This document discusses problems and complications that can occur with breastfeeding. It notes that 25% of women do not initiate breastfeeding within 24 hours, 50% discard colostrum, and 75% give prelacteal feeds. Common breastfeeding problems include reluctance to breastfeed, infant attachment issues, anxiety, and inadequate milk production. Complications include breast engorgement, plugged ducts, cracked or sore nipples, mastitis, and breast abscesses. The document provides information on prevention and management of each issue.

1. PROBLEMS AND COMPLICATIONS
OF BREAST FEEDING
MRS KALYANI RATH
ASSO.PROFESSOR, KINS

2.  “A newborn has only three
demands. They are warmth
in the arms of its mother,
food from her breasts and
security in the knowledge
of her presence.
Breastfeeding satisfies all
three” .
(Grantly Dick Read)

3. WHY EMPHASIZE ON BREAST FEEDING???
 When Indian women breast feed without
exception

4. CONT...
 25% do not initiate
within 24 hrs
 50% discard colostrums
 75% give prelacteal
feeding Many women
believe they do not
have sufficient milk &
indulge in top milk
feeding

5. BREASTFEEDING PROBLEMS
DUE TO MOTHER
 Reluctance or dislike to breast feeding
 Infant’s attachment to breast
 Anxiety and stress
 Following operative delivery
 Milk secretion is inadequate
 Breast ailments

6. DUE TO INFANT
Low birth weight
baby
Temporary illness
Over-distension of
the stomach with
swallowed air
Congenital
malformation

7. BREAST FEEDING COMPLICATIONS
 Breast Engorgement
 Cracked and sore nipple
 Plugged Duct
 Mastitis
 Breast abscess

8. BREAST ENGORGEMENT
 Breast engorgement is due to
exaggerated normal venous
and lymphatic engorgement of
the breast which precedes
lactation.

9. PREVENTION
Avoid prelacteal
feeds
 Initiate breast
feeding early and
unrestricted
Exclusive
breastfeeding on
demand

10. MANAGEMENT
 Manual expression of
any remaining milk
after each feed.
 Administer analgesics
for pain
 The baby should be
put to the breast
regularly at frequent
interval.

11. PLUGGED DUCT
 A Plugged duct is
where an occlusion or
plug has occurred in
the milk passageways.
This plug prevents milk
from passing through
or the milk passage
may be slower than
usual.

12. MANAGEMENT
 Learn how to
position your baby
so that the baby can
latch on properly
 Try using warm
compresses
 Take a mild pain
reliever, such as
ibuprofen.

13. CRACKED NIPPLE
 Loss of surface epithelium with the formation
of raw area on the nipple
 Fissure either at the tip or the base of the
nipple.

14. MANAGEMENT
 Correct attachment
 Application of fresh human milk
 Application of lotion (miconazole)
 Rest to the affected nipple.
 Use of nipple shields.

15. SORE NIPPLES
 Sore nipples are any persistent pain in the
nipples that lasts throughout the entire
breastfeeding or hurts between feedings.

16. PREVENTION
 use a proper breastfeeding technique
 keep the nipples dry by exposing them to
air or sunlight
 avoid products that remove the natural
protection of nipples, such as soaps,
alcohol.
 breastfeed on demand
 avoid the use of nipple shields.

17. MANAGENENT
 Offer the least affected breast first;
 Express enough milk before
breastfeeding to stimulate the let-down
reflex, thus preventing the infant from
sucking too vigorously on the breast;
 Alternate between different positions,
reducing the pressure on sore areas or on
damaged tissues;
 Use "breast shells"
 Use oral systemic analgesics, if

18. MASTITIS
One of the more
serious complications
of breast feeding
includes a breast
infection, otherwise
known as mastitis.
Mastitis can be
caused by an

19. MANAGEMENT
 Breast support
 Plenty of oral fluid
 Breast feeding is
continued with good
attachment.
 The infected side is
emptied manually with
each feed
 Antibiotic therapy to be
continued for 7 days.

20. BREAST ABSCESS
 Breast abscess is caused by
untreated mastitis or results
from late or inefficient
treatment. It affects 5 to 10% of
women with mastitis.

21. MANAGEMENT
 Treatment is done with analgesic &
antibiotic.
 Abscess may need incision &
drainage.
 Breast feeding must be continued in
the uninvolved side.
 The infected breast is mechanically
pumped every two hours.
 Once cellulitis has resolved breast
feeding from the involved side may
be resumed.

22. INADEQUATE MILK PRODUCTION
 infrequent suckling.
 Anxiety state in puerperium.
 Ill development of nipple
 Painful breast lesion.
 Prolactine inhibition.

23. MANAGEMENT
 Counseling mother regarding advantage of
breast feeding.
 Treatment of abnormalities.
 Encourage adequate fluid intake.
 Treatment of painful local lesion.

24. THE BABY WHO DOES NOT SUCKLES
 Avoid artificial food or water.
 Expressed milk to be given.
 Nipple should be placed slightly
upward towards the roof of the
baby mouth.
 Keep the baby nose free during
breast feeding.