Try as many moms might to breastfeed, there are various health concerns or challenges stemming from nursing that many women face. As International Board Certified Lactation Consultant (IBCLC) Freda Rosenfeld notes, many of these issues are related. In other words, if you experience something like cracked, sore nipples, treating it at its onset is even more important, as it could preempt further problems down the road. That said, here, some of the most common breastfeeding ailments and how to tackle them …
1. Mastitis
What it is: This inflammation of the breast is thought to be caused by infection. It typically causes a hard, red, tender, swollen area of one breast, and fever. Other symptoms include muscle aches and chills.
How to treat it: Conventionally treated with antibiotics, women who suspect they are suffering from mastitis should be diagnosed by their health care provider. "Even if a woman is being treated with antibiotics, I always recommend they continue nursing their baby and nursing often– especially on the infected side," says postpartum doula and co-founder of Baby Caravan Emily Crocker. "This can be super painful but the truth is that mastitis is usually being caused by a clogged duct, and the best way to unclog a duct is to latch that baby on and let her do her job." (Mastitis won't hurt the baby, however, it may reduce the milk supply in the affected breast.) Crocker also recommends warm showers (during which you can massage the breast), cold compresses in your bra, and rest. "Now your body is not only caring for all your infant's needs, but it’s also fighting off an infection, so make sure you are taking care of yourself as well as your baby," Crocker advises.
2. Fungal infection
What it is: A fungal infection, also called a yeast infection or thrush, can occur from an overgrowth of natural Candida bacteria in the body and form on your nipples or in your breast, because it thrives on milk. Antibiotic use, cracked nipples, adiabetics are known for having a propensity for yeast, due to their inability to digest sugars properly can all contribute to a fungal infection of the nipples.
How to treat it: "Before we run to treat yeast, we should make sure it is not bacterial, dry skin, or eczema, other things that could cause sore nipples," says Rosenfeld. If it is yeast and you are taking or were recently on antibiotics, most doctors will recommend taking probiotics to strike the right balance of healthy gut flora, notes Rosenfeld. Otherwise, antifungal creams (over-the-counter or prescription) are often the fix, however, proper diagnosis requires seeing your physician or lactation consultant.
3. Nipple color changes due to circulation
What it is: If you suffer from Raynaud's disease or have unusual cold sensitivity, you may develop a narrowing or constriction of the blood vessels of the nipple related to breastfeeding. "It's like your nipple falls asleep every time you feed, because the circulation is poor," explains Rosenfeld. This can lead to painful, whitened (blanched) nipples during, immediately after, and between feedings. Some women have a two-part color change (white and blue), while others experience a three-color change (white, blue, and red).
How to treat it: Avoiding cold and applying warm, dry compresses can increase circulation. Medication and supplements, like magnesium, can also improve blood flow, however, should not be used without supervision by a pediatrician, OB/GYN, midwife, or lactation consultant.
4. Clogged ducts
What it is: Clogged ducts can occur in the breast where the flow of milk is blocked, usually by clogs of skin cells and milk. When the milk duct fills and stretches, the surrounding breast tissue can become tender. You can recognize a clogged duct by a tender or reddened lump in the breast. This usually occurs in one breast, and develops gradually. The discomfort is generally mild.
How to treat it: Nursing from the affected side first may help to more fully empty that breast and begin the flow of milk. Positioning the infant with the nose pointed toward the plugged area may facilitate drainage of the affected area. To more fully empty the breast, "you want to nurse often on the side with the clogged duct, as well as take hot showers and massage the breast," recommends Crocker. "Also, it never hurts to get it checked out by your healthcare provider if you’re nervous your clogged duct might turn into mastitis. Better safe than sorry."
5. Cracked or bleeding nipples
What it is: Nipples may crack from improper latch or using a breast pump improperly.
How to treat it: "Cracked nipples need to treated immediately," says Rosenfeld. "That can be done with olive oil or other antibacterial creams if we feel the nipple is really cracked, and we want to prevent yeast. You also want to make sure the baby is draining the breast properly." Working with a lactation consultant can help you adjust ever so slightly or ensure you have the right size pump to prevent further discomfort.
6. Engorged breasts
What it is: Although it is normal for breasts to get fuller with milk, engorgement — caused by milk build-up — can cause breasts to become hard and painful. You may also notice breast swelling, tenderness, warmth, redness, throbbing, flattening of the nipple, or low-grade fever.
How to treat it: Although your baby and your body may work out engorgement on their own, it may also be a sign of a misguided latch, says Crocker. "If the baby is not latched on right, she is not draining the breast properly and engorgement can set in. If you are experiencing lots of pain, have your lactation consultant or health care provider come and check out your baby’s latch."
