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More Breastfeeding Health Ed

SORE NIPPLES

Sore nipples can be caused by incorrect nipple care, incorrect latch-on technique, or incorrect positioning of the baby at the breast. The initial tingling or tenderness felt when baby latches on should not be confused with sore nipples. The cause needs to be determined to make appropriate suggestions for treatment.

NIPPLE CARE

  1. Avoid using soap or alcohol on the nipples.
  2. Do not apply creams or oils to the nipples. Breast milk is the best treatment. Rub expressed breast milk on the nipples after each feeding. If tenderness continues, you can use a small amount of Lansinoh (ultrapure USP modified/medical-grade lanolin) on the nipples after each feeding.
  3. Avoid plastic-lined bras or nursing pads.
  4. Change breast pads after each feeding or more often if needed.
  5. Allow nipples to air-dry after each feeding by leaving the bra flaps down. A blow dryer on low setting can be used to dry the nipples.

CORRECT LATCH-ON & POSITIONING

  1. The baby should be held on his side facing the breast, tummy-to-tummy with the mother.
  2. Support the breast with fingers underneath and thumb on top in a "C" hold.
  3. Tickle the baby's lower lip with the nipple until his mouth opens wide. You may have to do this several times before the baby opens his mouth wide like a yawn.
  4. The baby's mouth should be centered on the nipple, taking in at least 1" in diameter of the areola.
  5. Quickly pull the baby toward the breast.
  6. The baby's tongue should be over his lower gum, between his lower lip and the breast.
  7. The lips should turn out and lie flat against the breast.
  8. Baby's nose and chin should be touching the breast.
  9. The baby's head, shoulders, legs and buttocks should be in a straight horizontal line.

TREATMENT FOR SORE NIPPLES

  1. AVOID using a nipple shield.
  2. Position the baby correctly at the breast. Change nursing positions at each feeding to avoid constant pressure on the same area. Use. The cradle hold, football hold and side-lying positions.
  3. Don't let the baby go too long between feedings. Short frequent feedings every 1 ½ to 2 hours for shorter periods of time may be helpful.
  4. Begin feeding on the least sore side first.
  5. Breast shells can be worn between feedings to avoid friction from your bra.
  6. Use childbirth breathing techniques to relax.

ENGORGEMENT

When your milk comes in, your breasts may become very full and even feel hard and hot. This condition is called engorgement and may be quite painful. As the first milk (colostrum) is changing to mature milk, more is made than is needed. The fluid necessary for milk production is carried to the breast through the blood and lymph. This increased supply of fluid collects in the breast tissue causing the breasts to swell. Early and frequent feedings will relieve the swelling and soften the breasts. When feedings are infrequent, delayed, or missed, engorgement occurs. Engorged breasts can lead to sore nipples because the baby cannot position the shortened, harder nipple correctly in his mouth and often ends up sucking on just the tip of the nipple.

TO PREVENT ENGORGEMENT

  1. Nurse baby as soon as possible after delivery and from then on feed baby every 1 1/2 to 3 hours.
  2. Wake baby at least once during the night. A newborn baby should not go longer than one long stretch of 4 hours during the night for the first 3 to 4 weeks.
  3. Offer both breasts at every feeding.
  4. Nurse long enough to soften the breasts. The length of time will depend on how often the baby pauses during a feeding. The more often he pauses, the longer he will need to nurse to soften the breast.
  5. Nurse the baby at the first sign of awakening.
  6. To help wake up a sleepy baby, wipe baby's face with a cool washcloth, change his diaper, talk to him, make eye to eye contact, or undress him. Baby will wake up if you sit baby on your lap, supporting head and chin, and walk fingers up and down baby's back.
  7. Make sure you have a comfortable, supportive, non-binding bra.

TREATMENT FOR ENGORGEMENT

  1. Take a warm shower or use a warm, wet washcloth over the breast before nursing.
  2. Massage breast before and during feeding.
  3. Relieve the fullness by hand expression prior to feeding to make it easier for the baby to grasp onto the nipple.
  4. Use childbirth breathing techniques to help with your let-down.

PLUGGED DUCTS

When the breasts are not emptied on a regular basis due to infrequent feedings, poor suck, or inadequate let-down, the milk will back up and cause a blockage in one of the ducts. When this happens, you may experience a tender spot, redness, or a sore lump in your breast. The area may or may not be painful.

TO PREVENT A PLUGGED DUCT

  1. Position the baby correctly on the breast.
  2. Do not delay or miss feedings.
  3. If necessary, pump or hand express to relieve fullness.
  4. Avoid bras that are too tight or bind making it difficult to relieve fullness in all parts of the breast.

TREATMENT FOR A PLUGGED DUCT

  1. Take a warm shower or use a warm, wet washcloth over the breast before nursing.
  2. Breastfeed more often during the day.
  3. Begin each feeding on the breast with the plug.
  4. Position the baby so that his chin is pointing in the direction of the plugged duct.
  5. Gently massage the plugged area while the baby is nursing.

MASTITIS

Bacteria can enter the breast through an opening in the nipple or a break in the skin. When feedings are delayed or missed, or when babies are feeding at irregular times, the breast overfill and a breast infection can occur. The mother has flu-like symptoms with fever. The breast is red, hot and painful.

TO PREVENT A BREAST INFECTION

  1. Position the baby correctly on the breast.
  2. If you delay or miss a feeding or if the baby nurses poorly, express or pump to soften the breast and relieve fullness.
  3. Use different breastfeeding position.
  4. Do not delay or miss feedings.
  5. Avoid bras that are too tight or bind.

TREATMENT FOR MASTITIS

  1. Apply wet or dry heat to the infected area (see treatment suggestions on other side).
  2. Position the baby correctly on the breast.
  3. Nurse frequently and offer the infected breast first.
  4. Continue to nurse on both breasts. The infection will not harm the baby.
  5. Do not delay or miss feedings.
  6. AVOID routine formula/water supplements. Baby needs to nurse every 2 hours to avoid milk back-up.
  7. Drink enough fluid to satisfy your thirst.
  8. Get plenty of rest.
  9. Call your doctor. Your doctor may want to prescribe an antibiotic for you.

The WIC program is an equal opportunity program open to all eligible persons regardless of race, color, sex, national origin, age or handicap. Any person who believes he or she has been discriminated against should write to the Secretary of Agriculture, Washington, D.C. 20250. Complaints regarding sex and/or handicap should be mailed to the EEO Officer, Illinois Department of Public Health, 535 West Jefferson, Springfield, Illinois 62761

DuPage County Health Department
111 North County Farm Road
Wheaton, Illinois 60187
(630) 682-7400