Breastfeeding Challenges: Mastitis

Mother breastfeeding baby in bed

When it’s hot outside, the last thing you need is breastfeeding trouble that leaves you with a fever and your breasts feeling hot to the touch. Mastitis can happen to any breastfeeding mother.

Mastitis is generally caused by too little milk being removed from the breasts. This can happen if your baby is having trouble getting enough milk, if you have too much supply, you’ve skipped feedings, or you have a blockage due to pressure on a duct or due to inflammation.

The heat and ache of mastitis can be intense. It feels a lot like having the flu.

Writing the cooling summer posts these past two weeks reminded me of one of my hottest, most miserable summers with my first baby when I had mastitis. That first baby is now a 16-year old. This week she was complaining, “My bra is so hot.” So, I reached into the refrigerator and showed her the trick someone taught me to cool my breasts during that hot summer. I gave her cabbage leaves to tuck into her bra and cool off.

Cooling off was one of the most important steps for me because it kept me calm so I could deal with the other steps.

  • Cool off.
  • Rest.
  • Get help.

Cool down

When you have hot breasts and fever in addition to the heat of summer, use a fan, mist water, even use the air conditioner if you need to do that to keep from adding to the heat burden. I found cabbage leaves straight from the refrigerator gave me temporary relief, like cool packs but without quite so much shocking cold.

Don’t stop breastfeeding

You need rest and hydration. Go to bed with your baby, and feed the baby frequently, emptying your breasts each time. Keep water nearby, and continue to sip while you are resting.

See a breastfeeding professional

Call a lactation consultant or talk to your local La Leche League Leader. The symptoms of mastitis and a plugged duct are similar. A professional can help you figure out the best approach specific to you, and it is very helpful to have that calming voice telling you that what you are experiencing will pass.

More information about the specifics of mastitis and the difference between plugged ducts and mastitis at KellyMom.com. La Leche League also has mastitis answers.

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Cool Breastfeeding in Hot Weather

Mother and baby breastfeeding outdoors in summer

Baby’s first summer? When it is hot outside, your baby still needs to breastfeed—probably more often than in cool weather. How can you stay cool while breastfeeding? It’s all about hydration and air flow.

Hydration

When it is hot outside, we sweat more in order to cool off. Because we lose more fluids, we need to take in more fluids.

Breastfeeding is enough to keep your baby hydrated, but a hot, thirsty baby may need to breastfeed more than usual. You may also notice that your baby wants to feed for shorter periods of time, which means more of the thinner foremilk and less of the hindmilk. This gives your baby exactly what is needed during hot weather.

Look for cues that your baby is asking to feed more often. Do not give your baby water or ice cubes. You will probably need to drink a lot more water to meet your needs and your baby’s, but your baby does not need supplemental water even in very hot weather.

If your house is air conditioned, your baby may lose more fluids through the skin, so keep in mind that a cool house doesn’t necessarily mean your baby won’t experience increased fluid needs in warm weather.

Bring your water. Before you sit down to breastfeed, grab your own water. Sip while you feed to keep yourself hydrated.

Air Flow

One of the keys to keeping cool in the summer, whether you are breastfeeding or changing diapers, is maintaining air flow. A breeze helps us feel cooler as it evaporates sweat.

When both you and your baby are hot and sticky, you might not be eager to be skin to skin for hours a day. Your baby might hesitate to feed because of the warmth, so try cooling off before feeding then keep feeding as cool as possible.

Stay Apart. If you lie down to breastfeed, you can put a bit more space between the two of you for air flow.

Cool Off. A quick bath, a dip in the wading pool, or just a splash in the sink and a wipe down can cool off your baby before feeding time. You could also keep a cloth near your diaper changing table and wipe your baby down with each diaper change. If nights are hot and humid with little relief from daytime temperatures, cooling off with water is a good way to calm down and make bedtime more comfortable.

Stay Cool. To keep from warming one another up immediately with skin-to-skin contact, insulate yourselves. Put a cotton prefold or flat diaper between you, or dress your baby in a very lightweight cotton outfit or just a diaper and a T-shirt. If you have a fan or a breeze, make sure that it won’t cool your baby too much during that relaxed, post-feeding state. Don’t sit with your baby directly in front of the fan or air conditioning. Keep the air comfortable.

For more cool tips for hot weather, read about cloth diapering. Next week, Cool Babywearing for Hot Weather.Link to sunscreen for infants

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Does Breastfeeding Change Your Body?

Nursing mother with baby

Before the experience of pregnancy and breastfeeding, you might be curious what changes to expect with your body during pregnancy, during breastfeeding, and afterward.

Because of the hormonal changes in your body, your breasts may get larger during pregnancy. Increased blood flow can make them feel tight or swollen. If you experience breast sensitivity before your period, you may have a similar, stronger feeling during pregnancy. You may even see some discharge, as your breasts create colostrum in anticipation of your baby’s arrival. The most noticeable physical change is in fullness of your breasts.

After your baby is born and breastfeeding is well established, you will notice the change in fullness and size. As your breasts fill with milk, they become fuller and firmer. When your baby empties one breast, it will look and feel noticeably softer. If your baby stops after one breast, you will probably look a bit lop-sided until the next feeding. As you breastfeed, your breasts will change in appearance and feel.

Most of the changes that come with pregnancy and breastfeeding are temporary. Many new mothers want to know if their bodies will change permanently. Your body will definitely change permanently, but the extent of the changes varies greatly among mothers.

Several physical changes are happening. The milk-producing structures of the breast fill and empty, creating firmness and softness. Milk production results in denser breasts, which does mean some increase in size. For all women, though, fat cells determine breast size. During pregnancy, our bodies put on fat to support the pregnancy and breastfeeding. Part of the increase in breast size is just about fat—and, lest this isn’t clear in our fat-obsessed culture, that is a very good thing. Breastfeeding can reduce overall fat stores for some women, but it isn’t a given that you will lose the pregnancy fat after your baby is born. Another change that happens with the appearance of your breasts when your skin stretches. Some women get stretch marks; some women just find that their skin doesn’t feel as tight; and, yes, some women find that their breasts sag.

Sagging breasts aren’t caused by breastfeeding, though. A study found clear factors in sagging—age, significant weight loss, higher body mass index, large cup size, number of pregnancies, and a history of smoking—but breastfeeding, weight gain during pregnancy, and lack of upper body exercise were not among the causes. So, no, breastfeeding won’t cause your breasts to sag, though stretched skin might contribute to sagging.

Experience varies quite a bit between pre-pregnancy to post-breastfeeding breasts. You could return to almost the same size and shape you had before, your breasts could shrink and sag, or you could go from being flat-chested to abundantly busty (as I did).

To support your breasts and prevent unnecessary changes, wear a well-fitting bra during pregnancy and breastfeeding, even at night. This isn’t a necessity for health, but it can make a difference to post-breastfeeding appearance. Larger breasted women need a lot more support, and smaller breasted women can be fortunate enough to need no more than a breastfeeding top with a built-in bra. We carry Bravado Bras as well as Glamourmom and Undercover Mama nursing tops because these are the products we found helpful ourselves.

My Baby Keeps Falling Asleep While Nursing

Baby sleeping on mother

Does your baby keep falling asleep while nursing? Are you wondering whether this is OK? It is!

It is common for a newborn to be very sleepy. The size of a newborn’s stomach is very small. Their need for sleep is often greater early on than their need for food. Some babies even lose weight for a bit, but weight loss won’t go on for long for a healthy baby.

It isn’t a problem if an older baby falls asleep nursing either, unless you find it a problem. A baby might nurse a bit here and there for an hour then want to be fed again in another hour. If this kind of feeding doesn’t fit your schedule, you can take steps to encourage your baby to stay awake and nurse more consistently for a shorter period of time.

Keep in mind as well that you want your baby to get the fatty milk that comes as your breast is emptying (sometimes called “hindmilk”). Whether you do this by nursing frequently (keeping your breasts relatively empty) or by nursing until empty on one side before switching to the other, it doesn’t matter. Just make sure that your baby is getting the full benefit of the fatty milk.


How to Keep a Baby Awake

Many mothers have developed gentle ways to keep a baby awake long enough to nurse thoroughly.

  • Start by changing your baby’s diaper before feeding. If you use a cold cloth to wipe the baby’s bottom or against her face and back, your baby will start the feeding stimulated.
  • Don’t put your baby’s clothes back on after the diaper change. Some babies stay awake longer with skin to skin contact.
  • Tickle his toes. Be aware of whether this is fun or irritating for the baby, but it is a common way to keep breastfeeding babies awake.
  • Sing to your baby. Your baby loves watching you. If you do something interesting, you might find that she stays awake just to see what you will do next.
  • Use the cold washcloth again. Brushing your baby’s cheeks with a cool washcloth can cause an intake of breath and more awareness—at least for a short time.
  • If you nurse on both sides at a feeding, stop in between and play for a bit. Sing and laugh. This is similar to the idea of changing diaper before feeding. If your baby is stimulated to start, he is more likely to stay awake.


Or, Just Let the Baby Sleep

Chances are you need more sleep yourself. If your baby wants to sleep, maybe you can take advantage and sleep as well. If you have a soft, comfortable chair or if you nurse in bed, this works better than sleeping sitting up.

If you don’t need the sleep, but you do need focus time, can you do your work with your baby on your lap? If you have set up a nursing station with water, phone, notebook, book, computer, or whatever it is you need to do, your baby’s sleepy nursing time could be a good time for you.

One of my babies was a leisurely, sleepy nurser, and I didn’t try to change her patterns. I went on with my work by nursing where I knew I needed to be next. Sometimes, especially when I was nursing a toddler and pregnant, I just slept.

In general, it isn’t a problem that your baby falls asleep while nursing, unless you find it a problem. You can help your baby adjust to your schedule, but your baby also needs you to adjust to her needs. If your baby is growing, alerts at other times, and happy, do what you can to go with the flow.

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The Emotional Side of Breastfeeding

Breastfeeding a newborn baby

The first few weeks of breastfeeding after giving birth can be an emotional time for a new mother. The physical and emotional changes, and the hormones that stimulate these changes, can leave you wondering what is going on.

Look what you’ve just been through! The experience of giving birth chances you. And, now, the complete dependence of your new child gives you new responsibilities. Those responsibilities might make it difficult to return to healthy patterns of sleeping and eating. Then, there are the physical changes you are going through. Your body looks different. It IS different. Hormones stimulate changes that help you transition from pregnancy to breastfeeding. What a ride those hormones can take you on. Hold on.

Four hormones are responsible for many of the changes you experience as you move from pregnancy to breastfeeding.

Estrogen and Progesterone levels go down immediately with birth because the source of these hormones was the placenta. They go down to post-menopausal levels, so some women experience symptom similar to those of menopause. Yes, it is completely normal, and your hormones will return to higher levels. The progesterone had a mood-elevating effect, so you may have some emotional let down immediately, though the experience of meeting and bonding with your baby may keep you from noticing much. Just as with hormone levels during the menstrual cycle, different women’s bodies respond differently to postpartum changes in hormone levels.

Prolactin and Oxytocin levels go up as you begin breastfeeding. Prolactin stimulates milk production, as well as stimulating your appetite for milk production. In the first few weeks, oxytocin causes uterine contractions as your uterus returns to is normal size. Oxytocin has a calming effect. The well-being you feel as you gaze at your nursing baby, the bonding you experience as you establish the breastfeeding relationship, is stimulated by oxytocin.

Other factors than hormones also influence the emotional side of breastfeeding. Sleep (or fatigue), changes in appetite, and, for many mothers, anemia, can all affect your physical and emotional well-being.

The first two weeks of breastfeeding are critical. Most new mothers experience some baby blues. Keep in mind that there is a difference between the baby blues and postpartum depression. The baby blues come with the extreme changes in hormones just after birth and with the beginning of breastfeeding. Hormones aren’t the only factor, though. As a new parent, you have a lot of responsibilities, and your probably aren’t getting as much sleep as your body needs. You can lessen the impact of the changes by arranging a support system. Let your friends and family help you if you need a break. Let them cook for you or watch the baby while you take a nap.

You need sleep. Your baby’s sleep patterns have a big impact on your own sleep or lack thereof. Don’t let lack of sleep exaggerate the negative. For your own physical and emotional health, it is important that you get the sleep your body needs to lessen the effects of hormone changes and to give you the best chance to experience the beauty of those early days with your baby. Let the oxytocin and prolactin give you all of the calming and bonding help and ride that wave of love for your baby. Get as much sleep as you can to avoid the effects lack of sleep has on mood, appetite, memory, immunity, and safety.

Your hormones will change again after those early days. Even when you breastfeed long-term, prolactin levels will drop in four to six months. If you are still experiencing emotional upheaval after months of breastfeeding, it is possible that you are experiencing postpartum depression. A professional can help with diagnosis and treatment. There are natural ways to treat PPD for most women, and you can make lifestyle changes that help.

The hormones, the experience of birth and motherhood, the complete upheaval in your life—it’s all a crazy ride. Give yourself and your baby the best chance of a positive breastfeeding experience by doing your best to get enough sleep, eat nutritious food, and build back up to your normal level of physical activity.

More on those important early days of breastfeeding.


Are you interested in learning more about postpartum hormone levels?