Breastfeeding: What it Should and Should Not Feel Like, Plus 5 Ways To Troubleshoot A Challenging Feeding

As new and expecting mothers we hear a whole lot about breastfeeding; mainly how natural it is, and how painful it can be. It's become a current school of thought that breastfeeding will cause pain in the beginning. And while incredibly common, nipple pain during, or after breastfeeding, is not normal, nor is it something you should have to "push through". We all know that breastmilk offers optimal nutrition for our babies, but few of us truly understand that the act of breastfeeding is a learned behavior. Just as we as adults get to know each other to form relationships and friendships, you and your baby are getting to know each other. Breastfeeding is a dance the two of you have to master together. 

It's one of the first opportunities we, as mothers, have to parent and guide our children. Unfortunately, many of us have little guidance ourselves on how or what we are supposed to be teaching our little ones; how to help them learn this new behavior. Throw in sleep deprivation, and sometimes pain, and breastfeeding can become a frustrating and daunting experience for some. Let's begin by talking about latch (the way baby attaches to the breast), quickly. Concerning breastfeeding, it is the absolute foundation of efficient and pain-free breastfeeding. It can also seem like one of the most tricky things at the beginning of a breastfeeding journey. Most breastfeeding struggles come back to a poor latch. For this reason, the following topics are geared toward obtaining an optimal latch. 

Below, we are going to discuss 5 ways to troubleshoot your breastfeeding session if you are experiencing pain, difficulty latching and how to redirect a challenging feeding session.

1. Skin to Skin

How did the feeding start? Did you practice skin to skin? Research tells us that babies breastfeed best, in the early weeks, when they experience uninterrupted skin to skin contact before a feeding. Strip baby down to her diaper and remove your clothing from the waist up. If you would like, you can wear a robe or sweater - leaving it open in the front. You want to lay baby on your chest, tummy to tummy, between your breasts. Skin to skin contact is comforting for them, allows them the scent of your milk, and gives them the opportunity to make their way to the breast on their own.  Skin to skin contact will also help a disorganized baby regroup, and I suggest using it as a reset button during challenging feedings. 

Side note: Many fathers struggle with their role in the early weeks of a baby's life when he is nursing or sleeping most of the time. Skin to skin with dad or the non-feeding partner is an excellent way to bond with baby. 

2. Timing

Is now the best time to attempt a feeding? Is baby too tired or too hungry? Infants nurse best when it's right for them. You want to try to nurse on demand, versus on a schedule, as much as possible. Not only is this the most ideal for your baby, but it is also best for maintaining your milk supply (by keeping your Prolactin levels high). While some infants feed on a regular schedule, it's more common for them to feed at varying times from day to day, hour to hour. Paying close attention to feeding cues is important. 

3. Feeding Cues

Many of us are taught the classic hallmarks of a hungry baby - balled up fists in the mouth, rooting and searching behaviors (moving the head around in search of a breast), and mouthing motions (opening of the mouth, sucking sounds, etc.). However, few of us know that a baby can quickly transition from this active, "hungry,"  state to an agitated stage. A frustrated baby is difficult to feed. It's ideal to soothe an upset baby before trying to attempt a feeding - especially if the newborn is still learning to latch and feed. 

One of the best times to feed a baby, who is still learning and possibly struggling, is during a light sleep, such as REM sleep; keeping baby close to you is helpful in catching this. Wait until you can see eyeball movement under the eyelid. Baby might also exhibit muscle spasms, or raise his arms above his head. These are the signs that it's the ideal time to start skin to skin and then transition into a nursing session. The best part about initiating a feeding during this state is that it allows you to pass through three different states of activity in hopes of achieving a successful nursing session before you have an upset baby on your hands. It allows for a more relaxed feeding attempt. It's critical that we respond to feeding cues accordingly - even a well-meaning diaper change can undermine a successful feeding.

4. Latching
How is the baby positioned as you attempt to latch to the breast? She should have her shoulders square and be facing you. Where is your hand? Your hand should be at the base of the neck, providing support, but not applying pressure to the back of the head. Ideally, she will come toward the breast nose-nipple, and tilt her head back with her mouth open WIDE; Returning to the breast quickly.  The lips should be tightly sealed, in about 140-degree angle. As Lactation Professionals, there is much more that we are looking for when we assess a latch and feeding. However, this will give you an idea of the fundamental characteristics of an optimal latch.  

5. When To Redirect

What is your comfort level while nursing? When breastfeeding with an optimal latch, you should feel firm pressure. The best way to give you an example of this is to have you hold out your left hand, fingers together, and thumb extended to the right. With the index finger and thumb of your right hand, repeatedly pinch (not using the nails) the thick fleshy part between the index finger and thumb on your left hand. Use this as a gauge of what you should feel while breastfeeding. If you feel anything other than firm pressure, especially pain, unlatch by breaking the seal with your finger, and begin again.

 Do not allow your infant to cause you pain; he will learn how to latch optimally at your direction. If he becomes frustrated or irritable during the feeding unlatch him and help him transition to a more desired state; go back to skin to skin, change positions, sing, and soothe him until it's productive to attempt feeding again. Patience and persistence are key. 

Having to unlatch and redirect feedings is not an indicator of your ability or success as a mother, or regarding breastfeeding. It's normal! While it can be frustrating, it will also be incredibly rewarding when the two of you have mastered this dance together. Remember, the above points are only a baseline for you to know what breastfeeding should and shouldn't feel like, in addition to basic ways to troubleshoot and redirect a feeding. The sooner we can teach an infant to nurse at the breast the easier it will be. If you are experiencing pain, or baby is experiencing difficulty latching to the breast despite your best efforts to guide her, please reach out of a Certified Lactation Professional as soon as possible. With the right support, you will be all your baby needs. 

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