Your breast will change during pregnancy and during the postpartum period. Hormones released by your body during pregnancy will make your breasts grow and produce breast milk. After the birth of your child, your breasts will start to fill up with breast milk in anticipation of feeding your hungry baby. You breast will be larger and feel tender due to milk engorgement which may leak through the nipples.
It is important to take good care of your breasts to prevent problems during breastfeeding. Here are some tips for breast care during breast feeding period.
1) Practice good hygiene by washing your breast and nipples with warm water while having your bath or shower. Do not use too much soap as it may dry your nipples causing them to crack.
Image Source: Smart Parents
2) Wear a supportive nursing bra which is not too tight and preferably made of cotton so that it does not sweat too much. Use breast pads to prevent milk leakage wetting the bra. This prevents fungus (thrush) growth and also makes it comfortable for you.
3) Get your baby to latch correctly from the first breastfeed and breastfeed regularly (at least every 2 to 3 hours) to prevent the development of painful breast engorgement, plugged milk ducts and mastitis. If your baby does not want to feed, pump the breast milk to release the milk and encourage the breast to produce a healthy supply of milk.
4) Moisturize your nipples with your breast milk after breastfeeding and then let the nipples air dry naturally.
5) Remove your child from your breast correctly. When you’re ready to take your baby off the breast, do not pull him/her off but instead, place your finger in the corner of her mouth to break the suction between the mouth and your breast.
Latching is the most important part of successful breast feeding. Always get into a good comfortable position to breastfeed. Use a support pillow and a comfortable chair which you can lean back to relax. Hold your breast (using a C or U hold) and guide the nipple to your baby’s mouth. Aim the nipple to the baby’s upper lip (not middle of the mouth) with the head slightly tilted back. Try to get as much of the lower portion of the areola in the baby’s mouth.
Image Source: Multi-Mam
A good latch will result in breast feeding which is not painful. You will know when you have a good latch when:
- Tongue is seen when the bottom lip is pulled down
- There is a circular movement of the jaw rather than rapid chin movement
- There is no clicking or smacking noises and you only hear swallowing
- The baby’s chin is touching your breast
- At the end of the feed, your nipple is not flattened or misshaped
- There is no pain during feeding
Blocked milk ducts
Blocked milk ducts occur when you are making milk faster than it is used or there is incomplete emptying. Other causes include pressure from an ill-fitting bra, stress, previous breast surgery scar and incomplete latch. The blockage feels hard and tender to touch.
Image Source: Mayo Clinic
Treatment options include:
- Warm compress and gentle massage towards the nipple to help express the blocked milk
- Position your baby to suck at the blocked duct area
- Have more rest to reduce stress and stay hydrated
Sore or cracked nipples
Cracked nipples are common and give rise to pain during breastfeeding. It typically arises 3-7 days postpartum and can increase the risk of nipple infection and mastitis. Cracked nipples can be treated with 100% lanolin or glycerin/hydrogel nipple pads placed over the nipples to help soothe and heal cracked or painful nipples.
Mastitis is breast inflammation (usually due to infection) and is common during the first 6 months of breastfeeding. Failing to empty the breast milk or going for long periods between feeds causes the breast to be engorged with milk. Infection happens when bacteria enters the breast through the nipple and is more common when the mother has a cracked or sore nipple.
The symptoms are redness, tenderness or pain which may be accompanied by fever.
Seek treatment immediately to prevent abscess formation. Mastitis is treated with antibiotics which will not harm the baby and acetaminophen (Tylenol) for the pain and fever. In the meantime, get more rest, drink more fluids and you can place a warm wet pack on your painful breast or massage the breast gently to increase the milk flow.
Feed your baby with your healthy breast. If your nipple of the affected breast is too painful to breastfeed, use a breast pump to empty the breast of milk. This will help the mastitis get better faster.
Guide to breast milk pumping
Image Source: Mother Nature Network
There are many reasons to pump breast milk to store and be fed to the baby at a later time.
- You have a premature baby in ICU who cannot be breastfed
- You have to return to work or unable to breastfeed during certain periods
- Your baby does not want to feed but your breast is engorged with milk
- Your nipples are too sore to breastfeed
- You have twins or triplets
Try to pump round 15-20 minutes on each side. It may take a few minutes before the milk starts to emerge so be patient. Divide the milk into the amount your baby will drink each time before freezing. This makes it easier for you to calculate the amount your baby drinks each time. Try to pump frequently and equally on both breasts as this allows the breasts to maintain a steady supply of milk and reduce the risk of blocked milk ducts.
If you have any concerns about your breasts or how to care for them during breast feeding, do contact your gynaecologist or a lactation consultant.
How to increase milk production
Have healthy well balanced diet, keep hydrated and feed (or pump) regularly (around every 2-3 hours) is the secret to maintaining a good milk supply. Foods which encourage milk production are called lactogenic foods. Some of the examples of lactogenic foods are oatmeal, barley, green leafy vegetables, garlic, almonds and etc.
Medications which encourage milk production are Metoclopramide and Motilium which can be used to increase milk production as a last resort.
Dr. Aqmar Suraya
Obstetrician & Gynaecologist (general OBGYN)
Dr. Azlina Firzah
Dr. Saladina Jaszle
Ms. Lactation Nurse
Breast Lactation Consultant