Breast Care During and After Breastfeeding

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Whether you’re breastfeeding your first or your fourth baby it’s a great idea to take care of your breasts. But how do you do that? Read on for ideas about breast care that will keep your breasts and nipples in great shape for the duration of your nursing relationship with your baby.

During pregnancy, one of the first telltale signs you might experience is tender, growing breasts, thanks to increased blood flow to your breast tissue. Later in pregnancy, often by week 20 or so, your body will likely start to make colostrum, the clear, golden liquid that could—if you choose to breastfeed—be baby’s first food. After baby is born, your body will likely up the production of colostrum, and then, a few days later, switch over to making breast milk.

The recommendation after baby’s birth is to put baby to the breast as often as possible and at least every two hours. Because your breasts respond to the stimulation of baby sucking—or of your breast pump if you’re going that route—this helps your body know to make milk. This strategy also means a lot of action at your breasts and nipples while you and baby are figuring out breastfeeding.

Most people haven’t used their nipples or breasts this much ever before in their lives, which means it’s possible for quite a bit of damage to happen. Depending on how big baby’s mouth is, how strongly they suck, and whether they have a tongue or lip tie, they may be able to develop a good latch easily or need a little more guidance and help. With a less than optimal latch, you might experience bruised or cracked nipples and breast infections, known as mastitis. The first thing to do to take care of your breasts is to make sure you know what a good latch looks and feels like. It can be so helpful to see an International Board Certified Lactation Consultant or IBCLC, a trained professional who can guide you and baby to nurse efficiently and without pain.

It is also common early on to experience engorgement, where your body makes tons of milk and increased blood flow also brings lymph, a fluid which can cause swelling of the breasts. Your breasts may look much larger than normal and be hard or sensitive to the touch. And in a cruel twist, engorged breasts can make it harder for baby to get a good latch. Things that help with engorgement include breast massage and putting ice packs—they make special ones for your breasts—or cool cabbage leaves in your bra or nursing tank. Cabbage can dry up milk, so use it sparingly and check in with your care provider—doctor, midwife, or IBCLC—if you have questions or concerns.

If your nipples are raw while you and baby are learning to breastfeed, it might help to use a cream that is especially designed for raw nipples. Many are available commercially and most do not need to be wiped off before nursing again—though of course you should always check to make sure yours is safe for baby.

If your nipples progress from raw to damaged, you have a few options. You can use a product called Silverettes, which are small silver cups that fit over the nipples and facilitate healing, perhaps due to the antibacterial, antifungal, and anti-inflammatory properties of silver. I used these and healed severe nipple damage fairly quickly. There are also prescription creams that are available that might help your nipples heal faster than some of the over-the-counter products. Ask your care provider if that’s something you want to try.

Another strategy is to protect the nipple from becoming more damaged by using a nipple shield while breastfeeding. Nipple shields are usually made of silicon, though rubber and latex versions are also available. They fit over the nipple, but have holes that allow milk to escape. They can help baby improve their latch and protect your nipples from direct contact, but sometimes they can make damage worse by changing where the pressure is on your nipple or by making baby’s nursing less efficient, which then can change how much milk your breast makes. It’s best to use a nipple shield under the guidance of an IBCLC.

You can also protect your nipples from becoming more damaged by pumping instead of feeding on the damaged breast. Pumping can be great if your baby has a very hard time nursing or if your breasts have a lot of damage, but it can also be really tough on you to pump and feed your baby by bottle or syringe and still get sleep. Plus, some people respond really differently to a pump than they do to a baby, which could cause problems for milk supply. If pumping is something you want to try to help your nipples to heal, be aware of the possible repercussions and seek professional help if you need it.

Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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