The Painful Truth About Breastfeeding

Mano!

(Photo: Aurimas Mikalauskas on Flickr)

Breast milk, or the scientific term ‘human milk,’ is the best food mothers can produce for their babies. There are endless benefits ranging from providing antibodies that help reduce sickness and infection, to improving growth, to reducing the risk of obesity as an adult. But successful breastfeeding takes time, patience, and determination.

Before I had my daughter, the idea of breastfeeding always seemed easy and natural to me. I learned about it in college, educated new parents at work, and coached and encouraged my sister through her first exclusive breastfeeding with my nephew. But I didn’t know about the ugly and painful side of it until I experienced it myself. You probably aren’t going to go through all the things on this list, but it’s always good to be in the know and prepared for what might happen.

1) Cramps!
When the baby first latches on and triggers the let-down reflex, the uterus will contract. Imagine a menstrual cramp but multiply the intensity, especially if you had a natural delivery. If you had a C-section, you probably won’t feel much because of all the pain medication you received during labor.

2) Your full milk supply doesn’t always come in within 48-72 hours
If you are one of the small percent of mothers whose milk supply doesn’t come in after day three postpartum, don’t panic! You have milk in your breasts throughout pregnancy, the precious colostrum the baby needs for the first few days of life.

There are many factors that can delay full milk production, such as a long second stage of labor, the quantity of pitocin used during an induction, vaginal vs. Caesarean birth, and simple fatigue and stress. Many women give up trying to breastfeed because of all these influences. However, keep latching baby at the breast or pump between feedings and this will tell your brain there’s an ongoing demand for milk, which in turn stimulates production.

My milk supply didn’t come in fully until the eighth day and I had to supplement with formula. I felt a certain level of guilt about it, feeling like I had somehow failed as a mother (I hadn’t). Once my supply came in, I didn’t have to supplement with formula again. Believe in yourself and don’t give up! The key is ALWAYS feed from the breast for 20-30 minutes first, then if supply is lacking, supplement with formula.

3) Sore and cracked nipples
Sadly, there’s no way to avoid this. The constant suction and heat from the baby’s mouth will leave your nipple sore and sometimes cracked and bleeding. Don’t wash your nipple with soap — the areola has natural oils that help protect and heal the skin. Washing with warm water is sufficient. You can also try expressing a couple drops of breast milk and applying that around your nipple before feeding.

4) Painful engorgement
As milk production continues to increase, painful engorgement will follow. Sometimes baby will only take one breast and you’ll need to pump and empty the other to relieve the pressure. If you have an oversupply of milk, you’ll need to empty the breast more frequently; however, frequent pumping leads to more production as the body recognizes supply is low once the breasts are emptied. If you don’t want to stock up your milk for later use, try wrapping warm, mashed cabbage leaves around the breasts to help slow down the production, which will help reduce the painful engorgement.

5) Leakage
Yes, your milk will leak from one breast when you are feeding the baby from the other. You will feel tingling or pins and needles and then notice your shirt is soaked with milk. This is caused by the let-down reflex, which can also be triggered when you hear your baby or another baby cry. Make sure you have plenty of nursing pads around to avoid these natural, but potentially embarrassing, moments.

6) Plugged Ducts
A plugged milk duct feels like a hard knot in the breast and is very painful to touch and massage. This usually happens when there’s a foremilk-hindmilk imbalance, or overproduction. Hindmilk (rich, creamy, high-fat milk) can thicken and clog the ducts, causing all the milk to back up in one area of the breast, especially if engorgement is prolonged. Sometimes plugging is caused by external pressure, such as a tight shirt and/or a poorly fitting bra.

To alleviate the problem, feed baby from the affected breast because they have powerful suction that can help unclog the ducts. Keep massaging the clogged area while the baby is latched on.

A warm shower can also help. Let the warm water run down the breast for a few minutes, then examine your nipple for a white pimple-like substance (known as a bleb). If you can access it with your finger, try squeezing it out and hand express the breast to see if milk will flow out. If it does, quickly empty the breast with pumping or by feeding baby. If plugged ducts are a recurring issue, you can try taking soy lecithin supplement — 1,200 mg three times a day.

7) Mastitis
Poor feeding and latches, oversupply, restrictive clothing, sudden weaning, and failure to clear a plugged duct can all lead to mastitis, a type of breast infection that is painful and warm to the touch. It’s recommended to keep breastfeeding during the infection, even though you’ll be on antibiotics, because sudden weaning can make things worse. You can choose to pump and dump the milk if you are concerned about it containing the medications you are taking.

8) Milk Blister
Milk blisters are tiny pockets of white or yellow fluid on the nipple or areola. They develop when the skin grows over the pores and blocks the flow of milk and you can usually see the blister bulge outward if you compress the breast.

The best remedy is to break open the skin with a sterile needle (place the needle over an open flame for couple seconds). After draining the blister, immediately apply bacitracin ointment (an antibiotic) to the open area. There will be some pain during breastfeeding as it heals.

9) Galactocele
A galactocele is a benign milk cyst that forms in the mammary gland. Though uncommon, it can form during lactation or weaning. You can usually feel the lump in your breast, but it can only be diagnosed through an X-ray. If the cyst becomes too painful, a doctor or a radiologist will have to aspirate it (remove the fluid through a thin needle).

Good luck to all first time moms and experienced mothers on your breastfeeding journey! Feel free to share your experiences and tips in the comments.

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