• Sore Nipples? Engorged Breasts? 5 Breastfeeding Concerns, Answered

    What do you do with milk blisters? And do you breastfeed even if you're sick? Find the answers here.
    by Claire Santos Mogol .

  • I have breastfed my son exclusively for six months and continued to breastfeed him for two years. He self-weaned when he was 4.5 years old. Today, I am still breastfeeding my 26-month-old baby girl. Looking back, I never thought I would breastfeed this long especially when I think about the struggles I went through. But armed with the proper knowledge, love from family members, support from doctors, a breastfeeding supportive environment at the workplace, and faith in my God-given ability to nurture my babies, I was able to overcome those struggles and find sustainable solutions. 

    I shared below some of my breastfeeding pains, so to speak, and other issues that I’ve encountered as a breastfeeding counselor, and how to best deal in my experience. When in doubt, you may always reach our breastfeeding support group (see details below) or, even better, consult your doctor especially when pain continues to persist.  

    1. Giving birth took a toll on my body and compromised my immunity, and I developed cough and colds right after. I don’t want my baby to get sick so should I still breastfeed? 
    Yes, continue to breastfeed. The mother’s body develops antibodies that help fight off the virus and protect the baby from getting sick. In fact, your breast milk is the best chance of protection for the baby, as opposed to separating him from you. But, for good measure, wear a mask when you breastfeed and cover your mouth when sneezing or coughing. 

    2. How common is jaundice? Is it dangerous? My baby daughter was a bit yellowish or “jaundiced” by day 3 after birth. Could it be because she is such a lazy breastfeeder?
    Breastfeeding expert Dr. Jack Newman described jaundice “as a result of a buildup in the blood of bilirubin, a yellow pigment that comes from the breakdown of old red blood cells.” Jaundice can occur when the baby is not getting enough milk especially if she has a "lazy" breastfeeding personality, like in this case. To eliminate excess bilirubin from the body, a baby should be breastfed on demand, around the clock. If the baby is sleepy, the baby is recommended to be put to the breast every two to three hours.

    You also need to make sure her latch and position are correct. My daughter had a very small mouth so she had a shallow latch. A shallow latch means she is not able to efficiently suck from the breast so she gets very little milk. The baby’s mouth should be wide open, as if she's yawning, when sucking to ensure a deeper latch. Trying different positions also helps the baby get as much breast milk as he wants. (Click here to read more about how to have your baby properly latch.) Monitoring your baby’s poop and pee output is also key to make sure that the baby is getting enough breast milk. If you suspect jaundice, best to consult your pediatrician.  

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    3. I am experiencing engorged breasts and plugged milk ducts, and I am wondering if I am doing something wrong with my breastfeeding. 
    Engorgement is when your breasts feel abnormally full, enlarged, and almost rock solid. Plugged ducts occur when the breasts feel sore and the milk ducts are inflamed. This can happen when your baby was was unable to empty your breasts properly. 

    For relief, soak a face towel in warm water (the temperature is something you should be able to tolerate). Put them over your breasts for a few minutes. After the warm compress, put virgin coconut oil (we like to use this because it is natural and digestible so baby can latch immediately) on your breasts. With the pads of your fingers, do circular motions from the base of your neck going down into the areola. Do these circular motions to different parts of your breasts, pretty much like how you would do a self-breast examination. You can also try expressing milk by hand with the Marmet technique or hand expression.  

    There are times when breasts are so engorged that mothers struggle with the pain. When this happens, you may want to try a lactation massage expert from Arugaan (email arugaan.breastfeeding@gmail.com). 

    4. How come no one told me about sore nipples? Is this normal? When my mature milk came by day 3, I was very happy. However, my nipples started becoming sore, looking a bit raw and light pink, peeling in some areas and starting to bleed. I began to dread breastfeeding. I was tired, sleepless, and in tears. 
    Sore nipples are quite common but not “normal.” It is an indication that something needs improvement in terms of the baby’s position and latch. I had sore nipples as well, and my sister brought me to neonatal pediatrician Dr. Maria Asuncion “Mianne” Silvestre. She took one look at how I was breastfeeding my baby and saw the problem immediately. She coached me to hold my baby tummy to tummy and ensured that my baby’s lips were wide open to ensure a better suck. That moment forever changed my life. 

    5. I am feeling extreme pain in my nipple, and a white spot seems to be protruding from it. What is it and should I be concerned?  
    A milk blister (or milk bleb) is most likely the “white spot” and the cause your extreme pain while breastfeeding. It is a blocked nipple pore described as “milk under the skin” since the blister typically bulges outward when the mom compresses the breast. It can remain for several days or weeks when left untreated. 

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    My fellow LATCH peer counselor, Jenny Ong, is someone I know who has experienced this condition often. Jenny said that she applied warm compress and let her baby latch on the affected breast to nurse while she massaged the blocked parts of the breast. This helped “push” the bleb towards the areola so that the baby can “unplug” it through breastfeeding. Sometimes, this solution does not work and a mom should consult with her doctor at the soonest possible time to help her “unplug” the milk blister.

    Claire Santos Mogol is a LATCH Philippines and Arugaan trained peer counselor. Together with Atty. Jennifer Joy Ong, she helped initiate the Bangko Sentral ng Pilipinas’ (BSP) adoption of the RA 10028 Expanded Breastfeeding Act as a formal lactation policy of the BSP. She is also part of the BSP peer mothers group that conducts breastfeeding counseling sessions in their office and in nearby communities in Manila. 

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