Lruiku xjkmus leL;kg: Problems

Breastfeeding problems are common, but Lruiku xjkmus leL;kg: lkekU; gqu~ rj fruhg: NksVks they last a short time. These tips may help. If le;lEe jgUNu~A ;h mik;g:ys eír xuZ lDNu~A rikbZays you find that the problems persist, call your leL;kg: dk;e jfgjgsdks Qsyk ikuqZgqUN Hkus] vk¶uks fpfdRld] doctor, nurse or specialist. ifjpkfjdk ok Lruiku fo’ks"kKykbZ Qksu xuqZgksl~A

Engorgement bUxkstZesUV Engorgement is when the become bUxkstZesUV Hkusdks rikbZadks Lruys nw/k mRiUu xuZ lq# full, firm, tender and sometimes painful as xnkZ Lrug: iw.kZ] dMk] VsUMj j dfgysdkgh¡ nq[kkbiw.kZ your starts to produce . This often gq¡nk gqus leL;k gksA ;ks çk;% MsfyHkjh ifNdks 3 nsf[k occurs 3 to 5 days after delivery. 5 fnuek ns[kkiNZA Signs of engorgement often last 24 to 48 bUxkstZesUVdk y{k.kg: çk;% 24 nsf[k 48 ?k.VklEe hours. Signs include: jgUNu~A y{k.kg:ek fuEu lekos'k gqUNu~% • Larger, heavier and tender breasts • Bwyk] xºzq³~xks j uje Lrug: • Breasts that are hard, painful and warm • Nqu xkºzks] nq[kkbiw.kZ j rkrks gqus Lrug: to the touch • Lrug: lqfUuus • Swelling of the breasts • Firm and • fuIiyg: j ,jksyk dMk gqus

Ways to Prevent Engorgement bUxkstZesUV jksdFkke xusZ rfjdkg: • Feed your baby at least 8 to 12 times • çR;sd fnu vk¶uks cPpkykbZ dErhek ifu 8 nsf[k 12 each day. Watch and listen for drinking iVdlEe Lruiku xjkmuqgksl~A fimu rFkk fuYus dk;Zdks and swallowing. ykfx gsuqZgksl~ j lqUuqgksl~A • Wear a support bra 24 hours a day while • rikbZadk Lrug: xºzq³~xks gq¡nk fnudks 24 ?k.Vk liksVZ czk your breasts are heavy. Use a comfort yxkmuqgksl~A rkjg: uHk,dks lgt 'kSyhdks czkdks ç;ksx style bra without under wires. Some xuqZgksl~A dsgh vkekg:ys czk fcuk lgt Hk,dks eglql find more comfort without a bra. xuqZgqUNA

Breastfeeding Problems. Nepali. 2 healthinfotranslations.org

• If your breasts become engorged: • rikbZadks Lrug: bUxkstZ Hk, Hkus% ÌÌ Place a clean, warm, damp cloth over ÌÌ uflZ³ xuqZiwoZ 3 nsf[k 5 feusVlEedks ykfx each breast for 3 to 5 minutes before çR;sd Lru ekfFk U;kuks] fHktsdks diMk nursing or get into a warm shower and let warm water flow over your jk[uqgksl~ ok U;kuks lkojek tkuqgksl~ j shoulders. Heating the breasts will rkrksikuhykbZ vk¶uk dk¡/kg: ekfFk cXu help your milk flow easily to your baby. fnuqgksl~A Lrug: rrkmukys lftySl¡x vk¶uks After heating the breasts, massage cPpkykbZ nw/k çokg xuZ eír gqusNA Lrug: them in a circular motion towards the rrk,ifN] ,jksyk j fuIiyfrj o`Ùkkdkj xfrek areola and the . Massaging will fruhg:ykbZ ekfyl xuqZgksl~A gkrek ok move the milk down. Massage under the arms and the collarbone area if dyjcksu {ks=ek ekfyl djk ;fn ;ks {ks= QeZ this area is firm and uncomfortable. j vlqfoèkktud N HkusA ÌÌ Soften the breast using hand ÌÌ LruykbZ gkrdks O;ogkj ok Lru iEidks ç;ksx xjsj expression or a . Express uje cukmuqgksl~A ,jksykykbZ uje cukmu i;kZIr enough to soften the Lrudks nw/k fupuqZgksl~ tldkj.k cPpk lftySl¡x areola so that baby can easily attach. layXu gqu lDuqgqUNA ÌÌ Breastfeed right away. Gently ÌÌ rRdky Lruiku xjkmuqgksl~A Lruiku xjkm¡nk vk¶uks massage your breasts while nursing. Lrug:ykbZ gyqdkl¡x ekfyl xuqZgksl~A ÌÌ If the breasts are still painful, full and ÌÌ LruikuifN Lrug: v>S ifu nq[kkbiw.kZ] iw.kZ gqus j swollen after a breastfeeding, or refill lqfUuus gqUNu~ ok LruikuifNdks vk/kk ?k.Vk fHk= iqu% within a half hour after feeding, you Hkfjus gqUNu~ Hkus] rikbZays Lrug:ykbZ uje cukmu may pump to soften the breasts. Only iEi xuZ lDuqgqUNA rikbZadk Lrug: iw.kZ :iek pump if your breasts are overly full iwjk HkfjUNu~ Hkus ek=S iEi xuqZgksl~ j fruhg: [kkyh and don’t pump until they are empty. ugq¡nklEe iEi uxuqZgksl~A ÌÌ Apply cold packs to the breasts for 20 ÌÌ Lruiku ifN 20 feusVdks ykfx Lrug:ek dksYM minutes after nursing I;kdg: jk[uqgksl~

Nipple Soreness fuIiyek ?kkm gqus Nipple soreness often occurs when the fuIiyek ?kkm çk;% tlks cPpk Lruek jkezksl¡x layXu baby is not attached well to the breast or ugq¡nk ok lgh rfjdkys ujk[nk gqUNA rikbZadks cPpkdk positioned correctly. Make sure your baby’s c³~xkjkg: vk¶uks ,jksyk ekfFk j rikbZadks fuIiydks jaws are deeply over your areola and about csl iNkfM yxHkx ½ bUp Nu~ Hkuh lqfuf'pr ½ inch behind the base of your nipple. Your xuqZgksl~A rikbZadks fuIiy cPpk Nqfê,ifN xksykdkj j nipple should be rounded and erect after the baby detaches. fl/kk gquqiNZA

Breastfeeding Problems. Nepali. healthinfotranslations.org 3

Ways to Prevent Nipple fuIiyek ?kkm gqusckV jksDus Soreness rfjdkg: • If you feel pinching, rubbing or biting • rikbZays Lruiku xjkmus le;ek fpeksV~us] jxMus pain during the feeding, check the baby’s ok VksDus nq[kkb eglql xuqZgqUN Hkus] cPpkykbZ position and attachment. jk[ksdks rfjdk j la;kstuykbZ tk¡p xuqZgksl~A • Air-dry your nipples by leaving your bra • Lruiku xjk,ifN dsgh le;dks ykfx vk¶uks czkdk flaps down for a couple of minutes after a ¶Y;kig:ykbZ ry NksMsj vk¶uks fuIiyykbZ gkokek feeding. lqdkmuqgksl~A • Express a small amount of or • dksyksLVªe ok nw/kdks lkuks ek=k fupuqZgksl~ j milk and spread it around the nipple and gkokek lqdk,ifN fuIiy j ,jksykdks ojij areola after air-drying. QSykmuqgksl~A • Avoid the use of soap, alcohol and extra • Lruek lkcqu] efnjk j vfrfjä ikuhdks ç;ksx water on the breast. Clean your breasts uxuqZgksl~A lkoj xnkZ Lrug: ekfFkckV ikuhg: by allowing water to flow over them when cXus xjh lQk xuqZgksl~A showering.

If You Have Nipple Soreness: rikbZaykbZ fuIiyek ?kkm gqUN Hkus% • Feed your baby more often for shorter • vk¶uks cPpkykà NksVk vUrjkyek NksVks&NksVks periods of time. vofèkdks ykfx Lruiku xjkmuqgksl~A • Do not allow your baby to become too • vk¶uks cPpkykbZ ,dneS Hkksdks ujk[uqgksl~A hungry. • Using an artificial nipple shield over • Lruiku xjkmudk ykfx Lruek —f=e fuIiy the breast for feeding may help with f'kYMdks ç;ksx xukZys ?kkm Hk,dksek eír xuZlDN soreness, but can damage your nipple rj rikbZadks fuIiyykbZ [kjkc xuZlDN j nwèkdks and get in the way of milk flow. Only çokgykà jksDulDNA fruhg:ykbZ Lruiku use them with the help of a lactation fo'ks"kKdks eír}kjk ek= ç;ksx xuqZgksl~A specialist. • Use a purified lanolin product or gel pad • Dz;kd Hk,dk ok [kqyk {ks=g: fudks xjkmu 'kq) ikfj,dks to heal cracked or open areas. Do not ykuksfyu mRiknu ok tsy I;kMdks ç;ksx xuqZgksl~A use lanolin and gel pads together. ykuksfyu j tsy I;kMg:ykbZ ,dlkFk ç;ksx uxuqZgksl~A • Begin feeding on the least sore nipple. • de ?kkm Hk,dks fuIiyckV Lruiku xjkmu lq# Be sure to break suction carefully by xuqZgksl~A vk¶uks cPpkdks eq[kek vk¶uks vkSaykykbZ sliding your finger inside your baby’s fHk= LykbM xjsj lko/kkuhiwoZd pqLu NqVkmu mouth. lqfuf'pr xuqZgksl~A • If it remains painful when your baby first • rikbZadks cPpkys lq#ek Lruiku xnkZ nq[kkbiw.kZ gqUN Hkus] latches on, remove your baby and try vk¶uks cPpkykbZ gVkmuqgksl~ j Qsfj ç;kl xuqZgksl~A again.

Breastfeeding Problems. Nepali. 4 healthinfotranslations.org

• A fast deep will put your baby’s • æqr xfgjks Lruikuys rikbZadks cPpkdks c³~xkjkykbZ fuIiy jaws behind the nipple and tender areas. j VsUMj {ks=g:dks iNkfM jk[NA If latching on still painful, talk to a lactation Lruiku xjkm¡nk v>Sifu ,dneS nq[N Hkus] Lruiku fo’ks"kKl¡x specialist. dqjkdkuh xuqZgksl~A

Plugged Duct cUn Hk,dks uyh A plugged duct is a tender or painful lump cUn Hk,dks uyh Lruek gqus tfVy ok nq[kkbiw.kZ yEi gksA in the breast. If left untreated, it may lead to mipkj xfj,u Hkus] ;lys laØe.k fuER;kmu lDNA Iyxg: an infection. Plugs often occur from changes çk;% cPpkdks [kqokmus I;kVªuek gqus ifjorZug: ok Lruek gqus in the baby’s feeding pattern or pressure on pkickV gqUNu~A ,dneS dflyks Hk,dks czkckV gqus ok Lruek the breast. Check your breast for pressure points that occur from a bra that is too tight Hk,dks /ksjS diMkckV gqus pkidk iksbUVg:dks ykfx vk¶uks or from bunched clothing on the breast. Lrudks tk¡p xuqZgksl~A

If You Have a Plugged Duct: rikbZaek cUn Hk,dks uyh N Hkus% • Apply moist heat to the breast 15 to 20 • çR;sd iVd Lruiku xjkmuqHkUnk vxkfM LruykbZ 15 nsf[k minutes before each feeding. 20 feusVlEe rkrks cukmuqgksl~A • Massage the breast from the area behind • vlgt gqus {ks=dks iNkfMckV fuIiyrQZ Lrudks ekfyl the discomfort toward the nipple. xuqZgksl~A • Change positions lining-up the baby’s • cPpkdks P;kiw j nk¡rykà Lrudks cUn uyhfrj jk[nS chin and jaw toward the plug. fLFkfrek ifjorZu xuqZgksl~A • Let the baby nurse first on the affected • cPpkykbZ lq#ek çHkkfor LruykbZ pqLu fnuqgksl~A cfy;ks breast. The stronger suck will help pqlkbZys Iyxek vkjke fnu eír xusZNA relieve the plug.

Breast Infection Lrudks l³~Øe.k A breast infection occurs from a blocked Lrudks l³~Øe.k cUn Hk,dks uyh ok çk;% Dz;kd duct or from that has entered the Hk,dks Lrudks fuIiyckV Lruek ços'k Hk,dks breast, often through a cracked nipple. Even C;kDVsfj;kckV gqUNA Lrudks rUrqek tyu Hk, rkifu] though the breast tissue is inflamed, the cPpkykbZ l³~Øfer LruckV Lruiku xjkm¡nk cPpk baby will not become ill from feeding on the infected breast. fcjkeh gqusNSuu~A Signs of breast infection may include: Lrudks l³~Øe.kdk y{k.kg:ek fuEu dqjk lekos’k gqulDNu~% • A headache, aching joints, fever or chills • Vkmdks nq[us] tksuhZg: nq[us] Tojks vkmus ok fplks ykXus • A hard, red and painful breast • Bksl] jkrks j nq[kkbiw.kZ Lru • A fussy or unwilling to nurse baby when • l³~Øfer Lrudks ç;ksx xjsj cPpkykà Lruiku xjkm¡nk using the infected breast mlys fnô ekUus ok vfuPNqd gquss

Breastfeeding Problems. Nepali. healthinfotranslations.org 5

Call your doctor right away rikbZaykbZ Lrudks l³~Øe.k Hk,dks tLrks ykXN if you think you may have a Hkus vk¶uks fpfdRldykbZ rq#UrS Qksu xuqZgksl~A breast infection. • Your doctor may order medicine to treat • rikbZadks fpfdRldys l³~Øe.kdks mipkj xuZ the infection. Take the medicine for the vkS"kf/kdks vkns'k fnu lDuqgqUNA vkns'k fnb,dks iwjk full time ordered. Do not stop taking your le;lEe vkS"kf/k fyuqgksl~A rikbZaykbZ jkezks eglql Hk, medicine, even if you feel better, without rkifu vk¶uks fpfdRldl¡x dqjkdkuh uxfjdu vk¶uks first talking to your doctor. vkS"kf/k fyu ujksDuqgksl~A • Continue to breastfeed your baby often • l³~Øfer LruckV nw/k fudkYudks ykfx çk;% vk¶uks to drain the infected breast. If your breast cPpkykbZ Lruiku xjkmu tkjh jk[uqgksl~ A rikbZadks Lru is too painful to breastfeed, you may Lruiku xjkm¡nk ,dneS nq[N Hkus] rikbZays vk¶uks cPpkykbZ need to use a breast pump until you are Qsfj Lruiku xjkmu l{ke ugq¡nklEe rikbZaykbZ Lru able to breastfeed your baby again. iEidks ç;ksx xuZ vko';d iNZA • Rest often and drink a lot of fluids. • çk;% foJke xuqZgksl~ j /ksjS is; inkFkZg: fimuqgksl~A

Talk to a doctor, nurse or lactation rikbZal¡x dquS ç'u ok ftKklkg: Nu~ Hkus vk¶uks specialist if you have any questions or fpfdRld] ifjpkfjdk ok Lruiku fo'ks"kKl¡x dqjk concerns. xuqZgksl~A

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Breastfeeding Problems. Nepali.