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In This Section Texas Health HEB
Breastfeeding Support

Education

Follow any of the links below to learn more about solutions to various breastfeeding problems. Please note that these checklists and educational components are for informational purposes and should not be used in place of consultation with a medical professional or physician.

Benefits of Breastfeeding

  • Aids in the prevention of excessive bleeding after delivery and helps restore the uterus to prepregnancy size
  • Reduces incidence of breast cancer, uterine cancer and osteoporosis
  • Economical
  • Aids in protecting the infant against bacteria and viruses
  • Aids in development of tooth and jaw alignment
  • Easier digestion and reduced incidence of constipation
  • Decreases allergic reactions
  • Reduces frequency of respiratory illness, gastrointestinal related disease and ear infections in infants

Engorgement

  • Wear a supportive bra with no underwires
  • Avoid the use of bottles/supplements
  • Nurse every two to three hours, waking infant if necessary
  • Pump two to three minutes first to soften areola for effective latch
  • Switch sides every five to 10 minutes
  • Gently comb/massage breast before and during feedings
  • Use warm compresses 10 minutes prior to nursing
  • Cold packs after nursing for five to 10 minutes
  • Try a warm shower prior to feeding
  • For extreme engorgement, consider cabbage compresses
  • Call your doctor if you have fever, a firm, reddened area in your breast or other concerns.
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Cabbage Leaf Treatment for Engorgement

  • Wash chilled uncooked green cabbage leaves
  • Remove base of hard core vein and gently pound leaves to soften
  • Wrap leaves around breasts and areola, leaving only the nipples exposed
  • Leave in place 20 minutes
  • Remove wilted leaves
  • Reapply new cool leaves until milk begins to flow or areola area is compressible enough to hand express, pump, or ideally baby can latch-on and nurse
  • Repeat only two to three times total

Overuse of cabbage can result in a reduction or complete suppression of milk supply.

Flat or Inverted Nipples

  • Roll or stimulate nipples prior to feedings
  • Use football hold for more visibility
  • Use breast pump three to five minutes before feedings to pull nipples out
  • If infant is crying, stop, calm infant and try again
  • Keep attempts to latch-on short
  • Use nipple shield under professional supervision only
  • Supplement using expressed breastmilk or formula if no latch-on four to five hours from the last feeding
  • Keep feeding log and record wet and dirty diapers
  • Call your doctor if feedings don't improve, change occurs in infant's behavior or number of wet or dirty diapers decreases
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Sore Nipples

  • Start with the least sore side first
  • Try short, frequent feedings
  • Express breastmilk for let-down prior to latch
  • Wear shells for sore nipples between feedings
  • Massage breastmilk into nipples after feedings
  • Use a purified lanolin on nipples between feedings
  • No soap on nipples
  • Change bra pads often
  • Avoid bottles to prevent change in baby's good latch and cause soreness
  • Rotate positions at breast
  • Reposition if incorrectly latched
  • Correctly break suction before removing baby from breast
  • Wait for wide-open mouth before allowing baby to latch-on
  • Pull lower lip out while feeding
  • Keep baby close to breast, with nose and chin touching breast during feedings
  • Look for signs and symptoms of yeast or thrush
  • Call your doctor if you have extreme redness with skin breakdown, severe pain, fever or other concerns related to sore nipples
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Plugged Duct

  • Remove bra if too tight, avoid underwires
  • Don't sleep in bra
  • Avoid bunching clothes under arm when breastfeeding
  • Nurse affected side first every two hours
  • Massage starting above the sore area and move toward nipple during feedings
  • Try different positions
  • Point infant's chin toward plugged duct
  • Increase fluids and eat high protein snacks
  • Soak breast in warm water several times per day by leaning over large basin and comb/stroke breast from above plug area to nipple
  • Take your temperature every four hours
  • Call your doctor if you have a temperature, extreme pain or redness, or if the plugged area is not resolving with the above recommendations Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Mastitis

  • Call your doctor, you may need antibiotics for the infection
  • Go to bed, get help with all household tasks
  • Nurse frequently, every two hours
  • If unable or too painful to nurse, pump frequently
  • Remove bra
  • Use moist heat 15 to 20 minutes before and during nursing
  • Check temperature every four hours
  • Increase fluids
  • Take medications for fever and pain as recommended by your doctor
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Inadequate or Delayed Let-Down

  • Nurse frequently
  • Use warm compresses five minutes prior to feedings
  • Massage before and during breastfeeding
  • Nurse your baby in the same quiet, relaxed environment
  • Switch sides frequently, every five to 10 minutes
  • Pump or express before nursing
  • Take warm shower prior to nursing
  • Increase rest time
  • Drink before and during nursing
  • Try breathing and relaxation techniques
  • Concentrate your thoughts on the baby
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant 

Inadequate Milk Supply

  • Breastfeed eight to 10 times a day and avoid pacifiers
  • Offer both breast at each feeding
  • Massage breast throughout feeding
  • Switch nursing positions
  • Pump or hand express after every breastfeeding for extra stimulation
  • Supplement baby if not gaining weight well
  • Weigh baby once or twice a week
  • Remember that breastfed babies have growth spurts at two weeks and six weeks, and then at three months and six months, and will feed very frequently for a few days each time
  • Review medications you are taking.
  • Milk supply is affected by demand, so feeding frequently is important to increasing supply
  • Stop smoking
  • Get plenty of rest
  • Improve diet, and increase fluids
  • Keep a record of feedings, infant's wet and dirty diapers
  • Call your doctor if your infant is not gaining weight, shows any change in behavior or you have other concerns
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Leaking Milk

  • Open opposite bra flap while breastfeeding, and let drip
  • Change brand of bra pads, avoiding those with a plastic lining
  • No shells
  • Wear a sleep/leisure bra and nursing pads at night
  • Nurse frequently
  • Put firm but gentle pressure against nipple, just as though you had a cut, to stop leaking
  • Limit actions that stimulate nerves in the nipple
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant 

Fussy Baby

  • Remember that breastfed babies have growth spurts at two weeks and six weeks, and then around three months and six months
  • Eliminate possible allergens from mom's diet such as cow's milk, fish, eggs and peanuts 
  • Nurse on demand, every two to three hours
  • Burp after breastfeeding on each breast and at the end of the feeding
  • Swaddle baby
  • Avoid giving water
  • Offer pacifier only if necessary
  • Provide monotonous movement such as a swing, car ride, bouncer, sling carrier
  • Talk or sing to the baby in a soft voice
  • Nurse in a quiet, dark room
  • Be sure the diaper is clean and dry
  • Provide skin-to-skin contact with mom or dad
  • Give baby a warm bath
  • Limit caffeine intake to two to three caffeinated drinks per day
  • Call your doctor if fussiness persists, or if you have any other concerns
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Sleepy Baby

  • Undress baby to diaper, provide skin to skin contact
  • Provide gentle massage
  • Hold infant upright and massage his or her back
  • Change diaper, and perform cord care on a newborn
  • Apply a cool washcloth to face, never the body
  • Talk to infant and try to make eye contact
  • Watch for alert cycle, don't wait for crying
  • Side-lying sometimes helps keep baby awake
  • Stimulate sense of taste/smell by bringing infant close to nipple and dripping milk in mouth
  • Stroke under chin if latched on
  • Continue to provide stimulation throughout feeding
  • Be persistent
  • Call your doctor if unable to wake for feedings or if you have other concerns
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant 

Jaundice

  • Call your doctor if you notice yellowing of the whites of the baby's eyes or skin. Some babies will become sleepy and not eat well when they are jaundiced.
  • Continue to nurse frequently, every two to two-and-a-half hours for 15 minutes or more each time.
  • Avoid water supplement. Bilirubin, can be excreted through the baby's stools, so effective breastfeeding is important in helping to reduce the jaundice.
  • If for some reason you are not breastfeeding during this time, express or pump your breast every three hours to maintain your milk supply.
  • Maintain a record of feedings and dirty diapers and call your doctor if the amounts decrease.
  • Call the Breastfeeding Support Center at 817-848-4773 to speak with a lactation consultant

Please note that these checklists and educational components are for informational purposes and should not be used in place of consultation with a medical professional or physician.

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