Friday, September 16, 2011

Breastfeeding Complications

As I stated on previous posts, when I started breastfeeding I didn't have ANY knowledge about it and therefore, I made ALL the mistakes one could make. First and foremost, I didn't get any information, read any book nor attended to any class about breastfeeding (BIG mistake). I was breastfeeding infrequently and wearing an underwired bra, I wasn't changing my nursing pads as often as I should and I didn't know how to help my daughter to latch onto my breast properly. As a result, I had all the breastfeeding complications listed in the books!

1) Sore and Cracked Nipples
    In the first few days and weeks of breastfeeding many women will have sore nipples. Even though sore nipple is normal and expected, cracked nipples is not. Just after giving birth, a mother starts to breastfeed very often, every 1.5-2 hours for about 10-15 min on each breast. With that frequency, it is normal to have sore nipples, specially if baby has very strong sucking reflex.

    Cracked nipples is caused by wrong breastfeeding position and/or poor latch onto the breast. It is important to have the baby facing the breast at its level and to proper latch on the areola, not on the nipple.

    I had them both. My nipples were VERY sore and cracked. I had to stop breastfeeding for about a 1.5 weeks to allow them to heal. Once I was ready to breastfeed again, I started taking classes to learn the proper latch technique and different feeding positions. It was wonderful to realize that I could do it without pain!

2) Thrush or Candida
    Candida is a fungus that grows in warm, dark and moist environments. The nipples of a nursing mother and the baby's mouth provide just that. After feeding, some mothers don't wait for their nipples to air dry before putting their bra and nursing pad back on, increasing their chances of developing thrush.
    The most common symptoms are shooting pain during and/or after breastfeeding; very sore/burning nipples; white patch on the baby's tongue and/or on sides of the mouth; and recent antibiotic intake (mother and/or baby).

    Since it can me transmitted from mother to baby or vice-versa, it is important to have both treated at the same time to avoid recurrence. 

    I also had thrush! I remember having terrible shooting pain on my nipples even when I was not breastfeeding. It was a constant burning sensation that it wouldn't go away. That was the main reason why I had to stop breastfeeding for 1.5 weeks. The pain was unbearable!

    Luckily my daughter didn't get it, but she still had to be treated as well.

3) Plugged Milk Ducts
    As the name already suggests, it is a blockage in the milk duct resulting in milk backing up behind it. The mother  notices a sore lump or wedge-shaped area of engorgement on the breast. 

    The best way to avoid it is to empty the breast from milk on each feeding and to breastfeed frequently. If the baby is satisfied, pump the rest of the milk and store it. An underwired bra on any kind of pressure on the breast can also cause a plugged milk duct.

    To unplug it, it's recommended to breastfeed very frequently massaging the area and to always start with the breast that has the blockage (as the baby has a stronger suck at the beginning of the feeding). It is also recommended to position the baby's chin pointing to the lump and to change baby's feeding position.

    I used to get plugged milk duct almost every other day and it would always be associated with a milk blister as described below.

4) Milk Blister
    It is a painful white, clear or yellow dot on the nipple caused by a blocked nipple pore. The blockage can be caused by an obstruction within the milk duct (plugged milk duct) or by a grow of skin over the milk duct opening. The white dot is often a dry clump of hardened milk.

    I also had them both. As I mentioned, I was having it almost every other day. I would have a very sore lump on one side of my breast and a very tiny white spot on my nipple on that same side. Sometimes the white spot and the lump would go away when I would apply a hot wet compress on the nipple immediately before feeding. Other times I had to literally soak my breast in warm/hot water to try to open up the nipple pore to release the obstruction.

    When both methods wouldn't work, I would do something that I do not recommend anybody to do it at home (Kellymom's site recommend to ask a health care provider for help on doing that).  I would sterilize a needle by holding it in a match flame until red hot, wait to cool and start to gently lift the skin at the edge of the tiny white dot to release the clump of hardened milk. As soon as the clump was out, the milk would start spraying out of the nipple pore, the lump on my breast would instantly go down and an instant relieve was felt.

    After several weeks going through the same problems, I learned that I should stop wearing an underwire bra and that I should start taking some Lecithin. With the combination of both, I was able to stop with the recurrent episodes.

    Lecithin is a safe food additive recommended for recurrent plugged milk ducts and therefore, milk blisters. On Kellymom 's site they recommend "3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day. After a week or two with no blockage, mom can reduce the dosage by one capsule. If there is no blockage within another 2 weeks she can reduce it again by one. Mom may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts."

    5) Mastitis
        Mastitis is an inflammation on the breast tissue that can be caused by plugged milk ducts or milk excess. It can become an infection when bacteria (Staphylococcus aureus - most common) from the skin enter the milk ducts through a crack in the nipple or through the opening to the milk ducts in the nipple.

       As described by Wikipedia Encyclopedia, "Mastitis typically develops when the milk is not properly removed from the breast. Milk stasis can lead to the milk ducts in the breasts becoming blocked, as the breast milk not being properly and regularly expressed. It has also been suggested that blocked milk ducts can occur as a result of pressure on the breast, such as tight-fitting clothing or an over-restrictive bra, although there is sparse evidence for this supposition . Mastitis may occur when the baby is not appropriately attached to the breast while feeding, when the baby has infrequent feeds or has problems suckling the milk out of the breast."

        The symptoms are intense pain on the breast,  fever over 101F, chills and/or flu like symptoms and systemic illness.

        If there is no infection, the treatment is similar as to plugged milk duct. Beside doing everything it's done when having plugged milk duct, it is recommended to rest, to alternate warm/cold compress on the breast to stimulate circulation and to take an analgesic for pain and fever.

        If it tuns into an infection, an antibiotic is prescribed.

        I also had mastitis. A VERY scary mastitis experience that I will write about it on my next post.

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    1. Wow, thank goodness I never experienced any of these complications. The only complaint I had while nursing was the sheer exhaustion.

      Stopping by from vB's Member to Remember. Have a great weekend.


    2. Girl, I can't believe you were able to stick with breastfeeding after going through all that! I think many people would've given up. You did great!

    3. Great post - very informative. I honestly don't know how I got so lucky with breastfeeding. I was similarly clueless, but somehow Mackenzie seemed to know exactly what to do. And the thing is, she had tongue-tie ("limited mobility of the tongue due to a short frenulum connecting its underside to the floor of the mouth" so it shouldn't have been so easy. That's another thing to keep in mind. Sometimes there can be something about the physical nature of the child's mouth that makes breastfeeding difficult. Didn't happen in our case, but some tongue-tied babies can't latch.

    4. Jen, you are so lucky! I wish my only complaint was being exhausted! LOL!

    5. I luckily didn't have those complications either. I did have several nurses and lactation consultants help me when I needed it...even after leaving the hospital. I would recommend people using the lactation consultant if one is available, they were great.

    6. Oh my goodness! I had some of those problems, but thankfully not all of them! With my first child I was pumping a LOT and I just couldn't get my breasts to empty properly with the pump, so I would get clogged ducts and angry hot red patches on my breasts. Awful! Not to mention the cracked and sore nipples, which NOTHING worked to help. I tried the Lansinoh stuff and the my son wouldn't nurse because he couldn't stand the taste!

      The whole experience of breasfeeding my son was pretty awful and stressful, which is surprising because he was born naturally and latched on immediately after birth. Then it all went downhill!! He wouldn't latch properly... I didn't have enough milk... eventually he refused the boob altogether and I ended up pumping exclusively.

      Ironically, my daughter (who was born via C-section and spent a week in the NICU) was a wonderful nurser by comparison. This is surprising, since she wasn't even given a chance to try nursing for the first few days of her life because she had to be intubated and sedated and it was just awful.

      But fortunately there was a REALLY good nurse there at the hospital, and when my daughter was having trouble latching, the nurse just reached over, grabbed my boob, smooshed it and forcibly SHOVED it in my daughter's mouth. My daughter stopped fussing and immediately started nursing. I thought, "What about all those books that tell you to rub your nipple over the baby's mouth until she opens wide?" Nope. Apparently the "squish and shove" was the method I should have been employing all along.

      So after that, the "squish and shove" it was, and my daughter was nursed until she was 16 months old. But even though she was an awesome nurser, I still had these awful shooting pains in my breasts for the first three months or so! It was like glass daggers stabbing me... I've heard of other women describing similar sensations... but anyway, I've always envied the women who had easy babies who nursed with no problems... who had no soreness or pain, who had no milk supply problems.

      I did join my local La Leche league with my second, and I found that the support was extremely helpful. But anyway, I really feel for you with all that you went through!

      I'm stopping by to follow you back and thank you again for joining in the Stumble Ed event! Have a wonderful weekend!

      Smiles, Jenn @Misadventures in Motherhood

    7. Great info, wish I knew half of this when I had my daughter. We had thrush and that nearly did us in! Luckily we were able to get past that and breastfeed. They should educate moms more on breastfeeding at prenatal exams and in the hospital when we give birth!!

    8. Wow I should have read your post 5 or 10 years ago, I should have learned a lot. I was wearing underwired bra all the time, I didn't know back then it is not recommended. I got problems with producing milk with my second baby. I should have known about Lecithin too. I'm just thankful I didn't got some mastitis but I got this plugged milk ducts. OH, now I know. Thanks for sharing.

      Dropping by from vB

    9. I don't feel like I was the only one who went through all that now! It was really bad with my first one, but by the 3rd one I had it down. Well, I never had thrush until my 3rd one, but other than that I lived through it Thanks for sharing with us. New follower from vB.

    10. @Kelly Thank you! It was very hard, but I'm glad I didn't give up.

      @Rebecca Thank you for the info! You are really lucky. You didn't have problems even with your daughter having tongue tie! My daughter didn't have tongue tie and I still had all kinds of problems! LOL.

      @Tracy You are right. I think all mothers should be seen by a lactation consultant!

      @Jenn After attending the bf classes and learning different positions and techniques, the technique that worked for me was to hold my daughter's head and as soon she would open her mouth wide I would just bring her to my breast as fast as I could. It was the only way that she would latch on the areola instead of on the nipple. After going through all those problems I was still able to bf her until she was 30 months old!

      @Camilleta You are totally right. I think it should be mandatory to have some classes if a mother chooses to bf.

      @Katya Kate I wish I would know about the bra as well. I only learned about it after going through a lot of pain!

      @Michorose I think a lot of women have some kind of trouble when bf, but we just don't talk too much about it!

    11. A very good article with a lot of information! I also used to suffer from mastitis several times with my second baby, it's really terrible! Now, would be great if someone posted about stopping with breastfeeding and how to get your baby drink from the bottle! Thanx again for sharing

    12. I'm soooooo sorry you had to deal with that many complications!!! I was also a breast-feeding mom of my 2 babies, and had some soreness, cracking, and occasional clogging of my ducts, so I know exactly what kind of pain you were dealing with, and believe me.. IT'S EXCRUCIATING!! (and exhausting too.. think about how much more time it takes us with difficult latch ons, treating sore/cracked nipples, trying to pump after unsuccessful feedings, etc. when other mommies got to "sleep when the baby sleeps", we were up crying in pain with rock-hard boobies and bleeding nipples!!)
      But I applaud you for sticking with it. What a trooper! That just goes to show how much we give and sacrifice as moms so that our children can have the best that we can possibly give them.. even as little babies!!!
      Thanks for sharing your trials and experiences, I know that other mom's will definitely benefit from this :)


    13. @Olga Thank you for the post idea. I will research about it!

      @Jackie You are so right. I remember reading and listening about moms bf without any complications and asking myself "why me?". But at the end it was all worth it!


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