Coping tips for new mum with flat nipples and milk just coming in...

[zippy34]

Anyone with any advice on this?

Ds is 4 days old and my milk came in with a vengeance last night.

I have big breasts anyway and fairly flat nipples so latching on hasn't been easy but we've been doing ok until now. Ds can't latch on at all to my right breast and is just feeding (last 3 feeds) from the left. He's happy but I know I need to empty the right breast to keep my milk supply and give him enough and to avoid serious engorgement.

I've sent dh out to buy a breast pump and I've got a syringe and cup that I used at first in the hospital which I plan to use to feed him the expressed milk. Up till now I've tried hand expressing but I can only get about 5mls and it isn't enough to soften the breast or get him on.

Nips v sore too as even on the left breast the latch is impaired by his difficulty getting on. I've been letting ebm dry on the nipple and that has helped. I also have lanisoh but it makes his mouth all gunky and the breast milk seems to work as well.

I've also got dh to get me a couple of nipple protectors as a last resort but I realise they can cause problems so I don't want to use them if there's anything else that will help.

We are coping and the community midwife should be round this afternoon but any help would be appreciated.

Also, I have no leakage although I seem to have enough supply to satisfy him. Is this normal? I thought I'd be squirting all over the place!

[lornaloo]

I can remember my nipples going quite flat when I started to wean ds off the breast. Im not an expert but I'm pretty sure your nipples should start to poke out abit more as breastfeeding becomes more established.
You should definitly keep trying ds on the right breast. I found feeding ds harder on the left so didn't feed him as much on it which ment I didn't ever manage to build up a good milk supply on that side. I had one boob alot bigger than the other the whole time I was bf ds.
I'm sure someone who knows more about this will be along soon with some helpful advise.

[liath]

I often had to express off a bit before dd could latch on. I recently read (on Kellmom site I think) of a way you can put your finger & tumb around the nipple/areola and press for a minute or so which softens the area & makes the latch easier. I'll try & find a link.

[liath]

Here we go - reverse pressure softening .

[mummyhill]

Keep trying hun you are doing really well my ds couldn't establish a latch at all due to the same problems and I ended up expressing for 12 weeks when I finally admitted defeat cause I wasn't able to stimulate supply enough to keep going. Dh and dd were also feeling a bit neglected at this point.

[Lio]

I have the big boobs/flat nipples combo and dd didn't feed until day 5, thanks to a bf specialist standing over us for half an hour making it happen with correct positioning, nipple shileds and perseverance. PLEASE ask your health visitor who your bf counsellor is and where and when is the SOONEST you can see her, there is no substitue for this. YOU CAN DO IT! Best of luck.

[Quootiepie]

I have large boobies, and flat nipples and DS didnt latch for a week. I tried after expressing as it drew my nipples out quite abit, took the balloon affect away, and covered the nipple in milk Took a week of trying for 20 minutes at each feed before giving a bottle of EBM, but, honestly, flat nipples arent a problem after the initial trying to get them used to it - DS sucks like mad now, just sort of laps them up until they are in his mouth!

[zippy34]

Thanks for your replies! Lovely community midwife visited this afternoon and was shocked at the state of my nips! We've decided that I will not try to feed from the right breast at all tonight but will express and feed the result and try to feed normally from the left breast.

Luckily supply seems to be excellent and I found the breast pump really easy to use. (and contrary to my op, I'm leaking like mad now! ) I'm feeling a lot better now that I know I can get the stuff out of there and into ds one way or another. The rest will sort itself out in time.

I have savoy cabbage leaves down my bra, am slapping on the lansinoh like noone's business, taking ibruprofen as an anti-inflamatory and when the cm comes back tomorrow we'll work on my latch and look at possible positions that might help. I'll also visit the breast feeding clinic at the hospital on Thursday.

I feel really lucky that all the postnatal midwives and community midwives that are dealing with me are very pro-bf and properly trained in breast feeding support. It really makes a difference and I'm feeling so much better than I was this morning .

If the worst comes to the worst tonight and I'm at a low ebb I've been told to pop up to the ward and they'll put me on the hospital electric pump but I think I'll be ok.

Will also try out that exercise Liath. Thanks for that and krimbo, the position you suggest makes a lot of sense - will give that a try too .

[lornaloo]

Thats good to hear Zippy .
I'm glad you're feeling happier now.

[zippy34]

I saw a breast feeding consultant at the hospital today and what a difference!

A big help is that the engorgement has gone down overnight - hurrah! So I'm a lot more comfortable anyway.

The consultant checked my positioning and Rory's latch and apparently we were just about there but needed to make a few alterations which have made the whole process easier on Rory. my nipples and my back so everyone's happy .

When she helped me get in a better position I was so comfy and feeding was such a pleasure that it really made me want to perservere and practice until it felt that way every time.

We've got another appointment on Monday but she says she fully expects me to ring and cancel it as she reckons we'll have got it sorted over the weekend.

I would heartily recommend getting some one-to-one trained help to anyone else having feeding problems. Sounds sad, but I'm on such a high knowing we can do it!

[Lio]

Not sad in the slightest, and in fact I don't even know you and I am delighted you can do it too! WELL DONE and a big pat on the back to midwives and bf consultants who have helped you, it's a great feeling to know that you are on the right track.

[liath]

Great news!

[hotmama]

So glad for you Zippy.

Was going to post with advice but it seems you won't be needing it!

Just in case you want to know, I also had/have flat nipples - I found putting a breast shell on about 15 mins before I was going to feed really helped to get my nips the 'right' shape.

Wholeheartedly agree about one to one help. I 'only' managed 10 weeks bf with dd1 - and she was mixed fed from the start.

A lovely La Leche lady has really helped me with dd2 who has been bf and no formula whatsoever - and dd2 is nearly 10 months!

You can do it - well done.

[plibble]

Only just spotted this thread. I'm glad you have found help and are getting it sorted out (well done!), but just in case anyone else is reading this and looking for something that might help them, when I had the same problem I resorted to using an ice cube to make the nipple poke out more. I also manually expressed a little milk so that DD could latch on. Once the baby has successfully latched a few times, the nipple starts to stick out more. It also becomes easier once your milk supply has settled down and you are not becoming so engorged. It is worth persevering if you can .

[zippy34]

Well, the sorry saga continues....

Just when we though we were turning a corner re: latching on & engorgement, now I have staph & strep infections in both my nipples and most of the ducts are blocked .

I have borrowed an electric pump from the hospital and feel abosolutely awful that when ds was screaming last night it was because he was starving hungry. My left breast (which was the good one...) seems to be losing its supply now due to the nipple being so blocked so I'm expressing from both as much as possible while still feeding ds as well as supplementing with the expressed milk.

The midwife says the antibiotics should work pretty quickly but does anyone have any experience of this situation working out?

Starting to feel demoralised and guilty but noone has suggested I supplement with formula yet. Does anyone know how much I need to express though so that ds gets enough?

I've got 4oz at the moment and can probably get similar every couple of hours if I really work at it and never sleep again...