Keeping Baby On (Part 1): Breastfeeding Troubleshooting

Baby is a few months old now, and you’ve (finally) managed to establish a decent breast milk supply. You and baby are now more or less comfortable with each other on…and off the breast. Congrats, you’ve gotten through that first stage of breastfeeding and parenting! It may not have been easy. But perhaps, like me, you’ve also discovered that the road of breastfeeding is still quite bumpy. Some breastfeeding sessions just don’t go very well and you know it’s not a supply issue. So what could be the reason(s)?

From experience, here are 5 simple reasons why baby might pull off the breast suddenly during a breastfeeding session, and some quick solutions to help you keep baby on the breast:

Check the latch.BFingMomBabypic2shorthair
Make sure baby has a good ‘mouthful’ of breast tissue so that the nipple is far back in baby’s throat, and baby’s lips are turned out (think of fish lips). Otherwise baby may be sucking on just the areola and not getting much and so pulls off. Baby is very smart! Why work for milk when there doesn’t seem to be any there? A bad latch would also not be very comfortable for you. If you think the latch is not good, then gently detach baby from the breast (by inserting your pinky finger into baby’s mouth to break the suction) and then try putting baby on the breast again.

Baby needs a mini-break.
Let’s not forget—sucking can be tiring! Baby may simply need a little break. Stand up, turn around or go briefly to another room. Sometimes just a minute’s break or change of scenery is enough. Also a tiny break may give the breast a chance to fill up a little more in the interim. Some other ‘mini-break’ ideas: change the baby’s diaper or change the clothes, and then offer the breast again.

Change the position.

Sometimes a change in the breastfeeding position is all that’s needed to get baby to suck a few more minutes, and this may allow more milk to be pulled out of the different milk gland areas on the breast. Baby may also latch on better in a different position. Often when breastfeeding, I would use two different breastfeeding positions per side.

Another idea is to try a completely new position that you have not tried before…who knows, this could turn out to be your baby’s favorite! If you’ve tried all the conventional positions (e.g., Cross-Cradle Hold, Cradle Hold, Football Hold and Side-Lying Hold), invent one yourself or try this new position that I’ve used regularly with my own little one during the breastfeeding phase (see A New Breastfeeding Position: the “Bear Hug”).

Got gas?
Try to sit baby up and burp baby. Once a burp is out, a baby is usually happy to get back on the breast. This is especially the case for younger babies. When my little one was between 4-6 months, she would often have at least one burp when she finished one side (and multiple burps when she was younger!).

Check the temperature.
Check the temperature of the room. Is it too hot? What about baby? Know that often breastfeeding and holding baby can increase both your body temperatures (and may cause you and/or baby to sweat), so check baby’s clothes to make sure she’s not wearing too much. Baby could be feeling a bit hot and bothered!

If you’ve done this bit of troubleshooting, and these are not the reasons why baby is pulling off the breast, try not to worry too much. Baby may have really had enough breast milk to drink! As babies mature and grow, the length of time on the breast and of breastfeeding sessions in general usually decrease. Often this is because babies become much more efficient at sucking and may also need less once solids are introduced into the diet.

Quick Tips to Prevent or Ease ‘Milk Lumps’

If you are breastfeeding your baby, you can sometimes experience these. If a milk duct is not draining well, it can become plugged or clogged, and inflammation builds up. This creates a tender, sore, lump in an area of the breast. These ‘milk lumps’ can come quickly and without warning. For me, it begins when I suddenly notice a bit of discomfort or tenderness in a spot, and then I can feel a small hard lump when I press on the area. Occasionally, I may get a lump forming from over pumping or when baby suddenly revs up demand for breast milk, causing the breasts to try to increase milk production quickly to match the increase in demand. Once the ‘milk lump’ forms though, it seems to take the better part of the day to resolve fully and I have to apply many measures including getting baby to consistently drain that spot for a couple of feeds. So the best thing I would advise is to keep checking (especially the prone breast or side that tends to get ‘milk lumps’ more easily) frequently, even daily if possible. But if you already feel a tenderness and hard lump forming, don’t worry—here are a few things from experience that you can try which may help ease the discomfort:

Massage, massage, massage.
When you feel a ‘let down’ reflex, especially at night, it often helps to massage the breast tissue (especially the outer parts of the breast) thoroughly using the base of your hand/palm in a big gentle circular motion to help with milk flow and circulation. Another tip is to massage the breast tissue all around the nipple as baby is sucking on that breast so as to help drain the different areas of the breast around it evenly.

Try using a different breastfeeding position.
Sometimes the tendency is to stick to a breastfeeding position because that’s what you and baby are used to. But if you find one particular position may be causing a milk lump to form on a part of a breast more frequently, then it may be time to try a new or different position! Your current breastfeeding position may be what is causing the milk lump to form, because a certain area is not being draining properly.

Change baby’s sucking direction.
During the course of a breastfeed session, you can switch positions and baby’s sucking direction a few times, to help drain different parts of the breast. If you already have a lump formed, then try lining up baby’s chin with the location of the lump so that it forms a straight line vertically, diagonally or horizontally to help with draining that specific area.

Try a hot shower.
A hot shower with hot water directed at the area, and some added massaging can help ease the discomfort you feel. Another idea is to put a hot wet cloth on the affected part of the breast a few times a day to help soothe that area.

What You SHOULDN’T Expect From Breastfeeding

I was debating whether to put this under the ‘Milk Milk Milk’ section or under the ‘You and Your Body’ section, but finally decided on the latter. This has much more to do with protecting your body from the possible long term effects of breastfeeding than on milk production. Read on ladies!

Prolapsed Nipples.
Yep, that’s right. Prolapsed nipples. Over time, the nipples naturally change in shape slightly to adapt to continued breastfeeding. However, you don’t want your nipples to change in shape more than they have to. So ladies, always make a conscious effort to keep baby’s mouth on par with the nipple level when feeding and ensure a good latch. It’s so easy to forget this (especially when you’re tired, and it’s another night feeding), but doing so will prevent baby from pulling on the nipple and cause the nipple to gradually sag or droop a little over time due to the pressure from baby’s mouth and weight of baby’s body. Baby will get increasingly heavier too, so make baby adjust to you, not the other way around!

Lower Back Pain.
It’s very easy to get lower back pain from sitting prolonged periods in certain breastfeeding positions trying to breastfeed baby, and doing this multiple times a day. So it’s very important to get a good breastfeeding pillow and a comfy breastfeeding chair with pillows to support your back. And of course, elevate, elevate! Bring baby to your breast level and don’t try to bend over to meet baby’s mouth instead. If you need to, you can use another pillow on top of a breastfeeding pillow to support baby’s body and head. This will help bring baby up more to ‘breast-level’ while feeding. This will help your posture too. Also, keep stretching! A daily simple stretch routine (5-10 minutes) can really keep backaches from getting worse and soothe those strained lower back muscles at the end of the day!

Becoming a Hunchback of Notre-Dame (or Godzilla…).
When my baby turned 9 months old, I happened to look in the mirror and was horrified that I had turned into a kind of ‘Hunchback of Notre-Dame’ with my shoulders hunched over and my shoulder blades sticking out. Either that or I had become like Godzilla with the stooping small rounded shoulders. I had unknowingly let my posture go to the wayside over all these months because of my focus on taking care of baby. Of course breastfeeding made matters worse, because often in my efforts to maintain a good latch while baby breastfed, I wasn’t sitting straight with a good posture. Even my husband noticed (and he doesn’t even usually notice when I have a haircut)! So when breastfeeding, get yourself into a comfortable position first before latching baby on, and try to keep sitting tall and straight. If you find yourself hunching over or in an uncomfortable position, then detach baby and re-latch baby on, or try a different breastfeeding position. And as you go throughout your day, remember what your mother told you all along, “Stand up tall and straight, and keep your shoulders back!” Or like in the film Miss Congeniality, Sandra Bullocks was told by the beauty pageant consultant to, “Keep your chin parallel to the floor!”

A New Breastfeeding Position: the “Bear Hug”

You’ve already heard or may have tried these common breastfeeding positions: Cross-Cradle Hold, Cradle Hold, Football Hold and Side-Lying Hold. I’ve tried all of them. But I ended up having to invent a new position basically out of necessity. I call this the “Frontal Hold” (or more affectionately known as the “Bear Hug”) position.

Why? First, I found I was getting milk lumps more easily on the right side from the traditional cradle hold, though the football hold position did help some. I also got tired of backaches from slouching and hunching over with the cross cradle and other positions. The side-lying position didn’t work as well for baby and I. Lastly, I was going to travel back to the States when baby was 4 months old, so needed a breastfeeding position that would work in the cramped quarters of an airplane seat using a breastfeeding cape.

Here’s how to do it (works best with the Brest Friend breastfeeding pillow):

  1. Sit up tall and straight, making sure you are comfortable with pillows behind you if needed.
  2. Put baby facing you between you and the breastfeeding pillow.
  3. Adjust baby’s legs so that they straddle around your waist.
  4. Use one hand to support baby’s head and neck (make sure baby’s back is straight) at a slight angle with baby’s mouth on par or level with nipple.
  5. Your other hand can be on the breast you are offering, when you bring baby’s head and mouth towards the nipple.

To help ensure a good latch, make sure the nipple goes far into the back of the baby’s mouth. Once latched on, baby should be able to suck comfortably this way. However, make sure to burp baby well in between or afterwards, as I have found that my baby often takes in a bit more air this way as a result.

If you are using the Brest Friend breastfeeding pillow, you can clip the two parts of the pillow together and pull the belt tight enough, so that the pillow holds the baby more snugly to your body. You can also angle or tilt the pillow so it supports the baby’s back better.

I started to use this new position when my baby was 3-4 months of age. This position became easier as baby started to sit up better unsupported, and as the football position got more difficult (baby’s body was longer and needed more pillows to support her body on the chair’s armrest). It came in so handy on the airplane too and prevented a lot of lower backaches! I still switch around positions during a breastfeeding session, but have used this “bear hug” position regularly for many months. I’ll have to stop using this breastfeeding position soon though, as she’s finally getting too big and sitting ‘too tall’ to latch and feed properly!