While I was pregnant I committed to breastfeeding my baby. Everything I did, every choice I made, was with the health and well-being of my baby in mind and feeding was no exception. After learning about the benefits of breastfeeding, I chose to breastfeed because I felt it was the best choice for our family. I spoke with lactation consultants, my OB/GYN, read books on the subject, attended classes, etc. Everyone told me it was the most natural, beautiful thing I could do. No one told me the one fact that most breastfeeding moms find to be true.
Breastfeeding is hard.
It’s really, really hard. At least it was for me and after talking with other moms, my experience is quite common. There are so many challenges you’re likely to experience from you start breastfeeding. Instead of only talking about the benefits of breastfeeding and how natural it is, I think if we more openly discuss the likely challenges you’ll face, you’ll be more ready to conquer them and successfully breastfeed.
Bad Latch
Newborn babies sleep a lot, are lazy and often latch onto the breast poorly. With a bad latch, the baby doesn’t nurse efficiently and your nipples become really sore. (Ouch!) 
When you prepare to nurse, wake the baby up for the feeding. Unswaddle the baby, change his diaper, tickle his shoulders and he should be alert and hungry. Express a drop or so of breastmilk, gently tap your nipple on his upper lip and then the baby’s mouth should open up really wide. Gently place the baby’s mouth all the way around your areola (whole areola, not just the nipple) and the baby should begin sucking while his mouth remains wide open.
When nursing, you should be able to see and hear the baby swallow and you should not feel any pinching or pain. If it is painful, check the latch again. When you’re in the hospital, have the lactation consultant frequently check your latch.
Baby doesn’t seem to be getting enough/any milk
Newborn babies nurse very frequently and when you’re breastfeeding and not seeing exactly how much milk the baby’s getting, it just seems like they’re not getting enough. 
The amazing thing is that the newborn’s stomach is actually very small and doesn’t need much milk. If you nurse frequently and nurse when the baby is hungry, your supply should keep up and your baby will have enough milk. Frequent demand is not a sign of a low supply. It’s just the sign of a healthy newborn. Newborns nurse A LOT and although it may be exhausting, it’s completely normal.
If your baby seems content after feedings, is producing enough wet diapers and your breasts feel a bit lighter after feeding, your milk supply is perfectly fine. If you are concerned, make an appointment with a lactation consultant. The LC can weigh your baby before and after a feeding to see exactly how much milk the baby is getting and if it’s enough. Most likely, it is!
Sore Nipples
It may be due to a poor latch, frequent nursing sessions, hormonal changes or leaking, but when you’re beginning to breastfeed, you’re probably going to deal with some sore nipples.
After feeding, rub a small amount of expressed breastmilk onto your nipples and allow them to air dry. Keep your nipples dry with breast pads and change them frequently. Use a lanolin or natural nipple cream after feeding and soothing breast pads. Make sure your nursing bra fits well and is not too tight. If you’re really sore, take a break and nurse using a nipple shield with the help of your lactation consultant.
Engorgement
After your milk comes in, a few days after birth, you may physically feel your breasts becoming fuller. You may also feel your breasts have inflated to Dolly Parton proportions and are extremely uncomfortable. This is engorgement.
To help relieve engorgement, you can use a warm compress before feeding to soften your breasts. While nursing, make sure the baby has a good latch. After nursing, apply ice packs to help reduce swelling. You can also keep a head of green cabbage chilling in the refrigerator and after nursing, take a leaf, rinse with cold water and place over your breast under your nursing bra for about 15-20 minutes. (Do not apply cabbage leaves if you’re allergic to sulfa medications.)
Yes, we do weird things as mothers, don’t we?
Mastitis
If you suddenly feel flu-ish symptoms like body aches, fever and fatigue along with pain during feedings and a redness, warmth or hot spots on a painful breast, you may have mastitis. Mastitis is an inflection of the breast tissue and is just awful.
To avoid catching a gnarly case of mastitis, always empty your breast completely during feedings and don’t skip feedings. Treat sore nipples. Wear a good nursing bra that fits.
As soon as the symptoms of mastitis arrive, call your doctor who will likely prescribe antibiotics. The good news is, once you begin taking them, you’ll start feeling drastic relief within a day or two. Rest and drink lots of water. Nurse frequently, you can still nurse as the milk is not affected. A warm compress and OTC pain meds like ibuprofen will help relieve some of the discomfort.
Plugged Ducts
A plugged duct feels like a tender and sore lump in your breast. Unless mastitis, there are no flu-like symptoms that come along with it. Plugged ducts are caused when the duct doesn’t properly drain completely, pressure builds behind the duct and becomes inflamed.
To relieve a plugged duct, breastfeed frequently which will help loosen the plug and keep the milk flowing freely. Place your fingers on the sore spot and gently massage in a circular motion towards the nipple. Keep a warm compress on the area before feedings. Rest as much as you can. (Hah! Right? Try anyway.)
Thrush
Thrush is a common yeast infection that can be developed by the mom or baby. If you have thrush, you may feel a prickly “pins and needles” feeling in your nipples or breast. Your nipples might appear red or shiny. It may be painful when the baby latches or even during and after a feeding.
If your baby has thrush, he may be extra fussy when feeding because his mouth is sore. He may have a bright red, patchy diaper rash. Occasionally, you may notice a baby with thrush has small, white spots in his mouth.
If you suspect either one of you has thrush, call your pediatrician who will likely prescribe a nipple cream and medication for one or both of you. You can rinse your nipples and/or the baby’s diaper rash area in a vinegar solution (one tablespoon of vinegar in one cup of water) and allow your nipples to air dry. Thoroughly wash everything related to feeding like nursing bras, bottles, breast pump parts, clothing, pacifiers, etc. Take your medication regularly. Stay away from sugar (because yeast thrives on it). Rest as much as you can.
Nursing Strike
Sometimes your baby may get fussy or just refuse to breastfeed. If this happens, try to rule out any other issues just in case your baby is trying to tell you something. Check for cold sores, thrush, colds, ear infection and if anything is discovered, treat it appropriately. 
If your baby will not nurse, try to pump or otherwise express milk as often as you have been nursing to keep your supply up. Keep offering your breast to the baby. Practice lots of skin to skin time. Try different breastfeeding positions. Keep the environment quiet and calm and give the baby lots of attention and comfort. You can also try wearing or holding the baby and nurse in motion while you sway, rock or bounce.
Nursing strikes can be incredibly frustrating. If the baby becomes upset when you’re offering the breast, take a break. Stop and soothe him before trying again. Try to be patient and keep trying.
Inverted, Flat or Very Large Nipples
After having a baby, your self-confidence is probably not at an all-time high and finding out you have slightly… weird nipples is not the most pleasant discovery. But it’s completely common. Some nipples are very big, some turn inward instead of protruding, some are flat and don’t protrude at all. Nipples are likely to flatten temporarily due to engorgement or swelling during the early stages of breastfeeding.
If your nipples are flat, use your fingers and try to pull your nipples out. Yes, it feels weird. Just do it. If you have very large nipples, the baby’s latch is likely to improve over time as he grows. If you suspect you have inverted, flat or very large nipples, talk with your lactation consultant and make sure you are latched correctly. You can also use a nipple shield temporarily.
Pumping is a Pain
If your baby is premature and unable to breastfeed, you return to work or just want to have extra breastmilk available for when you’re away from your baby, pumping is a great solution to have breastmilk for your baby. Unfortunately, pumping is not fun and may make you feel like an overworked dairy cow. 
If you’re going to be pumping frequently, be sure to get a good quality breastpump and pump regularly if you’re away from your baby or your baby isn’t able to nurse. Although pumping may be a pain in the ass, it shouldn’t literally be a pain. If pumping hurts, try a different size flange. Get in tune with your inner Madonna and try a hands-free pumping bra so you can multi-task and be more comfortable. Keep a photo of your baby or a blanket he uses nearby. It may seem silly, but thinking of your baby is likely to keep you motivated to pump and help release the “love hormone” oxytocin, which will actually help you produce more milk.
Be ready to face these challenges and I think you’ll have success with breastfeeding. Happy Breastfeeding Week!
Judgment-Free Zone Disclaimer: If you choose not to breastfeed from the beginning, were unable to breastfeed for any reason, were stalled by the challenges of breastfeeding, that’s Ok. We all make choices and formula is a perfectly fine one. No shame, mamas.
Farrah Alexander 