Management of common breast-feeding problems

The benefits of breast-feeding have been well documented in the literature: it reduces morbidity from many illnesses and is considered the ideal nutrition for the newborn infant. This paper reviews common breast- feeding problems that family physicians may be called upon to manage: maternal problems, infant problems, and problems related to the need for maternal medication. Ensuring proper position of the infant at the breast and attention to the let-down reflex is the recommended method for prevention and treatment of nipple soreness. Prompt identification and treatment of blocked ducts, mastitis, and monilial infection of the nipple can prevent complications and allow uninterrupted nursing. Poor weight gain in the infant is managed by more frequent nursing. Neonatal jaundice or infant gastroenteritis rarely requires discontinuation of breast-feeding. Although physicians frequently recommend that women discontinue breast-feeding because of the administration of some maternal medications, maternal illness can often be managed with medications that do not interfere with nursing. Given proper advice and support, many mothers continue to breast-feed even after returning to work.