10 Signs that You May Need Some Breastfeeding Help

Are you breastfeeding a new baby and not sure if it is going well?

Then these 10 important signs will help you determine if there is a problem.

If you are breastfeeding in Dubai you are likely doing it without enough help and support from experts or family. Unfortunately, there is no midwife or health visitor turning up to check in on you, and your own mum may be far away, or she may not have any breastfeeding experience. New mothers and babies here can have real breastfeeding problems and not even realize it. The good news is that there are excellent breastfeeding resources in Dubai and most problems have a good solution if you catch it early enough. Trying to “grin and bear it,” or simply hoping to continue with sheer grit and determination is unnecessary and even fool-hardy. Babies who are not getting enough milk can get into trouble really quickly, and if you wait too long the only solution may be formula.

Please seek help if you are experiencing any of these signs:

1. Your nipples become sore or damaged.

Besides some minor sensitivity and tenderness in the first couple weeks when the baby first latches on, breastfeeding should not hurt and it should not damage your skin. When it does hurt and when your nipples show any sign of damage, it is usually an indication that the baby is not latching correctly. In addition to causing you pain and suffering, a baby who sucks on the nipple incorrectly may not get enough milk to thrive and grow, and may not empty your breasts well enough for you to produce an adequate milk supply. Even if you have loads of milk now and baby seems to be thriving, after a few weeks your milk supply “down-regulates” to meet your baby’s demand. If baby is not latched properly now you can suddenly lose your supply. A breastfeeding specialist can help you correct the latch and heal your nipples.

2. Your nipples look compressed, flattened or lipstick-shaped after a feed.

Your nipple should look exactly the same after your baby feeds as it did before. Even if they do not hurt, if your nipples look different after your baby feeds on them it means the latch is incorrect. While it may not be hurting you, the baby will not be getting enough milk and will not be stimulating your milk supply adequately. A breastfeeding specialist can help you correct the latch and show you how you can tell if baby is actually getting milk at the breast.

3. Your baby is not nursing at least 8-12 times every 24 hours.

While the recommendation is to feed your baby "on demand," some very young babies do not "demand" often enough. Babies who are very sleepy are not necessarily “good babies;” they can be babies who are “happy to starve.” New babies should wake up and ask to be fed frequently, both day and night. Once you know they are feeding and gaining weight well, it is okay to let them sleep, but while breastfeeding is being established, check with a lactation professional if your baby is not nursing often enough.

4. Your baby is not producing enough wet and soiled nappies.

Babies should produce at least 1 pee and 1 poo per day of life for the first 5 days. After that, they should produce at least 5-7 VERY wet disposable nappies (6-8 if using cloth nappies) and lots of nice yellow, soft, curdy poo. If you are not seeing it come out the hind end, it may mean that not enough is going into the front end! Also, if poop has not turned bright yellow by day 4, it is likely that baby is not getting enough milk. A breastfeeding specialist can help you determine whether baby is drinking well at the breast or not and can help you fix any problems.

5. Your baby loses too much weight after birth.

A healthy baby who is feeding well shouldn't lose more than 7-10% of their birth weight and they should be back to birth weight by 10-14 days. Newborn weight loss after birth is normal, but if the weight loss is too high, and if baby doesn’t gain it back quickly enough, it is usually an indication that feeding is not going well. Don’t let your doctor just wait and see what happens, or prescribe formula supplements without addressing the breastfeeding problem. Get help from a breastfeeding specialist early to solve the problem and avoid a crisis situation.

6. Your baby is not gaining enough weight.

Babies all grow at their own rates and breastfed babies grow differently than formula-fed babies, but all babies should grow fairly steadily on their own growth curve. Be sure your health care provider is using current WHO baby weight and height charts , as these are based on breastfed babies. If your baby is gaining less than this you need to see a breastfeeding specialist to check your latch, milk supply, and your baby’s ability to get the milk from the breast.

Kellymom.com has a very helpful article and chart on how much weight breastfed babies of different ages should gain here.

7. Your baby often struggles, arches or pulls at the breast.

If your baby regularly seems to struggle at the breast, arching his or her back, pulling on the nipple, and fussing rather than relaxing during a feed, something is not right. This can be a sign of incorrect positioning, poor latch, low milk supply or milk flow that is too fast or too slow--babies like milk to flow in at a certain rate. It can also be a sign that baby has a sore neck or head from the birth and may benefit from some chiropractic or osteopathic cranio-sacral massage therapy. A breastfeeding specialist can help you figure it out and make nursing more pleasant for both you and your baby.

8. Your baby constantly falls asleep at the breast.

While new babies normally like to suck a lot and want to spend a lot of time at the breast, especially in the early days, babies who are getting enough milk should come off the breast on their own and be satisfied for at least short times. If your baby never seems to be satisfied, falls asleep constantly while feeding or isn’t able to stay on the breast, there may be a latch problem that can be fixed by someone who is trained in breastfeeding. Also, babies are more likely to close their eyes and sleep when they are not getting a good flow of milk. A breastfeeding specialist can check to see if baby is actually drinking milk at the breast or merely sucking for comfort.

9. Your baby has a tongue tie or lip tie.

If your baby was diagnosed with a tongue tie or lip tie, or if you think the baby’s tongue or lip may be attached too tightly to the mouth they may not be able to latch correctly nor empty the breast sufficiently. Releasing a tongue tie or lip tie is a minor procedure which can be performed in the doctor's office. There are several doctors who can diagnose a tongue-tie, but only a few in Dubai who can correctly and completely release it. Unfortunately many pediatricians do not know how to recognize a tongue or lip tie, or they believe that there is not need to release it. Check with a breastfeeding specialist to make sure that the diagnosis is correct, and that the procedure is being done completely and with appropriate follow up to avoid having to redo it. If you have had a tongue-tie released and still have problems, see a breastfeeding specialist to assess why it hasn’t helped.

10. You have not received any breastfeeding follow-up since leaving hospital

In Dubai most of us are receiving our postnatal care from the private health care system which is pretty fragmented and depends entirely on us seeking out help. As a result, many new mothers and babies don’t see ANY health care professional until the 6-week postnatal check-up or even the 8-week immunization visit. By then it can definitely be too late to easily fix a breastfeeding problem. The best way to avoid this is to arrange your own postnatal follow up.

At the very minimum you should:

Be seen by a breastfeeding specialist in the hospital who observes at least one breastfeed from start to finish before you are discharged to go home.
Be seen again between days 3-5 to make sure that your milk supply is increasing and your baby is feeding well. This is usually AFTER you have left the hospital, so you will need to arrange this appointment yourself. Both you and your baby will need to be present for this visit and a feed should be observed.
Finally, all babies should be weighed around 2-3 weeks of age to make sure that they have returned to their birth weight and are still feeding well.

Who should you see when you need breastfeeding help?

Pediatricians often do not have much training or understanding of how breastfeeding works and may undermine breastfeeding by giving unnecessary formula. Alternatively, some pediatricians may assume that if the mother thinks that breastfeeding is going well then it must be. I have seen babies failing to thrive even while under a pediatrician’s care. Seeing someone who is trained and experienced in helping breastfeeding mothers and babies is the best way to ensure success.

Breastfeeding Q&A on Facebook maintains an updated list of breastfeeding resources and people who can help throughout the UAE. If you have not already done so, join this group and check out their resources list under files. Some of my favorites are Healthbay Polyclinic and Genesis Health Centre which both have a number of experienced lactation consultants who can come to your home, or will see you in the clinic.

Written by Amy Vogelaar. LM, IBCLC

Licensed Midwife and International Board Certified Lactation Consultant

Thank you so much for reading this post!

If you would like to learn more about breastfeeding before your baby's birth, I teach half-day Breastfeeding Basics workshops for pregnant couples. This workshop is suitable for both first-time parents and those who struggled previously with breastfeeding. It is designed to help you get off to a good start with breastfeeding, to avoid common pitfalls, and to know when and how to get help when you need it.

You can also read more in my previous post on Our Top 3 Tips for Successful Breastfeeding in Dubai.

Happy breastfeeding!

With love