single feeding. Close the top well and attach a label with the date of extraction. The milk can be kept at room temperature for approximately 8 hours, or stored in the fridge for up to 72 hours, in the freezer for a maximum of 3 months or in a freezer at - 18°C for a maximum of 6 months.
The milk must be thawed at room temperature. Before feeding, it must be heated in a Bain Marie, with a feeding bottle warmer or in a microwave oven. Before feeding the baby, gently shake the container to ensure that the milk has a uniform temperature. The containers that can be used with a ring and teat allow you to feed the baby without further changes of containers. |
