Speed Bumps
These are more serious problems you may encounter while breastfeeding. Most can be easily resolved and should not stop you from continuing to nurse your baby.
Clogged Milk Duct
A clogged milk duct is fairly obvious — you feel a small lump in your breast, and it can be painful. (The lump can be anywhere in the ducts, which run all over.) To treat it, put a warm washcloth over it for five minutes, then massage the lump gently, pushing the milk down toward your nipple. Then start nursing your baby, making sure the baby is positioned so she faces the clogged duct, and continue massaging. The more you nurse, the faster the clogged duct will drain.
Breast Infections (Mastitis)
Breast infections are serious. If you have flu-like symptoms, a low fever, red streaks or patches on the breast skin, pain in your breast, or a hard lump in your breast, you may have one. Check with your health care provider. She may prescribe antibiotics (which won't hurt your baby). She will also tell you to go to bed, drink lots of fluid, apply warm compresses on the infected side, and continue to nurse on the infected side.
Absolutely do not stop nursing, as that will only make the infection worse. Do not delay treatment of a breast infection, since untreated infections can abscess and require surgery.
Thrush
Also called a yeast infection, thrush may present with cracked nipples that burn the entire time your baby nurses. Your baby may also develop thrush in her mouth (white patches) and diaper area (rash). Talk to your health care provider for a definite diagnosis. To control thrush, make sure your nipples and everything that touches them are clean, use a nipple wash (one teaspoon of vinegar in one cup of water), or nystatin cream (a prescription drug) that stops yeast from reproducing.
Common Drugs: Are They Safe for the Baby?
Be sure and tell your doctor that you are breastfeeding before he prescribes any medication. Most are safe for your baby, but here is a list of common drugs and whether they are considered safe for nursing infants.
Safe |
Not Safe |
Acetaminophen |
Tetracycline |
Antihistamines |
Cyclosporine (maybe, check with your doctor) |
Ibuprofen |
|
Robitussin (guaifenesin) |
Amphetamines |
Antidepressants |
Nicotine |
Decongestants |
Anticancer drugs |
Most antibiotics |
|
Antacids |
|
Thyroid medications |
|
Insulin |
|
Kaopectate |
|
Vitamins |
|
Vaccines |
Some women have trouble breastfeeding at first because they aren't experiencing a let-down. In fact, some women who give up breastfeeding because they think they don't have enough milk actually have plenty of milk; they just don't have a let-down reflex. Without the let-down reflex the baby gets a trickle of milk, enough to sip but not gulp. Stress is the biggest inhibitor of the let-down reflex, so anything that can reduce stress helps, such as a warm bath or listening to music. There are also prescription medications that can jump-start a let-down, including Reglan, a prescription antinausea drug that can increase milk supply. It's vital that you discuss the issue with your doctor, as Reglan should not be taken by anyone with a history of depression.
Milk Flow That Is Too Fast
Milk coming too fast may make your baby gulp, choke, or pull away. You may want to express a little milk first. Try nursing from just one breast at each feeding (you may have to pump the other one in between feedings if you're uncomfortable). Try leaning back in a recliner or on pillows while nursing, positioning your baby so the top of her head is above the top of your breast, so she can sip at the milk without it pouring down her throat.
Flat or Inverted Nipples
If your nipples don't protrude when you're aroused — or in a cold breeze — you may have what the breastfeeding books define as inverted nipples. To check, squeeze the areola at the bottom of the nipple and press it toward your chest. If your nipple doesn't protrude, it is flat. Truly inverted nipples can prevent successful breastfeeding, but most will respond to treatment — manually rolling your nipples several times a day, wearing a breast shield inside your bra that presses the areola and encourages the nipple to protrude, or pumping with a heavy-duty pump.

