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close this bookInfant Feeding in Emergencies: A Guide for Mothers (WHO, 1997, 48 p.)
View the document(introduction...)
View the documentForeword
View the documentIntroduction
View the documentWhy is breastfeeding so important?
View the documentAre commercially-made baby milks as good as breastfeeding?
View the documentWhy are commercially-made baby milks not so good?
View the documentBut can every woman breastfeed?
View the documentBut why don't the experts tell us this if breastfeeding is so important?
View the documentDo babies also need tea and water?
View the documentWhen do babies need more than just breast-milk?
View the documentSo a sick baby should go on breastfeeding?
View the documentDo breastfed babies get fewer diseases?
View the documentBut my friend's baby got ill and he was breastfed
View the documentSo breastfeeding is like a medicine?
View the documentPeople say that stress stops the milk, so during stressful times how can we breastfeed?
View the documentWhat about women who have lost a lot of weight? Can they produce milk?
View the documentDo we need special nutrition for breastfeeding?
View the documentBut what about anaemic women? Does breastfeeding drain their strength?
View the documentSomeone told me breastfeeding stopped you getting pregnant, but isn't that just a story?
View the documentHow does breastfeeding work?
View the documentWhat about women with small breasts or flat nipples?
View the documentYou said the baby has a part too. What can he do?
View the documentWhy is the baby's suckling-action important?
View the documentHow does a baby stimulate the milk?
View the documentThe first principle of breastfeeding: good attachment
View the documentWhy does good attachment not always come naturally to the baby?
View the documentWhy does the baby not always get this right?
View the documentSometimes it is hard to get a baby close because he is swaddled and his clothing gets in the way
View the documentEven if my baby attaches well, how can I be sure there will be enough milk?
View the documentYou said earlier that milk changes during a feed. Can you explain that?
View the documentBut I thought you must feed from both breasts?
View the documentYou said earlier that confidence was important but not everyone has that. What can we do?
View the documentI know women with breastfeeding problems. Can they be helped?
View the documentMy mother told me that you always get sore nipples and you just have to put up with them
View the documentWhat about special creams for sore nipples? How can we get them during an emergency?
View the documentWith this baby-led feeding how can I be hygienic and wash my nipples?
View the documentSo if I get my baby well-attached, I will never get sore nipples?
View the documentYou say breastfeeding should not hurt, but what about the engorgement that every woman gets a few days after the birth?
View the documentYou mentioned blocked ducts, mastitis and abscess. Are they common and how can we treat them?
View the documentAll these problems make breastfeeding look too difficult
View the documentYou said earlier that you can breastfeed even if you have stopped completely. How can this be done?
View the documentFood supplies can be precarious. How can we feed the babies over 6 months who need more than breast-milk alone?
View the documentWhat about premature or very small babies?
View the documentI can see the reason for expressing milk for sick or premature babies, but must all women learn to express?
View the documentHow do I express milk?
View the documentI can see that breastfeeding is possible in most cases, but we still have to face the times when it is not possible: emergencies create orphans, abandoned babies and severely ill or wounded mothers
View the documentIs it possible to feed a baby artificially without a bottle?
View the documentHow do you cup-feed a baby?
View the documentA final word

You mentioned blocked ducts, mastitis and abscess. Are they common and how can we treat them?

They do not need to be common conditions as they result from engorgement, infrequent feeding or poor attachment. They become rare if The Ten Steps are implemented. They all need rapid help.

A blocked duct shows as a tender red lump. This can happen if one part of the breast is not well-drained.

· Try to improve the baby's attachment, perhaps by changing the position when you feed.

· Check that your bra or other clothing is not tight. Bras with flap openings can put pressure on one area of the breast and obstruct the milk flow. If you cannot get another bra, cut the cloth where it presses. If you feel comfortable without the bra, stop wearing it.

· Do not use the 'scissor hold' as that can obstruct the flow.

· If it feels more comfortable support your breast from underneath with your hand.

· Gently massage the affected area while the baby is suckling.

· If possible apply warmth to the breast between feeds.

Mastitis is when the breast is red, swollen and painful. Unlike engorgement it may be in one breast only or just a part of the breast. You may feel ill and have a fever. Mastitis is caused by poor drainage of milk from sections of the breast. Sometimes germs will multiply because of the poor drainage and cause infective mastitis. It is difficult to tell, but if fever and flu-like illness persist it may be infective mastitis. If you can, ask a health professional to give you the following antibiotics and finish the course. See box below. They will not harm the baby.

Show this to a health professional

Antibiotic treatment for infective mastitis

The commonest bacterium found in breast abcess is Staphylococcus aureus. Therefore it is necessary to treat breast infections with a penicillinase-resistant antibiotic such as either flucloxacillin or erythromycin.





250 mg orally

Take dose at least 6 hourly 30 minutes before food for 7-10 days


250-500 mg orally

6 hourly for 7-10 days

The commonly used antibiotic ampicillin is not usually effective.

If you can get paracetamol tablets for the pain, use them. They are safe to use while breastfeeding.

Whether you can get antibiotics or not, it is very important that you keep the milk flowing. The best way to remove the milk is to let your baby suckle.

The germs from infective mastitis will not harm your baby and are destroyed by his digestive enzymes.

It is a risk for both you and your baby to stop feeding. It may be hard to attach a baby to a swollen hard breast, so gently express a little milk first.

Some women do not want to breastfeed when they have mastitis. They need help to keep the milk flowing through gentle hand expression several times a day. The baby can be cup-fed with the milk which is still the best food for the baby. Resume breastfeeding as soon as possible.

An abscess is a hard, painful swelling filled with pus that can result from neglected mastitis. Use the same treatment as for mastitis. You may need a health professional to excise and drain the abscess, but you can still carry on feeding. If it is too painful, continue feeding from the unaffected breast and gently express milk from the affected breast for 2-3 days. Then resume feeding.