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A blocked duct often feels like a painful lump. Generally speaking a blocked duct develops because of poor positioning and attachment or from pressure put on the breast.
Improve positioning and attachment and massage gently while feeding. Applying a warm flannel to the breast may help and try different feeding positions. Check for any tight clothing, bra or fingers on the breast while feeding. Ask your breastfeeding peer supporter to watch a full feed for tips on positioning and attachment. An untreated blocked duct can develop into Mastitis.
Mastitis and Breastfeeding
Mastitis means inflammation of the breast. The first sign of mastitis is a red, swollen, usually painful, area on the breast. The redness and swelling is not necessarily a sign of infection. Antibiotics may not be needed if self-help measures are started promptly.
You may get mastitis when milk leaks into breast tissue from a blocked duct. The body reacts in the same way as it does to an infection. This produces the inflammation (swelling) and redness.
DO NOT STOP BREASTFEEDING DURING MASTITIS as this can make mastitis much worse. Continuing to breastfeed will help you recover more quickly and will not harm your baby.
- Red area on part of the breast, which may be painful to touch
- A lumpy breast which feels hot to touch
- The whole breast aches and may become red
- Flu-like symptoms – aching, increased temperature, shivering, feeling tearful and tired – this can start suddenly and get worse very quickly
Prevention of Mastitis
- Try to avoid suddenly going longer between feeds – gradually cut down if possible
- Make sure your breasts do not become over full
- Avoid pressure on the breast from clothing and fingers
- Start self-help measures at the first sign of redness
Factors which make Mastitis more likely
- Difficulties with attaching your baby may mean your breast is not drained well
- Pressure on the breast from clothing, fingers, your bra during feeding
- A blocked duct
- Stress and tiredness
- Sudden changes in how often baby is feeding, leaving breasts feeling full
These will also help to clear blocked ducts and engorgement.
- Keep on breastfeeding even if you feel ill as this is the quickest way to recover and will not hurt your baby
- Feed your baby more frequently and/or express on the affected side
- Feed from the sore side first to drain it as thoroughly as possible
- Express gently after feeds, so that your breasts are drained as much as possible and keep expressing until you feel better
- Check your baby is well positioned and attached to your breast – have it checked by your midwife, health visitor or breastfeeding peer supporter
- Try feeding your baby in different positions(See Positioning and Attachment)
- Soften an engorged breast by expressing a little milk or running warm water over it, so baby is able to attach easier.
- Warmth on the breast may help aid comfort.
- A wide tooth comb may help if stroked over the red area and towards the nipple to help milk flow, or massage gently
- Check and remove any tight clothing or fingers on the breast
If you do not begin to feel better despite using self-help measures, especially if you start to feel worse, you should speak to your GP, midwife or health visitor as you may need to take antibiotics.
Click here for a link to the Breastfeeding Network’s information on Mastitis
Thrush and Breastfeeding
Thrush (Candida albicans) infection can affect a mother’s breast while she is Breastfeeding. Symptoms of thrush are a sudden start of breast and/or nipple pain in BOTH breasts after some weeks of pain free breastfeeding – pain is severe and can last for an hour after every breastfeed.
Signs of thrush in your baby
Creamy white patches in your baby’s mouth, on the tongue and may be far
back or in the cheeks. Patches do not rub off.
Baby’s tongue/lips may have a white gloss.
If you think you have thrush
Before treating either you or your baby you should ask the midwife, health visitor or breastfeeding peer supporter supporting you with breastfeeding to watch a full breastfeed from the moment the baby goes to the breast to the moment he/she comes away from the breast at the end of the feed. They need to look at your nipples at the end of the feed to look for change in colour and shape.
If your baby has a white tongue but you are not experiencing pain, be aware of the risk of thrush but do not treat either of you immediately. Some babies have white tongues in the first few weeks after birth or this may be associated with tongue tie where the milk is not thrown to the back of the mouth.
BREASTFEEDING SHOULD BE PAIN-FREE from the point of attachment onwards (Pain from thrush begins after a feed).
- Thrush can be passed between you and your baby – and also between you, your partner and other children.
- Anecdotally, some mothers find acidophilus capsules can help to restore bacteria which can keep thrush under control (available from health food stores or chemists).
- It is necessary to be very careful with hygiene in order to get rid of Thrush completely – be sure to wash your hands well after each nappy change.
- Use a separate towel for each person in the family.
- If used, change breast pads regularly
- Change your bra regularly and wash on high temperatures or iron if possible
- Anecdotally, some mothers find reducing the level of sugar and yeast in their diet helps.
- Ensure any teats and dummies that may be used are sterilised after every use and kept sterile until placed in your baby’s mouth.
IMPORTANT – Ask your midwife, health visitor or GP if you think you may have thrush. To make sure that you get rid of thrush infection, both you and your baby need treatment. Usually once treatment begins the pain and other symptoms will begin to improve within 2 or 3 days. It may take longer for full recovery.
Click here for a link to the Breastfeeding Network’s information on thrush.
What is a tongue tie?
The frenulum is a piece of skin/tissue that attaches the underside of the tongue to the bottom of the mouth. A tongue tie (also known as ankyloglossia) is where the frenulum is too short or too tight.
How common are tongue ties?
Tongue ties occur in about 1 in 20 babies.
What problems do tongue ties cause?
Most babies with a tongue tie will have no problems at all. They can feed perfectly well and maintain adequate weight gain. Some babies can have problems with breastfeeding and a few have difficulty bottle-feeding. Many parents worry that tongue ties will cause problems with speech later on in life but this is very rare.
Should my baby have his or her tongue tie treated?
If you are worried that a tongue tie might be affecting your baby’s feeding then you should see your midwife or health visitor for information and support. Most babies with a tongue tie do not need any treatment. Some tongue ties stretch over time and some are divided naturally by the baby while putting things in their mouth such as, toys or spoons. If you are experiencing problems with breastfeeding despite support around latch, pain or discomfort then dividing the tongue tie may help.
The National Institute for Health and Clinical Excellence (NICE) guidelines suggest that there is evidence to support dividing tongue ties in babies who are having problems with breast feeding. There is no research suggesting that babies with tongue ties who are bottle feeding will benefit from the procedure. Dividing a tongue tie in a baby carries a small risk of a painful ulcer under the tongue and a very small risk of bleeding that would have to be treated with an operation under general anaesthetic. It would be wrong to put a baby through the discomfort and risks of a tongue tie division where there is no evidence it would be helpful and for this reason we do not divide tongue ties in babies who are bottle fed.
How do I get my baby an appointment to have his or her tongue tie treated?
In babies (up to 6 months of age) it is possible to divide the tongue tie in the outpatients clinic at Sheffield Children’s hospital. A referral to the hospital is made via your midwife, health visitor or GP.
Weaning baby on to food
Most babies with a tongue tie will wean on to food with no problems
If the problems persist ……..
If your baby is not gaining weight adequately, then please see your GP, as there could be an underlying medical problem. If there are no medical problems and your baby is not putting on weight because of the tongue tie then ask for another appointment to consider tongue tie division; this is, however extremely rare.
If you experience problems when weaning your baby on to solids then referral to a speech and language therapist may be beneficial. Likewise, if you are worried about your child’s speech in the future, referral to a speech and language therapist before dividing the tongue tie is recommended. This is because it is extremely rare for tongue ties to cause problems with speech and it is much more likely that there is a different cause of the speech problems.
Teeth and breastfeeding
Teething can make baby’s gums sore and swollen and feeding may change and he may begin to chew on the nipple to ease discomfort. This is often temporary and will pass and you do not need to stop breastfeeding. Many babies never attempt to bite and often those who try once usually respond to your startled reaction and do not bite again.
If your baby bites more than once, try to stay calm and try to not pull baby off the breast while he is clamping down as this will be painful and cause more damage to the nipple then the bite itself. Instead of pulling your baby off, try pulling your baby in as close as possible to your breast and this may cause him to release the nipple.
You could also try breaking the suction with your little finger to release the nipple and then firmly say “No”. Some mums want to take firm action after a bite and put baby down for a very short period. Trying different feeding positions sometimes help(See Positioning and Attachment)
Please remember your baby associates feeding with the comfort and security of being with you. He does not understand that putting his teeth on your nipple causes you pain. Babies do not bite out of “meanness”. He has to get use to breastfeeding with new teeth and sometimes learning is by trial and error!