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During breast-feeding, especially during the most delicate early phases, a mother may have different problems of a medical, psychological or social nature. These problems can make breast-feeding difficult or indeed prevent it. Often, some of these problems can be overcome, especially if the mother wishes to breast-feed and has the physical and psychological support of her partner, of the people who are close to her, or of the health experts. The practical and specific supports available on the market can also help. In other cases, on the advice of a paediatrician, it may be necessary to change from breast-feeding to mixed feeding, or to formula feeding.

Maternal Difficulties

There is No Milk Volume Increase

Cases of actual impossibility for the breast to produce milk are extremely rare. It may happen that the milk volume increase does not occur. In this case, and in the case that the production of milk stops or becomes insufficient for the needs of the baby, the paediatrician will then advise the mother whether it is necessary to use formula milk.

The Use of Medicines

Because medicines can pass into maternal milk, even in very small quantities, it is recommended not to take medicines during the period of breast-feeding. If necessary, it is advisable to consult your doctor.

Nipple Rhagades


Rhagades often occur, especially in women who have recently started breast-feeding or have started for the first time. Rhagades are small cuts, situated at the base, in the middle and at the tip of the nipple. They often cause bleeding and are very painful, especially during feeding. The pain can become acute, to the point of discouraging the mother from latching the baby on to her breast. It is necessary to treat this immediately in order to avoid infection from germs commonly present on the skin and a consequent inflammation of the mammary glands (mastitis). It is possible to prevent rhagades effectively by:

  • Paying particular attention to the correct position of the baby during feeding.
  • Cleaning the nipple thoroughly, before and after the feeding, avoiding the use of soaps or detergents.
  • Keeping the nipples dry and allowing the free circulation of air around them.
  • Frequently changing nursing pads.

For treatment, it is advisable to:

Spread some drops of milk on the nipple, as this has sterilizing, moisturizing and healing properties.

Flat or Retracted Nipples

The erection of the nipples, which in most women occurs when the areola is stimulated, is, on the contrary, very weak in the case of flat nipples. Even rarer, is the situation in which the nipples not only fail to become erect, when stimulated, but also tend to retract inwards. These cases are known as retracted nipples. To have flat or retracted nipples, does not mean that a mother is unable to breast-feed, as the baby does not take only the nipple but also all of the areola. Obviously, however, the baby will have difficulty in latching on to the breast and feeding will be more difficult. To make feeding easier, it is necessary to adopt some measures. It is advisable to use nipple correctors, which will stimulate the erection of the nipple. Naturally, they must be used on the advice of a gynaecologist or an obstetrician, and not prior to the fifth month of pregnancy. The nipple correctors can also be used after birth, immediately prior to the feeding. The rest will be done by the suction movement of the baby which will ensure that the nipple is modeled in the best way. The use of nipple shields, in the presence of this problem, can also help breast-feeding.

Breast Congestionreast Congestion

This involves an increase in the texture and tension of the breast, together with swelling, redness, pain and a rise in the local temperature following the presence of a residue of milk in the ducts and the mammary glands. In turn, this presence causes problems in the milk secretion cells and a consequent reduction in the production of milk. Breast congestion is important as it can make a woman more vulnerable to the risk of mastitis (a breast infection), resulting also in a high temperature. The primary cause of the problem is insufficient suction by the baby, which, as a result, is not sufficient to empty the breast. Breast-feeding on request can prevent this condition as can empting the breast manually or with a breast pump after feeding. The necessary measures to avoid this are:

  • Breast-feeding more frequently (beginning with the more swollen breast);
  • Gently squeezing the breast during feeding, leaning towards the baby to help the opening of the obstructed ducts. These actions “soften” the breast and therefore help the baby with the sucking;
  • Placing hot-damp compresses locally to help the outflow of milk.
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