Day 3 - painfully engorged, sore nipples, feeling dreadful, help!

[louschmoo]

Sorry, I have a feeling this may be epic. I had DS2 by CS on Wednesday. The section was more complicated than expected as DS was tangled up in the cord and was very high up in my womb so they had to manually turn him to breech in order to get him out as they couldn't reach his head. I also lost a lot of blood. This has left me feeling pretty battered really and I'm in a fair amount of pain from the incision & the hideous afterpains.

I've been BF DS and he is a good feeder, wanting to feed every 3ish hours for around 20-40 mins per feed. But my nipples are very sore, they aren't cracked but appear to have little bloody bits at the tips. The base of the nipple is also sore and when he comes off my nipples are usually a little misshapen & lipstick shaped. I know the latch isn't right but I just don't seem to be able to fix it. I saw a feeding specialist in the hospital and my midwife today. Both agreed that the latch needs work but neither were able to get him latched on without a little bit of pain throughout the feed. They gave me advice on getting him latched on but it just doesn't seem to work.

My milk came in last night, accompanied by a hormonal mental breakdown in the middle of the night. But got through it, fed DS and felt a lot better today. However my breasts have become more and more engorged throughout the day. I can't even squeeze into the J cup nursing bras I wore when feeding DS1. They are very tender and sore and my nipples are almost flat. Midwife today advised me to express just enough to make it bearable, take paracetamol, stuff bra with cabbage leaves and feed regularly. I know this is all good advice and i am trying to follow it. But the thought of latching DS on while my nipples are so sore is almost frightening. And he isn't drinking nearly enough milk to relieve the engorgement anyway. With DS1 i had masses of milk - could express whole bottles right from the start if I wanted to (although I didn't of course!). It seems that things are the same again.

With DS1 he was in hospital with jaundice when my milk came in, and I was expressing milk to bottle feed him. So I was expressing 60ml every 3 hours throughout the engorgement stage which kept it at bay and left my nipples intact. So I never had to deal with the pain of engorgement on top of the nipple pain. But I wasn't planning to introduce bottlefeeding yet to DS2 and so I'm struggling a bit.

So, any advice please? I kind of know what I need to do but I could really do with some encouragement right now as I'm feeling pretty miserable and sorry for myself.

[Iggly]

Oh poor you - sounds hard :(

Has he been checked for tongue tie? Can you get an experienced bf counsellor on the phone or to visit you?

[CelticPromise]

Congratulations. Sorry you are having a rough time. It does sound as though latch needs work. Could you call one of the BF lines for some help? They might know someone who can do real life help in your area ( my area has drop ins every weekday and peer supporters who can do home visits and tend to have more time than a midwife).

You can feed expressed milk in a cup if you need a break and don't want to use a bottle. Hand expressing in the shower might give you some relief.

To help him latch while you are engorged you can try expressing a bit or you can press in your fingers and thumb in a circle around your nipple and hold for 30 secs or so to try to soften it.

Mainly I would try to wait for a really big mouth when latching him on and if he goes on and it's very painful don't be afraid to take him off and try again. There might be some pain if you are already sore as nipples heal, but you can judge what is bearable.

If you're looking for further info on the internet you can't go wrong with Kellymom.com. Best of luck.

[elvislives2012]

Sounds sore. Poor you but also sounds like you're doing well . When I had problems I went to a BFing group and they had BFing counsellors. I found them more useful than the MWs and HVs and more knowledgeable. Do you have one locally? I also arranged for the NCT counsellor to come and visit. They do it for free and u don't need to be a member. They can also check for tongue toe as it sounds like this could be a possibility with your LO.
also make sure you apply lansinoh after every feed- it's magic!
Good luck I hope it gets better x

[BluddyNora]

I agree with the lansinoh, it's brilliant stuff.

I was sore and engorged at first, and I used to have to grit my teeth for the first 10 seconds or so of each feed as it was excruciating!
I went to a breastfeeding group, the leader listened to what I was telling her, suggested xy&z and we were fixed!

If the midwives can't help then push to see a lactation consultant if your hospital has one or call la leche league or the NCT.

Congratulations on the birth of your baby :)

[SpaghettiBologneighs]

Do you have a local La Leche League group? I found them fantastic when I had a difficult start with my now three week old DS2 recently. They even offered to come round and sit with us while I fed and their expertise is second to none.

Hand holding and sympathy here in the meantime. I knew the second my milk came in on day three because I burst into tears for no reason.

[louschmoo]

Thank you. I think we're going to try cup feeding for the next few feeds to let my nipples recover (I'll express whatever he drinks so as not to overstimulate my supply) and i will see if i can get a breastfeeding counsellor to visit next week. Hopefully if my nipples aren't sore it will be easier to get a good latch with help from a professional.

[McBaby]

Get checked for tongue tie as can cause lots nipple pain and damage. It's also difficult for anyone to fix latch as it seemingly looks ok to an outsider!

[louschmoo]

Yes, he's really good at opening his mouth nice and wide, but I just think his mouth is a bit too small to get the nipple in deep enough right now. But hopefully a BF counsellor can help get it right - then it's just a question of getting it right without someone there helping.

weissdorn - i wish my boobs were leaking, that might be a relief! Sadly i don't have leaky boobs at all, they just get fuller and fuller and milk only comes out with expressing or baby latching. I'm wearing a stretchy crop top and using lansinoh after every feed/pump and it seems to be helping. I don't think i could face just wearing a loose top, my boobs are so heavy i have to have some kind of support or the weight of them just adds to the pain. Oh woe is me! I will look for the extended latch video and give that a go as well.

[louschmoo]

Yes, I tried in the shower this morning, and this evening I put warm flannels on my boobs before hand expressing to try and ease it and get the milk flowing. There's just so much milk in my bloody boobs! DS would have to feed like an elephant to drain one. Still I won't be complaining once it's settled and I have plenty of milk.

McBaby - he was checked for tongue tie in hospital by the feeding specialist and the paediatrician. If I can get a BF counsellor round next week I will ask for him to be checked again just to make sure.

Honestly, the way I feel at the moment I just want to express all feeds and give him breastmilk in a bottle. But I know that that is not a long term solution. Gah, why can't it be a bit easier?!

[Iggly]

DD's tie was spotted by the paed who declared it to be minor that was the understatement of the century. When I got an experienced lactation consultant in she said it was 80% restricted, hence all the feeding trouble we had.

I found that three days in was bloody hard as milk came in so babies couldn't get a mouthful.
In the end, I realised that trying to get dd to open wide then onto boob didn't work as I'd miss the point. In the end I had to aim my nipple towards the roof of her mouth, not the middle of her mouth and almost flick it in. That worked better.

[RubyrooUK]

Louschmoo, I was you exactly a week ago! I posted a thread about my horrific engorgement here (but alas can't find a link to it as on my phone).

One week on and it's completely gone. I suffered the same after DS1. I am 32C when not pregnant and couldn't get on my 34HH nursing bra....

I did the following things:

1. Used Lansinoh obsessively. Literally every 15 minutes and it very quickly improved the nipple pain. I felt like I could never feed again but a couple of hours later, I was able to bear it.

1. To get DS2 to latch on properly, I expressed a tiny amount with my breastpump. I then fed this to DS2 with a cup so he wasn't quite so desperately hungry when trying to latch on. This meant I could spend a lot more time wiggling the nipple and his mouth to find a good latch without him getting really arsed off. Both of us were a lot less stressed then and he found a much better latch. I only did this for about 12-24 hours, by the way, at the worst of the engorgement.

1. I looked at some YouTube videos of reverse pressure softening. It's basically pressing the nipple down on each side so there's enough nipple for the baby to latch onto. I was really cynical but after about 12 hours or so of the expressing a tiny bit, I found RPS alone let my DS2 latch on. So I didn't have to express. I wish I'd known about RPS first time round.

1. As soon as I could get it on, I put on the bra. This really helped relieve my pain. Wearing nothing was agony.

1. After every feed, I stuck cabbage leaves in my bra. I changed them every few hours. They stunk but did help I think.

I'd say that the engorgement began on day three, was worst on day four, began improving on day five and although my breasts sometimes get a bit hard when I haven't fed for a while, we are on day 10 - I think - and engorgement is a memory.

(Now my problem is that DS2 has become such a fast efficient feeder, he can drain two breasts in under five minutes and then vomits because no baby needs that much......)

[McBaby]

Our TT was missed on numerous occasions for first seven weeks while iI was in constant pain feeding! So while you have pain I would ask everyone for there opinion and keep seeking help till your pain free.

[louschmoo]

Thanks all! I think it's getting me down as it's coming at the end of a very difficult and painful pregnancy, and I suppose I had latched on (ha ha) to the idea that things would get easier physically after I'd had the baby. I fed DS1 for 7 months and although I had a few problems at the beginning I don't remember any pain like this.

I'll try calling LLL tomorrow and for tonight we'll see how we get on with cup feeding. I'm afraid I just can't face trying to get him latched on right now :(.

[littlepig]

Feeling your pain... or at least I remember feeling something like it.

Probably a little reptitive but...
I have to agree with the Lansinoh: shouldn't take too long to help
Hot showers and expressing a little by hand (if it doesn't come by itself anyway
Cabbage, as odd and stinky as it may be
My boobs got so big when my milk came in that I had to carry them around with me second time round as I couldn't face even attempting to get them into any sort of bra til the home maternity bra fitter could come and get me something appropriate... it's baby number 2, right? You can carry him over one shoulder and support your boobs with the other, yeah?
I also (aided by the paracetamol) expressed a little by hand so that my nipples weren't such a horribly unnatural hard round shape for my little ones to get latched onto. It was tender and still not too much fun at the start but much better from about half wway through for those few days.

Hope it gets better soon.