Nipple blanching - tips please for getting a better latch! (sorry, rather long)

[louschmoo]

Hello, I have a 6 week old boy and have recently (in the last couple of weeks) found that some feeds are very painful (about 50% of them) and that afterwards my nipples go white at the tips. They then get really sore (after the feed) while the blood flows back into them and then they go pink again. During the feed it feels like his gums are gripping (chewing) the base of my nipple rather than the areola.

I have called the NCT BF helpline and they suggested trying feeding lying down or using the biological nurturing position. I've tried both of those and to be honest found them very uncomfortable to maintain - DS keeps slipping off which results in just as much nipple soreness. I also went to a BF clinic last week, where they suggested positioning DS much higher, using 2 pillows. I did this and it helped a lot, but for some reason things seem to have regressed this week and it is now painful again despite using 2 pillows.

Part of the problem I think is that DS sometimes 'forgets' to open his mouth wide enough, and instead just opens and closes his mouth like a goldfish. This of course makes it difficult to get much nipple in his mouth. Any ideas on how to make him open his mouth nice and wide?

The other difficulty I think is that my boobs are very large (32J) but my nipples are relatively small. This makes it almost impossible to see if he has latched on well, as my breast covers his face and to see how much nipple he has I have to push my boob back, which then changes the latch anyway. I do shape my nipple before shoving him on the boob to make it easier for him to latch.

Does anyone have any advice on how to deal with nipple blanching, and how to get a deeper latch? DS is feeding well despite these problems, so it's only me being affected, not him (thank goodness).

[nearlyreadytopop]

hi
I have had very similar problems. I'm still not sorted properly and Im sure someone else with more experience will be able to help you better with positioning etc but,
I have found that applying heat to the nipple area after a feed helps, I had a little hot water bottle for this. I have also read that Vit B6 is helpful but havent tried this yet. The Kellymom site has info on vasospasm.

Baby was clamping down on my nipple to try to slow the flow of milk. By feeding lying down it meant he could back off when the letdown happened and milk flow was at its max. Feeding lying down was tricky at first but with a bit of practice its fantastic (especially at night). Also Ive found that baby needs to feel supported when feeding so put my arm over his bum and up his back. This leaves his head free to move off the nipple if needed.

Hope you get sorted

[nearlyreadytopop]

should have also added that once he comes off I wait till the let down settles and then put him back on by rubbing top lip with nipple, this makes him open wide.

[louschmoo]

Thanks Nearly, yes I think a fast letdown may be part of the problem. Maybe I need to give the lying down feeds another go - it just seems like you need three hands to do it, and then once he's latched on I have to stay propped up on my elbow to hold my breast in place otherwise he slips off- not comfy at all! Practice I guess...

I'll try the warmth thing as well - if I could stop the post feed burn I could live with the soreness during feeds.

[nearlyreadytopop]

the way that seems to work for me is to lie the baby down on a cloth (there will be milk dribbled and you dont want a wet patch on the bed) then I get myself comfy with nipple at baby nose height, once I am settled in a position that is good for me I roll the baby over onto his side. If you need both hands free after this maybe use a rolled up blanket at his back to keep him in position. So his tummy is pretty close to mine and his ear, shoulder, and hip are aligned.
Im still having problems with nipple pain despite our latch being checked numerous times, but I did learn early on that it is much better to take the baby off and wait until the let down has subsided rather than suffer through a poor latch when the baby has moved back on the nipple.

[magpieC]

Have you had him checked for posterior tongue tie? My DS could poke his tongue out quite happily but struggled to lift it which meant that the only way to get the nipple in the right place was to close his mouth and suck. Once he slipped down the nipple he couldn't get himself back on so I had to keep latching him. I often ended up with lipstick shaped nipples and occasional blanching too.

Since having it snipped a month ago (when he was 10 weeks) he's been opening his mouth much wider and it's a much "softer" action when he feeds.

I would recommend trying to find someone locally who knows about these things - I had various people look at his latch and all said it was fine and it wasn't until I found a particularly good lady at a drop-in clinic that we got it sorted.

[magpieC]

Meant to add there's a list of tongue tie symptoms at www.ann-dobson.co.uk/tongue-tie_symptoms.html