Here's how to handle common challenges experienced in the early days of breastfeeding.
Baby spluttering at the breast
Some moms have milk that lets down really fast or flows so quickly that baby gags on it, brings up lots after feeds and may even do frothy green nappies. Lean back, propped on pillows with your baby’s head at your breasts, tummy against tummy and legs pointing to yours. This position helps your flow slow down a bit. Some mothers find that when baby comes off the first breast, they offer that same breast again for two or three feeds, before using the other breast for a few feeds. This can be particularly helpful in the early morning hours. This helps milk supply adjust down to what baby needs.
Baby falling asleep at the breast
Sometimes a newborn baby has a little suck and then falls asleep without actually getting the milk to let down. To keep baby interested at the breast, try breast compressions to keep the milk flowing. When the sound of swallowing stops, let go for a quick count of five and then compress again. When there is no more swallowing, swap to the other breast and repeat.
You can continue to swap from breast to breast like this (it’s called switch nursing) until there is no more swallowing. If baby is still not satisfied or sleeping, or is gaining weight very slowly, some of your own expressed milk could be offered by cup, spoon, syringe or eye dropper after a breastfeed. Some babies feed quite quickly, so if your baby only feeds for five or ten minutes, but you can hear swallowing and baby is de-latching or falling asleep satisfied and gaining weight well, then there is no need to do anything about this.
A full-term healthy baby needn’t be woken for feeds. If however, baby is jaundiced, premature, has low weight gain, insufficient wet and dirty nappies, and is going past three hours without a feed – then offering a feed when he is in a light sleep can be helpful. It is easiest to wake baby when eyes are fluttering under the lids and arms are moving. A little milk squirted into the mouth can sometimes get baby interested too.
Baby feeding for a long time
Some babies feed quickly and some babies feed slowly. Both are quite normal. If a baby is only allowed to feed for a set number of minutes, it can lead to low weight gain and lowering milk supply, so it’s best to let baby feed as long (or short) as they want to.
How long they feed for really only tells you how fast your milk flows. If baby regularly feeds for more than an hour, breast compressions can help. If nappy output is low, expressing and supplementing with your own milk by dropper, spoon or cup can help. As baby gets bigger, they will suck more strongly and even a baby who fed for 45 minutes will feed much more quickly. Their little mouths get bigger, making feeding faster.
Sore nipples are not a normal part of breastfeeding; it means that there is a problem. In the first few days, nipples can be a bit tender, and the start of feeds can be uncomfortable as the tissue stretches, but if it is toe-curlingly sore or goes on longer or your nipples crack – something needs fixing. Your baby’s mouth might not be open wide enough so the nipple is not far back enough in the mouth, or perhaps you need more cushions to prop your baby into a more comfortable position so that he is close enough.
In rare cases, baby could have a tongue tie or an upper lip tie. This comes right by itself over time, however, if it is causing a feeding problem, then, once your doctor has confirmed the problem, seeing an ENT for treatment can help. Some mothers may also get thrush on their breasts and in baby’s mouth which can be painful. A nurse can check for this and your GP can assist you with treatment.