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No matter your experience level with breastfeeding, there is always a learning curve. To help you stay ahead of that curve, we’ve put together some tips for ways to avoid some of the common breastfeeding mistakes that happen a lot with new moms.
If nursing hurts your nipples, it’s a sign that something is wrong and it should be addressed as soon as possible. “Breastfeeding is like any other normal body function, like going to the bathroom or breathing, and if any of those normal functions really, really hurt and you went to your doctor they would probably want to figure out why,” says international board–certified lactation consultant Ashley Pickett.
Nipple pain could be a sign that something is off with the latch, and can sometimes be fixed by addressing the angle you’re nursing at, or it could be caused by something like a tongue tie that may need to be released in order for the baby to nurse effectively. A lactation consultant can help you get to the bottom of it all.
If it’s your breast that hurts, not your nipple, you may be experiencing vasospasms, which feel like a throbbing, burning sensation in your breast. They are caused by a decrease of blood flow due to compression, thanks to a tight latch. When the blood flow returns after the baby is off the breast, the burning feeling starts up —it’s kind of like pins and needles.
Never ignore this pain, because the bad latch that causes it may mean your baby isn’t fully draining the milk from your breast, which could lead to blocked ducts and potentially mastitis, an infection in your breast. There is another potential outcome of a poor latch: Milk-flow issues. “The latch itself is kind of the key to unlocking that milk supply,” explains Pickett. “In those early days, when there’s tons of hormones working to help elevate milk supply, it’s not so much of a concern, but usually, what we’ll see is around two, three or four months, in that sort of range, what we call late-onset slow milk flow.” When a baby nurses effectively, it gives a signal to the nursing parent’s body that they need to make more milk. “If that signal’s not strong, and it’s not suggesting to the mom’s body to release a lot of oxytocin, which then causes a letdown, then those letdowns become shorter and fewer and farther in between—it can lead to a cycle for babies,” says Pickett. A lot of babies will start to come off the breasts during a feeding or be really fussy at the breast when the flow slows down. “If they come off and they’re not full, what we tend to see is babies who are not quite satisfied, and they’re fussy and they might not sleep as long,” she notes.
Nursing can take a lot out of you—literally. “To make breastmilk the body will take nutrients from the blood, the bones, the muscle, it’ll kind of steal from mom, and so the breastmilk ends up being fine but the mom might feel these nutrient deficiencies if she’s not replenishing well enough,” says Pickett. If you feel depleted in this way it can affect you physically and mentally. You may feel more tired, for example. Dehydration can also contribute to this. And particularly since your sleep is likely already taking a hit, avoiding doing anything that will contribute to exhaustion will make nursing a bit easier. But the reality is, taking care of a newborn doesn’t leave a lot of time for taking care of yourself, so as a safety net, Pickett recommends continuing to take prenatal vitamins as long as you’re breastfeeding to help keep your nutrition levels up.
“Quite often the tongue tie is dismissed as not being a tongue tie, or not being a real problem,” says Pickett. If you’re having breastfeeding problems and investigating your baby’s tongue, it’s important to look at the tongue’s upward mobility, not just how far it sticks out, says Pickett. “It’s the back end of the tongue that’s doing the majority of that work of breastfeeding. So no matter how far back the tie is, if it’s very restricted it can matter.”
Pickett explains that it’s beyond a lactation consultant’s scope of practice to diagnose a tongue tie, but they can help give you an idea of whether your baby may have one, and may suggest you get it assessed by a health-care provider who has experience diagnosing this. One potential sign of a tie she sees is how often they eat. “Tongue-tied babies feed in short amounts of time very frequently because they really can only get that initial letdown, and then they can’t get anymore.” She says this type of restriction may affect the milk supply, since a tongue tie can decrease the signal to the body to make more milk. “I always say to clients, it’s like me knocking at the door very lightly and you may or may not answer that door. But if I knock really hard, you’re going to hear me, you’re going to come answer it. And it’s the tongue that’s moving upwards that’s kind of doing the knocking.”
“There’s nothing wrong with putting a baby to sleep at the breast,” emphasizes Pickett. “But if that baby is being put to sleep at the breast and wakes up five minutes later upset, or has a restless sleep and wakes up a half hour later to eat again, there’s usually something we can do to improve that just by improving the efficiency of the breastfeed.”
A baby may fall asleep without being full because they’re not getting enough milk, and they check out because they’re putting out more energy than they’re getting in return, she explains.
And while a baby not getting full isn’t necessarily a breastfeeding problem unless the baby is not showing enough markers of good health, like gaining enough weight and doing enough pees or poos, says Pickett, learning how to make feeds more efficient and making sure your baby is full before falling asleep could make life easier for everyone, she notes. You’ll get a bit of a longer break, and your baby will feel satisfied. To check if your baby is full she recommends what she calls the put-down test. This is where you place them down without a swaddle or a pacifier, which can impact their ability to communicate to you that they’re hungry, after they’ve fallen asleep. If they start to squirm and squawk, pick them up and put them in an upright tummy to tummy position with you. They may burp, or settle in your arms because they need touch time, which is completely normal. But if they start to bob their head around and root for the breast, or suck on their hands, it means they’re still hungry.
A baby who’s nibbling a lot and has fluttery sucks isn’t giving your body the signal it needs to make milk. To get them drinking longer and having proper mouthfuls, where you see their chin pause, Pickett recommends you use breast compressions to keep your milk flowing, and switch to the other breast when they slow down so they continue to drink instead of nibbling and then falling asleep.
When you allow others to decide what your goals are, you can set yourself up for some serious disappointment.
“With breastfeeding and parenting we can look at intent over impact,” says Pickett. “And if it is your intent to do the best you can for your baby, it doesn’t matter what that looks like. If you’re doing your absolute best, if your goal was one thing and you couldn’t make that work, then we just shift our goals.”
And similarly, what some people may find manageable, others may find a challenge. So do what works best for your family. “With frequent feeds at night, some parents are just like ‘Alright, so we’ll bedshare and I won’t even notice how frequently my baby nurses, and that’s fine with me.’ Another mom might look at that situation and be like ‘I won’t even continue breastfeeding if I have to deal with that,’” says Pickett. “There’s no right or wrong. There’s no one way to do it.”