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Breastfeeding: Problems with establishing breastfeeding

Information

The most common reason for pain when breastfeeding, especially when breastfeeding is still establishing, is poor positioning and attachment. Please direct women and families to their HV/FNP/CMW for advice.

Other causes of pain may include:

  • Breast/oral thrush
  • Mastitis
  • Breast abscess
  • Vasospasm

The Health Visitor, Family Nurse or Community Midwife should always be the first point of contact and support for families experiencing any feeding issues. They are all trained to the standards set by UNICEF Baby Friendly and offer advice to families needing support. They will work closely with each family to develop a plan alongside the local Infant Feeding Advisor. Where breastfeeding issues cannot be resolved with their support the local infant feeding advisor can arrange an appointment at the breastfeeding clinic for mother and baby. There is one clinic in each hospital (Edinburgh Royal Infirmary and St John’s Hospital).

Problems with establishing breastfeeding

GPs should, in the first instance, direct families to their Health Visitor, Family Nurse or Community Midwife. They will work with the family to develop an infant feeding plan. Families requiring additional support may be referred to the Breastfeeding clinic.

Who can refer:

Health visitors, FNP and community midwives

Who to refer:

Any families experiencing complex breastfeeding issues if the initial infant feeding plan hasn’t been successful.

How to refer:

Referrals should be made by Health visitors, FNP and community midwives via email referral form to BreastFeedingClinic@nhslothian.scot.nhs.uk

Encourage parents to continue breastfeeding, go over the benefits of skin to skin and discuss with appropriate community colleague (midwife or health visitor). Do not suggest stopping breast feeding or introduce the use of formula milk.