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Q. How can sore nipples in the mother
caused due to lactation be managed?
Soreness of
nipples results most often due to incorrect
position of holding the baby while breast
feeding. If baby is not held very close to the
mother, he pulls at the nipple while feeding.
Feeding the baby in correct position, i.e.
holding him close to the mother’s body
prevents sore nipples. In this position the
baby’s gums press upon the areola which
facilitates the release of milk.
If you develop
sore nipples, continue to breast feed in
proper position and apply some simple cream
around the areola at the end of feeding.
Applying your own hind milk (milk expressed
from a nearly empty breast) is equally
effective since it is rich in fat
Do not use plastic
lined nursing pads since they hold the
moisture. Avoid frequent washing of nipples
with soap. If nursing the baby is very
painful, express the milk from that breast
manually and feed the baby using a cup and
spoon till the nipple heals. Continue to feed
from the other breast.
Q. How should engorged breasts be managed?
Sometimes the
breasts get swollen due to milk collection.
This usually occurs around the 3rd
day after delivery. It is more likely to occur
if baby has not been breast feeding. The
breasts feel heavy and painful. The breast
engorgement is best prevented by early feeding
and frequent suckling of the baby. If
engorgement continues, the baby may not be
able to attach to the breast. In that
situation, some milk can be manually expressed
and collected in a clean container. The baby
can then be put to breast for feeding. If baby
is not in a position to suck (for example a
very LBW baby), the expressed milk can be fed
to the baby using a spoon/ tube feeding. Hot
fomentation relieves pain and facilitates
manual expression of breast milk.
Q. What should be done if the mother has
small nipples that a baby cannot take in his
mouth?
Many women with
first baby have small nipples. Sometimes these
nipples are not projectile and are buried
inside the surrounding areola. It is difficult
for a baby to hold such a nipple in his mouth
and breast feed. The mother should pull her
nipple out and roll it using her thumb and
index finger. She should then put the baby to
breast immediately thereafter. A few attempts
may be needed before baby can hold on to the
nipple. The problem resolves in most
situations once baby feeds from the breast
following this maneuver for a few times since
suckling itself would help in bringing out the
nipple.
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