Northwest Arkansas Mama Doc: Breastfeeding advice on engorgement, clogged ducts, mastitis and more

By Dr. Haley Vo, Mercy physician and mama of 3

So you’ve finally made it through nine long months, anxiously awaiting the birth of the newest member of your family. You’ve got a sweet baby wrapped up in your arms. I really don’t think there’s a more blissful feeling in the world. You gaze down lovingly into those bright eyes and notice your child is looking at you intently, as if she’s trying to tell you something.  Maybe she’s even put her tiny hand to her mouth. That’s when it dawns on you:  she’s hungry! And she wants to eat. From your body. Now.

Pretty daunting, isn’t it?

Somehow during my first pregnancy, I was sure that breast feeding would just happen, like magic. The baby would know what to do. I would know what to do. Then I promptly delivered a 4 pound baby girl 8 weeks early.  Breastfeeding wasn’t magic. It took a lot of work. And a lot of help. But eventually we both got the hang of it.

The second time around, I thought, “Oh, I’m a breastfeeding pro. I can feed my son no matter what! No worries.” And then my son wouldn’t latch on. At all. Insert more work. And more help.

The moral of the story is this:  please seek help. Lactation consultants are excellent resources. Many babies and moms have trouble at first. The hospital can give you names, La Leche League can give you names, your doctor may be able to give you names. Don’t give up!

The most common thing I hear from new moms is that they don’t know if their child is eating enough. Here are two things most doctors look for: Is the baby eating every two to three hours? Is the baby having a wet diaper every time he or she is fed?

And here’s the scoop on poop: Many breastfed babies poop 6-8 times a day. It’s totally normal. It’s also normal for it to be yellow or green and watery. It may look like it has seeds in it. Before you had children, you probably had no idea how much you would worry about poop. I know I didn’t.

There is, unfortunately, some discomfort associated with breastfeeding. Early on, many women have engorgement. This is because your body hasn’t yet been able to regulate how much milk it needs to produce. This can be very painful. To relieve engorgement, you can express, either with a breast pump or your hand, a small amount of milk, just until you’re comfortable.  If you drain your breasts completely, your body will think your sweet bundle of joy needs that much milk to fill him up, and it will continue to produce that much, thus creating a vicious cycle.

Another painful condition is called a clogged duct. This happens when the exit track for milk gets clogged for some reason. This hurts a lot! You may notice one breast feels very full, might be firm to the touch, especially in one spot over the clogged duct. It may also be slightly red. This is best treated with warm heat – a heating pad or a rice bag – and continue to feed your baby or pump. It will eventually resolve, but it can be pretty miserable until then. Some women have more trouble with clogged ducts when they wear under-wire bras. If you’re plagued with this problem, try going wire-free and see if it helps.

If bacteria happens to enter the breast, sometimes from a tiny break in the skin, you can get mastitis, which is an infection of the breast. It may make you feel as though you have the flu. Many women get high fevers. The affected breast is red, warm to the touch, and painful. You really need antibiotics for this, so you’ll have to see your favorite health care provider.

One key point during mastitis:  Keep feeding your baby or pumping! The milk is not harmful to your baby, and it’s important that it continues to be drained.

There are a few things that you should know about taking care of yourself during lactation. One of the common things that I see with new moms is complete exhaustion. You have just undergone some of the most drastic changes, both physically and mentally, that you will ever go through. Please know that I think breastfeeding is best. However, I also know that occasionally a mom needs a break. A bottle of formula, here and there, isn’t going to ruin breastfeeding. In fact, resting up may help your milk supply. So every once in a while, go easy on yourself and let your partner do the work!

Here are a few other tidbits: On average, a breastfeeding mom needs between 500 and 600 extra calories a day. That’s more than you needed while pregnant! It’s best that those calories come from nutrient dense foods, such as lean protein, fruits, and vegetables. She also needs to be careful to replace the fluid that she’s losing in milk production.

Keep it up, Mamas! It will be worth it for you and your baby! But when you experience bumps in the road, please seek some help. I promise, we’ve all been there.

To visit with Dr. Vo in person, you can schedule an appointment with her by calling the Mercy Clinic Primary Care Sugar Creek in Bella Vista.  It’s located at 24 Sugar Creek Center and the phone number is 479-876-1414. Same day appointments will be available at the clinic.

If you have a general health question for Dr. Vo, you can email it to and she may answer it in a future post.