The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Low Milk Supply: Studies indicate that low milk supply is often cited as the primary reason that women stop breastfeeding. Yet experts contend that an improper technique (such as a poor latch) and not feeding frequently enough are more often to blame than an inability to produce enough milk. Regardless, call your pediatrician if you’re concerned that you don’t have enough milk. And consider scheduling an appointment with a lactation consultant. (See “Got a Problem?” at left for information on how to find one.) Signs include not being able to hear your baby swallow while nursing and poor weight gain. Also, your baby may repeatedly pull off the breast in frustration and have fewer than six wet diapers a day and/or irregular bowel movements.
If your doctor or lactation consultant does determine that you’re not making enough milk, she will likely advise you to breastfeed more often, aiming for eight to 12 times a day. (Generally, the more the baby nurses, the more milk your body produces.) She may also instruct you to use a breast pump between feedings to further stimulate production.
As a last resort, your doctor may prescribe a medication called metoclopramide, says Ruth Lawrence, M.D., a professor of pediatrics at the University of Rochester School of Medicine in New York and a former chairwoman of the American Academy of Pediatrics breastfeeding section. While it is most commonly given to stimulate premature newborns’ breathing, this drug can also spur milk production; however, it can have side effects, so it is usually only used for short durations. An herbal alternative is fenugreek, sold at health food stores, although it’s not safe for mothers or babies with peanut allergies, Lawrence says.
Mastitis and Other Problems: About 10 percent of breastfeeding mothers will experience mastitis, signs of which include a sore, red or swollen area of the breast; blood in the milk; and possibly fever, chills and malaise. The infection can occur when bacteria enter the breast through the ducts or a crack in the skin. It can also arise from a clogged duct, which may feel like a lump or knot in the breast, Harvey says.
Clogged milk ducts can occur for many reasons, including skipped feedings and a poor latch, which prevents milk from fully draining from the breast. Remedies include warm compresses; massaging the area before and during breastfeeding; and pointing the baby’s nose toward the plugged duct during feedings.
If you suspect mastitis, see your doctor, as you’ll need antibiotics. Whatever you do, don’t stop nursing. The antibiotic used to treat the infection is safe for the baby, and he won’t “catch” the illness. Plus, continued breastfeeding will help the infection clear faster, Newman says.
Another condition linked to breastfeeding is Candida albicans, a yeast infection of the nipples and ducts. While you can experience Candida at any time, you can be particularly susceptible after taking antibiotics; signs include burning pain during and after breastfeeding. Candida likes to grow in moist, dark areas, Newman says; to treat and prevent it, let your nipples air-dry after feedings before relatching your bra.
If you think you have Candida, contact your doctor, who will likely suggest an antifungal cream or medication. You can pass the infection to your baby; this will cause thrush in his mouth, so you’ll want to treat him as well, even if he doesn’t appear to have the infection, Harvey says. Thrush can look like white patches on the tongue or insides of the cheeks.