The Ultimate Breastfeeding Survival Guide

Breastfeeding: You’ve got questions? We have answers!  Latch, engorgement, clogged ducts, mastitis, milk supply, let down, Thrush, yes infections, baby biting, and more…

Breastmilk IS the perfect food for your baby.   Breastmilk is the gold standard for infant nutrition. The American Academy of Pediatrics recommends that babies breastfeed exclusively for the first 6 months (meaning only breastmilk and no formula, juice or even water), and up to at least the first year of life with combined foods.

Breastmilk is the perfect food for your baby’s digestive system, and has all of the nutrients, calories and fluids your baby needs to be healthy. The cells, hormones, and antibodies in breastmilk protect your baby from illness. Formula does not have the same substances to protect your baby from diseases and infections – you make your baby’s perfect food!

The first milk that comes in is called “colostrum” and is yellowish and thick. It is very rich in nutrients and has antibodies to protect your baby from illness. Colostrum changes into mature milk within one week of birth, which has the perfect amount of protein, water, fat, sugar and nutrients for your baby’s optimum health and growth.

 Health benefits to Mother and Baby

The health benefits to breastfed babies and breastfeeding mothers are seemingly endless. Some include:

Economic benefits.

You can save between $1200-$1500 by breastfeeding and by not buying infant formula in the first year alone. A study published in the journal Pediatrics estimated that if 90% of U.S. families followed guidelines to breastfeed exclusively for 6 months, the U.S. would annually save $13 billion from reduced medical and other costs – that’s 13 billion dollars!!! Studies also show that breastfed babies have 1/3 the medical expenses to that of formula fed babies.

First things, first - a proper latch is essential for successful (and painless) breastfeeding.

A good latch is critical for successful breastfeeding for your baby and for you. If your baby is bobbing his head, bringing his hand to his mouth or acting squirmy, he’s probably hungry. Don’t wait until your baby is crying to feed him. In order to help your baby latch on to your nipple, try to avoid giving your baby any pacifiers or artificial nipples.

Make sure you are in a comfortable position (if on a chair, use a stool for your feet, have water next to your chair, use a breastfeeding support pillow). Hold your baby skin-to-skin against your belly and support your baby’s head as he searches for your breast. In order to get a good latch, your nipple and areola need to go far back into your baby’s mouth.

Signs of a good latch include:

• It feels comfortable and does not hurt or pinch (if it hurts it’s a sign your baby may not be latched on properly).
• Your baby is relaxed and does not have to turn his or her head while drinking.
• Your nipple is deep in your baby’s mouth - make sure your baby sucks the areola (dark part around the nipple), not just the nipple as this could cause sore nipples.
• You hear or see your baby swallow.
• Your baby’s top and bottom lips should be turned out (“fishlips”). Use your index finger to pull out his lip if necessary.
• Your baby’s chin indents your breast.
• You can see your baby’s ears wiggle.

 If you do not have a good latch, gently put your finger between your baby’s mouth and your nipple to break the seal, and then try again. 

Prevention and Treatment of Breastfeeding Pain and Conditions

Breastfeeding can be the most beautiful and rewarding experience for both you and your baby. Don’t let breastfeeding pain derail your breastfeeding goals or enjoyment. Take comfort in knowing there are simple ways to relieve your pain and treat your conditions. Here are some tips to deal with common and painful breastfeeding conditions.

Generally: A good latch is one of the most important ways to help avoid common and painful breastfeeding conditions. Proper positioning helps ensure that your baby drains the milk from all areas of the breast equally. Don’t skip feedings and don’t allow yourself to become engorged. Drink plenty of water and get as much rest as you can (with a baby). Don't get discouraged! Just like anything worthwhile, it may take some work and some time to get it right. If you are having trouble, call your doctor or a board certified lactation consultant in your area.

Engorgement.

What it is: Engorgement happens when your breasts become uncomfortably full, or “engorged” with milk from missed feedings, or fewer feedings.

What to do: Engorgement is best managed by frequent nursing, and moist heat applications to the breast just before nursing, and cool compresses applied to your breasts after nursing and between feedings to alleviate swelling, congestion and pain. Moist-heat compresses, especially before feeding, helps to increase circulation and bring the hormone oxytocin (the “Love” hormone) to trigger milk let-down, which will provide relief of uncomfortable engorgement.

Click here to see how Rachel's Remedy can help!

Unrelieved engorgement can be a precursor to clogged ducts and mastitis, so be careful not to allow engorgement to persist or long intervals to elapse between feedings.

If you are weaning, use the cold compresses rather than warm so you do not increase your milk-flow or encourage additional let-down.

Clogged/Plugged Ducts

What it is: Milk flows through milk ducts in your breast and out the nipple. One of those ducts becomes clogged if milk builds up and forms a blockage. A clogged or plugged milk duct can be very painful and should be treated immediately as it can develop into mastitis. Clogged ducts can be caused by inadequate draining of the breast, engorgement, skipping feedings or change in your feeding schedule, improper latch or positioning, or wearing clothes or bras that are too tight.

Symptoms: A tender lump or pain in one area of your breast that may or may not hurt when you touch it or when your baby nurses.

What to do: 

• Nurse often. It is important to continue nursing even when it hurts, and to make sure to drain your breast as much as possible each time you pump or nurse. When you begin nursing, begin on the side that has the clog first to ensure the most drainage. 
• Apply moist heat to the affected breast before you nurse or pump and between feeding. Moist heat promotes drainage and relief of clogged ducts. Our Breast Relief Packs are the only wearable solution to apply moist heat so you can be hands free and your clothes stay dry.
• Gently massage your breast beginning on the outside and working your way toward your nipple. 
• If you have a fever and/or flu-like symptoms, or the lump increases in size or redness, see your doctor. 

 Milk Blebs/Blisters

What it is: A blockage of milk that builds up at the nipple is called a “milk bleb” or “milk blister.” A nipple pore that is blocked by milk causes the bleb. If the bleb blocks the flow of milk completely, a plugged duct or mastitis can result. A milk bleb looks like a tiny white shiny bump or dot on the nipple, and can cause severe pinpoint pain when your baby feeds or when you pump.

Symptoms: Very severe pinpoint pain on the nipple that looks like a white dot.

What to do:   

• Nurse Frequently.
• Apply moist-heat before each feeding and between feedings to soften the bleb. Check out Rachel's Remedy for the easiest and only FDA-cleared way to apply moist heat - click here.
• After you apply moist heat, gently rub the surface of the nipple with a warm cloth to open or loosen the bleb.
• Breastfeed or pump right after you apply the moist heat and again, rub the nipple with a warm cloth.

Mastitis (also known as the “boob flu”)

What it is: Mastitis is a painful inflammation of the breast. If your mastitis is due to an infection, it can produce generalized aches, swelling, burning, redness, pain, flu-like symptoms and may require antibiotics. If you have any of these symptoms, you should call your doctor immediately. Mastitis can occur anytime during lactation, and is most common during the first 3 months of breastfeeding.

Mastitis may be caused by bacteria, poor latch, restriction from a tight bra or baby carrier, use of a manual breast pump, a clogged duct, missed feeding(s), not fully draining the breast during feedings or while pumping, engorgement, exhaustion, and cracked or sore nipples.

What to do: If you are experiencing flu-like symptoms, or have a lump that increases in size or redness, or you develop a fever, see your doctor immediately because antibiotics may be necessary to treat infective mastitis. Moist-heat compresses should be applied for 20-minute intervals, 4-8 times per day, and before feedings.

Non-infective mastitis can be treated by:

• Moist heat compresses, applied for 20 minute intervals, 4-8 times per day. Rachel's Remedy can help! Click here for the easiest way to apply moist heat.
• Frequent breastfeeding with full breast drainage. Moist-heat compresses should be applied before feedings and can help drain the milk, whereas cold compresses may be applied after feedings to help relieve pain.
• Drink plenty of water and get as much rest as you are able.

 Nipple Pain, Vasospasm and Raynaud’s Phenomenon

Nipple pain can range from an uncomfortable feeling to severe pain with cracked, sore or bleeding nipples. Moist-heat compresses are a very effective way to minimize nipple pain. Moist-heat compresses have been shown to be effective in treating sore nipples and superior in reducing pain, compared with the use of lanolin or dried breast milk. Click here for the easiest and most effective moist heat available.

Raynaud’s Phenomenon of the nipple - vasospasms that cause extreme pain, burning, numbness, throbbing, prickliness or stinging. Immediately after nursing, your nipple may appear white and the burning and other pain may also begin. A vasospasm is a constriction of the blood vessels in the nipple that can be triggered by a shallow latch, exposure of the nipple to cold temperatures (even just the nipple being exposed to the cooler air after the baby finishes nursing), nipple cracks or trauma and certain medications can trigger a vasospasm. The pain may be felt right after breastfeeding or between feedings.

What to do:   

• Keep warm – cover your breasts and avoid exposure of your nipple to cold.
• Moist-heat compresses – but when removing, dry nipples completely. Click here for the most effective and the easiest way to apply moist heat.
• Don’t smoke – nicotine can increase episodes of vasospasm.
• Work on a better latch.

Breastfeeding women can develop a yeast infection in their breast which can be passed back and forth between mom and baby. It’s called thrush when it occurs in the mouth and a yeast infection when it occurs in the breast. Candida, also called yeast, is a fungus that occurs naturally in the mucous membranes and on the skin. An overgrowth of yeast can cause an infection. Don’t let a yeast infection go untreated, as both mom and baby must be treated to prevent reinfection.  Yeast infections may lead to plugged ducts and mastitis.

Risk factors for yeast infections:

• Antibiotics (causes yeast to multiply);
• Vaginal yeast infection in the mother during pregnancy;
• Diabetes in the mother;
• Anemia in the mother;
• Cracked nipples make mother and your baby more at risk for developing a yeast infection;
• Damp nursing pads or bras;
• Plastic lined nursing pads – they prevent air flow to the nipple area.

Symptoms in the mom:

• Red, pink and sore nipple;
• Sharp, burning pain in the nipple and shooting pain deep in the breast;
• Severe stinging;
• Severe burning ;
• Cracked nipples;
• Nipples that are itchy or burning;
• Shooting pain in the breast during or after a feeding (yeast most is in the milk ducts);
• Nipple or breast pain with correct use of a pump.

Symptoms in baby:

• Thrush appears as white spots or patches in the baby’s mouth;
• Diaper rash;
• Nursing may be uncomfortable for the baby and he may pull off the breast or refuse to nurse;
• Excessive gassiness; and,
• Thrush can also be symptomless.

What to do for mom:

• See your doctor and strictly follow her recommended course of treatment
• Wash hands often;
• Nurse frequently for shorter amounts of time;
• Eat yogurt;
• Rinse nipples after nursing and air dry well;
• After feeding apply antifungal cream (if recommended by your doctor);
• Change nursing pads at each feeding and keep nipples as dry as possible;
• Watch your sugar intake – yeast feeds on sugar;
• Your doctor may prescribe an antifungal medication like Diflucan (fluconazole) which can be very effective;
• Violet on your nipples (if recommended by your doctor); and
• Feed baby with expressed milk – freezing the milk will not kill the yeast.
• Use our Antimicrobial Nursing Pads with silver ions that help stop and prevent the growth of yeast.

What to do for thrush in baby’s mouth: 

• See your baby’s pediatrician and strictly follow her recommended course of treatment.
• She may prescribe nystatin drops;
• Boil any objects that go in baby’s mouth for 20 minutes.

Yeast is persistent so it’s very important to get a follow-up with your doctor even when you think the infection is gone.

 Mommas- if you are suffering with a yeast infection now, we are sorry and know how much pain you are having. You’re not alone and you and your baby will get better. Call your doctor asap if you haven’t already to get on that road to recovery. We’re here for you!

Dr. Brown’s Rachel’s Remedy Antimicrobial Breast pads have an antimicrobial finish that help eliminate and inhibit bacterial and microbial growth that is often found in warm, damp areas. You can get them here. 

Let-Down and Milk Supply. How Moist Heat Helps Increase Breastmilk Supply:

More milk, more milk, more milk! We know, most nursing moms want more milk. One of the most effective ways to increase milk supply is to breastfeed or pump often. You should aim to breastfeed or pump 8-10 times per day with a new baby, and be sure to completely empty the breast each time. Milk left in the breast is a signal telling your body to decrease milk production. But when you have slow let-down or low milk supply, maintaining breastfeeding can be hard or even seem impossible. Here’s where moist heat comes to save the day! (Buy Rachel's Remedy Breastfeeding Relief Packs here – the easiest and most effective way to apply moist heat!)

When it comes to resolving breastfeeding pain and discomfort, moist heat is a nursing mom’s best friend! It’s safe, natural, and most important -- it’s effective. If you’ve suffered from any of the problems above, chances are your OBGYN or International Board Certified Lactation Consultant (IBCLC) recommended you use moist heat to help resolve your problem, because it’s one of the most widely recommended remedies to help treat and prevent breastfeeding issues. Moist heat is a miracle for breastfeeding moms, and we have the research to back it up.

If you’re wondering how and why moist heat is so effective at battling these common breastfeeding problems and increasing milk supply, the science behind it is quite simple. Heat improves blood circulation because heat prompts blood to rise to the surface of the skin. Stronger circulation means more oxygen and nutrients are being delivered to the targeted area, and heat also helps relax veins and arteries to reduce or prevent constriction. Moist heat is especially effective because the moisture allows heat to penetrate the skin on a deeper level and more quickly than dry heat alone. If you’ve ever dealt with any breastfeeding discomforts, you know you want relief delivered as quickly and easily as possible!

When it comes to breastfeeding, moist heat does more than improve circulation. Research shows that moist heat enhances the body’s natural let-down reflex by helping to increase circulation and stimulate oxytocin, the hormone responsible for the let-down reflex. This means your body will respond to your baby sucking more quickly, and the milk will flow more freely. So, if delayed or slow let-down is a problem for you, moist heat application right before breastfeeding can help. Rachel’s Remedy to the rescue – this is the most effective way to get moist heat and the only wearable moist heat available.

Many of the other common breastfeeding issues listed above can impact milk supply, and moist heat helps resolve those as well. Studies focusing on engorgement have found that applying moist heat to engorged breasts before breastfeeding helps increase circulation and soften the breast, allowing babies to latch more easily and empty the breast more thoroughly. Similar studies show how moist heat application helps prevent and resolve clogged ducts, as well as prevent and relieve mastitis by helping milk ducts relax, allowing clogs to clear. Clogs are unlikely to appear if moist heat is applied regularly, so if you’re prone to mastitis or clogs, moist heat application should be part of your daily routine for as long as you are breastfeeding.

As for painful milk blisters - while they can take weeks to go away on their own, using moist heat softens the blisters, helping them to clear much more quickly. Also, moist heat soothes the pain caused by milk blisters, helping moms continue to breastfeed even when a blister is present.

For some moms, low milk supply is your only issue. Moist heat helps increase milk supply, too. Studies have shown that there is a significantly greater amount of milk produced with moist heat applied prior to breastfeeding or pumping versus not using moist heat. The reason for this is that moist heat increases circulation and improves vascular tone (meaning it allows the milk ducts to open rather than constrict). Additionally, because moist heat stimulates oxytocin, milk is able to flow more easily. Moms concerned with low milk supply will certainly benefit from moist heat. Get it here and start increasing your milk supply!

With Rachel’s Remedy Breastfeeding Relief Packs, there is a simple, natural and effective way for you to improve their milk supply and resolve breastfeeding discomforts so that you no longer have to worry whether your baby is getting enough food, and you do not have to resort to supplementation if you prefer to exclusively breastfeed. Rachel’s Remedy Breastfeeding Relief Packs are the only FDA-cleared moist heat/cooling relief pack that fits right into any bra, stays warm for 20-minutes, and best of all - they are hands-free and keep clothing dry so that you can treat your conditions and improve your milk supply without having to stop your life.

Baby Biting.

OUCH. We so feel your pain. When you’re breastfeeding and your baby is biting, nothing about it feels like a “baby” bite. It definitely feels more like your nipple is caught in a car door and the rest of your body is about 100 feet away. You want to keep breastfeeding but don’t want the baby bites, so what can you do? Fortunately, all babies, no matter how old, can learn not to bite during breastfeeding. Nursing can and should continue when your baby gets teeth! If your baby is nursing properly, then you should not feel teeth, even if baby has all of his teeth.

Most babies try biting during the teething stage when they are around 6 months old. Teething hurts and chewing helps to relieve your baby’s pain, so basically your baby will chew on your shoe if you let him (we don’t recommend this). 

• Here’s the good news: Biting is temporary and can be stopped within a few days. A baby who is latched on and nursing properly cannot bite your nipple. If the nipple is positioned far back in his mouth, and his lips and gums are positioned about an inch behind the nipple on the areola, then his tongue will cover his gums, between his lower teeth and your breast. If he is actively nursing, he can’t bite – and if he is biting, he can’t be actively nursing at the same time.

Try these tips and the baby bites should stop for good:

• Biting at the end of a nursing session:- Biting is most common when your baby is full and loses interest in nursing toward the end of a session. WATCH for signs of boredom, and remove your baby from the breast before the biting starts – usually when the intensity of nursing slows down. Also, watch for tension in baby’s jaw before he starts to bite down. He may also pull his tongue back from it’s normal position over the lower gum/teeth.
• When baby is teething:Biting can also be brought on by teething. If baby seems to be teething rather than wanting to nurse, offer him a teething toy or something cold to bite (instead of you). Offer your baby a teething toy after he bites or tries to bite and say something like: “This is for biting. Do not bite me.”
• Test him out before nursing. Offer your baby a teething toy and see if he starts gnawing at it or sucking it. If he’s sucking it, he’s probably hungry.
• Make sure baby opens wide when latching on and use your pinky to help. Praise your baby when he latches on correctly, without biting.
• Distracted baby: When your baby is distracted, don’t force a nursing. If he’s wriggling, rolling, or pushing against you with his arms, he may not be hungry or interested in nursing. Try lying down with him in a quiet room, walking or rocking. Minimize distractions by dimming lights, turning off the TV, playing soothing music, or lying down in a quiet room.
• Biting for attention: Focus your attention on your baby while nursing if you’re having a problem with biting. Some older babies will bite for attention. Paying attention will also help you to be aware of when baby is about to bite. Maintain eye contact so you can see cues.
• Use positive reinforcement and praisefor good latch on and careful unlatching. Even the youngest babies can learn to nurse properly when mom uses gentle encouragement.

 If baby bites: Calmly remove him from the breast and say “no biting” in a calm voice and wait a few seconds or a few minutes and then try again (unless your baby doesn’t show interest in nursing). Whatever you do, do not yell. Some babies will be so scared they will go on a nursing strike, and others may continue to bite for the reaction because they want attention or think it’s funny. Usually his feelings will be hurt and negative reinforcement could cause bigger problems like refusing to nurse. This is very rare, but, if your baby bites down and doesn’t let go – Do not pull him off your breast. Quickly place your finger between baby’s gums so you can pull away without (more) pain.

As with any breastfeeding concern, be sure to consult your doctor or IBCLC, especially if you are experiencing a fever or you are concerned about your baby's health.

Copyright © 2018 by Rachel’s Remedies, LLC. All rights reserved.

Email: rachel@rachelsremedy.com

Sources:

Economic Benefits Sources: CDC; HealthyChildren.Org;  Bartick, et al. Pediatrics The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis 2010; 125;5 e1048-e 1056.

Engorgement Sources: Giugliani, E. Common problems during lactation and their management. J Pediatr (Rio J). 2004; 80(5 Suppl): S147-54.    Neifert, M., Seacat, J. Medical Management of Successful Breast-Feeding. Prevention in Primary Care, Pediatric Clinics of North America. 33(4) 1986, August. 743-63.   Resmy V, Nalini S.J., Sumathi, G. Effect of Lukewarm Water Compress On Prevention of Nipple Pain and Breast Engorgement Among Primiparous At A Selected Hospital In Chennai. Journal of Science. 2014. 4(10). 620-624.

Clogged/Plugged Ducts Sources: Walker, M. Conquering Common Breast-feeding Problems. J Perinat Neonat Nurs. 2008. 22(4). 267-274 Heller, M., Fullerton-Stone, H., Murase, J. Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers. International Journal of Dermatology. 2012. 51: 1149-1161 Healthychildren.org

Milk Blebs/Blister Sources: Walker, M. Conquering Common Breast-feeding Problems. J Perinat Neonat Nurs. 2008. 22(4). 267-274.   Heller, M., Fullerton-Stone, H., Murase, J. Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers. International Journal of Dermatology. 2012. 51: 1149-1161.

Mastitis Sources: Spencer, J. Management of Mastitis in Breastfeeding Women. American Academy of Family Physicians website. 2008, Sept. 15; 78(6).   Foxman, B D’Arcy, H, Gillespie, B., et al. Lactation Mastitis: Occurrence and Medical Management among 949 Breastfeeding Women in the United States. Am J Epidemiol. 2002 (155)(2): 103-114.    Strong, G. Provider Management and Support for Breastfeeding Pain.   JOGNN. 2011; 40, 753-764. Healthychildren.org

Let-Down and Milk flow Sources: Resmy V, Nalini S.J., Sumathi, G. Effect of Lukewarm Water Compress On Prevention of Nipple Pain and Breast Engorgement Among Primiparous At A Selected Hospital In Chennai. Journal of Science. 2014. 4(10). 620-624. Neifert, M., Seacat, J. Medical Management of Successful Breast-Feeding. Prevention in Primary Care, Pediatric Clinics of North America. 33(4) 1986, August. 743-63.

Nipple Pain, Vasospasm and Raynaud’s Phenomenon Sources: Resmy V, Nalini S.J., Sumathi, G. Effect of Lukewarm Water Compress On Prevention of Nipple Pain and Breast Engorgement Among Primiparous At A Selected Hospital In Chennai. Journal of Science. 2014. 4(10). 620-624.    Heller, M., Fullerton-Stone, H., Murase, J. Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers. International Journal of Dermatology. 2012. 51: 1149-1161. Walker, M. Conquering Common Breast-feeding Problems. J Perinat Neonat Nurs. 2008. 22(4). 267-274.

https://intermountainhealthcare.org/ext/Dcmnt?ncid=520697949
http://health.utah.gov/mihp/pregnancy/preged/afterpreg/milksupply.htm
https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Engorgement.aspx
http://www.nursingmothers.org/html/supply.html 
Neifert, M., Seacat, J. Medical Management of Successful Breast-Feeding. Prevention in Primary Care, Pediatric Clinics of North America. 33(4) 1986, August. 743-63.
Resmy V, Nalini S.J., Sumathi, G. Effect of Lukewarm Water Compress On Prevention of
Nipple Pain and Breast Engorgement Among Primiparous At A Selected Hospital In Chennai.
Journal of Science. 2014. 4(10). 620-624.