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Breastfeeding Problems and Solutions

Michael Brian

Breastfeeding even under the best of circumstances can present challenges, as both mother and baby are learning what to do. Yet, breastfeeding is well worth the effort it takes to overcome hurdles you encounter. Your baby receives important nutritional, immunological, and developmental benefits, and both of you get to enjoy the special closeness of a nursing mother and baby. Here are some common breastfeeding problems mothers experience, and the solutions our personal and professional experience has taught us.

How can I get my baby to latch on properly?

In our experience, the most common breastfeeding obstacle is improper latch-on. A baby who does not take the breast correctly will not get as much milk and will probably give his mother sore nipples. Here's what we tell mothers:

First, position yourself correctly. Milk flows better from a relaxed mother, and it's easier to breastfeed your baby if your arms, back, and shoulders are well-supported. Prepare a nursing station in your favorite room with a comfortable chair, plenty of pillows for support, and peace and quiet or soothing music. After you've prepared your body to breastfeed, prepare your mind. Take a few relaxing breaths and imagine your nourishing milk flowing from your breasts into your baby. Help your infant to relax, too. If she's crying, rock and sing to her until she quiets down. If she's sleepy, gently bring her body into a sitting position while saying her name. Babies latch on best when they are in a quiet, yet alert, state.

Next, position your baby correctly. Whether you use the cradle hold (baby cradled in your arms lying on a pillow on your lap), the clutch or football hold (baby's body tucked to the side, under your arm, near your breast, neck supported by your cupped hand), or the side-lying position (nursing in bed), be sure that Baby's head and body are turned to face your breast with her mouth at the level of your nipple. Pull her in close -- she should not have to turn her head or strain her neck to reach your nipple.

Cup your breast in your hand, with your fingers and palm underneath and thumb on top, well behind the areola. Avoid the "cigarette hold" (when the nipple is between your two fingers) because your fingers would be right where baby needs to latch on. Express a few drops of milk. Using your milk-moistened nipple, gently massage your baby's lips, encouraging her to open her mouth wide, like yawning. As she opens wide, direct your nipple slightly upward and toward the center of her mouth, and with a rapid arm movement, pull her close to you, so that her mouth will close down over your areola. We call this technique "RAM," an abbreviation of "rapid arm movement." It may sound startling at first to say "RAM Baby on," but it really helps mothers remember two important components of latching on: that they need to move their arm to draw their infant in closer (rather than leaning forward, which can make their backs sore), and that they must move quickly before the baby's mouth closes again.

Make sure your baby feeds from the areola, not just the nipple. To prevent painful breastfeeding, her gums should take in a one-inch radius around the nipple as she latches on. Compressing this area allows your baby to get more milk, since the milk sinuses are located under the areola.

Contributing editors Martha Sears, R.N., and William Sears, M.D., are coauthors of The Breastfeeding Book.