Breastfeeding: Common Challenges and Effective Solutions for Mothers

Many mothers face challenges that hinder breastfeeding, such as cracked nipples, low milk supply, and difficulty for the baby to latch onto the breast. In this article, we review the main difficulties a mother may face during breastfeeding and provide practical solutions to overcome them, ensuring the continuation of this process correctly and maintaining the health of both the mother and child.

Main Reasons Preventing Mothers from Breastfeeding

Breastfeeding faces some barriers that can be either external, related to the child or the surrounding environment, or internal, related to the mother, or both. A major barrier preventing breastfeeding in mothers is their reluctance due to rumors about breastfeeding. This is a simple issue that can be addressed by understanding the mother's beliefs about breastfeeding and educating her accordingly, which can be done by lactation educators or consultants.

External Factors Hindering Continued Breastfeeding

1. Influence of Traditions and Customs on Mothers' Breastfeeding Decisions
In some societies, breast feeding is seen as healthily beneficial, but it might not be welcomed in public places. Some mothers may feel uncomfortable breastfeeding in front of others due to societal views, leading them to stop early or prefer formula milk.

2. Challenges Mothers Face in Hospitals Post-Childbirth
Breastfeeding usually begins in the hospital after delivery, but some hospitals do not encourage breastfeeding and provide formula milk to infants without medical necessity. Additionally, a mother might not find support from lactation specialists, making it difficult to handle the early days without assistance.

3. How Work Environment Affects Continued Breastfeeding
Some mothers are forced to return to work shortly after childbirth, making it challenging to continue breastfeeding. Furthermore, some workplaces do not provide suitable spaces for mothers to pump milk during work hours, reducing milk production and leading to early weaning.

4. The Role of Marketing Campaigns in Favoring Formula Over Natural Milk
Some companies promote formula milk as a good or even better alternative to breast milk, prompting some mothers to believe it's the easier option. In some hospitals, free formula milk samples are given to new mothers, making them rely on it instead of breastfeeding.

Reasons Affecting a Mother's Ability to Breastfeed and How to Overcome Them

Several factors can impact a mother's breastfeeding process, including:

● Chronic Diseases in the Mother: Diseases like kidney inflammation, HIV, alcohol or drug addiction, severe neurological diseases, and herpes simplex virus (HSV-1) sores require avoiding breastfeeding until active blisters disappear.

● Nipple Cracks and Inflammation: Blocked milk ducts can impede milk flow and cause pain or inflammation. Causes include short feeding periods, improper milk drainage, tissue damage, and bacterial entry through nipple cracks. To relieve pain, try improving milk drainage, correcting breastfeeding position, frequent feedings, wearing loose clothing, and massaging the nipple.

● Engorgement: Breast engorgement occurs due to fluid buildup, causing pain and swelling, and possibly difficulty in milk flow along with fever lasting up to 24 hours. To treat it, it's recommended to remove milk frequently using hand expression or a pump and start breastfeeding early while ensuring proper latch.

● Insufficient Milk Supply: Resulting from delayed breastfeeding start, lack of physical contact, health issues, or reduced feeding frequency. To increase it, focus on early breastfeeding, enhancing contact, seeking specialist support, and frequent breastfeeding while avoiding formula unless medically necessary.

Why Does a Baby Suddenly Reject Breastfeeding?

Sometimes a baby might refuse breastfeeding, but this doesn't mean they're ready for weaning; it could be a temporary phase. Reasons for refusal include:

Health Problems Causing the Baby to Refuse Breastfeeding:

● Nasal Congestion or Ear Pain: Breathing difficulties during feeding caused by nasal congestion or ear pain could lead to refusal.
● Sore Throat or Mouth: Pain from sore throat or mouth irritation can make breastfeeding uncomfortable for the baby.
● Teething: Gum pain from teething might lead to refusal.
● Gastroesophageal Reflux: Reflux can cause discomfort during feeding.
● Nipple Confusion: Difficulty distinguishing between breast nipples and bottle or pacifier nipples can cause refusal or difficulty in latching. This issue usually arises when the baby is introduced to artificial nipples early on, making adaptation to breastfeeding challenging.
● Infection: Conditions like ear infections or urinary tract infection can make breastfeeding painful.
● Vaccination Pain: Post-vaccination pain might result in refusal.

Psychological Factors Affecting Child’s Feeding

● Frustration from Low or Excessive Milk Supply: The baby might get frustrated if milk flow is too slow or fast.
● Startle During Feeding: Like hearing a loud noise or feeling the parent’s pain, which disturbs the child.
● Change in Mother’s Scent: Using a new perfume or deodorant may lead to refusal.
● Change in Milk Taste: Medication or hormonal changes can alter milk taste.
● Change in Feeding Pattern: Changing feeding times or introducing formula alongside breastfeeding.
● Separation Period: Returning to work or a separation phase might lead to refusal.

Some infants struggle to get milk from the breast despite its availability due to various reasons, such as:

● Weak latch or poor suckling ability, common in premature infants.
● Mixing formula and breastfeeding might get infants used to easy bottle milk flow, reducing their ability to suckle from the breast or preferring the bottle, known as nipple confusion.
● Health issues affecting the infant's ability to feed, like:
● Down Syndrome, where some infants experience muscle weakness, making breastfeeding harder.
● Tongue-Tie (Ankyloglossia), a condition limiting tongue movement due to a short or thick tissue band connecting the tongue’s underside to the mouth’s base, potentially hindering breastfeeding. The severity depends on tongue movement restriction, possibly hindering feeding and later causing eating or speech issues.
● Cleft Lip/Palate, congenital anomalies preventing proper mouth closure around the breast, making breastfeeding ineffective, potentially leading to poor growth and weight loss.
● Laryngomalacia, a congenital laxity in larynx tissues making them floppy during breathing, causing wheezing or stridor upon inhalation. Mild cases aren't a big concern, but severe instances can cause breathing and feeding issues, impacting nutrition.

Sometimes, the exact reason for a child’s breastfeeding refusal is unknown. If refusal persists, consulting a pediatrician or lactation consultant is recommended to ensure there are no health problems.

Handling Child’s Refusal to Breastfeed

Dealing with breastfeeding refusal can be distressing and uncomfortable for both you and your child. However, there are various steps and methods to resolve this issue, including:

● Minimizing Distractions: Try breastfeeding in a quiet room to reduce distractions.
● Changing Positions: If your child refuses the breast, try a comfortable feeding position, such as lying down on your back with the baby beside you.
● Bathing Together: Bathing together might help soothe your child and make them more ready to breastfeed.
● Feeding While Drowsy: Try feeding when your child is sleepy, as they may be more receptive to the breast.
● Applying Breast Milk to Lips: Putting some breast milk on your child's lips might encourage them to feed.
● Stimulating Milk Flow Before Feeding: Boosting milk flow before feeding can simplify the process for your child.
● Offering Small Milk Quantities by Other Means: Providing a small amount of milk in alternative ways before returning to the breast can reduce hunger and make the child more willing to feed.
● Offering Frozen Breast Milk Pops: If your child is teething or has mouth pain, frozen breast milk pops can help soothe them.
● Reducing Pressure: If you feel pressured, try different feeding methods along with spending skin-to-skin time with your child.
● Providing Pain Relievers: If your child is in pain, appropriate pain relief before feeding might help.
● Consulting a Doctor: If you suspect illness, consult a pediatrician to ensure your child's health.

Best Milk Pumping and Storage Methods for Ensuring Child Nutrition

Mothers often resort to pumping breast milk for use in breastfeeding or alternating with formula. This approach is taken when facing certain breastfeeding obstacles such as:

● Medical conditions preventing breastfeeding post-birth, like hepatitis B and C, mastitis, and tuberculosis.
● Leaving the child when needing to go to work, requiring suitable milk storage to satisfy the child's hunger.
● Beginning the child's weaning process.
● Desire to increase milk supply through pumping, employing the power pumping technique to stimulate more milk production by increasing pumping sessions daily, simulating intense breastfeeding phases.

Applying Power Pumping Technique

To gain optimal results, it’s preferable to dedicate an hour daily for at least a week. Some mothers might need a longer duration to notice a clear milk supply increase.

The most common power pumping schedule:
- Pump for 20 minutes
- Rest for 10 minutes
- Pump for 10 minutes
- Rest for 10 minutes
- Pump for 10 minutes

Repeat this schedule once or twice daily as needed, as responses vary from mother to mother. Some may notice an increase within days, while others may require a week or more for clear improvement.

Electric or manual pumps can be used, but the electric pump is more convenient, saving manual pumping effort and helping complete sessions without fatigue.

Nifas Advice

Remember that breastfeeding isn’t just about nutrition; it’s an emotional bond providing your child with security and comfort. If experiencing low milk supply, maintain physical closeness with your child, frequent breastfeeding, and seek professional support when necessary. Don’t hesitate to consult a doctor or lactation consultant for a successful breastfeeding journey for both you and your child.

Frequently Asked Questions (FAQs)