Question: I have just started breast feeding my baby, who is three weeks old. I keep hearing about the trouble some women have with breast feeding, but I am very keen to feed myself for at least six months, as I know it is better for her. What problems can occur with breast feeding and how can I avoid them?
Many problems can arise with breast feeding, but most are easily prevented and treated, and should not cause feeding to stop. The most common problems are engorgement and infection. If the breasts are swollen and overfilled with milk, expressing the excess milk usually relieves the discomfort. This can be done by hand under a shower or into a container, or with the assistance of a breast pump. At other times, expressed milk may be kept and given to the baby by a sitter while the mother attends a social function. Breast feeding need not tie the mother to the home.
Mastitis is an infection of the breast that requires rapid treatment by a doctor to prevent the formation of an abscess. If one of the many lobes in the breast does not empty its milk, the milk may become infected, and the breast becomes very tender red and sore. Fortunately, antibiotics can usually settle the problem, and it does not mean that the woman must stop feeding.
The best way to determine if the baby is receiving adequate milk is regular weighing at a child welfare clinic or doctor’s surgery. Provided the weight is steadily increasing, there is no need for concern. If the weight gain is very slight, or static, then supplementation of the breast feeds may be required. It is best to offer the breasts first, and once they appear to be empty of milk, a bottle of suitable formula can be given to finish the feed.

Question: I have extremely itchy nipples, and I can’t scratch them in public without people staring at me! I don’t have particularly large breasts, in fact my boyfriend teases me about m ‘fried eggs’ when I sunbath topless. What can I do?
This is a relatively common problem, particularly in summer and in women who are less well endowed. These women may go without a bra and their nipples are irritated by clothing moving across them, or have loose fitting bras that constantly move across the nipple, irritating it. Padding a bra may help this problem. Synthetic materials in the bra may also aggravate the problem—only cotton bras should be worn.
Allergies to soaps, perfumes and washing powders may cause itchy nipples. Infections such as thrush are common in breast feeding mothers, and your doctor can prescribe medication to cure this.
If no cause is apparent, lanolin and other skin moisturizers may be beneficial. As a last resort anti-itch creams can be obtained from a chemist, or your doctor can prescribe a mild steroid cream to ease the embarrassing itch.
Having plastic surgery to increase the size of your breasts may be an option if their size concerns you.