Breastfeeding

Sore nipples

Nipple soreness and damage is often a result of your baby not being attached well to the breast. It is important to seek advice and guidance about correcting the problem so that breastfeeding becomes pain-free and comfortable. Advice can be sourced from the Extended Lactation Care Service. If your nipples do become sore, express some milk onto the nipple after feeds and allow them to air dry.

For further information, please click here.

Blocked ducts

A blocked milk duct can occur if the milk flow is restricted in some way. This may be due to the baby not draining the breast well, a sudden reduction in feeding frequency or a restrictive tight bra. If you have a blocked duct, you will notice a sore area of your breast that has a hard lump. It is very important to clear the blockage so mastitis doesn’t occur.

In order to do so, follow these steps:

• Gently massage the breast in long strokes toward the nipple then walk your fingers back up the breast while you are feeding your baby.
• Offer the affected breast twice each feed to the baby to help drain the breast well
• Apply a cold pack after the feed to help reduce any inflammation
• Offer this breast first at each feed until the blockage clears
• Try hand expressing in the shower or bath if not resolving

If you begin to feel unwell with a high temperature and flu-like symptoms, mastitis may be developing and you need to seek medical attention.

Mastitis

Mastitis is an inflammation of the breast that may be due to a blocked duct or an infection. You will usually have a reddened area on your breast, which will be painful. Treatment is the same as for a blocked duct and your doctor may also prescribe antibiotics if you have an infection. You may wish to take simple pain relief such as paracetamol or an anti-inflammatory (e.g. Ibuprofen). If your baby is reluctant to feed or it is too painful, express often to keep the breast well drained. It is very important that you do not wean at this time. 

Click here to read more about mastitis.

Low supply

Many mothers have times when they feel their breast milk supply is not enough. It is one of the most common reasons for early weaning. Feel confident that your body can make enough milk for your baby. Remember that supply equals demand, so if you swap breastfeeds with formula, your breasts will make less milk. If you feel your milk supply is low, you can increase your milk supply by:

• Offering extra breastfeeds
• Making sure your attachment and positioning of the baby is correct
• Having extra rest and looking after yourself for a few days
• Expressing half an hour after breastfeeds. This will provide extra messages to your breasts so they will produce more milk and also provide some extra breastmilk for your baby if they are not content after feeds or will not have extra feeds

If the above measures do not result in your supply being enough for your baby’s needs, seek professional guidance.

For further information, please click here.

Difficulty attaching

Breastfeeding is a learned skill for you and your baby and it is common for women to have difficulty attaching, particularly when breastfeeding for the first time. 

It takes plenty of practice and patience. Be reassured that often this becomes easier with assistance and time, and there are many resources available to help. There is a great video on attachment available here.

For further information please click here and if further advice and assistance is required, please contact the Extended Lactation Care Service.

Medications and breastfeeding

Most medications are quite safe in breastfeeding mothers. The risks associated with not breastfeeding your baby and using infant formula instead, can be much higher for the infant. For accurate information speak to a pharmacist who is supportive of breastfeeding. 

Information can be obtained through:

• Pharmacy Department, University Hospital Geelong (03) 4215 1582 
• Monash Medical Centre Drug Information Line (03) 9594 2361
• Royal Women’s Hospital Drug Information Line (03) 8345 3190

Tongue tie

Tongue tie or ‘Ankyloglossia’ is when the thin piece of skin under the tongue (the lingual frenulum) is very short and restricts the movement of the tongue. Tongue ties are present at birth and can range from mild to severe. Approximately 5% of babies are born with a tongue tie. Researchers, health professionals and doctors are divided as to whether or not tongue ties cause enough problems to warrant intervention. What is agreed, is that each case should be assessed individually.

NB Please be aware that there is an increasing trend to diagnose “upper lip ties” and “posterior tongue tie” without full assessment of a feed leading to referrals for babies to undergo relatively expensive, and sometimes, unnecessary treatments such as laser surgery.  There is little evidence to support the validity of these diagnoses or their requiring invasive treatment. General Paediatric consensus is that such anatomical variation is not pathological and generally does not warrant such invasive intervention.

What are the symptoms of tongue tie?

A tongue tie may not always be obvious and symptoms will depend on severity. Features of tongue tie can include:

• Inability to poke the tongue out past the lips.
• Inability to touch the tongue tip to the roof of the mouth.
• A flat, square, notched or ‘heart-shaped’ tongue tip.
• Difficulties moving the tongue into the corners of the mouth.
• Feeding difficulties.

1. If your baby is not having any difficulties breastfeeding, is gaining weight well and your nipples are pain-free during and after feeding it is unlikely that your baby has a tongue tie

Treatment

If a tongue tie is suspected a thorough examination needs to be completed. If it is within the first 6 weeks of age a Lactation consultant is available through University Hospital Geelong to assess the tongue and assist with any feeding difficulties you may be having. For older babies, a thorough assessment should be completed by a Paediatrician.

When a tongue tie is diagnosed a frenotomy (cutting of the frenulum) may be suggested. This is carried out by a doctor and is a very quick and easy procedure. Once the frenulum has been cut, the tongue will no longer be ‘anchored’ to the bottom of the mouth and is free to increase its range of movement.

It is possible that treatment is not considered necessary because as the mouth grows the frenulum can stretch and loosen, thereby giving the tongue more freedom of movement. In this instance, no direct intervention is required unless problems continue.

Symptoms in older children

These may include;

• Difficulties with the control of food, drink and saliva in the mouth.
• Problems with speech sound development.
• Poor oral hygiene and dental decay can occur if the tongue cannot clear away leftover bits of food in the mouth.

If these symptoms are present please make an appointment to follow up with your GP

Where can I get more information?

• Raising Children Network
• Australian Breastfeeding Association
• Better Health Channel
• Royal Children’s Hospital
• Speech Pathology Australia fact sheets

Alcohol

There is no safe level of alcohol intake for breastfeeding so avoiding alcohol is the safest option. Alcohol is passed through to breast milk and may reduce the supply or cause poor feeding and sleep disturbance to your baby. It is recommended that mothers avoid alcohol when breastfeeding.

For more information, please click here.