Struggling to breastfeed? Here's where to get help

What to know when breastfeeding's a struggle

First things first: just by starting to breastfeed, you've done a wonderful thing – even breastfeeding your baby for a few days only means they get colostrum, the pre-milk your breasts make first, that's known to help develop immunity in your newborn.¹

If you've carried on past the 1st few days or are even 1 of the 24% of mums still exclusively breastfeeding at 6 weeks (according to stats shared by Unicef in 2010), good for you. But, if you're not sure you'll make it that far – or have got that far but don't think you can go much further – we get that, too. Before you pack it in for good, though, you need to know that there is help out there and it's not an admission of failure to ask for it.

If breastfeeding's a struggle, you shouldn't feel it's something you have to deal with on your own, says Justine Fieth, postnatal doula and breastfeeding supporter at La Leche League GB. "Speak up and seek skilled professional help," she says.

"If it doesn’t feel right to you, then it isn’t fine – whatever anyone says," says Justine. "Breastfeeding should be comfortable for you and your baby should be getting milk efficiently. If either of those things aren’t happening, then you need skilled breastfeeding support both for you and your baby.

Keep asking for help, rather than suffering in silence. Breastfeeding isn't meant to be uncomfortable. If it’s hurting, get support. Sometimes, a few adjustments can make a huge difference to how it feels.

"And who you get help from can make all the difference," adds Justine. "Not everyone is equally trained, experienced and practised to the same level of breastfeeding support and knowledge: finding someone with an IBCLC (International Board Certified Lactation Consultant) qualification (see Professional groups who can help with breastfeeding, in the box below) is a really good starting place."

6 reasons we struggle to breastfeed – and 6 simple solutions

1. I can't get my baby to latch on properly

Getting a good 'latch' (so your baby's mouth is correctly attached to your breast for a feed) is key to ensuring breastfeeding isn't painful and that your baby's getting enough milk.

It can take a little while to get the latch correct but, says Justine, there are key signs that you've got it right – such as it feeling comfortable for you and seeing your baby's cheeks staying rounded as they're sucking.

If you think you've not quite got it correct, check our our 8-step guide to a correct latch – with pictures – compiled with Justine's expert help.

• How to make sure your baby's latched on correctly

2. Breastfeeding is just so painful

Pain when you're breastfeeding could mean your baby's not latching correctly (see problem number 1, above). As well as looking at our guide to getting the right latch, it might be worth changing up the way you hold your baby as you feed them, to see if that improves your baby's ability to latch correctly and helps them to get milk more easily.

• Breastfeeding positions you didn't know about, with pictures

Sometimes, pain when breastfeeding can have other causes, though, including engorgement, cracked or sore nipples (often as a result of an incorrect latch), blocked milk ducts, inflammation (such as mastitis) or infection (such as thrush). None of these are pleasant, we know (we've been there) but there are ways to make sure it doesn't hurt as much, and to stop it happening again.

• Why does it hurt when I breastfeed? How to ease the pain
• Mastitis: the signs and symptoms – and what to do if you have it

3. I don't think my baby's getting enough milk

Anyone who's ever breastfed has worried about this at some point – and no wonder, when you can't see and measure how milk much your baby is drinking like a formula-feeding parent can. But when this becomes a stressful, daily worry – particularly if your health visitor is telling you your baby's not gaining weight – it can undermine any confidence you have in your ability to breastfeed.

If this is something that's affecting you, read up on the key indicators that your baby's getting enough milk (which settling well after a feed and producing 6 to 8 wet nappies a day). If you're still worried, seek help from a qualified breastfeeding counsellor (see Professional groups who can help with breastfeeding, in the box above); this is exactly the kind of issue they're trained to sort out.

• How to tell if your baby's getting enough milk

4. My baby was born prematurely

Having a premature baby changes any expectations you may have had about breastfeeding. If your baby's poorly or very premature (born before 32 weeks), they probably won't be be able to nurse at your breast yet, and you'll be encouraged to express breastmilk that can then be given to your baby through a tube or syringe or from a cup.

The hospital medical team will make sure you're able to feed your baby (either from a tube, from the breast or from a bottle) before you bring them home. But once you're at home, it can be tough transitioning from feeding with support all around you to feeding a hungrier, more alert baby on your own.

Sometimes, the solution is just a matter of practicalities (such as finding a chair or cushion that allows you to raise your baby high enough to latch on well) but often what you actually need is 1-to-1 support from a qualified lactation counsellor. Don't be afraid to seek it out: you and your baby deserve it.

• Everything you need to know about breastfeeding a premature baby

5. I just feel very 'down' when I breastfeed

As Justine says, breastfeeding should be both comfortable and enjoyable. But for a small number of women, the physical reality of a baby suckling at your breast actually makes triggers feelings of overwhelmingly sadness.

If this is the case for you, it's possible that you have D-MER (Dysphoric Milk Ejection Reflex), a rare and only-recently-recognised condition that makes breastfeeding an emotional 'downer' and seems to have a physiological, rather than psychological, basis, possibly caused by an abrupt drop in dopamine levels when your breastmilk is released as your baby latches on.²

As D-MER is only recently recognised, the scientific literature about it is limited and there's no direct research into it, so your doctor or health visitor may not know much about it. But there is now a Facebook support group (see Struggling to breastfeed: here's who can help, above) where you can share your experience with others, and get practical tips and encouragement.

• D-MER: what it is and what you need to know

6. I feel I'll be judged if I stop breastfeeding

If breastfeeding's painful or uncomfortable, it's always worth getting help to see if you can make it easier (with the right support, it's nearly always possible). But if you strongly feel that you don't want to breastfeed any more – for whatever reason – that's totally your decision and no one should make you feel bad about it.

Yes, official guidelines from the World Health Organisation (WHO) recommend that breastfeeding exclusively for 6 months is best for your baby but gone are the days when, if you told your midwife or health visitor you're switching to formula-feeding or mixed feeding, you'd be strongly advised not to or simply left to get on with it on your own.

In fact, it's now part of a midwife's job to support women who decide to stop breastfeeding – or not to breastfeed at all. "If, after being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so," says Gill Walton, chief executive of the Royal College of Midwives, "her choice must be respected. Women must be given all the advice and support they need on safe preparation of bottles and responsive feeding to develop a close and loving bond with their baby."

So, if you've tried everything and are still struggling so much, you want to stop, you won't be judged. The most important thing, as all health professionals acknowledge, is that your baby's getting the milk they need, and that you're staying as happy and healthy as you can and enjoying your role as a new mum.

• Mixed feeding: how to make it work
• How to make up a formula bottle for your baby

Pics: Getty

References

<sup>1. Colostrum and its benefits: a review. Florence O. Uruakpa et al. Nutrition Research 22(6):755–767 June 2002. DOI: 10.1016/S0271-5317(02)00373-1
2. Dysphoric milk ejection reflex: a case report. Alia M Heise et al. International Breastfeeding Journal, 2011 Jun 6. DOI: 10.1186/1746-4358-6-6</sup>

Read more...

• How to breastfeed
• How to get your baby to latch correctly
• What to eat when you're breastfeeding
• When breastfeeding hurts: how to ease the pain
• How - and when – to stop breastfeeding