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Breast engorgement is when the level of milk contained in the mother's breast is greater than the areola or the size that they have to contain it. It's basically what happens when you overfill the container. Breast engorgement can happen for a lot of reasons. The most common is just that the baby hasn't taken the milk out the way the body expected. Babies teach the body how much milk they want by suckling, so when the baby goes to the breast on a day when it wants more comfort, it teaches the body to just have a lot of milk on hand. The next day, the baby might not want as much milk, and so the mother gets very pained and very uncomfortable because her breasts have overfilled amd so are engorged.
Nipple trauma or sore nipples are only caused when the baby doesn't get far enough back on the breast. So, the most important thing you do is encourage the baby to open its mouth nice and wide before you let it go onto the breast. That will keep your nipple from ever being traumatized or caused any trouble. If the baby however keeps latching shallow, just wait and wait and wait, and then you might want to apply a little bit of pressure on its jaw so that the jaw opens wider before it latches onto the nipple.
Once the baby has latched incorrectly and the nipple becomes sore, it is very difficult to make it stop being sore without letting a week or so go by. The best thing to do would be to apply some Lanceno cream, which is a safe, non toxic cream available in all stores. The baby can breastfeed while the cream is in place, and that will help to soothe and relieve the pain. However, if the pain is more intense than the Lanceno cream there are certain things called comfort gels, which are very soft, cold, moist gels that can also be used during periods of engorgement. You apply it over the nipple between breastfeeding sessions and it encourages the nipple to heal rapidly. Take it off when the baby feeds again. Put on more Lanceno cream. Also, letting your breasts air naturally is good. (which is a very strange thing in a culture that believes in covering up) Leave your breasts outside of a bra for about 15 minutes. If they've had trauma, the breast milk itself may heal the nipple.
If your baby refuses to breastfeed, then something else is probably wrong. Most babies will breastfeed with very little encouragement. They want to breastfeed. They're programmed to breastfeed. Some babies, however, will go on nursing strikes, or have a fussy period, refusing to breastfeed for a lot of reasons; if there's fluid in their ears, if they have a little bit of a cold or a stuffy nose. Babies are nose breathers, so if their nose is stuffed up, they can't breastfeed and breathe at the exact same time. So a lot of babiesthat won't breastfeed, they just have a cold that you don't know about. Frequently just suctioning and comforting the baby will allow it to breastfeed again. The baby will be okay if it goes about 24 hours and doesn't breastfeed. If it goes longer than that you probably need to get someone involved to try to help you feed it. Babies also tend to have preferences. They like to breastfeed in one position and not another. They may not like their sibling around while they're breastfeeding. They may not enjoy the football game. So if you can try to figure out whatever is happening that's upsetting your baby and eliminate it, the baby will go back to the breast.
A nursing strike is when a baby who otherwise nurses really well suddenly decides not to nurse for a period of time. Nursing strikes can happen for a wide variety of reasons, but usually nursing strikes are because something has changed in the nursing environment. Either a period of stress or separation, and the baby is just telling Mom that it's not very happy with what's going. The baby could bea little bit ill, teething, or maybe it's just having a day where it doesn't feel like eating.
If you baby has a nursing strike, the most important thing to do is not panic. Remember that you can convince the baby to come back to your breast. Calm, gentle persuasion, holding the baby close and skin-to-skin contact, soothing your baby, talking to your baby, just interacting as a mother and baby is the most effective way to eventually get a baby to decide to break the nursing strike. If a nursing strike should persist for more than 24 hours, you should probably see your doctor or a lactation consultant to discuss the problem and see if the baby has any illness that needs to be treated.
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