A common problem with early breastfeeding is soreness. There are several reasons for this:

1) Unfamiliarity. Women in our culture are not used to any sensation on their breasts as they usually wear a bra that allows no movement and layers of clothes to keep warm. It takes a while to get used to nursing a baby on skin that is not usually exposed even to the rubbing of clothes, and certainly not to the elements, as our hands and faces are. Even the normal pinching sensation of the baby latching on feels strange to begin with.

2) Incorrect positioning. Breastfeeding should not hurt once the baby is latched on and is suckling correctly. Even if the skin is already damaged, and then the correct position is adopted, it will stop hurting after the initial latch on. Take him off the breast if it is hurting (put your little finger into the corner of his mouth to break the suction), wait until he turns with his mouth wide open, pull him quickly onto the breast while his mouth is as wide as he will open it. You can also try putting more breast into the baby’s mouth - while he is on the breast - by posting it in from underneath. If you have no joy finding a health professional able to help you to latch satisfactorily you may ’phone a breastfeeding counsellor.

3) Ignoring the pain. Women ignore the warning signs and continue to nurse and allow the baby to damage the breast. Often this is because they are so afraid that he will not latch on again that they continue incorrectly because at least he is nursing. Professional knowledge is thin on the ground. Women are sometimes advised that the baby is correctly latched on when the pain the mother is feeling clearly states that he is not. The mother is not in a position to argue at a time like this: she does not know that it is not supposed to hurt.

4) Engorgement. A very full breast is difficult for a baby to draw into his mouth to begin to nurse. He will apply as much suction as is necessary - and sometimes it is a lot. The breast is more easily bruised when overfull. It can help to express a little milk and have a bath. It is a situation best avoided if you can. See Engorgement p.45.

5) Baby’s mouth size. To start off with the breast is bigger than the baby’s head and he may have trouble getting all the breast he needs into his little mouth. It may take several tries each feed to get latched on, so that he has enough breast in his mouth to milk the breast effectively. The baby grows quickly and the breast diminishes in size quite naturally as the balance of supply and demand emerges.

Many women have a temporary soreness while the breast gets used to the baby suckling. I guess that the skin is renewed several times a day as the baby nurses. What needs to happen is that you are renewing the skin slightly faster than the baby is wearing it off. The same is true of any area of the body that does physical work - palms of hands, lips etc. - and we only notice a problem if the replacement time gets out of synchronization with the wear and tear. I liken it to wearing a new pair of shoes and getting blisters if you keep wearing them when you are getting sore heels. There are certain measures that you can take to help, but do not let them stop you from getting the positioning right. This is fundamental to preventing further problems.

Remedies for soreness:

(i) Correct positioning (ii) Fresh air (iii) Calendula cream (not lanolin based) (iv) Light (v) Vitamin E (vi) Avoid iron tablets (vii) Breastmilk (viii) Alternative feeding position

(i) I have covered correct positioning. See: Latching on p.7, as well as comments above.

(ii) Fresh air seems to help skin damage to heal, either leave off bra and wear loose clothing or tea strainers in the bra with the handles cut off. Avoid breast pads as they can perpetuate soreness.

(iii) Calendula cream is sold as a cut cream, not specifically for breastfeeding (sometimes sold as Hypercal, you will find it in Health Food shops and Boots homeopathic range). I have found it speeds up the healing process remarkably, which is really useful when you know your baby is going to want to feed again shortly. Avoid the lanolin based one; some women are allergic to it and that makes their problem worse, it is also sticky whereas the non-lanolin based one is quickly absorbed. You only need to put a trace on.

(iv) Sunlight and daylight are ideal, even through glass. If you are in the middle of winter as you read this you can use artificial light. You only need a short exposure to really help the healing process: a minute or less at eighteen inches from a bare light bulb. Be careful not to over expose already delicate skin. Continued on page 2

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