Breast Care For The Breast Feeding Mother

WHAT YOU SHOULD KNOW:

Experts suggest that a woman breastfeed a newborn infant for his first six months of life, without giving other liquids or food. You should keep on breastfeeding after 6 months, even while having your baby try other foods and drinks. Breastfeeding your baby is healthy for you and your baby, now and in the future. Breast and nipple problems and certain conditions can make a woman not want to breastfeed as long as experts suggest. Caring for your breasts while breastfeeding your baby can help both you and your baby enjoy the benefits of breastfeeding.

INSTRUCTIONS:

Keep a current list of your medicines:

Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

Over-the-counter medicine:

Over-the-counter (OTC) medicines are the kind that you can buy without an order (prescription) from a caregiver. OTC medicine may be used for many reasons, such as decreasing pain or a high body temperature (fever). These medicines are safe for most people to use and can help you feel better when used correctly. However, they can cause serious problems when they are not used correctly. People using certain other medicines or that have certain medical conditions are at a higher risk for problems. Using too much, or using these medicines for longer than the label says can also cause problems. Follow directions on the label carefully. If you have questions, talk to your caregiver.

Schedule and attend all follow-up visits with caregivers.

When you take your baby to a visit with his caregiver, or you see your caregiver, talk about breastfeeding problems that you are having. Caregivers may suggest that you, or you and your partner, attend classes on breastfeeding. You also may want to attend a breastfeeding support group. Ask caregivers for information about where to rent a breast pump, and if you should see a lactation consultant. This is a caregiver who can teach you more about breastfeeding. Ask your caregiver when and how often to schedule follow-up visits for yourself and your baby.

How to manage breast problems that can occur while breastfeeding:

• Nipple soreness: Many women have painful nipples when they begin to breastfeed a baby. A small amount of nipple pain is normal. Repositioning your baby and helping him latch on to your breast correctly may decrease or stop the pain in your nipples. Do not use nipple creams, ointments, or any other medicine or devices on your breasts or nipples unless your caregiver tells you to. Do not use a new kind of soap to wash your bra. Placing warm, wet compresses, tea bags, or breast milk on your nipples may help decrease pain. Ask your caregiver for more information about breastfeeding and nipple soreness.
  
  
• Engorgement:
  
  
  • Your breasts may grow swollen and painful as your milk comes in soon after you begin breastfeeding. This is called engorgement. Feeding your baby often and emptying your breasts is the best way to decrease engorgement symptoms. Feeding your baby when he shows signs of being hungry instead of feeding him on a set schedule can help prevent engorgement. Massaging your breasts or expressing some milk by hand may decrease your discomfort.
    
    
  • Your caregiver may suggest medicine to decrease pain or swelling. Cabbage leaves placed on your breasts may also decrease your symptoms. Cold compresses or gel packs may help you feel better. Breast redness, pain, and a fever (high body temperature) are signs that engorgement is getting worse. If engorgement worsens and is not treated, your baby may not get enough milk, and your nipples may be damaged.
  
  
• Plugged milk ducts: Plugged ducts cause painful breast lumps. Plugged ducts can be caused by not emptying your breasts fully. To prevent plugged ducts, empty your breasts through breastfeeding or using a breast pump at each feeding. Do not wear underwire bras or tight clothing over your breasts. Find ways to manage stress, and try to get enough sleep. Drink plenty of fluids. Ask your caregiver about diet changes that can decrease your risk of getting plugged milk ducts. Changes may include avoiding high-fat dairy products, or adding a diet supplement. To help avoid plugged ducts as you are weaning your baby, slowly increase the time between feedings. You can stop breastfeeding and begin using a breast pump to drain your breasts instead. Feed breast milk to your baby using a bottle or a cup. Slowly increase the time between pumping your breasts.
  
  
• Breast infections:
  
  
  • Having plugged ducts or not emptying your breasts can lead to a breast infection called mastitis. With mastitis, your breasts grow red, swollen, and painful. Treatment includes emptying your breasts fully and often by breastfeeding or using a breast pump. When your baby pauses while breastfeeding, massage and gently squeeze your breast. Gentle massage may unplug a blocked milk duct. Pump out the milk left in your breasts after your baby is done breastfeeding. Ask your caregiver about feeding your baby when you have a breast infection.
    
    
  • Using heat on your breasts may decrease the pain. You may want to place a moist, warm cloth on the painful breast or both of your breasts. Ask your caregiver how often to do this. Your caregiver may suggest anti-inflammatory medicine to decrease pain and swelling. Your caregiver may order antibiotics (germ-killing medicine) to treat mastitis. Getting enough rest and sleep and drinking more liquids can also help.

Tips to help make breastfeeding a good experience:

• Work with your caregiver to learn how your baby should be latched on to your breast, and how to hold him while he is breastfeeding. A correct latch helps prevent sore nipples and other breast problems. If your baby is attached correctly, he will pull your breast deep in his mouth. He will not only be attached to your nipple. Your baby is latched on well if you feel comfortable, your nipples and breasts are not painful, and your nipple is the same shape as it was before breastfeeding. If you have flat or inverted nipples, ask caregivers for help to position and help your baby latch on to breastfeed.
  
  
• Feed your baby 8 to 12 times a day. You may need to wake your baby up at night to feed him. It is okay to feed from one or from both breasts at each feeding. Your baby should breastfeed from both breasts equally over the course of a day. If your baby only feeds from one side during a feeding, offer your other breast to him first for the next feeding. Fully draining your breasts by breastfeeding and using a breast pump helps your body make more milk.
  
  
• Prevent biting. When your baby gets teeth, which might be at about 3 to 4 months of age, you may worry that he will bite you while breastfeeding. To help avoid biting, when your baby is finished draining your breast during a feeding, do not let him keep sucking. Take him off of your breast when he's finished or if he has fallen asleep. If your older baby bites you, respond with surprise or unhappiness. Offer praise when he does not bite you.
  
  
• Stop smoking. It is never too late to quit smoking. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. If you smoke, avoid smoking while breastfeeding. Smoking can decrease your milk supply. Do not let anyone smoke around your child. Your child is more likely to get ill if he breathes in cigarette smoke. Being around cigarette smoke can affect your child’s lungs and cause breathing problems.
  
  
• Talk to your caregiver if you drink alcohol. If you choose to drink alcohol, breastfeed your baby before you drink it. Do not breastfeed your baby for at least 2 to 2 ½ hours after having one drink. One drink of alcohol is 12 ounces of beer or four ounces of wine. One ounce of liquor, such as whiskey, is one drink of alcohol.
  
  
• Eat a healthy diet. Eat a variety of healthy foods from all the food groups every day. Ask your caregiver for more information on breastfeeding and your diet.
  
  
• Talk to your caregiver about breast exams and tests. Your risk of getting breast cancer decreases if you breastfeed. Mammograms and other breast cancer screening exams and tests can be done even if you are breastfeeding your baby. Ask your caregiver for more information, as well as when and how often to have these exams and tests.

What to know about breastfeeding and contraception:

• Breastfeeding delays the return of monthly menstrual periods after having a baby. Not having a monthly menstrual period makes it less likely that you will get pregnant, but it is still possible. If you do not want to get pregnant right away, do not wait until your periods begin again to start using contraception. Contraceptive methods are ways to help prevent pregnancy. Some methods are intrauterine devices (IUD), condoms and spermicides, female or male sterilization, birth control medicine, and the lactation amenorrhea method (LAM). With LAM, your risk of getting pregnant is low if you are within the first six months of giving birth and your periods have not returned. For LAM to help prevent pregnancy, you must be breastfeeding your baby only, without using infant formula.
  
  
• Some methods of contraception can be started right after or very soon after having a baby. Other methods must be started later. When deciding on a method of contraception, talk to your caregiver about your thoughts and feelings. Also talk about your plans, such as returning to work. Tell caregivers about your breastfeeding and sexual activity patterns. To prevent pregnancy, you must remember to use the method that you select, and to always use it correctly. After selecting and starting a method, see your caregiver and tell him about any side effects or problems. Tell him if you want to use a different contraceptive method. Ask your caregiver for more information about contraceptive methods that may work for you.

CONTACT A CAREGIVER IF:

• One or both of your breasts is red, swollen or hard, painful, and feels warm or hot.
  
  
• Your symptoms, such as breast pain and swelling, are getting worse, even with treatment.
  
  
• Your signs and symptoms of engorgement are not getting better within 24 hours.
  
  
• You see or feel a lump in your breast. The lump may be tender (painful when touched).
  
  
• You have nipple pain while feeding or between feedings. Your nipples may look red, dry, and cracked or bleeding. They may have scabs on them.
  
  
• You feel you are not making enough breast milk for your baby.
  
  
• Your milk has not come in within five days of giving birth. Your milk has come in if your breasts feel full or swollen. Your breasts may also be leaking milk.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.