Breast Care For The Breast Feeding Mother

WHAT YOU NEED TO KNOW:

Why is breast care important while I am breastfeeding?

Your breasts will go through normal changes while you are breastfeeding. Sometimes breast and nipple problems can develop while you are breastfeeding. Learn about changes that are normal and those that may be a problem. Breast care can help you prevent and manage problems so you and your baby can enjoy the benefits of breastfeeding.

What breast changes happen while I am breastfeeding?

• For the first few days after your baby is born, your body makes a small amount of breast milk (colostrum). Within about 2 to 5 days, your body will begin making mature milk. It may take up to 10 days or longer for mature milk to come in. When your mature milk comes in, your breasts will become full and firm. They may feel tender.
• Breastfeeding your baby will decrease the full feeling in your breasts. You may feel a tingly sensation during feedings as milk is released from your breasts. This is called the milk let-down reflex. After 7 or more days, the fullness may feel like it has decreased. Your nipples should look the same as they did before you started breastfeeding. Breasts that feel full before and empty after breastfeeding are signs that breastfeeding is going well.

What breast problems can occur while I am breastfeeding?

• Nipple soreness may occur when you begin to breastfeed your baby. You may have nipple soreness if your baby does not latch on to your breast correctly. Correct positioning and latch-on may decrease or stop the pain in your nipples. Work with your caregiver to help your baby latch on correctly. It may also be helpful to place warm, wet compresses on your nipples to help decrease pain.
• Plugged milk ducts may cause painful breast lumps. Plugged ducts may be caused by not emptying your breasts completely during feedings. When your baby pauses during breastfeeding, massage and gently squeeze your breast. Gentle massage may unplug a blocked milk duct. Pump out any milk left in your breasts after your baby is done breastfeeding. Avoid wearing tight tops, tight bras, or under-wire bras, because they may put pressure on your breasts.
• Engorgement may occur as your milk comes in soon after you begin breastfeeding. Engorgement may cause your breasts to become swollen and painful. Your breasts may also become engorged if you miss a feeding or you do not breastfeed on demand. The best way to decrease engorgement symptoms is to empty your breasts by feeding your baby often. Engorgement can make it hard for your baby to latch on to your breast. If this happens, express a small amount of milk and then have your baby latch on. Cold compresses, gel packs, or ice packs on your breasts can help decrease pain and swelling. Ask your caregiver how often and how long you should use cold, or ice packs.
• A breast infection called mastitis can develop if you have plugged milk ducts or engorgement. Mastitis causes your breasts to become red, swollen, and painful. You may also have flu-like symptoms, such as chills and a fever. Place heat on your breasts to help decrease the pain. You may want to place a moist, warm cloth on the painful breast or both of your breasts. Ask your caregiver how often to do this. Your caregiver may suggest that you take an NSAID, such as ibuprofen, to decrease pain and swelling. Your caregiver may also order antibiotics to treat mastitis. Ask your caregiver about feeding your baby when you have a breast infection.

What can I do to help prevent or manage breast problems while I am breastfeeding?

• Learn how to position your baby and latch him on correctly. To latch your baby correctly to your breast, make sure that his mouth covers most of your areola (dark area around your nipple). He should not be attached only to the nipple. Your baby is latched on well if you feel comfortable and do not feel pain. A correct latch helps him get enough milk and can help to prevent sore nipples and other breast problems. There are several breastfeeding positions that you can try. Find the position that works best for you and your baby. Ask your caregiver for more information about how to hold and breastfeed your baby.
• Prevent biting. Your baby may get teeth at about 3 to 4 months of age. To help prevent biting, break his suction once he is finished breastfeeding or if he has fallen asleep. To break his suction, slip a finger into the side of his mouth. If your baby bites you, respond with surprise or unhappiness. Offer praise when he does not bite you.
• Breastfeed your baby regularly. Feed your baby 8 to 12 times a day. You may need to wake your baby at night to feed him. It is okay to feed from 1 or both breasts at each feeding. Your baby should breastfeed from both breasts equally over the course of a day. If your baby only feeds from 1 side during a feeding, offer your other breast to him first for the next feeding.
• Schedule and keep follow-up visits.Talk to your baby's caregiver or your caregiver during follow-up visits if you have breast problems. Caregivers may suggest that you, or you and your partner, attend classes on breastfeeding. You also may want to join a breastfeeding support group. Caregivers may suggest that you see a lactation consultant. This is a caregiver who can help you with breastfeeding.

When should I contact my caregiver?

Contact your caregiver if:

• You have a fever and chills.
• You have body aches and you feel like you do not have any energy.
• One or both of your breasts is red, swollen or hard, painful, and feels warm or hot.
• You have breast engorgement that does not get better within 24 hours.
• You see or feel a lump in your breast that hurts when you touch it.
• You have nipple pain during breastfeeding or between feedings.
• Your nipples are red, dry, cracked, or bleeding, or they have scabs on them.
• You have questions or concerns about your condition or care.

Care Agreement