Breastfeeding Problems in Newborns: The Correct Approach for Babies Who Have Difficulty Breastfeeding
Breastfeeding is the cornerstone of the healthy growth and development of the newborn baby. Breast milk is unique due to both its nutritional properties and its contribution to the immune system. The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend exclusive breastfeeding for the first 6 months. However, some babies have difficulty breastfeeding in the days after birth, cannot feed enough, or get tired in a short time. This situation increases the anxiety of both the mother and the family.
Causes of Breastfeeding Problems
👩⚕️ Mother Origin
- Late or low milk supply
- Nipple problems (flat, sunken nipple)
- Wrong breastfeeding position
- Stress, fatigue and anxiety
👶 Baby Origin
- Prematurity or low birth weight (poor sucking reflex)
- Intraoral anatomical problems (tongue tie, palate problems)
- Sleepy, passive babies
- Nasal congestion or postpartum respiratory adaptation
symptoms
- The baby has difficulty latching on to the breast
- Sucking for a short time and getting tired quickly
- Restlessness or dissatisfaction after breastfeeding
- Decreased daily urine output (less than 6 wet diapers per day)
- Continued weight loss
The Importance of Breastfeeding in the First Hour (Golden Hour)
According to WHO and UNICEF, skin-to-skin contact of the baby with the mother in the first hour after birth and initiation of breastfeeding increases breastfeeding success and milk production. This process is especially critical in babies who have difficulty breastfeeding.
Common Mistakes
- Giving water or formula before breastfeeding
- Premature feeding of a bottle or pacifier (nipple confusion)
- Using wrong nipple creams or soaps
- Keeping breastfeeding intervals too long
Things to Do at Home
- Correct breastfeeding position
- The baby's face should be turned towards the breast, and his body should be kept close to the mother.
- Cradle grip, side grip or cross grip can be tried.
- skin to skin contact
Naked skin contact between mother and baby increases milk flow and strengthens the sucking reflex.
- try often
It is more effective to attach the baby to the breast in calm moments without leaving him too hungry.
- Expressing breast milk
In cases where the baby has difficulty breastfeeding, milk can be expressed and given using methods other than a bottle (cup, spoon, syringe).
Maternal Nipple Cracks and Abscess Risk
- Crack alone does not prevent breastfeeding. Breastfeeding should be continued with correct position and care.
- Expressing a few drops of milk and applying it to the nipple before breastfeeding, moisturizing with lanolin-based creams and breast milk helps heal cracks.
- Actual contraindication: The cracks progress turning into an abscess In this case, breastfeeding from the relevant breast is interrupted. During this process, milk should be expressed and started again after treatment.
True and False Contraindications of Breastfeeding
Actual Contraindications (WHO & AAP 2022)
- Galactosemia (rare metabolic disease)
- HIV infection (varies depending on country policies, not recommended in Turkey)
- Maternal chemotherapy or radiotherapy treatment
- If the mother uses heavy psychoactive drugs or illegal substances
- Breast abscess (temporary contraindication from the affected breast)
False Contraindications
- Mother cold, flu
- Maternal antibiotic therapy (most medications are compatible with breastfeeding)
- Mastitis (breastfeeding from uninfected breast should be continued)
- breast milk jaundice
- Mild jaundice in baby
Supports for Mother
- Drinking plenty of fluids and eating a balanced diet
- Breast massage or warm shower before breastfeeding
- Stress management: If the mother is relaxed, milk flow becomes easier
- Getting breastfeeding consultant support
When to Consult a Doctor?
- The baby does not suck at all or constantly refuses to suckle
- Inadequate weight gain or weight loss
- Urinating less than 6 times a day
- Vomiting, bloody stools, bruising
- Severe restlessness and non-stop crying
❓ Frequently Asked Questions (FAQ)
- My newborn baby has difficulty sucking the breast, is it normal?
It can be seen frequently in the first days. With the right position and patience, most babies recover in a short time. - Does tongue tie cause difficulty sucking?
Yes. Tongue tie may reduce suction power. A pediatrician or ENT specialist should evaluate it. - I feel like I don't have enough milk, what should I do?
Breastfeeding the baby frequently, drinking enough fluids and managing stress increases milk supply. - Is my baby breastfeeding but constantly restless and not getting enough?
Monitoring the baby's weight and daily urine count shows that the baby is full. If in doubt, a doctor's check is necessary. - If I have to give formula, should I give up breast milk?
No. Breast milk is always priority. Formula should only be used as a supplement with a doctor's recommendation. - Why do premature babies have difficulty breastfeeding?
Because the coordination of sucking-swallowing-breathing is weak. These babies require special methods and close monitoring. - My nipple is flat, my baby can hardly latch on. What can I do?
Support can be provided with a chest shield or appropriate apparatus. It is useful to get help from a lactation consultant. - My baby does not want to breastfeed while sleeping, is this normal?
Newborns tend to sleep. Feeding can be tried by gently awakening (diaper changing, light touch). - Is it right to express my milk?
It is beneficial for the baby's weight gain. However, if possible, contact with the mother's breast should continue. - I have breast cracks, should I continue breastfeeding?
Yes. Crack does not prevent breastfeeding. However, if an abscess develops in advanced cases, that breast is temporarily suspended.
🍼 Conclusion and Call
Every baby's sucking habit is different. Problems such as breast cracks, difficult breastfeeding, and lack of milk can often be solved with the right methods.
In our clinic, one-on-one breastfeeding training is provided by our neonatal nurse, and mothers are taught the correct techniques. We are at your service for newborn follow-up and breastfeeding consultancy in Izmir Alsancak.
📚 Resources
- World Health Organization (WHO). Exclusive breastfeeding for optimal growth, development and health of infants. 2023.
- American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 2022.
- T.R. Ministry of Health, Baby Friendly Health Institutions Program, 2023.
- Cochrane Database of Systematic Reviews: Interventions for promoting the initiation of breastfeeding, 2020.
- Cochrane Review: Management of Breast Abscesses, 2018.
