It’s estimated that about 70% of moms experience at least some difficulty with breastfeeding. 1 According to pediatrician and certified lactation counselor Margaret Rozier Chen, MD, persistent pain and baby’s difficulty latching are among the top issues she sees. Many new parents feel like breastfeeding should be easy – and feel guilty when it’s not. But as Dr. Rozier Chen explains, “Breastfeeding is really hard – and may be one of the hardest things you’ll ever do.”
If pain gets in the way
Many women deal with nipple pain, and often that comes from improper latching. Dr. Rozier Chen suggests holding baby as close to your body (tummy-to-tummy) as possible. Allow for neck flexion – having your hand on the back of baby's neck allows them to control the movement of their head. Wait for the baby's mouth to be wide open before latching – like a yawn. “Try stroking the nipple on the tip of your baby's nose or upper lip,” she says. “Once wide open, bring the baby to breast, ideally leading with their chin first and ‘rolling’ baby onto the breast. If after 10 seconds you are feeling pain, de-latch and try again to get deeper.”
Another source of pain is mastitis, which results in swelling or redness of the breast and flu-like symptoms. It can be caused by a blocked milk duct or infection that enters through a crack in the nipple. According to Dr. Rozier Chen, the latest recommendation is to start with cold compresses on the breast and ibuprofen for 48 hours and then proceed to antibiotics if it does not resolve. “Milk oversupply puts a person at risk for mastitis, so I also talk with the parents about avoiding excessive pumping to reduce their risk.” She adds, “Always check with your doctor for advice specific to your condition.”
Breastfeeding NICU babies
At SSM Health Cardinal Glennon, parents of newborns may be trying to initiate breastfeeding while their child is in the Neonatal Intensive Care Unit (NICU). Dr. Rozier Chen notes that, in those cases, breastfeeding problems can arise early on. “Pumping needs to begin right away to stimulate the breasts when the baby is unable to. I always recommend frequent pumping (at least eight times in a 24-hour period), and as much skin-to-skin contact as you can.” She advises parents to take advantage of the lactation counselors in the NICU to help, adding, “Be sure to seek help in the community after baby is discharged as well, such as from an IBCLC (International Board Certified Lactation Consultant) or a breastfeeding medicine physician, to help meet your goals.”
When frustration sets in
As Dr. Rozier Chen notes, “There are so many emotions involved in feeding your baby, and it can be very difficult when the feeding regimen looks different than what you were expecting when you were pregnant.” For some, that leads to periods of frustration and self-doubt. “My advice is to set small goals – don't think about how you are going to breastfeed for one year, think about how you can make it to next week.”
Dr. Rozier Chen believes that any amount of time that a parent is able to provide breastmilk is amazing, saying, “There are many physical and social barriers that prevent parents from being able to breastfeed for one year or longer.” Still, health benefits of breastmilk and lactation (for both baby AND mom) do not end at one year, and parents are advised to continue as long as it makes sense for them.
She adds, “I love helping parents with breastfeeding and pumping, but I also remind parents that this is a small part of parenthood and their worth is not defined by the amount of milk they make.” She suggests that when seeking feeding help, be sure to find someone who is gentle, knowledgeable, supportive, and helps you find the path that is right for your family.
1 Gianni, M. L., Bettinelli, M. E., Manfra, P., Sorrentino, G., Bezze, E., Plevani, L., Cavallaro, G., Raffaeli, G., Crippa, B. L., Colombo, L., Morniroli, D., Liotto, N., Roggero, P., Villamor, E., Marchisio, P., & Mosca, F. (2019b). Breastfeeding difficulties and risk for early breastfeeding cessation. Nutrients, 11(10), 2266. https://doi.org/10.3390/nu11102266
