My Parenting Site

What does it mean to swaddle a baby?

Swaddling is the art of snugly wrapping your baby in a blanket for warmth and security. It can also keep him from being disturbed by his own startle reflex, and it may even help him stay warm and toasty for the first few days of life until his internal thermostat kicks in. Most important, it's a method that can help a baby get calmer.
Nowadays, you probably won't leave the hospital without a little lesson in this technique. Try it, after you've made sure your baby isn't hungry, wet, or tired. It can be used to help settle your baby down when he's overstimulated or when he just needs to feel something close to the tightness and security of the womb. Once your baby is about a month old you might want to stop swaddling him while he's awake as it may interfere with mobility and development in older babies. It's fine to keep swaddling your baby while sleeping if he seems to sleep better that way; he'll let you know by crying or kicking when he no longer wants to be bundled up.

How do I perform this cozy art?
Lay a blanket on a flat surface and fold down the top-right corner about 6 inches. Place your baby on his back with his head on the fold. Pull the corner near your baby's left hand across his body, and tuck the leading edge under his back on the right side under the arm. Pull the bottom corner up under your baby's chin. Bring the loose corner over your baby's right arm and tuck it under the back on his left side. Some babies prefer to have their arms free, so you may prefer to swaddle your child under the arms so he has access to his hands and fingers.

What are they?

Clogged or plugged milk ducts are just what they sound like ducts that have become blocked, inflamed, and sore.

The first sign of a plugged duct may be a small, hard lump that is sore to the touch, or a very tender spot in your breast. Some women also notice redness on the breast. In addition, you may feel achy, run down, and feverish, which may indicate your clogged duct has become infected.

What causes them?

Ducts become plugged when milk fails to drain completely. This can happen because of a poorly fitted nursing bra, incomplete or skipped feedings, an inadequate pump, an illness such as a cold, stress brought on by the holidays or work, or simply out of the blue. Left untreated, a plugged duct can evolve into a full-blown breast infection known as mastitis, so don't ignore these symptoms.

What should I do?

Nurse, nurse, nurse! Frequent nursing is crucial to completely empty the breast, for comfort, and to reduce inflammation.
Experts also recommend that you massage the sore area frequently and firmly, starting at the top of the breast and working your way toward the nipple. Applying warm compresses before nursing can help empty the breast.
Vary your nursing position. For example, if you use the cradle hold, try the football hold or nurse lying down. Also, many women swear by this trick: Position the baby at your breast with his chin pointed toward the sore spot. This directs suction at the plugged duct and seems to promote healing.
Some women also report success using herbal remedies such as echinacea, lecithin, and vitamin C. Taking ibuprofen sparingly may help relieve pain and inflammation, but ask your doctor first.
Next to nursing, the most important thing is rest. This may seem difficult or impossible with a baby to care for, especially if you have other children, but it's an important element of recovery. To get a bit more shut-eye, consider keeping your baby with you in bed. Put a stash of things you'll need nearby, such as diapers, toys, books, and drinks, to minimize trips out of bed. If possible, ask someone to help you for a few hours a day so you can get some sleep.

To help prevent future plugged ducts, avoid long stretches between feedings. A poorly fitting or constrictive bra may also contribute to plugged ducts, so buy nursing bras that really fit.

Will they affect my baby?
Sometimes your milk flow on the affected side is slower than usual and your baby may become fussy when nursing on that breast.

Can I still nurse?
Yes. The antibacterial properties of human milk keep baby safe from any bacteria that may be present as the result of an infection. However, if you have a fever after 24 hours and continue to experience pain after trying rest, heat, massage, and frequent nursing, you should visit your doctor or healthcare professional. You may need medication if you have an infection.

What is it?
Mastitis can leave you feeling as if you've come down with the flu. You may notice areas of redness, hardness, soreness, or heat in your breast, and swelling of the affected milk duct. Common, and more serious, signs of the infection include chills, a fever of 101 degrees Fahrenheit or higher, and fatigue.

If you find yourself with a breast infection, you're not alone: About one in 20 nursing moms get it, and some non-nursing mothers do, too. And while you can get mastitis more than once, it's very unlikely that you'll get it in both breasts at the same time. (We hope that's some consolation!)

What causes it?

The problem is caused by invading germs. Typically, those germs pass from your baby's mouth, nose, and throat into a milk duct through cracks or fissures in the nipples, though non-nursing moms may get a breast infection when they experience engorgement. Other contributors include not completely emptying breasts of milk, and lowered resistance to illness (most new mothers are tired, stressed, and probably not eating all that well) factors that can affect nursers and non-nursers alike. First-time moms who haven't mastered a good latch-on technique and are suffering from cracked nipples are more likely to contract mastitis, although experienced nursing mothers aren't immune.Mastitis can occur at any time while you're breastfeeding, but it's most common between the 10th and 28th days postpartum.

How can I treat it?

See your caregiver if your symptoms don't improve after several hours of applying moist heat to your breasts, feeding your baby more frequently, and taking ibuprofen to ease the pain. She'll prescribe antibiotics (if you're nursing, check to make sure the medication will not affect your baby, though the most commonly prescribed antibiotic for this is safe for babies), bed rest, pain relievers, and ice or hot compresses. When the antibiotics kick in during the next 48 hours, you'll start feeling better.

Another way to ease the pain:
Nurse frequently to keep the affected breast empty, which may help clear up the infection faster.

How long will it last?

If the infection is diagnosed early, it's easy and quick to treat, and you won't need to stop nursing from the affected breast. Be sure to take all of the prescribed antibiotics to keep the infection from returning a few days or weeks later. It won't be long before you feel 100 percent better. If your breast remains tender and you still have a fever, contact your healthcare provider without delay.
Ignoring mastitis can cause complications. If untreated, it can lead to breast abscesses, which require antibiotics, and surgery (usually performed while the patient is under general anesthesia) to drain the abscess. Consequently, your baby won't be able to nurse on the infected breast.
The best way to avoid mastitis is to get plenty of rest and eat a healthy, balanced diet while you're nursing. The more run down you are, the more susceptible to infection you become.

Should I stop nursing if I have mastitis?

No. In fact, it's important that you continue nursing through an infection. Although nursing may be extremely painful at times, you need to let your baby feed frequently to keep your milk supply flowing and avoid further blockage. Try warm compresses on your breasts for several minutes before each feeding this should help your letdown reflex and make nursing more tolerable.
If your baby doesn't empty the inflamed breast during each feeding, finish the job yourself with a breastpump. And if you find that it is unbearable to nurse, try pumping your breasts and giving the milk to your baby in a bottle. But don't rely on this solely to get you through the infection, as your baby can "pump" your breasts more efficiently than any device.

Will it affect my baby?

Though you no doubt feel lousy, mastitis will not affect your baby. In fact, the germs that caused the infection probably came from your baby's mouth in the first place, so don't worry about passing the same germs back to him.

Is it normal for my nipples to be sore from breastfeeding?

Sore nipples are so common to new breastfeeding moms that you may think they're a normal part of nursing. Not so. Most women feel some tenderness in the beginning of a feeding during the first few days, but severe or prolonged pain associated with nursing is neither necessary nor normal. If the pain is intense or lasts longer than a few days, it's a sign that you may need to make some changes. Nursing can and should be a pleasurable experience for both you and your baby.

What causes the soreness?

If your nipples are sore, you most likely have a baby who's latching on improperly or is positioned incorrectly at your breast. Make sure to place your breast well into your baby's mouth so his lower lip is splayed out well below your nipple. If he has to suck or pull your nipple into his mouth, it can cause you soreness and pain. If your baby is latching on improperly, he may develop poor sucking patterns that can be hard to correct later. (If you develop sore nipples once your baby is older and you've been breastfeeding for a while, it may be due to a yeast infection known as thrush.)

How can I tell if my baby is latching on properly?

Follow these guidelines:

1) If you're using a breastfeeding pillow, wrap the pillow around your body and secure it snugly. Try positioning the pillow just below your breasts. Many mothers find that holding the baby at this level allows for a better latch.

2) Position your baby on his side facing your left breast and cradle him with your right arm (or vice versa). Place your thumb and index fingers around the base of his head, behind and below the ears, so that you can support his head, neck, and shoulders.

3) Snuggle your baby's lower body close to your body. Tip his head back slightly so that his chin is closer to your breast than his nose.

4) Support your breast with your free hand so that your thumb is about an inch or two behind the nipple and your index finger is directly across from it on the opposite side of your breast. Compress your breast right in front of your baby's nose and right below his chin. Shape the breast tissue to match the shape of your baby's mouth to allow for a more complete latch.

5) Line up your baby's nose in front of your nipple. Touch his upper lip with your nipple; when (and only when) he opens his mouth wide, quickly pull him onto your breast, chin first, while keeping your breast compressed. Aim for the underside of your nipple so that your baby takes in more of the tissue below the nipple than above.

6) Your baby's bottom lip should be as far away from the base of your nipple as possible. Resist the temptation to move your fingers out of the way or center your baby's mouth around your nipple. Keep your breast tissue compressed until he's actively sucking.

7) If your baby latches on without opening his mouth wide enough, break the suction by putting your finger into the corner of his mouth. Take him from the breast and start again. Don't pull your nipple out without breaking the suction.

How can I help my nipples heal?

Try using a purified, hypoallergenic lanolin cream formulated especially for sore and cracked nipples, such as Lansinoh or Pur-Lan. These creams are considered safe for babies, and you can find them at many pharmacies. You can also try chilled glycerin gel pads, such as Soothies, to keep your nipples moist and cool and to protect them from friction.
If your nipples are cracked and sore for longer than five days, the cracks are most likely infected with bacteria, which can slow healing and put you at risk for a serious breast infection. See your practitioner for an antibiotic ointment to clear up the infection.

Can I still nurse?

Yes. But if you're still having a lot of pain even after trying the above tips, get expert help from a lactation consultant. Some moms find a short break from breastfeeding (two to five days) is all they need. You can express your milk into bottles (using a fully automatic breast pump) and feed it to your baby while your nipples heal.