Expert: Sally Wendkos Olds - 3/8/2004

Question
After a really rough start once I get the hang of BF something is always happening.  I have had mastitis twice (ouch), my breast are so engorged some mornings(not all) that I can barely touch them and my baby screams when I put her to the breast because the milk comes down so fast.  And for the past 6 weeks I have had a VERY painful yeast infection.  (It was treated but never really went away and now I am taking antibiotics again for strep throat and it has come back.) I am sick of it all.  I truly enjoy the experince of nursing my daughter, but I do not want to endure all this pain.  (Now along with the yeast my nipples are sore again.) Do you have any suggestions as to how I can PREVENT yeast infections, not be so engorged in the mornings, sore nipples after 3 months of nursing. I have tried eating yogurt for the yeast but it gives the baby gas.

One last more difficult question concernign my family.  Noone supports my choice to BF.  My SIL gives my 3 month old mashed potatoes and ice cream!  Every chance they get my sister and mom want to give her formula.  Even my husband gives her solid foods when he know the hard raod I went down to be able to BF at all.  How can I address these issues without hurting their feelings?  I have asked them all to please not give her anything but breastmilk. While I want and need their help and support I want to choose what is best for her.  (My SIL really makes me mad because she is alwasys suggesting that I wean my baby now.)  I do not have a forceful personality but I want them to know that I am seriuos about this.  

I nurse about every 2-3 ours for about 5-10 minutes each breast(sometimes she refused the second breast). She is 4 months and 15 pounds 7lbs 10 oz at birth.  I pump at work using a Pump In style.  

Answer
Dear Kim:

First of all, congratulations for giving your baby the best start in life by breastfeeding her! Then, I'm sorry to hear about the problems you have been having, and I do have some suggestions. If you want more information, you may want to take a look at my book, THE COMPLETE BOOK OF BREASTFEEDING (Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books), available at most public libraries, online and earthbound bookstores and La Leche League chapters.

1) engorgement: try expressing a little bit of milk manually or with your pump before putting your baby to the breast so the milk won't come so fast.

2) yeast infections: be sure your baby and your husband are treated too, since these are sometimes transmitted back and forth either from nursing or sex. Also, tell the doctor who is prescribing your antibiotics, about your yeast infections. She or he may be able to prescribe a different antibiotic; some are less likely to kill the good bacteria which ordinarily fight the yeast infection. Also, there are medications that can be given along with the antibiotics to counter this effect. (There's a section about the yeast infection "thrush" in my book, pp. 294-295.)

3) your family: You really need to be forceful here, as difficult as it is. You are doing the best thing for your baby, and you should be the only person who determines what she should be eating. She should definitely not be fed solid foods or formula unless you want her to or your doctor determines that it is necessary. If it is hard to tell your sister-in-law, sister and mother these things in person, write them notes expressing how important this is to you as a mother and to your baby's health. If you let them bully you now, they will be interfering with your child-rearing practices for years to come.
      There is a complete chapter for fathers in my book, and I am sending, below, an excerpt from Chapter 2 (Questions & Answers) about family issues. As far as your baby's weight is concerned, check with your pediatrician to see whether she/he feels your baby's weight is progressing normally.

Here are the excerpts:

Q:  I want to breastfeed, but my husband doesn't like the idea. Is it worth making an issue about this?
A:  Your husband may need both information and reassurance. You may want to point out some of the advantages nursing holds for him --  like relieving him of the responsibility for those middle-of-the-night feedings. You can also reassure him that he can still play a major role in his baby's care; new babies need much more than food, as he'll see if he reads Chapter 14, which is addressed to fathers.
  Many a husband initially opposed to his wife's breastfeeding goes on to become her staunchest supporter. The help and reassurance of a supportive partner are enormously valuable, so it pays for you to make extra efforts to find out what his concerns are and to answer them as well as you can.

Q:  Ever since I decided to breastfeed, everyone has been trying to talk me out of it. How can I deal with all this opposition?
A:  Opposition to breastfeeding is less common these days than it was a few years ago, but you may still sometimes hear put-downs like "You wouldn't make a good cow" or "Why can't you be like everyone else and do the natural thing -- give the baby a bottle?" or "What are you trying to prove?" Or people may blame a baby's every crying jag on your milk (or what they diagnose as your lack of it) or by doctors who suggest that you stop breastfeeding if you run into a minor problem.
      When these situations arise, try to think why people say these things, and then respond accordingly. When people have good intentions but poor information about the normal course of breastfeeding, you can enlighten them. When a trace of jealousy affects a grandmother (who sees you care for your baby so competently without her help) or a friend (who did not have a good nursing experience herself), you can help build up their morale. And when a doctor seems to be misinterpreting your questions, thinking that you're asking for permission to stop nursing, while you're actually asking for support and information, you can be clearer in your communication.
  In any case, once you make your decision to breastfeed, stick with it. You may not be able to change other people's minds, but you don't have to let them change yours.

Good luck!
Sally Wendkos Olds