Unfortunately for mothers, breast-feeding doesn't come with instructions or a faulty part replacement guarantee. Many a new mother has been too shy or too embarrassed to discuss problems relating to feeding with either her mother or her mother in law or even her gynecologist. If that's you we are talking about, read on for a list of what could go wrong and how to put it right.

Nipple confusion - This problem arises when a mother introduces a top feed while still breast feeding. The breast nipple and the bottle teat call for different sucking styles, and when both are simultaneously used the baby gets confused.

Many mothers like to give a top feed to ensure that even if she is away for a few hours, the child will not go hungry in her absence. Sometimes a top feed is also given to an older child to ease future weaning problems. The trouble is that the introduction of even one top feed sets up a self-perpetuating cycle:

• A top feed satisfies the child's appetite for a longer time. As a result the baby feeds less frequently, thereby reducing the sucking stimulation, and leading to a decrease in the supply of breast milk.
• The rubber teat of the bottle is easier to suck on. The baby may thereafter not be as willing to put in the effort required to suckle at the breast.
• A baby suffering from nipple confusion sometimes suckles at the breast as if at a bottle teat causing sore nipples.

Fussy feeders - There are babies who fall asleep after only a few minutes of feeding. But put him on the bed and he will wake up crying for more. Or he may want to feed for a few minutes every half-hour or so resulting in a tense, tired and irritated mother, and a decrease in the milk supply due to tension.

• Remain calm.
• If he falls asleep, try and wake him gently, maybe by tickling the soles of his feet.
• He may be tired from the effort at sucking. Give him a small break and hold him in your arms and sing to him.
• Try other feeding positions, as your current one may not be comfortable for him.
• If she goes to sleep and wakes up crying a little later, try giving comfort rather than milk. If however this doesn't work than feed her.

Retracted Nipples
Sometimes nipples can be flat or drawn back into the breast tissue leading you to believe that breast-feeding is not possible. Not true. A baby feeds by sucking at the areola (the darker patch around the nipple) rather than at the nipple itself. However, if you don't teach him how to get a grip on the areola, he will feed less, setting up a cycle leading to diminished milk supply.

Using a breast pump or expressing milk can draw out the nipples, as does the baby's sucking motions.

Engorged breasts.
Too much milk can cause engorgement and pain, as can a missed feed or two. If not treated immediately the breasts become rigidly hard, hot and painful.

• Soften the breasts by gently bathing with warm water first.
• Wash hands well and express the excess milk. Express just enough to ease the `discomfort as too much stimulation will lead to more milk production and then you will be back to square one.
• Suckle the baby.

Related Links
Breast feeding	Bottle feeding	Expressing milk
Maternity Bras & Nipple care