Breastfeeding is a skill that needs practice. Many people find it challenging, especially in the early days and you may need help. It doesn't matter if it's your first, second or third baby as every breastfeeding experience is different.
| When breastfeeding is going well | When to talk to your midwife |
|---|---|
| Your baby has at least 8 feeds in 24 hours | Your baby is sleepy and has less than 6 feeds in 24 hours |
| Your baby feeds for 5 to 40 minutes at each feed | Your baby feeds for less than 5 minutes at each feed |
| Your baby is calm and relaxed during feeds | Your baby feeds for more than 40 minutes at each feed |
| Your baby is content when the feed ends | Your baby comes on and off the breast, seems agitated or refuses the breast |
| Breastfeeding is comfortable | Your baby stops having at least 2 stools per day |
| Your nipples are the same shape at the end of the feed | You have painful/damaged nipples |
| Your baby has a normal amount of wet and dirty nappies | Your baby appears yellow (jaundice) |
| You may hear swallowing when the baby is over 3 days | You feel you need to give formula milk |
Sore nipples
Sore or sensitive nipples are very common in the first few weeks of breastfeeding when you are learning to feed together. It is usually because your baby is not latching on as well as it could. If you do have nipple pain, speak to your midwife, health visitor or breastfeeding specialist as soon as possible - breastfeeding should not be painful.
If you stop or reduce the amount you breastfeed then your milk supply will also drop. If you are unable to feed directly from the breast, try expressing your breast milk to maintain the supply and this can then be given directly to the baby instead.
Blocked ducts and mastitis
Blocked ducts are caused by inflammation in the breast. They might start as pea sized lumps that can swell to become quite large. Often they are caused when milk is not being drained well, so it is important to look at positioning and attachment again, see latching tips:
- Use warm compresses before you feed to help bring a good milk supply to the breast
- Use a cold compress/ice or cabbage leaves after a feed to reduce the swelling
- Take anti-inflammatory medication to reduce inflammation
- Use gentle massage back towards your armpit to drain the inflammation - this should be no firmer than you would stroke a cat
Block ducts can develop into Mastitis. Usually this is in one breast and can feel quite similar to when you have flu often making you feverish. Treat in the same way as for a blocked duct. Do not pump too much as this can increase the inflammation and you may need some antibiotics if it develops into a bacterial infection.
Thrush
Thrush is a fungal infection in the breasts. Often when you have thrush you get sharp shooting pains deep in the breast, or a burning sensation. This can last after the feed has finished. Thrush is easily spread, and if you are breastfeeding, you and your baby can pass it back and forth to each other. In the baby it may appear as white spots on the gum, roof of the mouth or tongue.
You can carry on breastfeeding while you have thrush. Or you can express milk if it is too painful. If you express any milk, we do not recommend you store it in the freezer as it may cause reinfection later.
You can avoid spreading it by washing bedding, towels and clothing on a high temperature wash. Make sure your hands are washed thoroughly. Sterilise any teats, dummy’s or nipple shields and change breast pads regularly.
If you think you have thrush, see your GP as both you and your baby will need to be treated.
Colic
It is not known why some babies suffer from colic, but it’s thought it could be caused by the baby’s immature gut. Generally, it starts between 2 to 3 weeks and often resolves at 3 months or soon after.
Colic signs - uncontrolled crying for 3 hours or more 3 times a week for at least a week, when baby is otherwise well. You may also see clenched fists or drawing knees up, baby may go red in the face.
Tips - keep baby close as skin-to-skin and carrying may soothe your baby, feed in an upright/laid back position, Gentle tummy massage in clockwise direction may help. Holding baby lying across your forearm, tummy down with your hand supporting their chest (Colic hold) may also help.
Treatment - there are several over the counter colic remedies. However, there is no current research to say this will resolve colic but they may offer some relief. Remember colic generally resolves around 3 to 4 months.
If your baby is unwell, see the GP.