The sound of my newborn son's cries filled me with dread. Because I hated to get up at three in the morning? No? well, yes, but that wasn't the reason for my anxiety. His cries meant that he was hungry and my already sore breasts couldn't take any more. Nursing him nearly brought me to tears. What I was experiencing was not uncommon, nor was it particularly serious, but I still needed help to solve the problem.

Diane Sonntag

In The Complete Book of Breastfeeding, authors Marvin S. Eiger, MD, and Sally Wendkos Olds, say, "The three essential tools for successful breastfeeding are (1) knowing what to do, (2) feeling confident that you are doing the right thing for your baby and yourself, and (3) being determined to persist in the face of any minor setbacks that may come your way."

Those "minor setbacks" can come in many forms. They can complicate breastfeeding, making it challenging and even downright painful. Described below are some of those setbacks, as well as some ways to overcome them. You can succeed with -- and even enjoy -- breastfeeding.

Sore nipples
One of the most common breastfeeding troubles is sore nipples. Mild tenderness is normal, but cracked, red nipples are not. The best way to avoid sore nipples is to make sure that your baby is positioned correctly on the breast.

"You've heard the old real estate saying 'location, location, location?' With breastfeeding, it's 'position, position, position.' It's more important to prevent sore nipples than to treat them later."

Katy Lebbing, a lactation consultant and the manager of the La Leche League's Center for Breastfeeding Information, encourages mothers to try asymmetrical latching. "Aim a bit higher, toward the roof of your baby's mouth. You'll get a deeper latch that way."

If you do get sore nipples, try lanolin cream. It will soothe sore nipples, and it doesn't need to be wiped off before nursing. You can also express some of your breast milk and rub it onto your nipples. It has the same affect as the lanolin cream, and it's free.

Engorgement
Engorgement happens when the breasts become swollen, hard and tight. The nipples are often flat, which makes latching on more difficult. To avoid engorgement, feed your baby often, eight to 12 times in a 24-hour period.

To soothe engorged breasts, alternate between warm and cold compresses and wear a firm bra for support. Lebbing also recommends putting cabbage leaves on your breasts. "They conform to the shape of the breasts, and they have no weight, unlike a bag of frozen green beans."

Thrush
Thrush is a yeast infection caused by a fungus. Babies can get it in their mouths and nursing mothers can get it on their nipples. A baby with thrush may have white spots inside her mouth, and a mother may have crusty, sore nipples. It is easy to pass back and forth from mother to baby and both need to be treated with an antibiotic.

Michelle Carlson, a mom from St. Louis, Missouri, had repeated bouts of thrush while nursing her son, Eric. Doctors prescribed a variety of medications, but the thrush kept coming back. "I have very seriously considered abandoning breastfeeding because of all of it," says Carlson, "but the lactation nurse has been so supportive and encouraging that it has kept me going. I think about how healthy my son has been, other than the thrush, and that keeps me focused."

Mastitis
A breast infection called mastitis is another painful breastfeeding complication. Symptoms can come on suddenly and can include headache, flu-like feelings, engorgement of the breast, and fever. Mastitis does require medical attention, usually an antibiotic, but does not require you to discontinue breastfeeding. In fact, most infections will clear up faster if the mother continues to nurse frequently.

Stacy Timmons, a mom from Columbus, Ohio, experienced mastitis. "I did the hot and cold compresses, took Advil, massaged the area and nursed more often. This was all recommended by my lactation consultant." Check with your doctor for the best treatment options for you.

Clogged milk ducts
A clogged milk duct is exactly what it sounds like. A milk duct is blocked so that the milk cannot pass through, causing a small painful lump. If left untreated, this can lead to a breast infection. You need to get as much milk out of the affected breast as possible. Experts suggest you nurse for longer periods of time, or pump that breast after each feeding. Apply moist heat several times a day, and be sure that your bra is not too tight. This can put pressure on the milk ducts.

Address problems immediately
Olds encourages breastfeeding mothers to seek help for any problems right away. "Most of the difficulties happen during the first few weeks. Deal with them right away. People think it will get better on its own, but usually it doesn't."

Lactation consultants can be an invaluable tool to breastfeeding success. New moms need "the right support and the right information," says Olds. A good lactation consultant will provide both.

Lebbing urges expectant mothers to attend La Leche League meetings before the birth of their baby. There are classes available that teach mothers how to avoid problems and how to get off to a good start with nursing a baby.

Finding a breastfeeding-friendly doctor is also important. "Be an advocate for your baby and yourself," says Carlson. "If you are not getting the support and expertise you need, look elsewhere."PregnancyAndBaby.com


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