When breastfeeding isn't working

Breastfeeding is one of the most natural things in the world, but it isn't necessarily the easiest. Most mothers are aware of minor and major problems that can arise when breastfeeding.

Breast engorgement

If several milk ducts are not drained properly or if the mother is stressed, this can lead to breast engorgement. Milk accumulates in one part of the breast, which then becomes hard, inflamed and sensitive to the touch. With this breastfeeding problem it is important to keep calm and try to relax. Feed your baby more frequently (approx. every 1.5 to 2 hours) and try different positions. It is also helpful to warm the breast before breastfeeding and cool it afterwards. If the symptoms mentioned above become more severe or if a fever develops, you should contact your midwife, a breastfeeding counsellor or a gynaecologist as soon as possible. Severe inflammation of the breast (mastitis) may mean that you have to stop breastfeeding completely.

Sore nipples

Almost all mothers experience sore nipples, especially when they first start breastfeeding. The baby has to learn how to suck on the breast. Correct positioning is also very important. It is helpful if the midwife shows mothers right from the start how to attach their baby properly in different positions. Above all, try to find a position in which you are relaxed and comfortable, so that the milk flows more easily and the baby can suck on the whole nipple rather than just the tip.

Important: Recurrent soreness may indicate a fungal infection. In this case the nipples are often red and shiny and may be itchy. The mucous membranes on the inside of the baby's cheeks may also show signs of a whitish coating which cannot be wiped away.

Too much or too little milk

After childbirth the breasts are full and tender before breastfeeding or expressing, as the body still needs to find out how much milk it should be producing. If after about eight weeks you feel that the breasts are still full and you are perhaps suffering from milk leaking, it may well be the case that you have too much milk. Some women alleviate this by using a breast pump to express the excess milk; others prefer to express the milk by hand. Nursing pads can be useful for absorbing leaking milk.

If you feel your baby is not getting enough milk, you should attach your baby frequently, including at night. After a few days the breast should have adapted to the increased demand for breast milk and the baby should start to gain weight.

One relatively simple way of checking how much milk the baby has actually had is to weigh the baby – clothed and with nappy on – before and after breastfeeding. The difference in grams is the amount drunk in millilitres (irrespective of whether the nappy has become wet or dirty in the meantime).