Breastfeeding Problems? We Can Help!

Karen Bodnar, MD, is a board-certified pediatrician at Inova Children’s Hospital and breastfeeding medicine specialist at the Inova Center for Breastfeeding Medicine. She is a Fellow of the American Academy of Pediatrics and the Academy of Breastfeeding Medicine, and is an Internationally Board-Certified Lactation Consultant (IBCLC).

Feeding your baby seems like it should be the most natural thing in the world. But natural doesn’t always equal easy. Nothing can totally prepare you for what being a new parent is like — or how exhausting the experience often is. And learning a new skill like breastfeeding can be hard at a time like that. This is compounded by the challenges that occur when infants are sick or premature, or when women have problems with their own health. Even if mom and baby are healthy, simply returning to work can challenge your breastfeeding routine. It’s no wonder 60% of women in the U.S. stop breastfeeding sooner than they planned.

But with the right support, many women can overcome these challenges and feed their babies breastmilk — the healthiest, cheapest and most convenient food available. We can help you troubleshoot some of the most common breastfeeding problems.

Will I Have Breastfeeding Problems?

You may not know if breastfeeding will go smoothly, but some women are at higher risk for nursing challenges, including those with:

  • Past breast surgery or nipple piercing
  • No breast growth during pregnancy
  • History of hormone problems or infertility
  • Diabetes, obesity or gastric bypass surgery
  • Serious bleeding after delivery
  • History of radiation therapy for cancer
  • Past breastfeeding difficulty
  • Tobacco use

It’s a good idea to identify sources of support as early as possible, especially if you’re at increased risk. If you can, look for a lactation consultant or a doctor trained in breastfeeding medicine before the baby comes. Many insurance plans now cover breastfeeding support and supplies, so check with your provider.

What Can I Do To Prevent Problems?

Every pregnant mother can benefit from knowing what to do in the first hour after her baby is born to prevent pain and get more milk sooner. Watching the free videos at will help you to get off to a great start.

Dealing with Low Milk Supply

When your baby nurses, your body gets the message to make more milk. Many mothers don’t understand how important it is to remove milk frequently to stimulate your body to make more milk each day. If you aren’t removing milk frequently, no amount of herbs or tea will help you increase your milk supply. If your baby isn’t removing enough milk, what should you do? In the first few days after delivering, use your hands to remove milk to get things flowing. After that, a pump can be essential for increasing your milk supply. But it’s important to work with someone knowledgeable to get you set up using the pump correctly. Too many moms spend hours pumping with the wrong settings or a poorly fitting pump.

Help for Nipple Pain

Breastfeeding should not be painful! Too often, nursing moms who experience nipple pain in the first days or weeks think they just have to suffer through it. Yet nipple pain often occurs because the baby is latching on to the breast too shallowly. If the latch isn’t right, your nipple might look pinched after feeding. Not only does that hurt, it makes it hard for the baby to get milk out. And that can mean you aren’t removing enough milk to keep your supply up. A nurse or lactation consultant can help you check your latch. If the latch looks good, they can evaluate further to find and fix the cause of the pain.

upply up. A nurse or lactation consultant can help you check your latch.

Some women are given small silicone covers called nipple shields to help a baby latch. That might help stimulate the baby to suck, but there’s a downside — it’s hard for babies to latch deeply with a nipple shield. Shields can decrease nipple stimulation and interfere with milk removal, leading to low supply. If you are using a nipple shield, you will need to remove more milk after breastfeeding to ensure your milk production will continue. I recommend seeing a lactation consultant to make sure your baby is latching well and getting plenty of milk.

Steps to Breastfeeding Success

Use these three simple steps if breastfeeding is not going well:

  1. Feed your baby something. Your milk, donor breastmilk or formula — the amount will be based on your baby’s age and weight.
  2. Protect your milk supply. Take steps to empty the breasts about 8 times each 24 hours, and don’t go longer than 5 hours without removing milk.
  3. Get support. Professional help, in and out of the hospital, can make all the difference.

Unfortunately, that last step can be easier said than done. Many pediatricians, family doctors and OBGYNs have little professional training in managing breastfeeding problems. You might have to be proactive to seek out a knowledgeable doctor or lactation consultant. Luckily, that’s changing as a new generation of doctors is taking an interest in breastfeeding.

My goal is to make the breastfeeding journey as successful as possible for you and your baby. We can help new mothers nurse effectively, and also help moms who run into breastfeeding problems later on, such as when they return to work. Learn more about the Inova Center for Breastfeeding Medicine, or contact us at 571-419-5644.

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