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The Breastfeeding Bible

Trouble-Shooting Tips

By teaching your baby efficient latch-on and by feeding on demand instead of on a rigid schedule, you can prevent most nursing nuisances, such as prolonged sore nipples, clogged milk ducts, engorgement, and mastitis. In addition, here are tried-and-true techniques we use every day to help new mothers avoid two of the most common breastfeeding problems.

CRACKED NIPPLES: Some newborns develop the habit of tight-mouthing the nipple -- perhaps learned from sucking on their fist or wrist in the womb -- which often leads to cracked, bleeding nipples. Before latch-on, cue your baby to open his mouth to its widest by using the index finger of the hand supporting your breast to press down firmly on his chin as you pull him onto your breast. (At first you may need someone else to do this for you.) Keep talking your baby through this important step in latching-on -- "Open,!" You can also show your baby by stopping for a moment to get his attention, then opening your own mouth wide and repeating "Open!"

PINCHING: If your baby's lower lip is tucked inward, you will feel a pinching sensation. And if you continue the feeding this way, you'll soon have very sore nipples. Try what we call the "lower-lip flip": Using your index finger, press down on Baby's chin to evert the lower lip, so that both of his lips encircle your areola fish-like instead of tightly turned inward. The lower-lip flip is the most useful trouble-shooting tip to prevent sore nipples, and it's so easy to do. When we teach it to brand-new mothers while making rounds on the maternity ward, many moms exclaim, "It doesn't hurt anymore!"

Since it's often difficult to bend over and see the position of a baby's lower lip while nursing (it's easier in the clutch hold than in the cradle hold, however), someone else may have to do the lower-lip flip for you. You will soon feel the difference when Baby's lips are well-positioned over your areola, and you'll be able to do the lower-lip flip yourself as soon as you get the uncomfortable message that Baby has a lousy latch-on. Even if you have to start over several times until you both get it right, hang in there. This is good practice and helps him learn the best way to latch on.