Ethnic Hispanic Mother breastfeeding her son

Breastfeeding Positions

How should I breastfeed my baby?

There is no right or wrong way to nurse your little one.  Any position that is comfortable for you and your baby is just fine.  And while it is important to ensure your baby is positioned and latched well in the beginning, after a few months your growing baby and then active toddler just might choose some positions you never would have considered!  The following breastfeeding positions will give you ideas of ways many moms have comfortably and effectively nursed their babies.

Positioning Techniques

Many moms find it helpful to have plenty of pillows to prop up around them so they don’t have to support the weight of their baby while nursing.  Other moms find having pillows and feeling like they can only nurse in their “nursing station” to be cumbersome.  These moms prefer to not use pillows or other support.  Either way is perfectly fine!

What is most important is to make sure your baby is supported throughout his head/neck/shoulder region, his head and neck are in alignment, and he has equal muscle movement on both sides of his body.  This means you will want his body gently pressed against yours – his tummy on your body – and your hand securely holding his head between his shoulder blades.  Make sure your hand does not hold his head though as this is very uncomfortable and keeps a baby from latching well.  (Imagine if you had to keep your chin down on your chest while you chewed and swallowed your food!)  His head should be free so that he can bring it back if his nose becomes blocked.  Your baby should have firm contact against his mother (skin-to-skin is ideal!).

Latching Techniques

In addition to ensuring good positioning in the early days, it is equally important to ensure a proper latch.  A mother can support her breast with her hand if necessary.  Make sure to keep your fingers behind the areola and position fingers in a C-hold so that you can easily help your baby latch on and take enough breast into his mouth.  A baby’s nose should be level with the mother’s nipple.  Your baby should have his head tilted back and lead his mouth to the breast with his lower jaw.  His mouth should be opened wide, tongue down and extended over the bottom gum, with nipple pointing up toward roof of baby’s mouth.  His chin should be pressed against breast with bottom of jaw/lip taking in more areola than the top.  Your baby forms a teat with the nipple and breast tissue, which should be tucked well into baby’s mouth.  His mouth should be open very wide with both top and bottom lips relaxed on the breast and flanged outward.  There should not be any pain!  Make sure to allow your baby to nurse as long as he wants – don’t set a time limit.

Cradle Hold

Cradle Hold

Cradle Hold

This is one of the most popular nursing positions.  A baby lies on the forearm of the side she is going to nurse, and her body extends across the front of her mother.  Her head may be cradled in the bend of the elbow or down lower on the mother’s forearm depending on the size of the baby.  The baby’s chest is against her mother’s chest without space in between; baby’s chest should not be facing up toward the ceiling.  Her legs/feet may be tucked in around the mother’s waist to feel more secure.  It is important that baby is held at breast-level rather than the breast being lowered down to reach baby (which can alter the latch, put pressure on the breast, and keep milk from draining adequately in some areas leading to plugged ducts and mastitis).

Cross-Cradle Hold

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Cross-Cradle Hold

Similar to the cradle hold, but the baby is supported in the arm opposite of the side she is nursing on.  If nursing on the left side, baby would be held by the right arm.  In this example, a mother could support her breast with her left hand and help ensure an optimal latch.  This position is often used with preterm infants.

Football/Clutch Hold

Football Hold

Football Hold

In this position, a baby lies at breast level on the arm of the side she is going to nurse.  Her head is by her mother’s hand and her body wraps around the side and back of her mother.  This hold is especially helpful for a mother who needs to be able to better see her baby’s latch – with large breasts or with a painful latch – as well as after a c-section so baby doesn’t put weight on the incision.  Many mothers of twins also nurse their babies in this position.

Laid-Back Nursing/Biological Nurturing/Reclining

Laid-Back Nursing

Laid-Back Breastfeeding

It has a variety of names but in this position, rather than sitting straight up, the mother is comfortably reclining.  She could simply slide down in a straight back chair, sit in a reclining chair, or lie on a bed propped up with a couple pillows.  A baby can then be positioned across the mother’s body allowing gravity to securely position baby’s body against hers as well as allowing gravity to help with the latch.  This position allows a baby’s natural breastfeeding instincts to kick in.  It is particularly helpful for a tired mom to get rest while nursing or when your baby struggles to open wide to latch such as in cases of tongue tie.

Nursing Lying Down (Side-lying)

Side-Lying Breastfeeding

Side-Lying Breastfeeding

Nursing lying down is an essential tool for breastfeeding and sleep.  Since babies need to nurse at night but mothers also need sleep it is a wonderful way to meet both needs.  In this position, mother and baby lie next to one another on a safe surface.  Baby is securely pressed against mother’s body, and a mother protects her baby with her legs curled around the bottom of her baby and arm over the top.  It can be challenging to first learn this position, but with practice most mothers find it very relaxing to know they can nurse while also getting rest.

Upright Nursing (Baby Sitting)

Upright Breastfeeding

Upright Breastfeeding

Some babies prefer to be in a seated, upright position when nursing.  This type of position is especially useful when a mother has a forceful milk ejection, baby has breathing or swallowing issues, cleft palate, etc.  This position helps reduce choking from a fast flow of milk.  It is still important to adequately support a baby in this position allowing her body to feel a secure touch across her body as well as ensuring her head is well supported by holding one hand in between the shoulder blades at the base of the neck.


Flat and Inverted Nipples

Nipples come in all shapes and sizes.  Two variations, flat and inverted, can present breastfeeding challenges in the beginning. However, neither makes breastfeeding impossible.  Babies take in a large portion of a mother’s nipple, areola, and breast tissue to form a teat in their mouths.  The nipple is in the back of baby’s mouth where the junction of the hard and soft palate meet.  It is called breastfeeding for a reason; and it is still completely possible for a mother with these nipple variations to exclusively breastfeed her baby from the very beginning.

How are flat and inverted nipples problematic for breastfeeding?

Nipple inversion occurs in about 3% of women, while another 10% – 35% or more will have nipples with poor protractility.1  Flat nipples can make it challenging for a baby to find and initially latch onto the breast.  Some nipples appear inverted but become erect when stimulated. There are typically no breastfeeding challenges with this type of inversion.  On the other hand, some nipples appear to be graspable but actually invert further with stimulation.  Both flat and inverted nipples usually benefit from techniques that increase its extension.

What can I do about a flat or inverted nipple?

Sometimes flat or inverted nipples will resolve themselves during the course of pregnancy. Many other cases do not display a degree of inversion that it significantly affects a baby’s ability to latch onto the breast – especially with an attentive mother helping baby latch well in the early days.  Many women find that the degree of inversion lessens the longer they breastfeed as well as subsequent pregnancies having much less inversion than before their first pregnancy.2

To help extend a flat nipple, many moms find it helpful to put a cold cloth on the nipple immediately before breastfeeding or to gently massage it.  Inverted nipples may benefit from taking a pump or syringe (cutting off the end with the point and putting the plunger in the opposite end so that the smooth end touches the nipple/areola) to help extend them before nursing. Nipple shields can also be helpful in creating a silicone nipple for baby to latch on to.  Nipple shields are very thin and should not impede milk flow.  However, nipple shields should not be used before a mother’s milk has “come in.”

Make sure to have qualified lactation support

Flat or inverted nipples can be a cause excessive weight loss and/or slow weight gain in the first week following birth.3  They can be a source of stress when initiating breastfeeding and it is extremely important for a mother to have excellent lactation support.  If you have flat or inverted nipples, there is nothing you need to do during pregnancy to change them.  Once your baby arrives, insist on talking with a qualified lactation consultant so she can help you with proper positioning and attachment to aid your baby’s breastfeeding success.


Mixed Feeding with Multiples

Many mothers of multiples want to breastfeed their babies but are unsure about committing to exclusive breastfeeding.  While it is completely possible for a mother’s body to make enough breast milk to nurse twins, triplets, and even quadruplets without supplementation there are many factors a mother must consider.  Weighing the pros and cons of breastfeeding multiples is important, but it is also not an all or nothing situation.  Mothers may also choose to do partial or mixed feeding with multiples. This means that some of their babies’ nutrition comes from breast milk and some from formula.

Breast milk is unique and unlike any other mammalian milk or infant formula.  Any amount of breast milk a mother is able to provide is a wonderful gift and should be celebrated.  There are multiple health benefits for both a mother and baby.  Breastfeeding will help with maternal-infant bonding – something that can be a challenge when there are multiple babies! Breastfeeding will also decrease feeding costs, visits to the doctor, time off work for illness, allergies, and health care costs both in the short and long term.

How does mixed feeding work with multiple babies?

There are several methods of giving mixed feeds with multiples:

  • Combination breastfeeding and bottle feeding
  • Combination breastfeeding and formula given via syringe, cup, finger feeding, etc.
  • Combination bottle feeding of expressed breast milk and formula
  • Exclusive nursing at the breast with an at-breast tube feeding device to supplement with formula
  • Breastfeeding with an at-breast tube feeding device and bottle top ups with formula or expressed breast milk

There are also several ways of supplementing breast milk:

  • Breastfeeding babies first then topping off with formula
  • Offering bottle as an “appetizer” then giving “meal and dessert” at the breast
  • Offering the breast to one (or more) and a bottle to one (or more) at a feed; then rotating who breastfeeds each time
  • Breastfeeding during the day (or night) and bottles the other times

There are different percentages of formula and breast milk given to babies:

  • Some mothers may start off giving majority formula but later build a strong milk supply and the majority becomes breast milk
  • Some mothers begin with a strong milk supply but allow it to decrease as they increase the percentage of formula given to babies
  • Some mothers give the majority or even all breast milk to a weaker or sick baby(s) and give formula to the stronger or healthier babies

There is no right or wrong way to provide mixed feeds to your babies.  One size does not fit all and the way a mother does this may change over time.  In fact, as her babies grow, one (or more) may take to breastfeeding more than another so a mother continues to nurse one and bottle feed another.

What are the risks of mixed feeding babies?

There are several risks to be aware of, as follows:

  • Decreased milk supply – Whenever a mother supplements her milk there is a risk of her milk supply decreasing.  This can be a slippery slope – as her milk supply decreases a baby receives increased supplementation, which cause her milk supply to further decrease until there is no more milk.
  • Nipple confusion – Babies may develop a preference for a certain feeding method – many times it is the fast flow of a bottle.  The flow of a bottle nipple is continuous whereas a baby at the breast must suck-suck-suck to have a let-down which lasts a minute or two and then there’s a pause before another let-down. Once a baby experiences the faster flow of a bottle they may get frustrated at the breast and begin to reject breastfeeding.
  • Health risks – While any amount of breast milk is a precious gift and wonderful for your baby, there are also well known and documented risks of formula.  Any amount of formula will change your babies’ intestinal flora to that of a formula-fed baby.  Any amount of formula will increase a baby’s chance of infection and illness. The more formula a baby receives the greater the chance of contracting infectious illnesses.  And, with multiples, if one baby gets sick it usually spreads to each baby.
  • Breast milk can be convenientWithout help, it can be easier and more convenient to breastfeed than give formula.  Breast milk doesn’t require mixing, heating, cleaning bottles, etc. so if mother is going to be feeding her babies it just makes sense to feed them in the most convenient way possible.  It is also a great way to multitask because breastfeeding requires touch and bonding that babies also need.  Even if mother does have help, it is many times easier for mother to breastfeed her babies and allow others to serve the breastfeeding mother.

Breastfeeding My Firstborn

Early Days of NursingMy experience with breastfeeding my daughter is a memory that I will treasure all the days of my life. I had always wanted to nurse my children. However, I was alarmed and even worried by the number of stories I had heard from mothers who had tried to breastfeed and were unsuccessful. My heart’s desire was set on nursing and I ached at the thought of not being able. But, I kept coming back to the fact that, throughout all of history before the last century, breast milk was the only option for nourishing a baby and if a mom wasn’t able, then a wet nurse had to be found or the infant would not survive. I remember talking with a doula early on in my pregnancy and asking her about breastfeeding and she said, “I can tell you a mother’s chances for success at breastfeeding based on how many bottles she has in her house.” She said that while nursing can be H-A-R-D, your chances of succeeding are much greater if you don’t have a Plan B. I took this to heart.

The very best resource I found on breast feeding was/is the book The Womanly Art of Breastfeeding by La Leche League. While I skimmed it before Lydia was born, I cannot count how many times I referenced it over the next years with specific questions. About the only thing I felt like I had down before Lydia was born was that nursing should not hurt. So, when she was born and her latch HURT I asked for the lactation consultant at the hospital. She was wonderful and showed me (and especially my husband who was a tremendous help and support in the beginning!) how to make sure Lydia was latched on correctly. I remember her saying it is “breastfeeding” NOT “nipple feeding” which is what Lydia wanted to do.

_10_00016_edited-1I’m really thankful I persevered in the first couple weeks to make sure Lydia learned to latch on well or I really don’t think I would have been able to continue nursing her. This was really the biggest issue I faced. From the first day Lydia had a strong suck. I remember many nights in the beginning just aching and being in pain with engorgement but I was absolutely determined to persevere. This all subsided after the first few weeks and then it was just total enjoyment to get to nurse my daughter. I loved the fact that, no matter who was holding her, she always got to come back to me every 2 hours or so!

By the time Lydia was 4-6 weeks old she nursed so much in the evenings I was convinced she wasn’t getting any milk. Again, I think this fear was fueled by so many friends I had who had doctors tell them they didn’t have enough milk and they should supplement. I knew this was a slippery slope for as soon as you do this, your milk supply will decrease and then you really will need to supplement, and the cycle will continue. I realized that overall, we really don’t have a “culture of support” for breastfeeding moms in the west. I had no idea that around 6 weeks your breasts settle into a routine and won’t feel as full; I also didn’t know that there’s always milk even when you don’t feel full.

When Lydia was four months old we moved overseas.  We traveled a lot while she was young and nursing made it easy.  I would sling her and nurse her about anywhere, one time I even nursed her while walking through an outdoor market in Africa!  As she grew I taught her how to use sign language for “milk” and then it was easy for her to ask.  We had a wonderful nursing relationship and it was an extremely hard decision for me to wean her a few months before she turned two. (Living overseas, we really wanted her to have a sibling close in age and I did not have a menstrual cycle nursing.)  To this day, Lydia and I are extremely close and I believe our trusting relationship has its roots in our nursing relationship.

Nursing my baby truly is one of the most special memories I have with my daughter. I’ll treasure it in my heart all the days of my life. Now I’m on the other end of nursing.  She has not only weaned, she is in school and growing up so fast!  But I know the time we spent together nursing laid the foundation for a strong relationship that will affect us for the rest of our lives.



Milk Oversupply

Milk Oversupply

Some women have such an abundant supply of milk it results in health issues for mother and/or baby.

What causes milk oversupply?

Oversupply can be simply that – a mother’s body making more milk than is necessary for her baby.  However, before concluding this is the cause, other factors need to be evaluated.  Perhaps a mother’s milk supply is what is necessary for her baby, but the baby has tongue tie or some other sucking issue that prevents him from nursing effectively.  If the baby consistently chokes when feeding, make sure to have the baby evaluated for gastroesophageal reflux and/or other issues.

Why is it a problem for the breastfeeding mother?

A mother with milk oversupply can live in a constant state of full, engorged, and/or painful breasts.  She may leak milk, even through bra pads, and soak her shirt.  It can be embarrassing when out in public.  Her baby may chew or bite the breast in order to try to slow down the flow of milk causing pain and cracking in the nipples.  Being very engorged with milk can lead to plugged ducts and mastitis.  Some babies become reluctant to breastfeed or even go on a nursing strike.

How does oversupply impact my baby?

When nursing at the breast, a baby whose mother has an oversupply of milk may cough, choke, gag, twist, and/or pull off the breast to try to control the fast flow.  The baby may swallow a lot of air from gulping, which can then lead to excessive spit up or gas.  He may always seem hungry, showing feeding cues even after having just breastfed; or, he may be fussy between feeds.  A baby may have green stools, watery stools or blood or mucus in the stools.  His weight will usually increase more quickly than the average of ½ pound each week.

Many of these symptoms can also occur in babies who have colic, allergies, or reflux disease so it is important to have your baby evaluated, especially before taking measures to reduce your milk supply.

If I have plenty of milk, why does my baby always seem hungry?

Research has shown that though a mom may actually have an over-abundance of milk, her baby is constantly hungry and trying to nurse.  Due to the large quantity of milk in the breast, her baby may eat often but never actually get to the creamier “hind milk.”  The initial milk, especially in a full breast, is higher in sugar and lower in milk fat content. 1  (It is incorrect, though, to assume the first milk is always low in fat as it depends on how full the breast is.  The initial milk at one feeding may contain more fat than the last milk of another feed, especially when the breast is full.)  Milk with a lower fat content is not as filling and will not leave a baby satisfied for as long as milk that has “cream” along with it.  This is what causes a baby who is eating often to continue to feel unsatisfied.

Interestingly, because of eating mostly high sugar milk content – the skim milk rather than the cream – is what also causes a baby to have the green, watery, frothy, bloody, and/or mucousy stools.

What can I do if I have oversupply?

Usually, if you are nursing your baby on demand and not pumping additional milk, oversupply will self-regulate itself after your baby is a few weeks old and your body adjusts to the amount of milk it needs to make.  If the oversupply is caused because of a sucking issue with your baby, just waiting until the baby is a few weeks older can also improve the problem.  A baby’s suckling coordination almost always improves over time. 2

Other measures to improve the situation include laid-back nursing, using only one breast at a feed, or “block feeding” for certain periods of time.  Laid back nursing can be helpful because gravity allows the baby control the milk flow.  In “block feeding” a mother may set an arbitrary time of say four hours and decide to only nurse her baby on one side during that block of time.  During the next block she would then switch to the other side, and so forth.  There is no rigid rule of how to schedule block feeds.  Some moms might find it easier to say between breakfast and lunch is the right side; between lunch and dinner is the left; etc.

Are there any herbs/medications to reduce my supply?

Herbs that have been used in cultures around the world and noted to decrease milk supply include sage, peppermint, parsley, and jasmine flowers.

Though not intended for this purpose, it has also been noted that birth control pills, especially those containing estrogen, decrease milk supply as do some decongestants, including pseudoephedrine. 3


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Lip Tie

What is lip tie?

Lip tie before the procedure.

Lip tie before the procedure.

A labial frenulum, or lip tie, is found when the thin membrane attaching from the top gumline to the upper lip, is tight.  Though breastfeeding problems are much more commonly caused from tongue tie, severe cases of lip tie can interfere with a baby’s ability to maintain a latch at the breast and make breastfeeding difficult.

Symptoms

A very tight lip tie can keep a baby from maintaining a latch while nursing.  If you notice the labial frenulum attached to the bottom of the gum line, as well as have problems with him maintaining latch even while trying various positions, lip tie may be the cause.

Does lip tie affect anything in addition to breastfeeding?

Though some cases will need revision for breastfeeding concerns, a tight labial frenulum can be more of a concern because it can cause a gap between a child’s two front teeth or the rotting of the front teeth.

Treatment

Same baby following laser release of lip tie.

Same baby following laser release of lip tie.

Increasing a baby’s head extension will usually allow a baby to grasp the breast sufficiently for breastfeeding.

As with tongue tie, a frenotomy can also be performed on lip ties.  By clipping the labial frenulum, the lip will immediately have more movement range, allowing the breastfeeding issues to be improved if not resolved.  However, unlike with tongue tie, lip tie revisions with scissors are subject to bleeding and most surgeons require a baby be put to sleep for the procedure.  Therefore, a preferred method by parents is usually to revise a lip tie with laser.  In this case, the procedure is quick and easy, with little to no bleeding.  Babies do not need anesthesia for the procedure and many times don’t feel a thing.  Typically being swaddled and held is much more alarming than the procedure itself.

Having a session of cranio-sacral therapy along with the lip tie revision can maximize results – the gentle manipulation of the head, neck, and back can help relax tension and thereby restrictions that were caused by a tight labial frenulum.

When should it be corrected?

If there are breastfeeding issues and your baby is diagnosed with lip tie, the sooner you have it revised the better.  It is safe to do the procedure on a newborn and, the sooner it is performed, the less relearning the baby has to do at the breast.  Even if the baby is a few months old (or older) when a frenotomy is performed, improvement should immediately be seen.

Post-Procedure

After a frenotomy, it is good to work with your baby to help her learn (or relearn) how to breastfeed properly.  This may include shaping the breast and holding the teat in the baby’s mouth for the duration of the breastfeed for the first few days to two weeks (depending on how much relearning the baby needs).  Be proactive to ensure good positioning and latch so she will learn to latch correctly.  It is also a good idea to perform some simple exercises on your baby for the first two weeks.  With clean fingers, gently sweep across the revision area.  Then place gentle pressure on either side of the revision lifting the top lip so scar tissue does not form.  Do these several times a day for two weeks.

You can read here about my experience breastfeeding a child with lip tie.


Cracked Nipples

Breastfeeding should not be painful.  Though it is normal to feel as if it’s a strange, new sensation in the early days of breastfeeding, your nipples should not be in pain, nor should you have damaged or cracked nipples.  If they are, it is important to take measures to remedy the situation quickly.

 Symptoms

  • Toe-curling pain
  • Dread of nursing because of intense pain
  • Pain that lasts beyond baby latching on
  • Burning sensation between breastfeeds
  • Lipstick shaped nipple when baby comes off breast
  • Cracking/bleeding on nipple
  • Compression stripe across nipple

Causes of Cracked Nipples

There are many reasons for nipple pain.  Some involve the baby, others the mother, and some both.    Once the cause of nipple damage has been identified, it can be removed and the mother can then focus on helping her nipples to heal – while continuing to breastfeed.

Below are possible reasons for nipple pain while breastfeeding:

  • Baby’s oral anatomy – e.g. tongue tie, high palate, cleft palate, etc.
  • Fast milk flow – baby chomps, bites, and/or squeezes on nipple to slow milk flow
  • Shallow latch – from baby’s oral anatomy, positioning at breast, engorgement, large nipples/small baby, etc.
  • Positioning and attachment
  • Inverted nipples
  • Breast pump having too strong/weak suction and/or improperly fitting flange
  • Nipple vasospasm (Raynaud’s phenomenon)
  • Baby biting nipple which may then allow infection
  • Dermatological condition

Treating Cracked Nipples

Once the cause is identified and removed, healing the nipple can usually be quick and easy. The best practice is to apply warm water compresses to relieve pain and then breast milk on the affected areas.  Breast milk has amazing, anti-infective properties that help to heal cracked nipples.  Allowing the breast to air dry, going without a bra or tight-fitting clothes is also helpful.  Once the cause is identified and removed, cracked and painful nipples should begin to heal immediately, even with continued breastfeeding.  You should have noticeable improvement within 24-48 hours.


Eczema on Nipples

Eczema on Nipples

What is eczema?

Eczema is a skin dermatitis which is an inflammation of the skin that can occur anywhere on the body, including on the breast and nipple. Eczema on nipples causes itching, burning, and pain, which can worsen over time.

What causes it?

There are a variety of causes of eczema on the nipples, including the following:

  • History of eczema
  • Using nipple creams/ointments that irritate the skin
  • Expressing with a pump that has too high of a suction can damage the skin, creating an environment for eczema to develop
  • Allergens that cause eczema breakouts on other parts of the body can also affect breasts
  • If mother is sensitive to residual foods, teething gels, etc. in baby’s mouth when he breastfeeds
  • Cold and dry climates or being hot and sweaty
  • Disposable breast pads can also cause irritation

What are the symptoms of eczema?

Eczema on nipples typically begins with tiny blisters or raised areas that then turn red, swell, and become crusty.  The skin is very dry and will thicken and becomes scaly.  Eczema causes itching, burning, and pain, especially while breastfeeding.  It is common to appear on both breasts and worsens over time.  Scratching can exacerbate the condition and allow for the development of a bacterial or fungal infection as well.

How do you treat eczema on nipples?

There are several natural remedies that can help.  It is important to determine what caused the inflammation and remove that allergen.  Some possibilities include the following:

  • Nipple creams and ointments
  • Disposable breast pads
  • Soaps and laundry detergents
  • Allergens in mother’s diet
  • Allergens in baby’s diet – when his saliva then comes into contact with mother’s breasts

Home treatment options:

  • Rinse nipples in cool (not hot) water and pat dry immediately
  • Do not allow skin to “dry out” but moisturize with non-allergenic cream (creams are better than lotions for skin with eczema)
  • Avoid having breasts/nipples become “hot and sweaty” – e.g. workouts, sitting in front of warm fires, extra covers, hot showers, etc.
  • Avoid perfumes, dyes, and other products that could cause allergens to this area
  • Eliminating allergens in your diet – things such as grains, dairy, sweets, etc. could exacerbate the eczema

If these do not help improve the eczema, contact your health care provider about possible topical ointments.  These medications can still be compatible with breastfeeding especially when it is applied immediately after nursing and gently wiped off before breastfeeding.

Please note:  If symptoms do not significantly improve within 3 weeks, a mother should see her doctor to rule out Paget’s Disease, a very rare form of cancer. 1  Early detection of this aggressive form of cancer is critical.

Can I still breastfeed if I have eczema on my nipples?

In short, yes!  A baby should not be affected by his mother’s eczema and breastfeeding can safely continue for baby.  As her symptoms subside, the pain she experiences while breastfeeding should also improve.


Signs Baby is Feeding Well

Signs Baby is Feeding Well

There is not one perfect way to attach a baby to the breast and everything else is wrong.  Different positions work for different babies.  Finding what works for you is key.  There are signs baby is feeding well.  These are the things to look for to ensure your baby is feeding well at the breast.

A good latch includes the following:

  • Wide, opened mouth
  • Flared lips
  • Deep latch with chin firmly against breast
  • Nose free to breathe without having to move breast tissue away

Signs baby is drinking milk:

  • Rhythmically takes long sucks and swallows
  • Pattern may change as he pauses sometimes but he should not slip off
  • Audible swallowing after milk ejection reflex
  • Relaxed arms and hands
  • Baby finishes the feed and comes off the breast on his own
  • Shape of the nipple at the end of feed should be round – not flattened

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Breast Abscess

What is a breast abscess?

A breast abscess is a pocket of pus that is enclosed and cannot drain on its own.

Rarely, breast infections can become a breast abscess. About 3% of mastitis cases develop into an abscess.1 A small abscess may be drained by needle aspiration, but a larger abscess will need to be cut with an incision and have a drain placed inside to allow for drainage. The incision is not sewn afterwards as this would not allow the abscess to drain.

Breastfeeding with an Abscess

Breastfeeding can (and should) continue during a breast abscess and following drainage surgery.2 If the incision is far enough away from the nipple and areola that the baby does not take this portion of the breast into his mouth, nursing can continue on this side.

Alternatively, the mother can breastfeed on the unaffected side and express on the side with the abscess. Expressing will not only keep the mother from developing engorgement and the possibility of another plugged duct or mastitis but also maintain her supply if she is unable to breastfeed for a number of days on that side. Once the abscess has been drained, it will begin to heal from the inside out, usually taking a week or more. Sometimes, depending on the size of the abscess, it is necessary to have it drained more than once. If there is pus or blood in the milk it is still safe and nutritious for your baby.