Postnatal Health
Breasts and Nipples
Your breasts will be bigger and heavier than usual, so you’ll find a good quality, well-fitting cotton maternity bra both convenient and comfortable. Have several so you can wear a clean one every day. If you’re using breast pads to prevent leaking milk from staining your clothes, avoid those that are lined or backed with plastic. Change pads after each feeding and whenever they’re wet.
Cleaning and washing Clean your breasts and nipples every day with cotton balls and baby lotion or water. It’s best not to use soap because it strips away the natural oils that protect the skin from drying and cracking, and can make a sore or cracked nipple worse. Always treat your breasts gently-don’t rub them dry but carefully pat them dry instead.
There’s no need to wash your nipples before or after each feeding, but before you fasten or put on your bra after feeding, let your nipples dry in the air. Always wash your hands before handling your breasts to prevent infection.
Engorgement Three or four days after you’ve given birth, your breasts will fill with milk. They’ll become larger and heavier, and feel tender and warm when you touch them. They can get too full-this is called engorgement. Engorgement usually only lasts a day or two, but it can be uncomfortable and may happen again.
To ease engorged breasts, express some milk with your hands or by feeding your baby-you’ll probably have to express a small amount of milk first so that he can latch on. It also helps to bathe your breasts with warm water or cover them with warm towels, and to stroke them gently but firmly toward the nipple.
Engorgement can come back at any time during breastfeeding, particularly if your breasts are never thoroughly emptied or if your baby misses a feed.
Blocked ducts In the early weeks of breastfeeding you can get a blocked milk duct. This can be caused by engorgement, from a bra that is too tight, or from dried secretions on the nipple tip blocking a nipple opening. If you get a blockage, your breast will feel tender and lumpy and your skin may redden.
To clear a blocked duct, start feedings with your affected breast and gently massage it just above the sore area while feeding to ease the milk gently toward the nipple. If the blockage doesn’t clear, don’t offer the breast to your baby; check with your doctor immediately. Your breast could become infected and cause a breast abscess, which is painful, although not disastrous.
Sore nipples When you begin breastfeeding, your nipples may feel slightly tender for the first minute or so of suckling. This tenderness is quite normal, and it usually disappears after a few days. Sore nipples, though, are a common problem in the early weeks and can turn what should be a pleasure into something of an ordeal. The main causes of sore and cracked nipples are your baby not latching on properly and not being careful enough when taking your baby off your breast. Taking care to start and finish feeding properly can prevent these problems, and is essential if nipples are to heal after they have become sore or cracked.
Sore nipples heal quickly when they are exposed to the air so, if possible, go topless or braless occasionally, especially when resting, in order to let the air circulate over them.
Cracked nipples If a sore nipple becomes cracked, you may need to keep your baby off that breast for up to 72 hours and express milk from the breast to prevent it from getting engorged. Cracked nipples can be very painful, and they can lead to breast infection. To help avoid cracked nipples, apply a drop of baby lotion to your breast pad.
Mastitis The first signs of mastitis (breast infection) are swelling, tenderness, and reddening of the affected area. You’ll also have flu like symptoms, including a high temperature, chills, aches, headaches, and perhaps nausea and vomiting. If you think you’ve developed an infection, call your doctor. If it’s treated promptly with antibiotics, mastitis usually improves within a day or so. The infection only affects your breast tissue, not your milk, so you can’t pass it on to your baby.