1. Inverted or flat nipples. Babies nurse areolas of the breasts, not nipples! While initial feedings may be more difficult with flat or inverted nipples, many women were able to achieve successful breastfeeding.
Prevention / Treatment: • Wearing special nipple cups called breast shells between feedings help draw nipple out. • Hand expression or pumping may help make the nipple more erect. • Do not roll, twist or pull on your nipple. These actions can cause nipple trauma.
2. Engorgement. Fullness of the breasts is normal two to three days after the birth due to milk production. When enough milk is not removed because of skipped feeding or limited feeding time, the breasts may become tender and engorged. This makes it more difficult for your baby to latch on.
Prevention / Treatment: • Try a warm shower or place hot washcloths on your breasts. • Massage your breasts to promote milk flow. Use hand expression or a pump to soften the areola just before latch-on. Do not skip feeding. Establish a feeding schedule based on your baby’s demand. • Wear a supportive bra. Avoid underwire bras.
3. Sore nipples. The primary cause of soreness due to improper positioning of the baby on the breast. However, even with proper positioning, some women may still experience temporary latch-on soreness.
Prevention / Treatment: • Establish a good latch on. Your baby’s mouth should be open before latching. The lower lip should not be drawn and the tongue is not up. • Try different positions until your baby establishes a comfortable routine. • Ensure proper release. Pull down firmly your baby’s chin to break the suction before removing him from your breast. • Express some breast milk onto your nipples after a feeding and then allow your nipples to air dry completely. • Consider applying a small amount of pure anhydrous lanolin to your nipples if they have small abrasions. • Avoid using drying breast creams that contain alcohol. The glands of your breasts secrete a natural oil for lubrication and protection. • If using nursing pads, change them frequently. • Wear clean, supportive 100% cotton nursing bras. Avoid underwires and tight bras.
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