Your milk comes in two to five days after birth. The breasts feel unusually full with noticeable swelling, tautness, as well as increased warmth and tenderness, explains Fonnie Lo, assistant director (clinical) and lactation consultant at Thomson Medical. This also makes it difficult for baby to latch on.
Some mums may develop a mild fever. Get help, so that baby will latch on properly. “Try to manually express a small amount of milk before each feed to soften your areola, making it easier for baby to latch on,” advises Associate Professor Yong Tze Tein, a senior consultant in the department of obstetrics and gynaecology, Singapore General Hospital (SGH).
Use a breast pump to relieve a bit of pressure, but don’t express too much as it will increase your milk supply and make engorgement worse, she notes.
“Try to manually express a small amount of milk before each feed to soften your areola, making it easier for baby to latch on.”
2. Blocked ducts
When ducts carrying milk from the glands in the breast to the nipple openings become blocked, milk builds up behind the blockage, Prof Yong explains.
As a result, you may feel a lump or your breast becomes sore.
A blocked duct is also associated with a white spot on the nipple, she notes, adding that you should seek medical treatment once you feel a lump or if you develop a fever. Don’t skip feedings. Massage the lump towards your nipple, and keep feeding from the affected breast.
Let your baby do a deep latch (get as much of your breast into his mouth as possible) to empty the breast, Lo advises. But avoid wearing an underwire bra or use of breast cream excessively, which can aggravate plugged ducts.
“Mastitis is an infection of the breast that occurs during breastfeeding when bacteria from baby’s mouth enters a milk duct via a crack in the nipple,” explains Prof Yong. Blocked milk ducts and a poor latch can also cause infections, she adds.
Often associated with flu-like symptoms, such as high fever and chills, you’ll also notice the breast is firm, red and tender. Place cool cabbage leaves in your bra to relieve pain. Get plenty of rest and drink lots of fluid.
Feed from the affected breast to drain your milk, but make sure baby latches on correctly, Lo suggests. See a GP if the condition does not improve in 12 hours, she adds. Backward arm-swinging exercises may also help.
4. Sore nipples
Your nipples will usually be extra-sensitive for days after birth. A poor latch or baby’s tongue-tie can worsen matters. Engorgement, plugged milk ducts and breast infections can also give rise to sore nipples.
Mums may experience tender nipples, pain during breastfeeding, and even cracks and bleeding, Lo points out. “Use breast shells to prevent breast pads and clothing from causing friction to the sore nipples.”
You should also learn the correct breastfeeding techniques, so as to prevent injuring the nipples. If the nipples hurt, offer baby the good nipple first, Prof Yong advises. Also smear breastmilk — which has excellent anti-infection properties! — over the nipples after every feed.
5. Nipple yeast (thrush)
The organism candida albicans causes this fungal infection, which can occur in the nipples, or breast tissue, or other parts of your body, explains Prof Yong. Nipple thrush is also linked to a history of vaginal thrush, recent antibiotic use or nipple damage, she adds.
“Breast thrush pain can be stabbing pains, a deep ache or burning sensation that radiates through one or both breasts,” she adds. Your nipples may also be tender to touch.
Signs of thrush also include white patches on your baby’s tongue or in his mouth. Both mother and baby can be treated with topical nystatin or miconazole, Lo says.
You can continue nursing baby. However, do rinse your nipples and air dry them after each feed, she advises. Besides washing hands often, you should sterilise contaminated items, including bottle nipples, pacifiers and breast pump parts, in hot water.
“Breast thrush pain can be stabbing pains, a deep ache or burning sensation that radiates through one or both breasts.”
6. Milk blebs/blisters
A bleb or milk blister is a white, clear or yellow spot on the nipple (blocked nipple pore). This happens when a tiny bit of skin grows over a milk duct opening and milk backs up behind it.
The blister may resolve on its own when you’re nursing. To reduce pain, check to see if baby is latching on correctly. “When baby feeds, the fragile layer of skin over the white spot can sometimes burst, thereby releasing milk from the duct behind it,” Prof Yong notes.
Soak the nipple in warm water and gently rub it with a face washer. Or massage olive oil to soften the nipple and break up the blockage, she adds. A lactation consultant may use a sterile needle to gently release the blockage.
Help for your breastfeeding woes…
* Thomson ParentCraft Centre Their lactation consultants provide personalised counselling. Home-visiting services are also available. Call 6251-4090.
* Breastfeeding Mothers’ Support Group This non-profit group offers counselling via the phone and on social media such as Facebook, as well as workshops and talks. Call 6339-3558 or e-mail firstname.lastname@example.org.
* Family Life Society This non-profit organisation runs a Joyful Parenting programme offering counselling sessions for breastfeeding mums. Call 6488-0286.
* KK Women’s and Children Hospital Call 6225-5554 from 8am to midnight daily for the KKH-Ask-A-Nurse Service.
* Mother and Child Singapore Their experts conduct one-to-one sessions to give advice on helping your baby latch on properly. The Tanglin Mall outlet runs a baby café every Monday from 2pm to 4pm. Call 6836-0063 or e-mail email@example.com.
* NUH Women’s Clinic It encourages mums to breastfeed their babies exclusively after childbirth. Call 9722-0376.
* Traditional & Holistic Post-natal Centre The centre’s founder, Rokiah Jantan, boasts over 10 years’ experience doing postnatal massages. These special postnatal and breastfeeding massages clear blocked ducts for those with engorged breasts and help new mums return to shape, post-birth. Call 9271-6091 or send a
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