Here are some of the ailments that can occur during this stage so that you know how to recognize them and treat the issue accordingly.

Flat and inverted nipples.

Many women who have inverted or flat nipples, from the beginning believe that it will be impossible to breastfeed their children because of this condition, and therefore give up breastfeeding before they even try.

But this detail should not be a problem for breastfeeding. If you remember the correct latch-on position, the baby does not suckle the nipple but must open their mouth and turn their lips to suckle from the areola, with as much tissue as possible inside their mouth. In addition to this latch-on position that we see inside, their tongue makes suction undulations, all this makes the nipple come out during feedings, and with the constancy of breastfeeding, the baby's mouth will mold your nipple.

In this case, breastfeeding means rupturing internal tissues to force the nipple to protrude. The vast majority of women overcome this barrier without any problem; however, it could be that the woman does not have the muscular filaments that make the nipple protrude or has very short ones. This condition is rare, but not impossible, but can only be diagnosed by a health specialist; discuss it with your gynecologist and lactation consultant to have different positions that will facilitate milk feedings.

Avoid the use of pacifiers or bottles in the first weeks after the baby is born.

This is the time when breastfeeding is established, and if it should not be done under normal conditions, in a breast with these conditions, it is worse. If you find it difficult to latch on, you can use nipple shields as a temporary solution.

Sore and Cracked Nipples

Breastfeeding should not be painful; if it is, it's almost always due to a poor latch-on.

The breasts are designed by nature to breastfeed your child, but in the process of breastfeeding, there may be different conditions that do not allow a correct latch (either by ignorance or even if your baby has a dysfunctional suction or physical conditions with a short sublingual frenulum). Incorrect latch-on is what causes pain and cracks. The latter usually occurs when the baby only suckles on the nipple, not the entire areola. You can apply lanolin to relieve the burning symptoms of a crack, but it is not the solution in itself, as that would be given by correcting the posture, or attending to another underlying condition.

If you confirm that it is not a problem with your baby's sucking and your posture is correct, check if the pain is felt even without breastfeeding, as it could be an infection or a physical condition that your baby may have (such as a short sublingual frenulum).

Do not wash the breast at each feeding, as this can cause the natural protective layer to erode and over-dry the area.

Nipple Infections

If you have pain in your breasts and/or nipples, even if you are not breastfeeding or without an apparent injury, if you correct the position and do not feel improvement, you are probably going through a nipple or duct infection.

Usually, when you have an infection, your baby is usually uneasy because there is usually inflammation, causing a reduction in flow, making them e harder, which causes more inflammation and pain. It may also be that the baby is rejecting the infected breast since infections tend to alter the taste of milk.

Go to your gynecologist or pro-lactation family doctor to check your health and prescribe medication compatible with breastfeeding.

Milk Pearls

They look like small, shiny white dots on your nipple, which usually swells when breastfeeding. These tiny dots are the milk pearls and are extremely painful, like a sharp, piercing burning sensation.

There are two reasons why they arise: from trauma, when your baby pulls too hard on your breast, damaging a duct and causing injury, or from a breast infection, which alters your microbiota. The latter is usually the most common cause, and that is why you feel a deep pain, because the infection goes over the entire duct, and what is visible is only the tip.

Apply heat and massage your affected breast and try a manual extraction, if this unclogs the duct and you feel relief, monitor to determine if it is necessary to see a specialist.
Go to your gynecologist or pro-lactation family doctor to check your health status and prescribe medication compatible with breastfeeding for infection.
There is controversy about whether or not to prick a milk pearl, mainly because it is not always possible to determine its origin. When we talk that the pearl appeared from a traumatic event and the pearl is only external, you can apply heat and with a sterile needle prick to drain the duct, however, in the case of infection, drainage may not be sufficient to treat the pearl, and pricking it will be counterproductive.
Even if it hurts, do not leave the affected breast unattended; empty it either by breastfeeding or with extractions, but do not leave it full, as this will worsen the problem.

Obstructions, Mastitis and Abscesses

When a duct is plugged it is called a breast obstruction, it feels like a painful and hard lump anywhere in your breast, although it usually occurs in the upper part near the armpit. Additionally, you may have a fever of 37.5°C and general malaise.

We speak of Mastitis when the lump becomes warm, reddened and the fever exceeds 38.5°C (100°F). In this condition, it is characterized by the presence of an agent called "S. Aureus", which multiplies to infectious levels, replacing the rest of the bacterial flora.

There are occasions when the mammary tissue tries to isolate the bacteria that cause Mastitis, leading to the formation of abscesses, and it usually occurs when there was no adequate treatment during Mastitis. It is normal for the fever to decrease and the general condition to improve, but the pain is concentrated in the area that has become hard externally and movable if palpated, like an internal capsule. In this case, going to a Health Center for diagnosis and treatment will be necessary. The abscess will need to be either punctured and drained with a catheter or opened and drained in the operating room.

Go to your gynecologist or pro-lactation family doctor to verify your health status and prescribe medication compatible with breastfeeding.
DO NOT apply local heat since we are talking about an obstruction; heat potentiates bacteria and can worsen the situation.
Massage the area for at least 3 minutes; you can use a soft bristle brush with rounded movements towards the nipple.
Allow your child to suckle so that the suction removes the blockage; the milk does not harm the baby despite the infection. If you can't stand the pain, or your baby refuses the breast because of the taste, don't leave it unemptied; extract the milk.

Conditions during lactation