When to Get Extra Breastfeeding Help and Where to Find It

Mother playing with baby
@danielhalis/Twenty20

The first few days and weeks of breastfeeding are the most important. When you get off to a good start, it's more likely that breastfeeding will be successful and continue for a longer period of time. It's always a good idea to have help in the beginning, especially for new moms, but there are some situations when having extra help is essential. If you experience any of the following circumstances, seek help right away.

Get the assistance and support you need right from the very first breastfeeding so that you can have the best possible breastfeeding experience.

When to Get Extra Breastfeeding Help

You had difficulty breastfeeding another child. If you've tried breastfeeding in the past and you weren't successful, it can be stressful to think about trying again. You may be worried that you'll run into the same issues and that's understandable. However, it's still possible to breastfeed successfully this time. Before your baby is born, talk to your doctor and see a lactation consultant if possible. Tell them about your past experiences. Your health care team can work with you to figure out what went wrong the last time, and find solutions to put you on the path to success as you try again. Plus, you'll feel better and more confident when you're prepared.

Your breasts didn't grow or change during your pregnancy. Some women may not have noticeable changes in the size of their breasts and still make a healthy supply of breast milk.

But, if your breasts do not grow at all or grow very little during your pregnancy, be sure to tell your doctor. Sometimes the lack of breast growth could mean a low milk supply. In this case, it's important to get extra help to monitor your milk production and your baby's weight.

You've had breast or chest surgery. It's definitely possible to make a full, healthy supply of breast milk with breast implants or after a minor breast surgery such as a lumpectomy.

However, depending on the type of surgery and where the surgical cut is located on your breast, your milk supply could be affected. Breast reductions and operations around the nipple and areola are more likely to have an impact on breastfeeding. So, tell your doctor and your baby's doctor if you've had breast or chest surgery, and get extra breastfeeding help in the beginning to make sure you're making enough breast milk for your baby.

Your baby's birth was a traumatic experience. A long, difficult birth with a lot of medications or an emergency c-section can cause physical and psychological stress. Medications, fatigue, stress, and pain can all interfere with getting breastfeeding off to a healthy start. A good support system and extra breastfeeding help can make all the difference.

Your newborn won't latch on. Problems with your baby's latch prevent your child from getting enough breast milk to grow and gain weight. It can even be dangerous if your newborn becomes malnourished and dehydrated.

Latching problems can also lead to a low breast milk supply and some painful breast issues such as sore nipples, plugged milk ducts, and breast engorgement. If your child is not latching onto one or both sides, or if he latches on but doesn't breastfeed well enough to remove the breast milk from your breasts, you need to get help as soon as possible.

You have flat, inverted, or very large nipples. When babies latch on to the breast correctly, they take in more than just the nipple. They also grab some of the surrounding areola. For this reason, most babies can latch onto almost any type of nipple that their mother has. Many times, the baby's suck or a breast pump can draw out flat or inverted nipples. But, if the nipples are flat due to severe engorgement, or they are truly inverted so that the baby can't latch on, then it's an issue. Very large nipples can also be difficult to latch on to for a preemie or a newborn with a small mouth. In these cases, extra breastfeeding help is needed to work around the nipple problems.

Your breast milk doesn't fill up your breasts by the fourth day. When you first start to breastfeed, you'll have a small amount of the first breast milk called colostrum. For many moms, milk production begins to increase quickly, and by the third day postpartum the breasts begin to fill up with transitional breast milk. For first time moms, it could take a day or two longer. A slight delay is usually not a problem, but if it continues, it could be dangerous for your baby. Newborns can become dehydrated, develop jaundice, and lose too much weight. If you don't notice an increase in your breast milk by the fourth day postpartum, call your doctor for help.

Your nipples are very sore. You can expect some mild nipple tenderness during the first week or so of breastfeeding. However, painfully sore or damaged nipples are a sign that something is not quite right. A common cause of very sore nipples is a poor latch, so get help right away to check how your baby is attaching to your breast. You should also see your doctor and learn how to heal and protect your nipples so you can breastfeed in comfort.

You're suffering from severe breast engorgement. Breast engorgement is normal in the first few weeks of breastfeeding when your breast milk supply increases and fills your breasts. However, some women experience severe breast engorgement, and it gets in the way of breastfeeding. If your breasts are so swollen, tight, and tender that your baby can't latch on, you should get some extra help. Seek the advice of a breastfeeding professional to help you relieve the engorgement and get breastfeeding back on track.

You have a health issue. If you're pregnant and you have diabetes, PCOS, or another medical condition that might interfere with building up your breast milk supply, you should seek extra breastfeeding help right from the start.

Your baby is born early or has a health concern. You should seek extra breastfeeding help if your child is born prematurely, has a physical problem such as a tongue-tie or a cleft lip, or is diagnosed with a neurological issue such as Down syndrome. It is still possible to breastfeed in these situations, but it often requires patience and extra help to learn the best techniques for success.

You get a fever. While some women get a fever, aches, and chills when their milk comes in, these symptoms are also signs of an infection. If you're sick, or you have mastitis, you don't have to stop breastfeeding, but you should call your doctor for help right away. You'll want to catch and treat any infection as quickly as possible to feel better and prevent breastfeeding problems going forward.

Where to Find Breastfeeding Help

If possible, get help before you even have to worry about problems. While you're pregnant, talk to your doctor, read about breastfeeding, and take a breastfeeding class.

Once your baby arrives, ask for help right away. Try to breastfeed as soon as you can after the birth of your child. If you have a natural birth, you can usually breastfeed in the delivery room within an hour of the delivery. But, if you have a c-section or your baby needs special care after the delivery, you may have to wait a little longer. When you can breastfeed, have your nurse, midwife, or doula help you get the baby to latch on correctly. Ask about breastfeeding positions and have someone show you the proper way to place your newborn in each hold. If you deliver in a hospital, request a visit from the lactation consultant and take advantage of the hospital staff while you're there so you can feel more comfortable when you go home.

Of course, breastfeeding problems can still pop up once you're at home with your baby. Thankfully, there is a variety of extra breastfeeding help available.You can:

  • call your doctor for advice or a referral
  • see a lactation consultant
  • ask a friend or family member where they found helpful information
  • keep a trusted breastfeeding book on hand for reference
  • find an online breastfeeding community for those middle of the night worries
  • join a local breastfeeding group for support and assistance

Don't Wait to Seek Help

If you run into a breastfeeding issue, get help right away. The longer you wait, the more difficult a problem can become. But, by getting the help you need when you need it, you are more likely to find a solution and go on to have a successful breastfeeding experience.

Sources:

Cruz, N. I., and Korchin, L. Breastfeeding After Augmentation Mammaplasty with Saline Implants. Annals of Plastic Surgery. 2010. 64(5): 530-533. 

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Spencer, J. P. (2008). Management of mastitis in breastfeeding women. American Academy of Family Physicians. 2008: 78(6), 727-731.

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