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Breastfeeding Problems and Solutions

Michael Brian

Clogged Ducts and Feeding After C-Section

How do I handle a clogged milk duct?

If you notice a tender lump somewhere in your breast, it may mean that a duct leading from the milk-producing glands to the nipple is blocked with milk. Untreated, the area can become inflamed and even infected (a condition called mastitis). To treat a clogged duct, apply warm moist compresses to the area for a few minutes before feeding. Breastfeeding on the sore side first often helps, as your baby is more likely to dislodge the plug at the beginning of a feeding when her sucking is strongest. As Baby nurses, gently massage the area down toward the areola to encourage the plug to clear. If you start to develop flu-like symptoms (fever, chills, body aches, and fatigue), you may have mastitis. Your doctor can prescribe antibiotics.

Plugged ducts are most likely to occur when your infant is nursing less often -- if you're away from home, or when she suddenly begins to sleep for longer stretches at night. To prevent them from recurring, breastfeed frequently, especially if your breasts feel full. (If your baby isn't hungry, pump and store the milk.) Feeding your baby in different positions also helps. Avoid tight bras and sleeping on your stomach, as both can put unnecessary pressure on your breasts. Most important, get adequate rest: Recurrent mastitis can be a sign of a run-down immune system.

I'm scheduled for a c-section. How will I breastfeed during my recovery?

After a cesarean birth, your body must be allowed to heal while you learn to care for your baby and breastfeed. You need extra help: Ask the nurses or your lactation consultant for help with early feedings, and have them show your partner how to help you get positioned for nursing. Breastfeed in the side-lying and clutch-hold positions to keep Baby's weight off your incision. Use lots of pillows: If you nurse lying down on your side, you'll need two pillows behind your back, a pillow between your knees, one under your head, and one to support baby on his side. Wedging a "tummy pillow" between the bed and your abdomen can help keep the pressure off your incision. You can also nurse while sitting up in bed; a day or two after surgery, you may be more comfortable nursing while sitting up in a chair, with your infant on pillows in your lap. Some mothers mistakenly assume that they should refuse pain medication, but there are medications that are safe for breastfeeding moms to take. Pain will only suppress your milk production and keep you from enjoying your first few days with your new baby. The anesthesiologist can give you a long-acting anesthetic immediately after the birth to ease postoperative pain when you are first holding and nursing your baby. It may take a bit longer for your milk to come in following a cesarean birth, and longer for the baby to learn to latch on, but mothers who have surgical births can be just as successful at breastfeeding as mothers who deliver vaginally.

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