Large breasts: Can you nurse?

I have very large breasts -- my cup size is DD. My first son was a small baby, weighing a little under six pounds. He could not stay latched on and I worried about him not thriving. I visited the hospital IBCLC and she sent me home with a nipple shield, breast shells and a rented breastpump. Breastfeeding was unsuccessful and very unsatisfying. I am pregnant again and would like to try breastfeeding and hope to nurse without all the hassles. Is it possible that my breasts are too large to nurse?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Congratulations on your pregnancy! I'm sorry to hear you had a disappointing attempt at nursing your son. Often it is thought that large breasted women have the easiest time nursing their babies, but this doesn't really turn out to be the case. You had an especially challenging situation, since your baby was very small. But many large breasted mothers do successfully nurse their babies.

Sometimes a small baby, born to a large breasted mom, will just need a few weeks to "grow into" nursing. Maybe it would help if you can slightly alter your expectations. Your new baby, depending on her size, and also circumstances surrounding the birth, may need a little extra help in the beginning. And if your baby isn't nursing well in those early days, you will need to express your milk when a feed is missed. But this doesn't need to go on forever. The first six weeks of your baby's life is a time of adjustment. You and your family are adjusting to your new baby, and learning to incorporate her into your life. It is also during this time that a mom and baby begin fine-tuning the nursing relationship.

It may not be necessary for you to wear breast shells or nipple shields this next time around, if you don't have nipples that are flat or invert when they are compressed. These were most likely used to help form you nipple so your little one would more readily breastfeed.

There are a few recommendations I have for you:

  • Consider avoiding the use of medications during labor and birth. If you do choose to use medication, using as little as possible, and for only a short period of time will help to keep the transfer to your baby at a minimal level. Medications, including the epidural can affect your baby's ability to breastfeed during her first two weeks of life. Hiring a labor assistant or doula will increase you chance of having an unmedicated birth and help tremendously with your comfort level and level of satisfaction.
  • When your baby is born, allow her to lick or nuzzle at your nipple shortly after the birth. Not all babies will latch-on at this time. Just enjoy this time together, allowing her access to your breast.
  • When you are ready to nurse, get comfortable. Often a chair is more comfortable and easier to nurse in than the hospital bed. Use pillows as needed behind your back, and to support your arms. Follow the normal recommendations for good positioning and attachment with a couple of exceptions. Your breasts will need to be well supported. A baby blanket or diaper placed underneath your breasts should be of help. Compress, or help form your nipple. This is often referred to as a "nipple sandwich." Keeping fingers well back from your areola (or as far back as possible, depending on the size of your areola) compress your breast by squeezing your thumb and fingers together. This compression can help make your nipple easier for your baby to grasp. Now, tickle your baby's lower lip with your nipple until he opens wide and hug him into your breast.
  • If your baby is still not nursing well, it is really important to be working along with a Board Certified Lactation Consultant who will help you in your efforts to encourage your baby to your breast. While you're working on getting breastfeeding established, you will need to express your milk using a hospital-grade electric breastpump for every feed missed. Most newborns nurse at least 10 to 12 times a day. You can feed your baby your milk with a cup, a syringe, or in a bottle if your prefer. (Look at milk expression as being short-term, and it may not seem as overwhelming for you.) It is very important to continue providing your baby with lots of skin-to-skin contact, while working at transitioning her to your breast. You can bottle feed her your milk at your breast. She will enjoy being so close to you. Once she is relaxed, you can try substituting your nipple for the bottle nipple. Be patient. Other ways to increase skin-to-skin contact are sleeping and resting with your baby, sharing a bath, carrying her in a baby sling and practicing baby massage. Not only are these wonderfully relaxing for her, but for you too. Best wishes in really enjoying your time with your new baby-to-be!
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