Breastfeeding is often thought of as a natural, instinctive function for both mother and baby. However, it still takes practice and experimentation to find the best positions to get baby latched on effectively.
Without good positioning and latch, mother may experience soreness, cracking, bleeding, or bruising, and potentially mastitis (infection of the breast tissue), and baby may be unable to obtain enough milk. Other factors that can cause problems include inverted nipples, inadequate let-down reflex, tongue or lip tie, or comfort sucking, especially after baby falls asleep at the breast.
Some soreness or tenderness in the early days is normal, but should be brief and mild. Intense pain or pain that persists or returns after seeming to resolve indicates a possible problem that needs to be resolved. The following tips can help you and your baby get an effective latch.
Get comfortable – Make sure you have something to drink and anything else you may want or need during the feed in easy reach. Sit in a comfortable chair with good back support and use a stool to put your feet up. Use a pillow to help raise the baby to your breast. The more comfortable and relaxed you are, the easier breastfeeding will be.
Express a little milk – Manually expressing a little milk just before feeding baby can help stimulate your let-down reflex and make it easier for baby to obtain milk. If you are engorged, expressing a little milk before feeding can help soften your breasts and nipples, making it easier for baby to latch.
Change sides and position – Your baby will suckle more vigorously for the first few minutes of the feeding. If you are particularly sore on one side, start baby on the other side. Also, change positions for each feed to put pressure on different parts of the breast. This will help baby empty the breast more efficiently.
Learning your baby’s early hunger cues – These include smacking or licking lips, opening and closing the mouth, rooting (turning head with mouth open), and sucking on fists. Fussing or crying is a later hunger cue; a fussy baby may be restless and may have trouble latching. Tickle the baby’s cheek with your nipple until baby’s mouth open and baby turns to the breast.
Know what a good latch looks like – With baby’s mouth wide open, guide baby onto the breast so that baby’s mouth covers as much of the areola as possible. You should be able to see the tip of the baby’s tongue peeking out from under the bottom lip. If baby doesn’t latch well at first, place your little finger in the corner of baby’s mouth to break the suction and try again.
Watch the baby – Baby’s ear, shoulder, and hip should be aligned and baby’s chin should be raised. You’ll be able to see the baby’s jaw move in a circular motion (down, forward, up, back) and hear the baby swallowing.
Air dry – Leave a few drops of breastmilk to air dry on your nipples after each feeding. Breastmilk is a natural skin softener and has antibodies that help fight infection and air drying will help prevent irritation. After your nipples dry, apply a bit of lanolin cream or ointment.
Cool compresses – To ease tenderness, place cool compresses on your nipples between feedings. Breast shields or hydrogel pads can be worn inside your bra to protect and sooth sore nipples.
Support – When your milk comes in, your breasts will get bigger and heavier. Find a good cotton bra with wide straps to support the extra weight without irritating. Nursing bras have flaps that can be opened as needed.
If your nipples are very sore, see a doctor or lactation consultant to evaluate your baby for tongue or lip tie. Tongue tie occurs when the frenulum, that bit of skin connecting the tongue to the bottom of the mouth, is too short, preventing adequate tongue movement. The same thing can occur with the top lip, preventing baby from latching onto the breast well.
If pain persists after using these tips, or if you experience a painful area that is warm or red, a hard knot in your breast, or you have fever or flu-like symptoms, call your doctor. These are all signs of an infection that needs medical attention.