mastitis advice · your pain is getting worse your fever is getting worse your fever lasts for more...

Mastitis Advice

By Rebecca Baxter

Text copyright 2012 Rebecca Baxter

All Rights Reserved

1st Edition

Please respect the hard work of the author by paying for individual copies of this guide. Your honesty is appreciated.

Table of Contents

What Are Blocked Ducts and Mastitis? What Are the Symptoms of Blocked Ducts and Mastitis?

When You Need to See Your Doctor

How Your Baby Can Help You Through Your Mastitis

6 Different Breastfeeding Positions You Can Try

Natural Remedies for Mastitis

15 Massage and Stretch Techniques

Epsom Salts Soak

Hot and Cold Compresses

Cabbage Leaves

Sleep

What Triggers Mastitis and How You Can Fix These Problems

Poorly Fitting Bras

Posture

Incomplete Emptying of Milk

Poor Breast Pump Use

Nipple Damage and Poor Attachment

Fatigue and Stress

Causes of Unsettled Behavior in Babies

Being Hungry or Thirsty

Feeding Problems

Feeling Pain or Discomfort

Pain from Digestion

How to Cope With an Unsettled Baby

Summary

About Rebecca

What Are Blocked Ducts and Mastitis?

Your breast has many glands that produce milk. The milk then flows through ducts and is sucked out by your baby. Sometimes those milk ducts get blocked causing a build up of milk behind them. This will feel like a lump.

Mastitis occurs when one of those blocked ducts becomes inflamed, and then it may become infected, this happens to one in six breastfeeding mothers, that's 16.5%.

It is safe for you to continue to feed your baby

Some mothers worry that their milk is off, or infected and that they shouldn't keep breastfeeding their baby because their baby may get sick. This is not the case.

A blocked milk duct and mastitis are initially caused by extra milk blocking the duct. The best way to clear a blockage is to keep breastfeeding as frequently as possible.

The techniques in this book can be used whether or not you need antibiotics

If you are able to clear blocked ducts quickly using the techniques in this book, you will also be much less likely to need antibiotics. If infection does occur, antibiotics may be necessary to support your body’s healing process.

Antibiotics don’t treat the cause of the initial blockage though. The techniques in this book will complement the antibiotics by helping to remove any blockages, which will help you avoid recurrent bouts of mastitis.

If you do need to see a doctor, the techniques you are about to learn can also help to calm the pain while you wait for an appointment.

Quickly clearing a blocked duct helps maintain milk supply

Pain, stress and fatigue can all impact on milk supply. Getting any blockage cleared quickly will help you maintain your supply by decreasing pain and fatigue, and making breastfeeding enjoyable again. It will also help to increase the flow on that side, making your baby less likely to be fussy at the affected breast.

Back to Table of Contents

What Are the Symptoms of Blocked Ducts and Mastitis?

A blocked duct on it's own will just feel like a lump. It may be a little tender to touch, but not much pain will be present.

The earliest symptom that mastitis is developing is usually the breast becoming warmer. This is a sign that inflammation has accumulated in the area. The body’s natural reaction to this increased pressure is to remove it, and so the excess milk is forced into your bloodstream.

At this stage you may experience flu like symptoms that rapidly lead to a fever. This is because your immune system sets up a response to your milk as though it was a bacterial infection.

If the duct is not cleared you may also go on to get a bacterial infection because the bacteria feed on the milk in the blocked duct. If this happens you will need antibiotics to help fight the infection.

Mastitis symptoms differ from mother to mother, but usually include one or all of the following signs and symptoms:

A lump or increased firmness in the breast

A red area developing in the area of the blockage

ncreased heat in the affected breast tissue

Pain in the breast or nipple either constantly or during the feed

Fatigue

Chills or fevers


When You Need to See Your Doctor

A blocked duct need not be seen by a doctor, but if you also have a fever which doesn’t subside within 24 hours it is important to access help.

Some important indicators that you will need help include:

Your pain is getting worse

Your fever is getting worse

Your fever lasts for more the 24 hours

You have had mastitis frequently before

You have cracked nipples

Your doctor will prescribe some antibiotics to help your body fight the infection. Make sure you let your doctor know that you are planning to continue

breastfeeding and that if antibiotics are necessary you want them to be safe for use during breastfeeding.

What can happen if You don’t seek help from a doctor

Many new mothers don’t wish to take any drugs whilst they are breastfeeding, but it is important to keep in mind that while natural therapies can help, a severe case of mastitis needs the help of antibiotics as well

If not treated appropriately, a severe case of mastitis can lead to a breast abscess, which would need surgery to remove – arguably more invasive than taking antibiotics. This procedure means you would be less likely to be able to maintain a successful breastfeeding relationship with your baby.

So, if you are at all concerned about your pain or fever getting worse, make an appointment to see your doctor immediately.


How Your Baby Can Help You Through Your Mastitis

When attached well, a baby is far more effective at removing milk from your breast than a breast pump is. It’s important to continue to feed from the affected breast so as to clear the blocked duct that caused the mastitis.

Breastfeeding frequently will help to clear the blockage as soon as possible. Every 60-90 minutes if possible. Using direct massage and breast compressions during the feed will also help to direct the milk out through the blocked duct.

Breastfeeding is Really Painful at the Moment. How You Can Cope

Feeding your baby while you have mastitis can be very painful but it’s worthwhile because the inflammation will clear up much more quickly. Different breastfeeding positions can empty different areas of the breast more effectively. Having the baby’s chin pointing toward your blocked duct is a good way to get your baby to clear the blockage for you.

The easiest way to cope with the pain at this time is to feed from the affected breast for as long as you can bear it and then switch to the comfortable side.

This may only be for a few minutes but it’s still worthwhile. Once your pain level is bearable again, try breastfeeding from the affected breast for another few minutes, perhaps using a different breastfeeding position.

If you are in too much pain to relax enough for a let down of milk though, you may wish to initiate the feed on your good breast and then switch over once your milk is flowing.

6 Different Breastfeeding Positions You Can Try

With all positions aim to:

Be comfortable – the less comfortable you are the more stressed your body is and so the more likely you are to have a blockage occur

Have your baby attached well (see the attachment section towards the end of the book) – poor attachment leads to poor drainage and potential nipple trauma, which makes blockages and mastitis more likely.

Line up your baby's nose with your nipple so they must open their mouth wide to attach

Allow your baby's head to extend back so they can open their mouth wide

More of the areola should be covered by the baby's lower lip than their upper lip

Jump Straight to:

The Cradle Hold

The Football Hold

The Saddle Position

Lying On Your Side

Lying On Your Back

Baby's Legs Over Mum's Shoulder

If Attachment Still Doesn't Work


The Cradle Hold

Figure 1

The cradle hold is the most common position used by breastfeeding women. This position will drain lumps that are in the centre of the breast. Other variations include the cross cradle hold where the arm that supports your baby is the opposite to the breast your baby is feeding from, and the biological nurturing position where you are reclining in a chair and your baby is diagonal across your abdomen allowing you to use a baby led latch.

It’s also easy to check that your baby is correctly latched in this position. The cross cradle hold is a variation where the opposite arm to the breast which the baby is feeding from supports the baby. If the woman in the picture above switched to the cross cradle hold she would keep her baby in the same position but use her right arm to support the baby instead of her left arm.

To really enjoy using the cradle position you firstly need to get yourself set up comfortably. Your chair needs to adequately support your mid and lower back, and not be so long in the seat that your bottom is drawn forward away from the backrest. Your feet should also be able to rest comfortably.

Some simple remedies if your seat is not quite suited to your body shape include putting a large cushion behind you to fill in the space behind your bottom if the seat is too deep for your legs, and if your feet are unable to touch the floor, placing a footrest under them to support you.

To take the pressure off your shoulders and neck you can try altering the angle of your baby's body so their bottom is closer to your lap rather than coming straight across your body. This means your arm is not working as hard to hold your baby up.

For very small babies who don't aren't long enough to reach their mother's lap, some mothers use a pillow to support the baby's weight. Many breastfeeding associations do not recommend this as it can push the baby up too far and make it difficult for them to attach effectively. So long as this pillow does

http://www.breastfeeding-babies.com/latching-on.html#baby-led-latching-on

not push your elbow up above it's resting position you should be fine from this regard.

You may also like to hold your baby with your free arm also and help to support your main feeding arm if it is getting tired.

Now to your baby's posture.

Many babies being fed in the cradle position end up lying on their backs with their head turned at a 90 degree angle to attach to the breast. If you imagine yourself doing that for half an hour or so and how cramped your muscles become it is then not surprising that babies can become irritable during a feed.

Some pointers on getting your baby to attach well using this hold are:

Have your baby’s stomach facing towards yours

Have your baby's spine in one straight line (check in a mirror if you need to)

Your baby’s head should be able to tilt backwards slightly so they can open their mouth wide, avoid holding it in position

Back to Breastfeeding Positions List

The Football Hold

Figure 2

A football hold is good for draining lumps in outer part of the breast. It is also a great breastfeeding position for mothers who have pain in their abdomen, such as after a caesarian, because it gets the baby off that area.

Lining up the baby so their nose is in line with the nipple is still important..

Using pillows to support your baby in this hold will make it much easier to do. A disadvantage of this position is that a some babies are very long and their legs hit the back of the chair that the mother is sitting in. To avoid the mother leaning

forward and not being supported by the backrest during the feed the baby's legs can be bent into a squatting position. Another way to help combat this problem is for the mother to use a thick pillow as a cushion so her back is further from the backrest but still supported (this only works well with a wide seat on the chair).

Figure 2 shows how you can support your baby without restricting their head movement. Your fingers rest underneath their neck and side of their face rather than only under their face. Your thumb should not be on the back of their head, but behind their neck so your baby is able to extend backwards to open up their mouth wide.


Saddle Position

Figure 3

This breastfeeding position involves the baby sitting astride the mothers leg, facing the mother. It will help to drain the ducts at the bottom of the breast. For babies who are too young to sit up well try sitting in a reclining position so that your body and arm supports their body. This can be seen in the baby led latch video. Done in this way you will not attach your baby but instead will wait for them to attach themselves. This gives a better attachment and will also help your baby to prime their breastfeeding reflexes, making them more likely to stick their tongue out further and open their mouth wider.

It is useful for mothers who have a particularly forceful letdown reflex as they can lean back a little (called a semi-reclining feed) so that gravity isn't increasing that letdown.

This is also a very good position to feed babies suffering from severe reflux as gravity helps keep the milk they've just swallowed in their stomach rather than coming back up the esophagus.


http://www.breastfeeding-babies.com/baby-led-latch.html


Breastfeeding Lying on Your Side

Figure 4

Feeding a baby lying down can be an excellent way of keeping off a newly stitched pelvic floor, allowing the swelling to go down. This position is another one which will help to drain the bottom part of the breast. It is not an easy position to use if you have very small breasts though, but worth trying to see if you can make it work.

To get yourself in a good position for a good latch lay your baby on their side and then position yourself around them, again lining up your nipple with their nose. To do this, make sure your baby is not placed too far up the bed.

Gently hold your baby's upper back and neck to assist and guide them towards latching on. Wait for them to open their mouth wide.

A pitfall to be aware of in this position is that you can be quite tired and end up falling asleep. A good way to ensure you won't roll onto your baby is to have a large pillow behind you to lean back on (this also helps avoid getting hip pain during a feed).


Breastfeeding Lying on Your Back

Figure 6

Breastfeeding lying on your back is an excellent position for mothers who are tired but have very sore shoulders or hips and don't tolerate lying on their side to feed, or those who can't get their baby to latch on well in the sidelying position.

It is also excellent for mothers who have a very fast let down reflex because gravity helps the baby to cope with the amount of milk ejected.

This position can be used with both the football and the cradle hold as a beginning, which the mother then lays down from. A pitfall of doing it this way is that you will need to contract your abdominal muscles to lower yourself down and this should be avoided if you have suffered a large abdominal muscle separation or had a caesarian birth. Try to use your free arm to help support you on the way down.

If this doesn't work for your abdominals you can try allowing your baby to attach themselves - see this video

To avoid extra strain when you go to get up it is advisable to first place your baby beside you and then roll onto your side and push yourself up with your arms rather than using your abdominals to sit straight up.


Baby’s Legs Over Mum's Shoulder

This is a very little used position and is valuable for mothers with blocked ducts in the top of their breast.

To position yourself for this start lying down. If possible, have someone else help you to place your baby’s abdomen near your shoulder with their legs up near your head.

It can be quite difficult to achieve a good latch in this position, and can be used as a last resort if other positions don't work. Practicing baby led latch, as mentioned in the saddle position, can be useful to get your baby used to latching on to the breast by themselves.


If Attachment Still Doesn’t Work

You may have other challenges such as a baby with a cleft palate or a tongue tie. Babies who have had a traumatic birth or have been engaged for a long time prior to birth can have also have musculo-skeletal strain which can make it difficult for them to open their mouth wide or keep their head comfortably in the right position to feed.

If the suggestions above don’t help it is useful to find a lactation consultant who can help you directly improving your baby’s attachment, or a physical therapist

http://www.breastfeeding-babies.com/after-the-baby-is-born.html

such as an osteopath or chiropractor who specializes in the treatment of infants to help gently release any strain in the baby’s jaw, neck or upper back.

Breastfeeding can usually still work for you if your case is individually looked at and you get the support needed to work out your situation. If one doctor, lactation consultant or therapist doesn’t give you the answers you need, keep looking, there is plenty of good advice out there, it may be just a matter of finding the practitioner who works well with you.



Natural Remedies for Mastitis

To make the most of the natural remedies for mastitis it is important to catch the problem early. These remedies will still be useful for mothers who need to use antibiotics but if they are employed in the early stages of mastitis they can often slow or stop the progression of the problem.

The easiest way to figure out which natural remedies will be the most useful for you is for you to identify which symptoms are the most prominent in your particular case so you can address them specifically.

One of the most common and easiest things to do is to use an alternative feeding position such as those mentioned earlier to better empty the ducts which are becoming blocked.

Also feeding more regularly when symptoms start, even though it will be painful, can help to remove the blockage before any infection can take hold by keeping the area less engorged. This also means that each feed will be shorter which will decrease the amount of time you will spend in pain.

Jump straight to:

15 Massage and Stretch Techniques

Shimmy Shake

Partner Assisted Shimmy Shake

Juice the Orange

Partner Assisted Juice the Orange

Squeeze the Toothpaste

Partner Assisted Squeeze the Toothpaste

Rollercoaster Arms

Broadway Arms

Partner Assisted Rollercoaster and Broadway Arms

Rollercoaster Arms in Bed

Breathing Recoil

Twisting Candy Cane

Extra Twisted Candy cane

Partner Assisted Twisting Candy Cane

Direct Massage

Epsom Salts Soak


Cabbage Leaves

Sleep


15 Massage and Stretching Techniques

To effectively use self massage you have to know a little bit of anatomy so you can direct the massage appropriately.

Figure 7

Figure 7 shows you how the breast tissue sits over the top of the pectoral muscles and comes quite far into your armpit.

This part in the armpit is called the tail of the breast and much of the lymphatic drainage comes through here so it is very important to get this part moving.

The other important parts to focus on are the centre of the chest and the pectoral muscle. Both of these areas are important for the rest of the lymphatic drainage.

Once the drainage is improved it is also useful to work on the part of the spine where the nerve supply comes from which is the upper back. If you are a bit hunched in your posture and are feeling some tension in the muscles of your upper back, neck and shoulders, you are likely to be causing some irritation to the nerves which supply feeling and control the blood vessels of the breast.

The techniques following are not found anywhere else on the internet and can help empower you to improve your situation. They are safe to do provided you do not feel more pain than you already do from the blocked duct and mastitis.

There are both self and assisted techniques presented. To make the assisted techniques safe you must have very good communication with the person who is massaging you. Too much pressure can cause further blockage so they must be very sensitive to your pain level (which will be different at different times) and be able to back off the pressure if you feel too much pain. In these techniques pain most certainly does not mean gain.

To help unblock your ducts and decrease your pain you will need to do the Shimmy Shake and the Juice the Orange techniques at least three times a day, and the Squeeze the Toothpaste at least once a day (these can be either the self or the assisted versions). To really get the most from the massage techniques though you should do all the other techniques at least once a day.

If you find them easy to do, however, any of them can be done as frequently as you wish. Important things to remember include:

Stop using any technique if it causes you more pain

Keep in mind the symptoms that mean you need to see a doctor

The Shimmy Shake

This technique is called the shimmy shake because in effect your breast is wobbled as much as it would be if you were to do a shimmy with your shoulders. In this case though it is much more controlled and your shoulders are not shimmying.

The vibrating movement helps the stagnant fluid to be broken up and this helps the lump of the blocked duct to start to break up.

The nicest place to do this technique is in the shower as it will help to relax you, however it is still very beneficial out of the shower too. If you do use it whilst not in the shower it is best not to wear a bra for this technique as it will stop the breast from wobbling.

Figure 8

Cup your hand under your affected breast (see figure 8)

Gently lift a little so that the weight of the breast is in your hand and not pulling on the skin above your breast

Now wobble your breast side to side, making sure not to make the skin stretch

Do this for 30 seconds

Back to Technique List

Partner Assisted Shimmy Shake

When a partner helps you with this technique you will need to make sure their wobbling motion is not uncomfortable. This technique should not hurt. If it does get your partner to make sure they aren’t pulling your skin around too much and aren’t pressing too hard.

Once again you should not wear your bra during this technique. You may however have a loose shirt over your breasts as long as it does not feel like it is stopping the motion of the wobbling.

Figure 9

Lie on a bed with your affected breast closest to the edge

Your partner stands at the level of your breasts facing towards your chest next to your breasts

Your partners hands are placed on the breast with one above the nipple and one below (see Figure 9)

Your partner then gently wobbles the breast side to side being careful not to stretch the skin whilst doing this motion. This is a very small movement almost like wobbling jelly

Do this for 30 seconds


Squeeze the Toothpaste – Anatomical Explanation

This technique is called Squeeze the Toothpaste because it is a useful metaphor to help you think of how you are removing the stagnant lymphatic fluid. The “toothpaste tube” is the pectoral muscle, which goes from under your breast to the top of your arm (see figure 10). It is responsible for nearly 80% of the lymphatic drainage away from your breast.

Figure 10

Figure 10 shows you how the pectoral muscle goes up and creates the front of the armpit. In the picture you can see the left hand is holding the edge of the pectoral muscle that's closest to the breast and the right hand is holding the edge that forms the armpit next to the arm.

In this technique you are going to gently squeeze and stretch those lymphatic vessels in the pectoral muscle starting as close to your breast as you can and then repeating this squeeze and stretch several times up the pectoral muscle until you reach the arm.

Again this technique can be done in the shower but is also useful whilst out of the shower as long as your bra is not restricting you.


Squeeze the Toothpaste

Using the thumb and forefinger of the opposite hand to your affected breast gently squeeze the pectoral muscle as close to your breast as you can (see Figure 11)

Hold the skin in this position as you raise the arm on the side of your affect breast out to the side, then up to the ceiling

Hold for 3 seconds

Lower your arm

Figure 11

It can be quite painful in the armpit when you have a very inflamed blocked duct so be gentle. If this technique causes pain you will need to decrease the squeezing pressure or decrease the amount you raise the arm to the side.

Now move the thumb and forefinger that were holding the skin one finger breadth toward the arm (see figure 12)

Squeeze and hold

Slowly raise the arm on the side of the affected breast out to the side then up to the ceiling

Hold for 3 seconds

Lower the arm

Figure 12

Repeat these steps each time with your thumb and forefinger closer to your arm until you can’t go any further (see Figures 13 and 14)

Figure 13

Figure 14


Partner Assisted Squeeze the Toothpaste

It is very important in this technique not to cause pain but rather just a stretching feeling. If your partner has particularly large hands and you are quite sensitive in your armpit make sure your partner is gentle. See Figure 10 again to get your bearings about where on the pectoral muscle you will be holding.

Figure 10

As for all of the techniques it is best not to wear a bra. This technique can be done with a loose shirt over you as long as you can easily raise your arm above your head.

Lie on a bed with your affected breast closest to the edge

Your partner stands at the level of your breasts facing towards your head

Your partners hand that is closest to your body will be the one which gently squeezes and holds the pectoral muscle (see the anatomy introduction at the beginning of the Squeeze the Toothpaste description) with their thumb and forefinger (see Figure 15)

Figure 15

Their hand that is further away from your body will hold your elbow and gently pull away from your body a little (see figure 16)

Figure 16

Then, while holding their thumb and forefinger still, your partner will gently swing your arm out to the side then above your head (see Figure 17)

Figure 17

Hold this position 3 seconds

Gently release the arm back down

If this is painful the pressure of the thumb and forefinger need to be less and the amount the arm is raised needs to be less.

Your partner then moves their thumb and forefinger towards the arm one fingers breadth, gently squeezes and holds (see Figure 18)

Figure 18

They then gently pull your arm out from your body

Then your partner will slowly move your arm out to the side then above your head.

These steps are then repeated a few more times until your partner is as close to your arm with their thumb and forefinger as they can get.


Juice the Orange

This technique is a direct compression and stretch of the lymphatic ducts in the breast itself. Think of juicing an orange and that’s the action.

This can again be done in the shower or out of it. Make sure your clothing if you’re wearing any doesn’t restrict the movement, a bra will not let you do this technique effectively.

Place one hand above your nipple and the other below so that your first knuckles are in line with the nipple and your hands are covering as much of the breast as possible (see Figure 19)

Figure 19

Gently compress the breast into the chest

Holding the compression gently twist the breast until the skin stops your movement (see Figure 20)

Figure 20

Hold this for 30 seconds

Release, then reverse the direction of twist. Place your hands with the one that had been below the nipple now above it and vice versa (see Figure 21)

Figure 21

Compress the breast and twist until the skin stops your movement

Hold for 30 seconds then release

As with all the techniques, this shouldn’t hurt. If it does you need to back off the pressure a little.


Partner Assisted Juice the Orange

As with the Squeeze the Toothpaste technique this can hurt and less compression and twist is necessary if pain is felt.

Lay on a bed with your affected breast closest to the edge

Your partner stands at around the level of your waist facing towards your breast

Your partners hands are placed above and below the nipple, covering as much breast as possible (see Figure 22)

Figure 22

Your partner then gently compresses in towards the chest – look out for pain and back off if it’s experienced

Holding this compression gently twist the breast until the skin stops it from twisting further (see Figure 23)

Figure 23

Hold for 30 seconds

Release and repeat with a twist in the other direction (see Figure 24)

Figure 24


Twisting Candy Cane

Okay, so your body is not going to twist like a candy cane but this stretch is one for your spine and ribs. It will help you to breathe a bit easier and will also decrease tension in the muscles and nerves of your back which will help the blood supply in your breasts.

Figure 7

Figure 7 shows you how your ribs sit underneath your breasts. They go all the way round to attach to your spine. There are tiny little muscle fibers in between all of the ribs and they are what you are going to stretch with this technique.

Again this should not hurt as your breast tissue is not being stretched, it should instead feel pleasant.

Sit on a chair

Place your right hand on the outside of your left thigh and hold the back of the chair with your left hand

Twist your body around to the left, using your hands to increase the stretch (see Figure 24)

Figure 25

While holding your chest in this position with your hands use your back muscles to pull against the stretch, trying to straighten you up

Hold this for 5 seconds then relax and allow your body to twist further to the right

Repeat this for the other side


Extra Twisted Candy Cane

If the Twisting Candy Cane stretch is too easy for you a great way to increase it is by adding a pectoral stretch at the same time.

Sit on a chair which has a back-rest

Take your right hand across your body to hold the left side of the backrest

Place your left hand just below shoulder level on the right side of the back-rest (see Figure 25)

Figure 26

Twist your body around to the right, using your hands to increase the stretch

While holding your chest in this position with your hands use your back muscles to pull against the stretch, trying to straighten you up

Hold this for 5 seconds then relax and allow your body to twist further to the right

Repeat this for the other side


Partner Assisted Twisting Candy Cane

This stretch can sometimes be more effective if a partner assists you.

They are aiming to help you rotate by pushing against your ribs about 3 finger widths from to the side of your spine.

Sit in a chair with your partner standing behind you

Place your right hand on your left shoulder (see Figure 26)

Figure 27

Your partner then holds your right elbow with their left hand and places their right hand on your ribs at the back (see Figures 26 and 27)

Figure 28

Your partner gently rotates your body to the left by pulling backwards with their left hand and pushing forwards with their right hand (see Figure 28)

Figure 29

Your partner, while holding you in this position, will then ask you to gently rotate back to the right, against the stretch, trying to straighten yourself up.

Hold this resistance for 5 seconds then relax and your partner will gently twist you further

Repeat these steps with your partners right hand further up your back (see Figures 29 and 30)

Figure 30

Figure 31

Repeat these steps with the other side


Rollercoaster Arms

This stretch is aimed at helping you to sit up and stand straighter more easily. If you’ve been hunched for a long period of time (which may not only be from breastfeeding but can also coming from old work habits) your body will be quite tight at the front, making it harder to have good posture.

This again should feel like a pleasant stretch.

Stand in a doorway with your arms raised

Depending on your height hold either the upper part of the side of the doorframe or the top of it

Now walk forward one small step so your hands are behind your shoulders (see Figure 31)


Figure 32

If you experience any tingling or numbness in this position stop the stretch or just move back to standing in the door frame so that you are less stretched.


Broadway Arms

The pectoral muscle being as big as it is has different directions in which it needs to be stretched. Like Roller Coaster Arms, this stretch is done in a doorway but instead of raising your arms above your head you hold them out at shoulder level (as though you are dancing on a stage on Broadway).

Stand in a doorway with your arms raised

Extend your arms out to shoulder height

Now walk forward one small step so your hands are behind your shoulders (see Figure 32)


Figure 33

If you experience any tingling or numbness in this position stop the stretch or just move back to standing in the door frame so that you are less stretched.


Partner Assisted Rollercoaster and Broadway Arms

This is a lovely stretch to use as an assisted position as it can be more dynamic.

Sit in a chair with your partner standing behind you

Raise your arms above your head (as for Rollercoaster arms)

Your partner will grasp your wrists and gently take your hands so they are just behind your shoulders (see Figure 33)

Hold for 15 seconds

Figure 34

Your partner then lowers your arms out to the side at 45 degrees and holds there for 15 seconds

Then down to 90 degrees (as for Broadway Arms) and holds there for 15 seconds

If you experience any tingling, pain or numbness in this position your partner needs to decrease the amount your arms are behind your head or you need to stop the stretch. You may find that you are okay with your arms in some of the differing heights but not others so try the stretch at 45 and 90 degrees also.


Rollercoaster Arms in Bed

This is one of the most relaxing forms of stretching you can do. It will help you to open up the front of your chest so that it’s easier to sit straighter. The best time to do this is as you are going to sleep (although try not to fall asleep in this position as our arms may get pins and needles). It can be done throughout the day also.

Lie down on your back

Place a thin pillow under your shoulders

Raise your arms above your head (see Figure 34)

Figure 35

Make sure you protect your neck and lower back in this position. To protect your neck make sure you aren’t looking up. Instead lengthen the back of your neck and look down towards your breasts.

To look after your lower back take note of whether it hurts during this stretch. If so raise your knees so that you flatten out your lower back onto the bed/floor.

If you experience pins and needles, pain or numbness in your hands and arms just place them back down so your hands rest to the side. If it is still uncomfortable rest your hands on your abdomen.


Partner Assisted Breathe Easy Recoil

This technique should not hurt the breast, chest or breastbone at all. Stop immediately if it does. It is aimed at increasing the amount that your ribs are able to move and how much you are able to breathe in.

Getting this to happen well means that all the venous and lymphatic fluids, not only in the breast but the whole body, will be able to be pumped around more efficiently.

Lie down on a bed

Your partner stands just above your waist level facing towards your head

Your partners hands rest on your sternum (see Figure 35)

Figure 36

You breathe in deeply

As you breathe out your partner follows your sternum down

As you begin to breathe in again your partner stops your sternum from raising by gently pushing against it

Again as you breathe out your partner follows your sternum down a little further, then doesn’t allow it to raise during your next breath

During your fourth breath in your partner suddenly releases the pressure on your sternum, giving you a recoil effect of a very deep breath

If you have a blocked duct towards the centre of your chest this may hurt a little. To avoid this place the partners hands further from the painful area.


Direct Massage to Unblock the Duct

Some women feel more comfortable than others to massage their blocked duct directly. If it is quite painful to do this, the preceding massages are best to be used first to start the process of unblocking in a less direct way.

Once you have used these techniques, in some cases they will need to be done a few times, you can then try to directly massage the blocked duct.

Purely pressing on the duct will merely be painful without achieving much movement of the stagnant milk. It is better to massage from the lump towards the nipple to encourage flow of milk down the duct.

Some women also find that massaging towards the duct from further up the breast will also help the milk to flow better.

This massage should not be done to cause significant pain. Very heavy pressure during massage is likely to cause more inflammation around the duct, making it even harder to unblock.



Epsom Salts Soak

Epsom salts are a wonderful, cheap natural remedy for gently removing swelling and inflammation. Used for many other problems such as arthritis and sprained joints they can also be effective for helping women with mastitis.

There are two ways of using them

1 - Have an Epsom salts bath. Pour 2 cups of Epsom salts into your bath and spend around ten minutes soaking. A warning about this is that it will dehydrate you so it is good practice to drink at least one glass, preferably two glasses of water during your bath. It is also wise to have someone else present in your house to help you should you feel faint after getting out (though this should not happen if you drink enough water).

2 - Soak your breast in a mixing bowl of Epsom salted water. This option uses less Epsom salts and can be done frequently during the day for short bursts. half fill the bowl with warm water, add half a cup of Epsom salts. Stir to dissolve. Place the bowl on a table. You can either sit or stand next to the

bowl, depending on the height of your table, and lean over to immerse your breast in the water, supporting your weight on your elbows.


Every body type responds differently to the application of hot or cold packs, and some bodies respond best to alternating between the two.

In general if you have a hot, red, inflamed part of the body, it is usually best to apply a cold pack. The only problem with this is that it will constrict the blood flow in the area. For this reason it is useful to use a cold compress between feeds but to then switch to a hot compress 5-10 mintues before a feed.

The cold will help to decrease the inflammation and pain levels, and the hot will help to allow the milk to flow more easily from the breast during the feed.

A hot compress for a few minutes before starting the Shimmy Shake, Juice the Orange and the Squeeze the Toothpaste massage techniques described below is also useful to help get the inflammation moving out of the breast and into the circulation.

Cabbage Leaves

Cabbage leaves contain colloids, which help to extract inflammation from the body. Placing a clean, cold leaf in your bra and replacing it when it reaches room temperature is a lovely, calming way of having a cold compress which is also removing inflammation.

Sleep

As mentioned under the What Causes Mastitis section, sleep is vitally important to help you recover from and avoid recurrent bouts of mastitis. Trying to sleep, even if it only ends up being rest, whenever your baby is asleep is incredibly important.

It is during sleep that your body allows all you muscles to relax and repair to occur. The inflammation and pain from your mastitis or blocked duct will be causing a certain amount of damage to the cells in the breast and the quickest way to heal this is to sleep.

Babies sleep best in the period between 7-12 at night. To make the most of this it is really important for you to go to bed early, if possible as soon as your baby is asleep, so you can get as many hours uninterrupted sleep as possible. Remember, this level of sleep interruption will only last for a few short months so it won't be long before you are able to start making the most of your evening hours for a bit of quiet time on your own.


What Triggers Mastitis and How You Can Fix These Problems

Many mothers experience blocked ducts during breastfeeding, but not all of these blocked ducts lead to mastitis. Effectively treating a blocked duct as soon as it’s noticed makes it much less likely to progress to mastitis.

There are also some triggers, which will make you more vulnerable to mastitis. Being aware of the most common triggers can help women to avoid a blocked duct becoming a case of mastitis.

The following is a list of mastitis triggers and their solutions so you can avoid this becoming a recurring problem:

Jump Straight to:

Poorly Fitting Bras

Posture


Poor Breast Pump Use


Fatigue and Stress


Poorly Fitting Bras

When your milk first comes in, your breasts may grow quite substantially. If this happens, it is important to get a bra which fits you well so that it doesn’t cause pressure on the breast which can block the ducts.

If you have problems with the bras you already own you will know because you will see indents on your skin when you take them off.

How to choose a new bra

If there is no shop assistant to help you get your bra fitted correctly some things to keep in mind are:

Take particular notice of the cup size. The breast tissue can be in line with the middle of your arm-pit. Even though a maternity bra has no

underwire, it could still compress your outer breast, so make sure the stitching for the cup comes right out the edge of your breast.

Try to go shopping just before a breastfeed as your breasts may be larger at this time and you will void getting a cup size which is too small. (If you are prone to leaking milk, take some breast pads with you)

While creating a nice shape under your clothes, very shaped, firmer cups can be hard to get out of the way during a feed. Try opening the bra and folding it under your breast. Is it easy to do or will it spring back up causing problems for your baby trying to latch on.

Back to Mastitis Triggers List

Posture

Stooped posture in general, and particularly a cramped feeding position, causes a decrease in the lymphatic and venous fluid drainage from your breasts and can lead to more pressure on the milk ducts making it harder for them to empty. Poor posture also changes the nerve supply to the blood vessels in the breast and heightens pain sensation.

How do I improve my posture easily?

When you are feeding a newborn you need to make sure they are attached properly to avoid nipple damage and this means you will need to look down at them at the initiation of a feed, you do not, however, need to continue with your head and shoulders stooped during the whole feed.

Part of the solution to poor posture is becoming aware that you are in it. Giving yourself a little reminder after starting the feed to straighten up is an easy way of improving your posture immediately. If at first you don’t remember to do it, use your body as a guide. If you feel any tension or pain at all it is a signal to you to straighten up.

Some easy tips for improving your posture even when you’re tired:

Sit with your bottom well back in the chair so your lower back is supported by the back rest

If you are still finding you want to slump place a pillow behind your lower back so it becomes a wedge and you are semi reclined – this posture is excellent for the biological nurturing hold and can help your baby to attach well

If the cradle hold is more comfortable for you, place a large pillow under your baby to hold them up rather than your arm supporting their weight – just be careful that the attachment is not compromised when you do this.

If the pillow is too high it can hold the baby in a bad position for them to attach well. Also if it is too low you will need to lean forward to meet it

Try not to take the breast to your baby. Bringing the baby to your nipple creates better attachment and also better posture for you



Ineffective emptying of the breast during a feed is a common cause of blocked ducts. This may be because your body is producing too much milk or because your baby is not feeding well.

During the early days after birth, as your milk comes in, you can end up with an over supply and/or engorgement. Another time you may have too much milk is if a feed is missed or delayed. Often your body will adjust, but sometimes the extra milk can put pressure on the ducts that take the milk from the gland to the nipple, blocking the flow of milk.

How do I know if all of my ducts emptied properly?

After each feed, gently compress your breasts to assess if there are any lumps. Sometimes, if you have more milk than your baby needed at the time, there may be an area of fullness. If this area doesn’t hurt, in most cases, it will be fine to wait until the next feed. If you find a lump that is tender though it is likely that you have a duct that is blocked.

My baby doesn’t have a full breastfeed

Some newborns don’t fully drain the breast, and this may be the cause of a blocked duct. There are a few potential reasons this may occur:

They may be the type that falls asleep at the breast, only to awaken 20-30 minutes later apparently starving. This usually happens because they are not well attached. If your baby is just nibbling at the nipple they won’t be getting as much milk as quickly as if they are fully attached, so there isn’t a good stimulus to keep them sucking. Breast compressions are another useful option to try getting some more milk flowing into your infants mouth.

Your baby may also be suffering from jaundice, which makes them tired. It is important to have your baby checked if you are concerned about them being too sleepy.

Some babies are also uncomfortable during their feed, causing them to keep pulling away from the breast. This can sometimes be due to colic

http://www.breastfeeding-babies.com/latching-on.html

http://www.breastfeeding-babies.com/breast-compressions.html

and trapped wind. If this is a problem reassess their latch to make sure no air is being swallowed.

Another reason a baby may be fussy at the breast is that your let down reflex may be very slow, or very fast. Stress and fatigue affect your let down reflex, but many women also find that their baby prefers one breast to the other. This may be because the preferred breast lets down milk more easily than the other. If you have a very slow let down reflex (you will know if you have ever tried to express any milk and it takes a while for the milk to start flowing) you may wish to start a feed from the preferred side and then switch to the other side once you notice the baby is drinking.

If you are concerned that these techniques don't help your problem seek advice from a lactation consultant.

What can I do if I do have some excess milk?

Some remedies which may help you clear excess milk include compressing your breast during the feed, trying a few different breastfeeding positions as shown below, or expressing any remaining milk after the feed.

Be aware that if you substitute a breastfeed with a bottle feed your body will still produce milk. If you don’t pump this milk at the time your baby is being given the bottle feed it can sometimes lead to the excess milk blocking a duct.


How Does a Breast Pump Cause Mastitis?

Mastitis caused by a breast pump may be due to poor cleaning or incorrect usage of the machine leading to damage of the nipple. These can both be remedied by following all instructions carefully.

Another way using a breast pump can lead to mastitis is by not using it regularly. Your breast will make more milk if more is drunk or expressed. If you express a lot of milk one day at a certain time, the breast will then produce a similar amount the next day at that same time. If you then don’t use your breast pump or feed your baby at that time your breast may become engorged and this can cause a blocked duct.





Nipple damage is caused by the newborn not suckling or attaching correctly. When attaching to the breast, the newborn's mouth needs to be open quite wide and the nipple goes into their mouth along with some of the surrounding skin/areola. If your baby only sucks on the end of your nipple it can cause a blister.

If the baby has more of the areola in their mouth the wave like motion of the tongue doesn’t move against the nipple, but instead compresses the ducts behind the nipple.

To do this easily the baby must be able to tilt it's head back a little. Try opening your mouth really wide while you are looking downwards and then again when you are looking upwards. It is significantly easier to do when you are looking upwards with your head tilted back. Click here to see a video and explanation of how to utilize the Asymmetric Latch.

Be aware that 4% of babies have what’s called a tongue tie. This means they are unable to poke out their tongue very far. This makes attachment very difficult for them and will cause a considerable amount of nipple damage. This can be rectified by some lactation consultants and some may refer you to a doctor to snip the tie. If all the remedies mentioned in the How Can My Baby Help Me Through My Mastitis section don’t help you get a good latch and decrease your pain and nipple damage it is well worth getting this possibility looked at by a lactation consultant.

What can I do about poor attachment?

Most mothers find that altering their feeding position or trying a different one makes a big difference.

Offering the breast more frequently means a shorter feed. Your baby is likely to be less frantic and therefore calmer about their attachment, and you are also less likely to make do with poor attachment.

Wait for your baby to open up their mouth really wide and poke out their tongue. Some babies do not do this well and need to be encouraged. Click here to see a video of how to prime your baby's breastfeeding reflexes using baby led latch.

Important indicators you have a good latch is an asymmetric latch where the baby’s upper lip does not cover as much of the areola as their lower lip. To achieve this:

Prior to attachment your nipple is in line with the baby’s nose/upper lip. Most women have their baby too far across, positioning the nipple to be in line with the baby’s mouth instead

The position you hold your baby in may be different for each side. Your nipples may point in slightly different directions, take notice of this before

http://www.breastfeeding-babies.com/latching-on.html#asymmetric-latch-breastfeeding

http://www.breastfeeding-babies.com/latching-on.html#asymmetric-latch-breastfeeding



deciding where to place your baby so you can line them up your baby appropriately to have their nose in line with your nipple.

Your baby’s lips should be curled out so you can see them

There is no pain (although during a case of mastitis this is unlikely to happen – keep an eye out for it when you improve though). Breastfeeding should not hurt if your baby is latched well

Baby’s head is able to tilt back a little – don’t restrict the movement of your baby’s head and neck by holding it in place. Allow them to rest it on your arm in the position they feel comfortable

If it doesn’t feel right, detach your baby and try again. Sometimes shaping the breast just behind the nipple a little can help the baby get more in their mouth.

You may also find that one breast is easier to feed from than the other. A common reason for this is that your breasts may have a difference in the speed of let down. Some women find it easier to initiate a feed on the easy side and then switch sides once the letdown has started.


Fatigue and Stress

Fatigue and stress are the most important factors in the development of mastitis (and most other ailments).

As you will have noticed even when not pregnant or attending to a new baby fatigue and stress make it more difficult to deal with infection. You are likely to be sicker longer and also feel more pain than someone who isn’t suffering from fatigue and stress.

Naturally at this point in time you are likely to be under some of the most extreme levels of fatigue and stress you’ve ever experienced, so it’s useful to learn some techniques to help you cope with what is happening so mastitis (and the other ailments fatigue and stress exacerbate such as flu, gastro, headaches etc) doesn’t become a frequent occurrence.

How to avoid fatigue and stress

Some people sail through life easily, riding whatever comes their way with ease and grace. Here are a few of the things that make these people’s lives so easy. With a little practice you can make their type of thought patterns a predominant force in your life too. Over time, you will become one of those happy, hardly stressed people too

High stress levels and sleep deprivation may seem to be difficult to remedy, but the best thing you can do is focus on what you can change rather than the facts

you can't. Moving past the frustration of the moment to something positive about the moment such as:

“I’m so glad my support network has been there for me” or

"Frozen meals are so easy at the moment, I’m so glad they were invented”

can make all the difference to your state of mind.

Always surrounding yourself with supportive people and avoiding contact with individuals who stress you out or make you doubt yourself is important. If you can’t avoid contact with stressful individuals (such as family members) then learn how to “smile and nod” your way through their advice, and once they have left you can go about things the way you would prefer to.

There is a certain amount of sleep deprivation which is par for the course of raising a newborn, but being realistic in the early days about the amount of housework you can and can't achieve is useful.

Making sure you attempt to sleep whenever the baby is sleeping is also a must - don't fill your day with too many appointments.

How to increase your energy levels

Being fatigued is almost unavoidable as a new mother. Even a content newborn will still require a feed every 3 hours for the first 6 weeks or so. For this reason it is important to sleep as much as possible when your baby is sleeping.

For some women this may be difficult. There are a whole range of factors that may compel her to do the housework, or be polite and stay up to play host to visitors.

Ultimately it is important to realize that if you wish to be the best parent to your child you must first look after your own health

This means being confident enough to tell visitors that they have arrived at an inconvenient time or that you need some help with the laundry or washing up the dishes. At this new and vulnerable stage in your life, make sure you keep this in mind. It is not selfish to ask for help, or to let people know that you need more sleep.

If you have another child visitors can be excellent for helping keep their day interesting so they aren't nagging you for more attention so often.

Another important factor in maintaining good energy levels is eating well and drinking enough water. Making milk is very tiring, but this is worse if you aren’t getting the right nutrients.

Here are a few simple suggestions to help you:

Have a glass of water at each breastfeed

Make sure you have some healthy snacks available like nuts, cheese and fruit

Keep your protein levels up by making sure there is some in every meal. Protein sources include dairy, eggs, meat, tofu and lentils

If dinners are becoming difficult try making a large amount of something healthy and eating it for a few nights running, or freezing it so there are emergency meals for difficult days.

If you don't have enough energy to think about meals much try following a breastfeeding diet. This way you won't have to think and you can get other people to help you out just by following what you already had planned.



Causes of Unsettled Behavior in Babies

Some babies cry more than others and this can be very distressing for new parents. Knowing the most common reasons your baby may cry and how to avoid these can be very calming for a stressed household. Being realistic about what your baby needs and being flexible in your approach to your crying baby and the routine you choose can be useful.

Causes of Unsettled Behavior:


Feeding Problems

Feeling Pain or Discomfort

Pain from Digestion

How to Cope With an Unsettled Baby



Breast milk is your baby's food and water. Keep this in mind when assessing whether or not your baby seems to be wanting to feed "too often". If you think of a common adult drinking eight glasses of water a day over a period of 16 hours of wakeful time (assuming 8 hours sleep at night) then they would be drinking a glass every 2 hours.

If you then include some time to have breakfast, lunch and dinner and perhaps one or two snacks then you will see that an adult is quite likely to be either eating or drinking every 1-1.5 hours.

http://www.breastfeeding-babies.com/breastfeeding-diets.html

This puts into perspective a baby who feeds every hour or two. The advantage of this frequent feeding is that your baby will not be feeding for as long at each session which can be much easier on sore nipples.

This being said, not all babies who feed this frequently are feeding well.

If you are worried that your baby is "snack feeding" and falling asleep at the breast it can be useful to learn breast compressions to help your baby get some of the more filling hind milk that comes in at the end of the feed. You may also be misinterpreting their crying as hunger when in fact there is another reason.

Back to Causes of Unsettled Behavior List

Feeding Problems

When your baby is not latched on well they will not be getting as much milk as when they latch on correctly. This can mean they seem to be hungry all the time. They may also be sucking in a lot more air than normal or only getting the fore milk which can lead to lactose overload and lots of wind and pain.

For some babies this can be just their technique, but for others it can be for reasons such as tongue tie. If you are worried that your baby is not feeding well contact a lactation consultant.

You may also find your baby is fussy on one breast but not the other. This can be because your let down of milk is slower or there is less supply on one side than the other or because your baby is uncomfortable being held on that side. Try using a different position for that side, breast compressions to increase the milk flow or consult a physical therapist such as an osteopath of chiropractor specializing in the treatment of babies to help reduce any muscle aches.

Your baby may also seem to be less satisfied in the afternoon. This is because your body makes less milk in the afternoon. This milk is more of the hind milk type which is more fatty. Feeding your baby more frequently in the afternoon can help them stock up on this fatty hind milk to help them sleep better at night.


Feeling Pain or General Discomfort

Some babies may have pains from a difficult birth such as a sore head or neck from a long labor, vacuum or forceps extraction. Some may have pain in their legs from a difficult caesarian delivery. This can mean that they don't feed well from one side or may be uncomfortable when lying on their back due to excess gas in their digestive system from lactose overload.

They may also be too hot, have a wet or dirty diaper or just feel uncomfortable from being in the same position for too long.


Some babies also cry because they are nervous about being alone. Coming from an environment of a constant touch from your uterus and a constant heart beat rhythmically patting them it can be quite distressing to be put down in a rocker or a cot. This is normal behavior and some babies just require more cuddles than others. If your baby is particularly clingy investing in a good quality baby carrier will really help you get some daily jobs done whilst calming your baby.


Overstimulation and Being Overtired

Unsettled behavior can be caused by your baby being overtired. If your baby is only sleeping for short periods of time this can sometimes be because the initial sleep cues are missed. In a baby under 3 months old the sleep cues include:

Not making eye contact

Looking away from very loud or fast moving people/objects

Staring

It's useful to pick up on these as soon as they occur and start your sleep routine (whether it be breastfeeding or rocking etc) as soon as possible.

Your baby may also be a bit over stimulated. Everything is new to a baby and even just being passed from one doting grand parent to another can cause overstimulation in some babies. This means they find it difficult to get to sleep and stay asleep. If your baby is sleeping for any less than an hour at a time this may be the case for you.

For a baby every day is full of new experiences and this can be very stimulating. Some babies do not cope well with overstimulation (which could have just been from being passed from one adult to the next for a few hours).

If you think this is part of why your baby is upset it is worth calming down your daily activities to a minimum in the short term. Think about how stimulating your routine is for your baby and whether you need to incorporate some quieter time and also learn how to resettle your baby. As your baby grows, these experiences will become easier to handle.


Pain from Digestion

Colic

Colic is a term for a baby who cannot be comforted by you even when being held by you. Crying lasts for hours and is usually due to pain. There is no medical explanation for colic. Some babies who are termed colicky babies actually have

other problems such as lactose overload, lactose intolerance or reflux which is causing them pain. Once these issues are addressed the baby becomes much more settled and happy.

If none of the following problems seem to fit for your baby you may still find that colic treatment such as Gripe Water or Marina Drops and other homeopathic remedies may be useful.

If colic symptoms are particularly severe some doctors choose to prescribe antispasmodic medication. This is not a first choice. The medication helps the bowels to relax by reducing any spasm in the muscle. Speak to your doctor if you are concerned about the severity of your baby's symptoms.

Lactose Overload

A very common reason for babies to have pain in their digestive system is lactose overload. This occurs when your baby is getting too much fore milk and not enough hind milk during their breastfeeds. The extra sugar load which is not balanced by the fatty hind milk can cause an excess of gas to be produced in the digestive system leading to bloating and pain. The symptoms of lactose overload are:

Explosive, come times green bowel motions

Screaming due to discomfort passing bowel motions and gas

Screaming with a hard, bloated abdomen

Seemingly hungry all the time

Babies with lactose overload seem to be hungry all the time because the sucking motion helps their bowel to expel the gas. To avoid lactose overload it can be useful to make sure you fully empty one breast before starting to feed from the other side. Using breast compressions can also be helpful in these cases.


Lactose Intolerance

Lactose intolerance is often diagnosed more frequently than lactose overload but is actually less common. The defining feature which distinguishes lactose intolerance from lactose overload is a failure to thrive. This means that despite drinking seemingly enough milk your baby is not putting on enough weight.

In cases of lactose intolerance you may end up needing to switch to a lactose free formula. Consult with your doctor or lactation consultant before doing this to make sure this is the correct diagnosis. Removing lactose form a baby's diet is a serious thing to do and the diagnosis should be firm before making this decision.



Reflux

Reflux is another possible reason your baby is in pain. There are two types of reflux. One where your baby has too much milk and vomits some of it back up, and the other where your baby is feeling pain from the digestive fluid in the stomach burning as it comes up.

If your baby is just vomiting milk without the discomfort this is not a big problem. If your baby shows some of the following symptoms they may be suffering from painful reflux:

Slow weight gain

Screaming during breastfeeds

Screaming 1.5-2 hours after a breastfeed as their stomach juice becomes more acid again

Prolonged inconsolable screaming day and night

Very short sleep with frequent overnight wakenings

Blood in their vomit

You need to consult your pediatrician. Reflux can be controlled with medication and should be diagnosed as early as possible. Apart from medications you can try:

Changing your baby's diaper before a breastfeed

Feeding your baby in a more upright position such as the Saddle and the Biological Nurturing positions

Keeping your baby upright for 30 minutes after the feed

Raising the head end of your baby's sleeping surface


How to cope if your baby just wants to feed or be held all the time

Some babies with unsettled behavior wish to feed very frequently. If this is the case read the nipple damage and poor attachment section well (regardless of whether or not you are suffering from nipple damage). If your baby only nibbles at the nipple, and doesn’t get a good mouthful of breast, they won’t get as much milk at each feed. This naturally makes them more unsettled. The better the attachment the more milk your baby will receive and the more your supply will stabilize.

Breast compressions can also be very useful in helping to increase the amount of milk your baby is getting at each feed. Breast compressions are done by


compressing your breast at the end of the feed to help remove any remaining milk. See this video for help with this technique.

Your baby may also be having a growth spurt. It is very common for babies at this time to feed very frequently to help your body make more milk. Don’t be worried about this unless it is lasting more than a week and you are struggling to cope. It is not a problem unless you are finding it to be a problem.

Speaking to a lactation consultant can help you identify if there is a problem which is causing more frequent feeding. They can also help you to decide on a course of action that suits your situation.

A key to coping with unsettled babies is to be realistic about your situation. Unlike common old wives tales about "spoiling your baby" by holding them all the time or "creating a rod for your own back" by helping them to get to sleep by breastfeeding to sleep, your attention and care will be helping your baby's neural development immensely. Research shows that babies who feel that their main care giver is responsive to their needs have much better long term outcomes with being able to socialize and work effectively in a group environment such as school.

To help you get through this intense period of time there are a few things you can try:

Invest in a good baby carrier such as a wrap sling or soft structured baby carrier. These are invaluable in allowing you to comfort your baby while still getting dinner on or getting out and about.

Get yourself out of the house and into a group of other mothers so you aren't stuck at home. Often these babies enjoy being out. Perhaps try a daily half hour walk (or more if you can cope) with your baby in the carrier.

Say yes to any help offered, even if it is just holding the baby so you can have a shower or get some washing done.

Look into various sleeping methods such as a baby hammock. These can be excellent for rocking a baby to sleep and helping keep them asleep for longer.

Realize that this time will pass. The majority of unsettled behavior occurs in the first 6-12 months.

Some will respond well to gentle natural therapies such as Osteopathy (always consult a registered professional who specializes in the treatment of babies and children).



Summary

After reading this book you should have the skills and confidence to begin treating your blocked duct or mastitis straight away. Just remember, getting on top of symptoms early avoids the potential for your situation to deteriorate and need pharmaceutical intervention.

So, know your warning signs:

Feeling more tired than is reasonable

Feeling a lump in your breast (check after every feed)

Feeling pain during a feed or after a feed

If you notice the above symptoms start the following techniques:

Juice the Orange every 30-60 minutes

Squeeze the Toothpaste every 30-60 minutes

Rollercoaster Arms at night

Breastfeeding every 60-90 minutes if possible

Direct massage during the breastfeed

Drink more water than you had been - an extra glass at each breastfeed as a minimum

Try to go with what's happening at the time on the day. Don't worry too much about schedule and any routine you had been implementing. You can get routines happening later, first get yourself well. Breastfeeding frequently will mean your baby won't feed for as long so your pain will be only be more intense for a shorter duration.

Once your blocked duct or bout of mastitis has resolved check through the causes of mastitis and try to avoid these stresses for your body.

I wish you luck in your mothering journey. Overall, remember to be gentle with yourself– you can’t give your best to your child or family if you are not feeling your best.


About Rebecca

I am a practicing osteopath working in Brisbane, Australia. Since starting practice in 2005 I have had a keen interest in the treatment of women's hormonal disorders, pregnant women, new mothers and babies.

I teach every pregnant woman and new mother I see in clinical practice the massage techniques I've shared here with you. I've always known how useful it is

to show women that there are ways of treating blocked ducts and mastitis before they occur because most people don't realize just how much they can do for themselves.

It wasn't until I had my own case of blocked ducts and mastitis when my son was 4 weeks old that I realized just how little information there is on the internet about how to massage your breasts to help remove any blockages.

I'm passionate about breastfeeding and helping to make it as easy and enjoyable as possible for every mother I meet. I hope this book really helps you through the painful time of having a blocked duct or mastitis so you go on to truly enjoy breastfeeding your child.

Connect With Me Online

For any other breastfeeding concerns I also host a breastfeeding website which has lots of useful information and videos. You can visit it at:

www.breastfeeding-babies.com


http://www.breastfeeding-babies.com/

mastitis advice · your pain is getting worse your fever is getting worse your fever lasts for more...

Documents