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I'm torn, advice please

(32 Posts)
OompaLumpa Wed 20-Jul-11 15:19:52

My DD is 5 weeks today and i have EBF from as soon as she could latch on (tongue tie sorted at day 2). I have been having real pain on one breast on and off since the beginning - blocked ducts, milk blisters etc and it keeps getting really engorged. I'm at the stage where I basically dread feeding as the pain is so bad. I've been to BF clinics and paid to have a private lactation consultant who all say my latch is good but clearly something is not right. Sometimes part of the nipple comes out misshapen.
I've been told that I might be suffering a bit of PND which I can in my more logical moments, see might be the case and I don't think the BF is helping. I wanted to do it as long as possible but I'm now seriously thinking of moving to formula so I can at least try and look forward to feeding times.
I would appreciate advice about how to do this without causing me more pain and least stress to DD and any other thoughts appreciated.
Thanks. sad

organiccarrotcake Wed 20-Jul-11 15:25:48

OP, sorry you're having such an awful time sad

Are both sides affected? Just trying to clarify this as you say that one side is bad but I don't know whether that means one is worse than the other, or whether one is fine and the other is horrible.

How is your DD's growth doing? Nappy output? What's she like in herself?

Are you getting pain at every feed? Can you see any links between when you get pain and when the nipple is misshapen?

Any other symptoms? Have you noticed any signs of thrush in your baby's mouth? Such as little white spots that aren't milk (don't rub off easily), or perhaps you feel her mouth is sore? Does she get nappy rash?

Which private LC did you use?

Have you checked that the TT hasn't re-grown?

Did you get a lot of damage at the beginning with the TT? Who noticed it?

Sorry it's 20 questions. smile

mistressploppy Wed 20-Jul-11 15:32:30

Organic has covered a lot of very important points. But I'm just popping in to say it IS ok to stop bfing and go over to formula. Really.

Could you express and try that in a bottle first of all?

Congrats on your baby, boo hiss to PND (make sure you get along to the GP if you feel you need to). Remember that it is most important to keep YOU happy, healthy and sane, for everyone's sake

OompaLumpa Wed 20-Jul-11 15:32:42

hi, both sides can be sore but one side is way more painful than the other. i have pain in the nipple and the breast itself gets really hard and hot and sometimes i get shooting pains in it - in between feeds.
DD is growing ok now and putting on weight and nappies are ok. she cries a lot but I guess that is a young baby!
I definitely get the pain at every feed and one side on the nipple is particularly misshapen and sometimes white when it comes out. Two of the BF counsellors i have seen have suggested it might be rubbing on the top of DD mouth somewhere.
I haven't noticed any white spots in her mouth but she is due for a feed in a bit so I will check again then.
The LC I used was called Mary Griffiths and I found her through some kind of association.
The TT was diagnosed the first night. I was quite poorly from the birth and was in high dependency so i had one nurse with me all night and she happened to be the midwife who runs the BF clinic at the hospital. She noticed it and luckily arranged for it to be clipped before i left the hospital. she was fed through a syringe for the first couple of days and sometimes can latch really well but sometimes she slips up the nipple and her mouth isn't so wide.
Sometimes it feels like someone is pinching my nipple when she is feeding even when her latch looks good.
I'm all over the place emotionally at the moment and this is really getting me down. i'm constantly looking at the clock to work out how long until i have to go through the pain again and i get really stressed having to re-latch her so much as that makes it hurt more.
I'm ashamed to feel the way i do and i don't want it to damage my relationship with DD.

mistressploppy Wed 20-Jul-11 15:37:13

Oompa, you and I have a few parallels - DS was syringe fed, then bottle fed EBM. No tongue-tie, but getting him onto the boob took a week or two. He wouldn't open his mouth wide enough. I used to get funny shaped nipples (sort of wedge-shaped) sometimes and it hurt for quite a few weeks before settling down. It wasn't as bad as you're describing though, and I never got hard lumps or hot bits.

We got through it by me stuffing as much boob into his mouth as possible and eventually he got the idea.

I stand by my post above though - do stop if you feel you need/want to. Formula is perfectly acceptable and it is MUCH better to use it than struggle on feeling dreadful.

OompaLumpa Wed 20-Jul-11 15:45:43

it's so difficult as i feel like it might be for the best to move to formula but i'm feeling so guilty about it and i haven't done it yet! i don't want to do something i later regret but at the moment i'm beating myself up about everything, i cry a lot and i am having "issues" about having people in the house and me leaving the house and that isn't me at all usually. I figure I need to try and address things like the feeding one way or the other but i'm completely torn. yikes sad

organiccarrotcake Wed 20-Jul-11 16:01:09

mistressploppy I know you're doing your best to help smile but it does sound a bit like you're pushing formula as opposed to trying to work out the best solution for OP smile

I'm sure that's not what you mean to do.

OP, I think there's a good chance that the TT has either re-grown, or hasn't been snipped enough. Can you get back to the TT clinic and get them to check?

Another thing to consider is cranial osteopathy. If you had a traumatic delivery it's quite likely to have left your baby with some birth trauma. This can really affect feeding a lot. Sometimes when birth trauma is released more TT can be seen so that's sometimes suggested before going back for another TT check.

The latch isn't right if you are getting squashed nipples and pain as you describe so even though it "looks" right if it doesn't feel right, it's not right. Trying to get a deeper latch every time may help. Have you tried the flipple? Every time you latch you need to watch for that deep latch, and if it's anything less then take her off and have another go.

It is so intense these first few weeks and you've had such a traumatic time that I'm not surprised that you're feeling so down. The thing with these types of BFing problems, though, is that they can be awful, but once you get to the bottom of them, they can clear up quickly. smile

What do you think?

ThePosieParker Wed 20-Jul-11 16:04:39

There's nothing wrong with formula and if you feel that would help then do it. You've sought lots of advice.

However I stopped, following crap advice, my first two at four months ish and I still regret it. Both my first two had 'proper' TT operations, where the whole thing was cut away but this was much much later.

I was sure though that their first words would be 'open wide'!!

And good luck!!

ThisIsYourSong Wed 20-Jul-11 16:12:12

I'm sure organiccarrotcake will be back (ha, have just refreshed and she is!), and she has a wealth of knowledge. I just wanted to say you are not alone, especially in your feelings of dread when coming towards feeding time.

I had a similar situation to you, although not as bad, but did get through it for 3 months before TT was diagnosed. Its all related to the TT. My pain was really reduced by using the exaggerated latch (flipple). I'm not sure I could have been able to do it without someone showing me though.

Also sounds like you could have raynauds/vasospasm, which I also had - its caused by the damage to the nipple. I found these links helpful:

The best thing for me was to never let any air get to the nipple. As soon as I finished feeding I would immediately cover the nipple, using my hand until I got my bra done up. A wheat pack made things worse. After showering I would keep a flannel on until I got my dressing gown on, etc.

Anyway sorry am just here quickly with DS before I put him back down (its the middle of the night here in NZ) but I wanted to let you know that others have been there and your feelings are all perfectly normal. Big hugs for the awful time you have had.

Oh finally the wide opening thing does get better and easier the older they get.

ThisIsYourSong Wed 20-Jul-11 16:13:12

sorry forgot to tick the box, here are the links:

organiccarrotcake Wed 20-Jul-11 16:24:21

Thanks thisisyoursong and I am back, trying to keep an eye on this thread while working (bad Rots).

I personally wouldn't be looking at Raynaulds just yet, just because the symptoms are far more likely to be caused by the TT which causes the similar symptoms. I'm still feeling that working on a deeper latch while trying to improve bub's ability to latch deeply may be the first port of call, esp as TT has already been diagnosed. Sometimes it takes a while for them to re-learn the latch.

violetwellies Wed 20-Jul-11 16:26:23

I have a similar probem, and double pump whenever the right breast gets lumpy, this has saved my bf. Don't do it too often as have quite enough milk thank-you and don't want to increase my supply any. I am freezing the milk. Why he can manage a civilised suck on one side and be as comfy as a bag of weasels on the other I don't know, & yes his first words will probably be 'wide open' smile Also attend a bf drop-in whenever I can, great for moral support and helpful suggestions.

organiccarrotcake Wed 20-Jul-11 16:28:21

violet if you have an oversupply your local milk bank may be chuffed to get it from you smile

(Never one to let a donor milk opportunity pass, me grin)

violetwellies Wed 20-Jul-11 16:38:19

Sorry OGCC, had a transfusion following section, (& unplanned hysterectomy. sad )

organiccarrotcake Wed 20-Jul-11 16:39:56

Oh I'm so sorry violet sad

OompaLumpa Wed 20-Jul-11 19:07:37

Thank you ladies for all your comments and advice. I can't see anything stopping her Tongue coming out and she can latch wide sometimes but other times it's a real (painful) battle. Best position in terms of least pain is lying down side by side but I keep trying other positions as don't want to be too reliant on that. I will check out the links thank you.
I'm going to give her expressed milk for dream feed tonight to give my poor nipple a rest. Which incidentally I have noticed is really pink now compared to the surrounding bit. Does that indicate anything?

twinklegreen Wed 20-Jul-11 19:44:33

Do you have any pain that lasts after the feed has finished?

organiccarrotcake Wed 20-Jul-11 19:59:22

hmm although her tongue coming out is a good sign, it doesn't necessarily mean that the TT isn't causing a problem still. However, as I've mentioned, a cranial osteopath may be a good first port of call.

Can you describe the pain a bit more? Is it deep in the breast or just on the nipple? Is it worse during or after a feed?

crikeybadger Wed 20-Jul-11 20:31:27

Oompa- you mention shooting pains in the breast and in between feeds and pink nipples. Have you considered thrush?

twinklegreen Wed 20-Jul-11 20:37:19

information about thrush here

qwepoi Wed 20-Jul-11 20:46:08

It does sound a bit like nipple blanching to me too, I had it and Kellymom website v good. In my case dd simply had a very strong latch, after a while the pain eased. I did use nipple shields for a bit, just to have a break, but I know that is generally not recomended. And paracetamol.

organiccarrotcake Thu 21-Jul-11 08:34:42

crikey that's the next route I was going down which is why I was asking for more info about the pain. Thrush can cause nipple blanching too but it was the nipple distortion that I wanted to get past first. Of course it could be both trauma and thrush.

Just thinking aloud at you smile

twinkle's thrush leaflet link is the best one to look at.

OP if you think the symptoms sound like thrush then it's well worth getting it checked out by someone who knows. The thing with ductal thrush - when it gets into your milk ducts - is that it's excruciatingly painful but with the right treatment it clears up really quickly. If you find that this is part of the problem come back over because there's lots of things to know about thrush treatment.

crikeybadger Thu 21-Jul-11 11:20:39

Sorry wasn't trying to jump the gun occ. smile

I agree- there's lots going on here with TT, blocked ducts, nipple blanching, engorgement etc.

orchidee Thu 21-Jul-11 11:37:29

hi, I also had cracked / blistered / lipstick nipples with nipple trauma causing vasopasm. DS is now 2 months old and I think he needed to grow a bit and practice a lot. Feeding is now pain-free. I used the nipple flip technique mentioned earlier and it helped a lot. We can now feed lying down which I couldn't have imagined ever happening just a few weeks ago.

So it seems that for some of us things are difficult initially but do improve with time.

Good luck

ThisIsYourSong Thu 21-Jul-11 11:38:23

DS could stick his tongue out fine, in fact it was one of our games! He did have what was considered a mild TT but it did cause me a lot of pain (mostly on one side) and milk blisters, etc. Definitely try the exaggerated latch, I found this animation shows it well, not sure what the others think: (ignore the text unless you speak Russian!).

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