HealthPartners - Taking care of you and your newborn

Common Concerns

BURPING

Over the shoulder

Lying belly-down across your lap

Sitting in your lap with chin supported

After feeding, try to burp your baby. Not all babies will burp in the first few days after birth. To burp, pat the baby’s back gently or stroke the back with an upward motion. If your baby doesn’t burp after a few minutes, resume the feeding.

SCAN + PLAY

SLEEPY BABY Your baby may have some sleepy days when it’s hard to keep them interested in feeding. Try undressing them down to the diaper. Sometimes rubbing the bottoms of their feet or back can help keep them awake. Massage and compress your breast during the feeding to increase your milk flow. This can be a gentle reminder to continue sucking. Switch breasts several times during a feeding and talk to your baby while you are nursing. This will help strengthen your bond and may keep them interested in finishing the feeding. Be patient with a sleepy baby and don’t give up thinking your baby doesn’t want your breast milk. Sometimes it may take a few weeks for them to stay awake during feedings. GROWTH SPURTS You may find that your baby has days when they want to feed more than usual. Many new parents worry that something is wrong, but this is common. The need to breastfeed more often usually lasts a few days to a week. Then your baby will return to feeding less often. These hungrier periods are known as “growth spurts.” And they’re your baby’s way of increasing your milk supply so they can grow. Although these times may be more demanding for you, trust when your baby’s telling you they need to breastfeed more often and follow their feeding cues. As long as you don’t hold back your baby’s need to breastfeed, your milk volume should be just right.

ENGORGEMENT Your milk supply really starts increasing around 2-5 days after childbirth. When it does, your breasts may become larger, and feel heavy or warm. This is called engorgement. It’s caused by increased blood flow to the breasts, swelling of the surrounding tissue, and the increase of milk. For some people, the breasts will be swollen and uncomfortable. Others may feel a throbbing sensation and discomfort as milk begins to flow. Everyone’s experience is different. But breast swelling usually goes down within 1-2 days.

You can minimize or prevent engorgement if you: • Breastfeed often and don’t skip feedings • Don’t limit time at the breast • Make sure baby is latched properly • Express milk regularly when baby’s not nursing well

• Apply cold compresses for 15-20 minutes after a feeding • Don’t wear a bra that’s too tight— it can decrease milk supply • Avoid early use of pacifiers, bottles, and formula

If the breast becomes too full and the areola is hard, it may be difficult for your baby to latch on. It may help to hand express some milk to soften the nipple area first.

DUCTAL NARROWING

Ductal narrowing may be triggered by one or more of these factors: • Baby isn’t latching well and doesn’t drain the breast • The breast is not drained frequently enough due to: between feeding or pumping sessions limiting your baby’s time at the breast • Unresolved engorgement • Improper/deep breast massage • The breast produces too much milk (hyperlactation) missed feedings or pumping sessions waiting too long

Treatment Ductal narrowing can usually be relieved at home within 24 to 48 hours after it starts by following these tips: • Continue to feed your baby on demand without delay • Express milk by hand or pump regularly if you are away from your baby To relieve pain, you can apply a cold compress or ice pack to the affected area and take a non-steroidal anti inflammatory drug (NSAID) like ibuprofen or naproxen. If ductal narrowing and inflammation persists or worsens, it can lead to the development of a more serious breast condition called mastitis . Learning to recognize the signs and symptoms of ductal narrowing and quickly taking action to treat it at home can help prevent mastitis. If the lump doesn’t go down in a few days, contact your health care provider to determine if you need medical treatment.

Ductal narrowing, which used to be called a plugged or blocked duct, causes your milk ducts to become inflamed, swollen, narrow, and tender. The most recognizable sign of ductal narrowing is a lump in your breast that is painful when touched. It may be red, warm, and large enough to be visible when you look at your breast in a mirror. If you’ve ever experienced engorgement, the lumpy area looks and feels very similar. Ductal narrowing describes inflammation and constriction in and around the tubes or ducts of your breast that carry milk from where it is made in your breast to the nipple. The narrowing may happen when the sacs of milk (alveoli) are overly full and/or there is an imbalance of healthy bacteria in the breast (mammary glands).

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Your Guide to Postpartum and Newborn Care