Strategies for Overcoming Breastfeeding Challenges

Some babies are born sleepy and do not wake up to breastfeed or refuse to breastfeed at the early stages of life. It is crucial to try diverse methods to maintain breastfeeding and ensure they receive proper nutrition.

Ways to overcome this problem

• Manual expression of colostrum: first, express colostrum (as described in the previous section) so that you can give it to your baby later.
• Skin-to-skin contact: especially with babies who refuse to breastfeed, it is essential to maintain skin-to-skin contact anytime it is possible, even beyond feeding times.
• Dripping milk onto the baby’s lips: you can drip a small amount of milk from your breast onto your baby’s mouth and lips to encourage them to latch. If this does not prove effective, engage in skin-to-skin contact by placing your baby on you, and try again after half an hour.

In their first few weeks of life, babies are supposed to wake and feed 8 to 12 times a day, not necessarily with regular intervals. Occasionally, they wake up less than 8 times a day, and it seems that they are not interested in breastfeeding.

Ways to overcome this problem

• Dripping milk onto the baby’s lips: you can drip a small amount of milk from your breast onto your baby’s mouth and lips to encourage the baby to latch.
• Undress and cuddle: try to undress and cuddle your baby to your body with the head facing the breast. You can talk and sing during this time to help the baby wake up.
• Try again: if your baby does not want to latch despite your efforts, try again after half an hour.
• Seek counseling: if your baby eats less than eight times a day for two consecutive days, talk to the Tipat Halav staff or a lactation consultant for support.

If you experience pain during breastfeeding or notice inadequate weight gain in your baby, this may signal difficulties with latching on. It is important to understand that breastfeeding is an acquired skill, and most babies learn to latch over time. Providing frequent opportunities for your baby to practice latching increases the likelihood of a quicker and more successful breastfeeding experience.

Ways to overcome this problem

• Proper latching on: try different breastfeeding positions to help your baby get a good latch of the mouth onto the breast. Ensure that the baby's chest and stomach are positioned against your body and ensure that the baby's head aligns with your body rather than turned to the side of the breast. The ideal latch involves the baby's mouth open, similar to a yawn, and encircling not just the nipple but also a significant portion of the breast.
• Frequent breastfeeding: breastfeed often, preferably 8 to 12 times a day, until breastfeeding becomes a smooth and effortless process. It is advised to avoid using artificial nipples that fit the mother’s nipple because it may disrupt the learning process.
• Seek counseling: after delivery, while still at the hospital, you can ask the staff for help during the entire day. If, when you are already at home, your baby still struggles with latching onto your breast and the problem is not resolved within a day or two, you can seek assistance from the Tipat Halav staff, a private nursing consultant, or a physician who specializes in breastfeeding.

Additionally, the structure of the mouth sometimes makes it difficult to latch on, for example, because of a condition called tongue-tie. Therefore, if the situation does not improve from one breastfeeding session to another, it is essential to seek assistance as soon as possible.

Breastfeeding is not supposed to be painful. However, in the first days of breastfeeding, you may sense that your nipples are sensitive. The most frequent reason for sore nipples is that the baby is still learning to latch, which causes soreness and cracks in the nipple.

Ways to overcome this problem

• Proper latching on: try different breastfeeding positions to help your baby get a good latch of the mouth onto the breast. Ensure that the baby's chest and stomach are positioned against your body and ensure that the baby's head aligns with your body rather than turned to the side of the breast. The ideal latch involves the baby's mouth open, similar to a yawn, and encircling not just the nipple but also a significant portion of the breast.
• Pain relief: use pain relievers, such as paracetamol, if you are not sensitive to them. Typically, once the problem is resolved through proper latching and correction of the tongue-tie is, the pain tends to diminish, and the area will eventually recover.
• Seek counseling: if the nipple pain does not diminish and subside within a day or two, you can seek assistance from the Tipat Halav staff, a private nursing consultant, or a physician who specializes in breastfeeding.

Breast congestion is common. It usually appears within two to four days after labor, indicating increased milk production. This fullness is expected to diminish after each breastfeeding session. Congestion is a condition of enhanced fullness, which causes breast pain and stiffness. This condition is often experienced after labor, when both you and your baby adapt to breastfeeding. It may occur when several hours pass without breastfeeding, such as when you are not in close proximity to your baby. Furthermore, introducing solid food to your baby exacerbates congestion and makes it challenging for the baby to latch onto the nipple.

Ways to overcome this problem

• Breastfeeding on demand: breastfeeding on demand can prevent congestion. In the initial weeks after labor, aim for 8 to 12 breastfeeding sessions a day.
• Pump milk: if your baby tries to breastfeed but struggles to latch due to breast congestion, try pumping some milk until the congestion diminishes, and then attempt breastfeeding again. If unsuccessful, pump to alleviate the pain. If you are unable to breastfeed at all, pump milk 8 to 12 times a day, engage in skin-to-skin contact frequently, and seek professional assistance promptly.
• Gentle massaging: before breastfeeding or pumping, gently massage the nipple towards the breast to reduce congestion and soften the nipple, to facilitate your baby’s latch at the beginning of feeding. The massage must be gentle, as a vigorous massage may damage the breast tissue and cause edema.
• Cold compress: in between breastfeeding sessions, apply cold compresses to your breasts, but not on your nipples, for 20 minutes to reduce the edema and pain.
• Pain relief: use pain relievers, such as paracetamol or ibuprofen, if you are not sensitive to them.
• Seek counseling: if the congestion does not diminish in spite of all the above efforts, it is essential to reach out to a professional counsellor as soon as possible. You can seek assistance from the Tipat Halav staff, a private nursing consultant, or a physician who specializes in breastfeeding.

Milk ducts may be clogged when there is a failure of milk flow behind the nipple or in the ducts further back. This blockage leads to localized breast pain and the formation of a hard lump or a hot and painful area in the breast. If left untreated, inflammation may develop, accompanied by flu-like symptoms and intensified breast pain. In some cases, red lines may appear on the skin of the breasts. Various factors contribute to a clogged milk duct, including incorrect latching, missing a breastfeeding session, hurried breastfeeding, and pressure on the breasts from tight clothing, especially bras, or the strap of a heavy handbag.

Ways to overcome this problem

• Breastfeed on demand: frequent breastfeeding and on demand breastfeeding of your baby may help prevent milk flow blockage. During the first weeks after labor, it is advised to breastfeed 8 to 12 times a day.
• Proper latching on: try different breastfeeding positions to help your baby get a good latch of the mouth onto the breast. Ensure that the baby's chest and stomach are positioned against your body and ensure that the baby's head aligns with your body rather than turned to the side of the breast. The ideal latch involves the baby's mouth open, similar to a yawn, and encircling not just the nipple but also a significant portion of the breast.
• Gentle massaging: during breastfeeding, gently massage the breast behind the blockage towards the nipple.
• Eat, drink, and rest: resting, drinking and proper nutrition are crucial for your overall balance and the prevention and treatment of a clogged milk duct.
• Pain relief: use pain relievers, such as paracetamol or ibuprofen, if you are not sensitive to them.
• Seek counseling: if the blockage does not diminish, it is essential to reach out to a professional counsellor as soon as possible. You can seek assistance from the Tipat Halav staff, a private nursing consultant, or a physician who specializes in breastfeeding.

If you experience redness or pain in your breast after breastfeeding, you may be developing breast inflammation (mastitis). This complication arises from an over-flowing of milk due to untreated congestion or a clogged breast duct, accompanied by a shift in the natural bacteria present in the breasts. Symptoms of inflammation include sensitivity, redness, warmth, and a general sense of discomfort resembling flu-like symptoms, such as fever, weakness, and shivering. Initially, it is a localized inflammation, but if left untreated, it may develop into an inflammatory process.

Ways to overcome this problem

• Breastfeeding on demand: to address inflammation, it is essential to continue breastfeeding 8 to 12 times a day, starting with the painful breast.
• Proper latching on: try different breastfeeding positions to help your baby get a good latch onto the breast. Ask the Tipat Halav staff or a Tipat Halav consultant to observe you breastfeed and, if needed, correct your breastfeeding position.
• It is preferable to avoid pumping: it is advised to refrain from using a breast pump. If you use one, avoid pumping more than the baby can consume.
  For instructions on the storage of pumped breast milk
• Warming the breast: gentle warming of the breast before starting to breastfeed may facilitate milk flow.
• Cold compress: between breastfeeding sessions, apply cold compresses to the breasts to alleviate pain.
• Pain relief: use pain relievers, such as paracetamol or ibuprofen, if you are not sensitive to them.
• Seek counseling: if redness persists beyond 12 to 24 hours or if you experience a rise in body temperature and general discomfort, promptly seek medical assistance. Inform the clinic's staff that you are breastfeeding to receive safe antibiotics for use during breastfeeding.

Fungal infection signs among babies include white patches on the tongue or gums or a fungal infection in the diaper area. Sometimes, there are no apparent signs in the mouth.

Fungal infection signs among mothers include sharp nipple or breast pain, lasting during breastfeeding and even afterwards, as well as a burning or itching sensations and redness and shininess around the nipples.

Ways to overcome this problem

• Visit a clinic: in case of a fungal infection, both you and your baby will need treatment with an antifungal medication.
• Avoid breastfeeding pads: it is recommended to avoid using breastfeeding pads. If you use such pads, it is essential to change them after each breastfeeding session.