I’ll never forget the fear I felt the first time I experienced engorgement for the first time. I’d never seen my breasts look so gigantic or feel so hard (and painful!) and, to be honest, I worried it would last forever. Thankfully, my worry was unfounded. But postpartum changes in your breasts can be unnerving, and there are a slew of breastfeeding issues that might seem scary in the moment but are, actually, completely normal.
Romper spoke with Jada Shapiro, a certified lactation counselor, birth and postpartum doula, and founder of boober, a platform which connects expectant and new parents to expert pregnancy, birth and postpartum care providers, to better understand the common breastfeeding issues that lactating parents often face. While it can be easy for new parents to get lost in an endless sea of WebMD searches and terrifying posts from other parents looking for guidance, knowing what to expect before you begin nursing can help you better manage your expectations and prepare you for a potentially-scary-but-ultimately-typical situation.
If you've never nursed before, it's often difficult to decipher typical situations from the "time to call the doctor" situations. So if you've found yourself, for lack of a better phrase, "freaking out" over the state of your nursing boobs, have no fear: you are not alone. And if you are experiencing any of the following, while your feelings are valid you should know that your experience is typical (and there are people who will help you!).
"Sometimes, around day three through five, breast milk comes in at full force and the breasts all of a sudden get so full that it becomes hard for the baby to latch on," Shapiro tells Romper. When this happens, she says to try hand expressing or pumping, just to soften the breast tissue enough to make it easier for the baby to latch. Avoid pumping for longer than a few moments, though, or you run the risk of overstimulating your breasts and creating overproduction.
2. Clogged Ducts
"Overproduction from overstimulation of the breasts from pumping too much early on can lead to clogged ducts or mastitis," Shapiro says. "If you got a little overzealous early on with your pumping, begin to drop one pump for three to seven days. Then drop the next pumping session. You don't want to quit cold-turkey.”
This can be incredibly painful for some, so it’s important to treat a clogged duct as soon as possible. Not only will early treatment help mitigate your pain, but it will help you avoid any future complications that can arise.
3. Problems Pumping
It’s important to remember that pumping is breastfeeding! And while it's common for people to experience pain while pumping, it is not "normal" for pumping to be painful.
“Some people can’t breastfeed or chestfeed or don’t want to for personal or medical reasons and in those cases exclusively pumping is a great alternative,” explains Shapiro, highlighting that there are different ways to nourish your child with breast milk. "If pumping really hurts, check to see whether your flanges are the right size.” Keep in mind that your nipple should not be getting chafed in the pumping tube. "There should be room all the way around the nipple,” Shapiro explains. There are different sizes of flanges made for this purpose!
4. Low Milk Supply
While low milk supply is actually pretty rare, and most people who choose and/or are able to breastfeed will end up making one-third more milk than their baby can drink, according to the Mayo Clinic, the perception of low milk supply is one of the leading reasons why people stop breastfeeding before they initially intended. According to a 2015 study published in the Journal of Nursing Scholarship, 35 percent of people who weaned "early" cited perceived insufficient milk as the reason.
Some common reasons why new parents might believe they have low milk supply include frequent feeds, short feeds, and soft breasts. If you are worried about your milk supply, it's best to consult a doctor or lactation consultant, who can review your medical history and, if necessary, help you treat any underlying issues that do lead to low milk supply.
5. Sore, Cracked, Or Bleeding Nipples
"It's common for the mother or lactating parent to experience cracked, bleeding nipples,” Shapiro tells me. Usually, this is the sign of a bad latch. Shapiro says that seeking the help of a professional to aid you in adjusting your baby's latch should make the entire nursing experience much, much easier on your nipples. Remember, while difficulties breastfeeding can be common, experiencing pain while breastfeeding is not.
6. Leaking Milk
"Squirting breast milk while not breastfeeding is normal! It may happen when thinking about your baby, hearing another baby cry, or while having an orgasm, due to the large oxytocin release," Shaprio tells me.
I, for one, deal with this all the time and I’m so thankful for nursing pads!
7. Tongue Tie
Tongue Tie — a condition where a child's tongue is tethered to the floor of their mouth — affects 5 percent of newborns, according to the Children's Hospital of Philadelphia's website, and can make it difficult for a newborn to breastfeed. It is also three times more common in boys than girls, per the same website.
Signs of tongue tie are “painful breastfeeding, damaged nipples, low weight gain, endlessly long feeding cycles, and more,” Shapiro tells me. In order to treat tongue tie, Shapiro says you may be referred to a pediatric dentist who specializes in lactation and tongue ties, or an ear, nose, and throat specialist, who can explain a course of action, which could include a minor surgical procedure or simply watching to see if the issues related to the tongue tie goes away on their own or through bodywork modalities like craniosacral therapy or chiropractic care.