Challenges
In order to avoid complications, proper breast care and a correct infant latch is necessary. If you are experiencing any discomfort, or notice any of the below, consult your healthcare provider.
01

Inverted Nipples
SIGNS (What does it look like?):
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Nipples retract when areola (brown surrounding) is squeezed
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Nipples do not protrude when stimulated
SYMPTOMS (Wha does it feel like?):
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Difficulty latching
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Swollen areola
TREATMENT
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do not allow baby to suck on pacifier or finger - cup feed if necessary for the first 48 hours
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use hand expression before feeds to draw out the nipple
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try different feeding positions
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sometimes a nippple shield may help if it persists for > 48 hours (consult your healthcare professional about nipple shields)
02

Nipple Pain/Trauma
CAUSES:
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most often times from a pump that’s too strong
SIGNS (What does it look like?):
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nipple may be red, blistered, and/or cracked
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scabs or crusts on the nipple
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nipple looks flattened or white after a feed
SYMPTOMS (What does it feel like?):
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pain when the baby latches or during the feed
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burning or stabbing pain between or during feeds
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nipples that are hypersensitive
TREATMENT
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*Seek medical advice on appropriate over the counter pain/anti-inflammatory medications*
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ensure the baby is latched correctly
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massage or apply warmth to breasts before feeds; this stimulates let down
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begin feeds on least sore breast
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express breast milk onto nipples after feeds and allow to air dry
03

Thrush/Candida Yeast Infection
CAUSES:
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most often times from a pump that’s too strong
SIGNS (What does it look like?):
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nipples may look normal
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may be painful, pink, and shiny
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nipples may be red and irritated
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may have white patches on nipples
SYMPTOMS (What does it feel like?):
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may sting or burn
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may have deep, penetrating pain
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baby may have oral thrush or diaper rash
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mother may have vaginal thrush or urinary tract infection
TREATMENT
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*Seek medical advice* – this needs to be treated with prescribed oral and topical agents
04

Engorged Breasts
CAUSES:
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ineffective suckling or ineffective drainage or breasts (infrequent feeds)
SIGNS (What does it look like?):
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breasts are over filled
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shiny, tight skin
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may be some nipple trauma
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fareola may look puffy
SYMPTOMS (What does it feel like?):
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breasts feel very heavy and painful
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nipples are more sensitive
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inhibited let down reflex
TREATMENT
-
*Seek medical advice on appropriate over the counter pain/anti-inflammatory medications*
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place heat on the neck and shoulders ONLY to help with let down
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elicit a let-down via gentle massage
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apply a cold compress between feeds for 24 hrs
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determine the cause to prevent reoccurrence
05

Mastitis
CAUSES:
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usually a result of an infection or milk stasis within the breast
SIGNS (What does it look like?):
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inflammation of the breasts
SYMPTOMS (What does it feel like?):
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tenderness and heat of affected area
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general flu-like symptoms
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fever, headache, tiredness
TREATMENT
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*Seek medical advice as this can become a medical emergency if not treated immediately; pain/anti-inflammatory medications may be prescribed, along with antibiotics
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DO NOT stop breastfeeding – the breast milk is still safe for the baby
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apply a cold compress between feeds for 24 hours – green cabbage leaves
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hand express breasts frequently to keep the milk flowing and the supply adequate
06

Blocked Duct
CAUSES:
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infrequent feedings
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inadequate removal of milk from that portion of the breast (this is why changing positions is important)
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pressure from underwire bras
SIGNS (What does it look like?):
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swollen area of the breast
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may be an apparent white bubble on nipple
SYMPTOMS (What does it feel like?):
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pain, swelling, and reduced milk flow
TREATMENT
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apply warm compress
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soak breasts in warm water
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massage affected areas gently toward the nipple
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alternate position (baby’s chin should be towards the affected area for the best drainage)
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express breast milk while massaging affected area
Health Nexus. (2013). Breastfeeding Matters: BestStart Guide. Retrieved from http://www.beststart.org/cgi- bin/commerce.cgi?preadd=action&key=B04-E
Ministry of Healthy Living and Sport. (2010). Baby’s Best Chance: Parents Handbook of Pregnancy and Baby Care.
Crown Publications Services: Victoria, BC.
Venter, Kathy. (2014). ‘Making a Difference: A Breastfeeding Course for Health Professionals.
