Obstacles to Breastfeeding
Minor problems are common during breastfeeding; however, most of these problems can be managed relatively easily. Lactation specialists, also called lactation consultants, often are helpful resources for nursing mothers.
Common breastfeeding problems include the following:
- Breast engorgement (congestion of the blood vessels in the breasts, causing swollen, hard, and painful breasts)
- Breast infection (mastitis; often causes flu-like symptoms and requires antibiotic treatment)
- Inadequate milk supply (rare)
- Interference with the let-down reflex (retention of breast milk; may be caused by stress, anxiety, or pain)
- Nipple soreness (may be caused by excessively dry or moist skin, and improper feeding techniques, nipple care, or positioning of the infant)
- Plugged milk duct (may cause tenderness, redness, and heat in one area of the breast)
- Thrush (type of yeast infection that may be passed between mother and infant; caused by Candida albicans and often results in white patches and redness in the infant's mouth)
In most cases, breastfeeding may be continued during minor illnesses (e.g., common cold). In fact, this may provide additional antibodies to the infant. However, women who have certain medical conditions (e.g., HIV/AIDS, active tuberculosis, untreated breast infection [abscess]) should not breastfeed because there is a risk for passing the infection to the baby. Women who are undergoing chemotherapy (e.g., to treat cancer) should not breastfeed during treatment.
Some types of breast surgery (e.g., breast reduction, breast implant, mastectomy) may interfere with a woman's ability to breastfeed. Women who may decide to breastfeed in the future should speak with their doctor about the effects of surgery on their ability to nurse.
Rare inherited disorders (e.g., primary lactase deficiency, galactosemia) result in the inability to tolerate breast milk or milk-based formula. In people who have these conditions, a genetic mutation causes a deficiency or absence of a digestive enzyme called lactase, which is necessary to break down sugars (e.g., lactose, galactose) that are present in breast milk and milk products, including milk-based formula.
Infants who have galactosemia experience severe feeding problems (e.g., diarrhea, vomiting, poor growth), lethargy, and irritability, beginning soon after birth. They require plant-based formula (e.g., soy formula) or specialized lactose-free formula and must avoid milk, milk products, and foods that contain lactose for life. These conditions can cause damage to the liver, brain, kidneys, eyes, and other organs, and result in malnutrition and impaired mental development.
In infants, medical conditions, such as cleft palate, Down syndrome, and premature birth, can present specific challenges to breastfeeding. However, with perseverance, most infants can nurse successfully.