Newborns are hard wired to breastfeed and are born with instincts to help them latch on right after birth. But that doesn’t mean it always goes perfectly right from the start. Many new moms expect breastfeeding to come naturally without many issues. In reality, breastfeeding can take practice and patience as you and our baby navigate breastfeeding for the first time. There are a lot of issues that can come up during breastfeeding in the first few days, and even months down the road. The more you know about the small speed bumps you could run into the more likely you are to be able to get over those and correct small issues before they become big problems. This episode is focused on troubleshooting issues that could show up in your baby like jaundice, tongue tie, yeast infection, thrush, food allergies or sensitivities, nursing strikes, sleepy babies, cluster feeding, growth spurts, and spitting up.
Article and Resources
This article will be helpful in learning about and tackling some breastfeeding issues but this is not a substitute for the value you can get from seeing a lactation consultant or going to a breastfeeding support group. I cannot emphasize enough how helpful it can be to get help as soon as you need it before a small issue becomes a bigger issue.
The thought of hiring a consultant may sound expensive, but many times you can find these resources for free. La Leche League is a great starting place for this. Also check with the venue where you are planning to give birth or check with your midwife if you are planning a home birth.
There is a page on the Pregnancy Podcast website with all of the breastfeeding resources, episodes, and articles in one place and you can check that out by clicking here.
Kelly Mom is an excellent resource for breastfeeding related topics and I reference it throughout this article.
The Womanly Art of Breastfeeding is an awesome resource to have everything you could possibly need to know about breastfeeding in one place. I have read this book multiple times and referred to it throughout both of my breastfeeding experiences.
Jaundice is when your baby has a yellowish tinge to their skin, and this often happens with healthy newborns. Jaundice is caused by a buildup of a chemical called bilirubin in your baby’s blood. Bilirubin is formed naturally from the body’s normal breakdown of red blood cells. The liver is responsible for removing bilirubin from the bloodstream. Often times a newborn’s liver doesn’t work quite as efficiently as it needs to and the result can be a slight yellow tinge to their skin.
It is common for babies to have a mild case of jaundice, which is completely harmless. If bilirubin does reach high levels, it can become a serious condition and if not treated effectively, and can lead to some pretty serious problems. Jaundice does tend to be more common in newborns who are breastfeeding, and most often in those who are not nursing well. If you are breastfeeding you should be nursing your little one eight to twelve times per day in the first few days, which will help produce enough milk and help keep bilirubin levels low.
If you suspect that your baby has jaundice contact your pediatrician. Keep breastfeeding, and do it often, this is one of the best things you can do to prevent this issue. If your baby does get jaundice, it will first appear on their face, then on the chest and abdomen, and finally on their arms and legs. The whites of the eyes may also be yellow. When you have your first checkup with your pediatrician they will examine your baby for jaundice, and if they suspect that it may be present they may order a skin or blood test to definitively diagnose the condition.
Jaundice tends to peak at three to five days old, since this is the time when the bilirubin level is highest. If your pediatrician determines that jaundice is present and needs to be treated, there are several ways it can be treated. Bilirubin levels can be reduced by placing the infant under special lights when they are undressed, this can be done in the hospital or at home. During this treatment their eyes will be covered to protect them during the light therapy.
For more reading on breastfeeding a baby with jaundice click here.
Tongue tie is when your baby’s frenum or frenulum (the membrane under their tongue) is too short and restricts the movement of their tongue. When your baby nurses they are sticking their tongue out and if they cannot do that it makes it difficult for them to get a good latch and effectively remove milk.
Some symptoms of tongue tie are your baby having difficulty maintaining a latch, not being able to suck or swallow effectively. While you will be able to see this it is best to have it diagnosed by your pediatrician or a lactation consultant.
To treat it a doctor snips the membrane, this is done with a local anesthetic and is really quick. If your baby has a tongue tie the sooner you get it fixed the better. If you have any concerns about tongue tie please bring it up with a lactation consultant or your pediatrician.
For additional resources for breastfeeding a baby with tongue-tie or lip-tie you can click here.
Yeast Infection & Thrush
A yeast infection on your breast makes your nipples pink and shiny looking, your skin may be flaking and you will have burning, itching, or pain. If your baby has a yeast infection in their mouth it is known as thrush and can be passed back and forth between you and your baby. A sign you would see in your baby is creamy white patches in your baby’s mouth and on their tongue that do not wipe off. It is common for babies to have somewhat of a white coating on their tongue from milk, and this should wipe off easily.
If you think you and your baby may have thrush seek out a lactation consultant or your doctor or midwife. You can see additional thrush resources on the Kelly Mom blog.
There is quite a bit to do to treat this involving you, your baby, and anything that is coming into contact with your breasts or your baby’s mouth. I really recommend seeing a professional if you think you may have thrush.
Your baby has food allergies or sensitivities
Everything that you are eating is passed to your baby in trace amounts in your milk. If your baby has an allergy or a food sensitivity it will show up as them being more fussy than normal, spitting up more often than normal, having more gas than usual, a rash that usually shows up on their cheeks or even on their bottom, you may see some signs of eczema. The only real way to tell if something you are eating is bothering your baby is to cut it out of your diet and see if the symptoms improve. Some of the foods that are most often associated with allergies and intolerances are:
- Cow’s milk (This isn’t just in milk, but is also found in cheeses, butter, and in a lot of packaged foods.)
If you eliminate something from your diet it could take a week or two to fully see symptoms improve, assuming that food was causing the problem. This can be a challenging process of trial and error. For more information on dairy and food sensitivities check out this article on Kelly Mom.
A nursing strike happens when your baby suddenly decides they do not want to breastfeed. They key word here is suddenly. This isn’t your child weaning, which they would rarely do on their own before age 2. A nursing strike can be for an infinite number of reasons, something simple to detect, like they have a cold, or something more obscure like a change in the taste of your milk.
Fortunately there are some tips for dealing with a nursing strike. First, you still want to express milk to keep up your supply and avoid plugged ducts. If your baby is not breastfeeding you can express milk by hand or with a breast pump. You cannot force breastfeeding, it just doesn’t work that way. Your baby may be more amendable to nursing at night or when they are sleeping. You may want to try breastfeeding in a different position or a different place. If you would like to read more Kelly Mom has a great article aptly titled, Help My Baby Won’t Nurse on Kelly Mom.
Your baby will not stop nursing
On the opposite end of a nursing strike is a baby who will not stop nursing. This can be frustrating at times, but this is normal. Your baby will not eat in the same patterns every day, this will vary all over the place, especially early on.
Cluster feeding is when your baby spaces feedings closer together during a part of the day. As an example if your baby wants to be attached to your boob from 5-8 pm, yes for 3 solid hours, then they are cluster feeding. It is pretty common for babies to naturally be fussier in the evening and they may prefer to be at your breast and nursing during this time. Your breast is their safe comforting place and remember, this is normal. If you find yourself dealing with a baby who is fussy in the evenings and cluster feeding you can read more on Kelly Mom.
A big contributor to cluster feeding is your baby going through growth spurts. You will know when they are because they are going to breastfeed a lot more often and may be more fussy than normal. When they do increase their feedings this will be temporary and usually just goes for 2-3 days, but it could be as long as a week.
Some common timeframes for growth spurts are 2-3 weeks, 4- weeks, 3, 4, 6, and 9 months. Every baby is different but these seem to be most typical. While growth spurts can be more challenging times with a baby it is pretty awesome that your baby and your body will adjust the amount of milk needed during and after a growth spurt. Kelly Mom offers more information on growth spurts here.
Your baby is falling asleep at your breast
With a newborn getting breastfeeding established in those early newborn days is really important. What do you do with a baby who is falling asleep at your breast or who is just overly sleepy. It is recommended to wake them up to nurse every 2 hours during the day or 4 hours at night. This is usually just until they get back to their birth weight. You can check with your doctor, midwife, or pediatrician for their suggestion on how often you need to be feeding your baby in those early days.
With my son I made the mistake of thinking I had to set alarms throughout the night for way longer than I actually needed to, and I could have probably used the extra sleep in those days.
The most common suggestions to gently wake a sleepy baby or to keep them interested in nursing is to gently burp your baby or change their diaper. Any activity that is gentle, like undressing them or holding them in a different position may wake them up a bit and get them more interested in breastfeeding. Kelly Mom has additional information that may be helpful if you are dealing with a sleepy baby.
Your baby is going to spit up. This is what all those burp cloths are for that you may stocking up on. Usually this doesn’t bother your baby much and it looks like more than it really is. Spitting up is common so don’t get stressed out about it. If you think your baby is spitting up more than they should be you can always bring it up with a lactation consultant or your pediatrician.
Spitting up is different from vomiting. Spitting up looks more like milk free flowing from your baby’s mouth, where vomiting is a forceful ejection of the contents of the stomach.
Luckily, there are some really simple things you can do to reduce spitting up. Burping your baby after eating may help reduce the amount of spitting up they do. Also keeping them upright for a bit, rather than immediately laying them down may reduce the frequency of spitting up. If you would like more information on spitting up and reflux check out this article from Kelly Mom.
Hopefully this article is helpful in scratching the surface of some common breastfeeding issues. It is always an excellent idea to refer to a lactation consultant. Seeing a professional can be a lifesaver for your breastfeeding relationship and can prevent a small issue from becoming a big issue.
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