What is engorgement?

As the milk supply rapidly "comes in" during the first week, some women experience breast engorgement (breasts feel overly full of milk). This can be relieved by a 2-step approach:

1. Cool compresses (for example, cabbage leaves, or you may reuse a bag of frozen peas/corn, which is easilly shaped to your breast). This helps reduce pain and swelling.

2. Remove milk from the breast. The best way is to feed the baby, but alternately you may pump or hand express milk. This ultimately eliminates engorgement.

What can I do for sore or cracked nipples?

Some women experience sore, cracked, or bleeding nipples. This is most commonly due to a poor latch. Be sure the baby is latching on well. If the problem persists, we can work with you to correct the problem. You may also try applying lanolin or a similar cream to the nipples after feedings. There is no need to wipe it off before the next feeding. Dabbing breastmilk onto the sore areas and letting it air dry is also often helpful. Do not let a problem like this persist for more than one or two days without speaking to a lactation professional.

Does diet affect milk supply?

Milk supply is not determined by any particular food in your diet. Good nutrition is important, but supply is determined primarily by how frequently and how well you nurse your baby. Consumption of extra fluid may help if you aren't getting enough yourself. Dieting for weight loss during lactation is not recommended, but through reasonable dietary guidance a return to prepregnancy weight is encouraged. Alcohol, smoking, and drugs are not recommended at this time.

How do I know my baby is getting enough milk?

If your baby appears satisfied after feedings, wets at least six diapers a day, is gaining weight, and otherwise appears healthy, they are probably well nourished and consuming the proper amount of milk. Some babies feed more frequently than every 2 hours during growth spurts.

When do I need to seek help with nursing?

• Inability of the infant to latch on to the breast within 8 to 12 hours after birth
• Absence of audible swallowing during breast feeding. (In the first three to four days after birth, several sucks may be noted before colostrum is swallowed; when the mother's milk is in, a swallow should follow most sucks.)
• Urine output less than six wet diapers and fewer than three stools in 24 hours
• Newborn weight loss above 10% of birth weight
• Maternal pain with nursing and/or visible nipple damage
• Maternal history of flat or inverted nipples, endocrine and/or fertility problems, breast surgery, or the absence of breast changes during pregnancy
• No change in the fullness of the breast after a feeding has ended
• Presence of a medical problem likely to affect normal breast feeding, for example, ankyloglossia (tongue tie), neurologic impairment, Down's syndrome, cleft lip or palate, or other congenital anomalies.
• Baby unable to latch due to any other reason