Breastfeeding Problems

Although breastfeeding is the natural way to feed your baby, you both still need to learn how to do it and you may both need some practice to get it right.

If you have good information and support, and are confident about feeding, you should be able to overcome any problems that arise.

Click below for online information to help you with painful breastfeeding and common problems, or if you are worried about low milk supply.

Mastitis

Around one in 10 women who are breastfeeding are affected by mastitis. Most women will develop mastitis during the first three months after giving birth.

For symptoms, causes, treatments, complications and prevention of mastitis, please view the following resource:

> NHS Choices Mastitis

Drugs In Breastmilk

The Breastfeeding Network (BfN) offers information sheets on a diverse range of drugs and treatments, including antibiotics, antidepressants, analgesia and dental treatment can be found below

> Please visit The Breastfeeding Network website for more information

Use of drugs to initiate or augment milk supply

Not having enough milk is one of the most common reasons for stopping breastfeeding. This often has a common reason but can be improved with increasing breastfeeding, pumping milk or expressing it by hand. If this doesn't work, only then can "Galactagogues" (drugs to increase milk supply) be considered. Talk to your breastfeeding group and/or your midwife or health visitor for support with breastfeeding. 

Expressing & Storage of Breastmilk

Why express breastmilk?

  • To start & increase milk production

  • Increase your confidence & understanding of how breastfeeding works

  • Produce a few drops to tempt baby to feed

  • Soften a full breast to help discomfort or help baby to attach

  • To get milk for a baby who cannot feed or is separated from mother

  • To prevent & deal with problems e.g. clear a blocked duct & prevent mastitis

  • Social reasons – including returning to work

 > For more information please view the UNICEF - Hand Expression Video

Why hand express?

  • Convenient – you can do it anywhere – no equipment needed

  • More like the action of breastfeeding & skin to skin than pumps which work by suction

  • Best way to express first milk – colostrum

  • Less painful than a breast pump if nipples are sore or cracked or breasts very full

 > Visist

  • Remember to use a sterilised container to put the milk in.

  • You can store mum’s milk in the fridge for up to 5 days at 4 C or lower (usually at the back, never in the door).

  • Mum’s milk can be stored for 2 weeks in the ice compartment of a fridge or for up to 6 months in a freezer.

  • Defrost frozen mum’s milk in the fridge. Once thawed, use it straight away.

  • If your baby prefers, you can warm the milk up to body temperature before feeding. Never heat milk in the microwave as it can cause hot spots which can burn your baby’s mouth.

Need to hire a hospital grade breastpump?

> Visit the Centrak Medical Supplies website to hire an Ameda breast pump.
> Visit the 'Express Yourselves' Mums website to hire a Medela breast pump.


Further Information

More information on the expressing and storage of breastmilk can be viewed on

> Best Beginnings - Expressing & Returning to Work (Video)
> Breastfeeding Network - Expressing & Storing
> UNICEF - Hand Expression (Video)

Your baby's weight and height

How do I know my baby’s weight is OK in the first 2 weeks?

Weighing in the early days is important. Babies usually lose some weight to start with but then put it back on, this helps to show that your baby is healthy and feeding well.

In Greenwich, your baby will be weighed at birth and in the first week, usually at 5-6 days, by the midwife and at 10-14 days by the health visitor. Your midwife or health visitor will also check your baby is well and ask how feeding is going. Your baby’s weight and progress will be recorded in the ‘red book’, which also has useful information for you to read about weighing, growth and development. 

If your baby loses quite a lot of weight or is slow to get back to their birth weight, this is a sign to look a little closer. If the weight loss seems a lot, your midwife or health visitor will calculate this as a percentage. If your baby has lost 10% or more of their birth weight, she will help you to make sure the baby is attaching to the breast properly. She may suggest some changes to the way you hold your baby, or that you feed more often. Your midwife or health visitor may also suggest that your baby has a medical examination.

Your midwife or health visitor will weigh your baby again to follow their progress. It is a good idea to visit a breastfeeding group for extra support and advice. Many mothers feel under pressure to give formula milk at this time, but help with breastfeeding and talking to other breastfeeding mothers usually makes all the difference.

For more information on weighing your baby see NHS Choices

How often should my baby be weighed?

In Greenwich, your baby can be weighed when you visit a breastfeeding group or a child health clinic. Once breastfeeding is established, your baby does not need to be weighed every week if your baby is healthy, happy and feeding well. Many mothers like to have their babies weighed more often than this. However, this is not always helpful and can cause unnecessary worry. For example, if one week your baby was weighed just after a big feed but the next week they were weighed after a big nap and before a feed, this could make it look as if they had not gained weight. So if you do weigh more often remember your baby will not always gain the same amount each week and that older babies grow much more slowly.

Weighing is important but only one way of knowing how well your baby is feeding. Weights measured over a longer time are more likely to show the true weight change. This is why it is recommended that babies should not be weighed more often than once a month from 2 weeks to 6 months of age, no more than every 2 months up to 1 year of age, and no more than every 3 months after that, unless there are special reasons. The time between weighing is longer for older babies because they are growing less quickly.

Your health visitor may suggest that your child is weighed more often than this if there are concerns about their health or growth.

The most valuable part of going to the breastfeeding group or clinic every week or as often as you need is the chance to get support or information and to get out and meet other parents.

When should babies & children have their length or height measured?

Length or height should be measured whenever there are any worries about a child’s weight gain, growth or general health.

If you are not sure about how well your baby is feeding or growing:

- see the about breastfeeding section of our website for breastfeeding advice 

- click on the leaflets below

- visit a breastfeeding drop-in group

- call your midwife or health visitor team or one of the national telephone helplines.

> Read What's in a nappy - How to know your baby is feeding well (PDF)

> Read How can I tell that breastfeeding is going well (PDF)

> Read UKWHO Growth charts - Parents Information in the Red Book (PDF)

 

 

Nighttime Feeds

Night time feeds are very important for your milk supply and your baby needs to breastfeed at night to grow well.

It is recommended that your baby shares a room with you for at least the first 6 months, as this protects babies against cot death and helps with breastfeeding .

Becoming a parent is a very special time and can be one of the most rewarding experiences of your life, however, it can also be challenging, especially when you are tired and your baby is awake and wanting to feed frequently during the night.

More information can be found at the following:

> UNICEF Caring for your baby at night leaflet.

> The NEW ISIS Infant Sleep Information Source website.

>Getting your baby to sleep from NHS CHOICES.

> View the 'Reducing the risk of cot death' leaflet (pdf) 

 

Thrush

Thrush is a fungal infection which usually starts after a period of pain-free breastfeeding or after a course of antibiotics. Other causes of breast pain should be excluded before diagnosing thrush.

The following NHS links provide clinical and prescribing information:

> Visit NHS CHOICES to read about oral thrush in babies.

> Visit NICE CKS to read about prescribing for oral thrush in babies.

> Visit NICE CKS for management of suspected candida breast infection

The Breastfeeding Network recommend that before a diagnosis of thrush is swabs of the mother’s nipples and of the baby's mouth are taken to detect bacterial or candida growth.

> Visit the Breastfeeding Network website for more information.

Low Milk Supply

Mums often say that concerns about not having enough milk mean they stop breastfeeding. Sometimes, it is othher family members who are concerned.

Do talk to your midwife or health visitor about any concerns or discuss your concerns with a breastfeeding advocate at one of the borough drop-ins. Often it is a matter or looking again at positioning your baby, or taking some rest during a growth spurt.

> Visit the UNICEF website for more information

Clinical ‘low milk supply’ is rare and your health visitor will refer you to your GP in these unusual cases.

Tongue Tie

Some babies are born with a tight piece of skin between the underside of their tongue and the floor of their mouth. 

This is known as tongue-tie and it can affect breastfeeding by making it hard for baby to attach effectively at the breast. Many tongue ties are minor and do not need treatment.

However, all babies with tongue tie need extra breastfeeding support to prevent problems. You can get extra support at one of the breastfeeding drop ins where breastfeeding advocates are experienced in helping mothers whose babies have tongue tie

Babies under 4 months old with breastfeeding difficulties can be treated for tongue-tie.

Please talk to one of the drop in staff or your health visitor if you are concerned