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Trying to breastfeed a newborn with a small mouth... please tell me it gets easier.

(42 Posts)
mummabubs Sat 02-Dec-17 16:42:52

I'm finding myself getting so upset over our feeding situation and just looking for anyone who's been in a similar position and can maybe offer hope/support?

DS is 6 weeks old. He was a forceps delivery so wouldn't latch in hospital and was cup fed expressed milk for the first week. After that we started breastfeeding but very quickly my nipples became bright red and started cracking. I had mastitis when he was 3 weeks old which didn't help. After attending breastfeeding clinic and getting health visitor involved we discovered that DS has a small mouth so doesn't often open wide enough to get a good latch and just slides straight down onto the nipple. (We tried using shields under guidance to see if they helped but be just does the same with them on so we're not using them). I also have 'flat-ish' nips, not completely flat but not as prominent as the average nipple which hasn't helped either.

I was advised to try and feed when possible but use expressed milk or formula to top up when necessary. My nipples have never healed since day one so are always pink and get sore very easily after a feed. (I use cream, try to avoid wearing bras and air then as much as possible but doesn't seem to make a difference so far). We tried just using expressed milk for a few days to give them a break but within a day of going back to feeding on me they were in the same state again.

I just feel utterly miserable and torn about it all. My husband was exclusively formula fed so sees no issue with it and doesn't want to see me in pain anymore, my mum EBF all three of us so is naturally keen for me to keep going. I feel pressure to stop from one side and to persist from the other, although neither of them are actually pushy about it. I'm sick of spending all my time either expressing and praying I get enough for another feed from it, trying to breastfeed but feeling anxious beforehand and then in pain afterwards, bottle feeding and praying he's not hungry for more at the end of it, or giving formula and feeling crap as I do so. DS is gaining weight well and seems content but he is going through a growth spurt and I'm now struggling to keep up with his hunger by expressing alone so am not sure how sustainable this is long term. It feels like he is getting better at opening his mouth wider sometimes but will also open slip down onto nipple or breaks the latch (so this also irritates my nipples as he's constantly on/off).

If anyone else had a newborn with a small mouth and managed to keep breastfeeding please tell me this is do-able and when it became so. I really, really don't want to switch but it's causing me so much stress and upset that without hope that it might have improve I don't know how much longer I can keep doing this. :'( Thanks for reading.

Tinselistacky Sat 02-Dec-17 16:46:24

My ds was 4-12 and early but managed with regular help from mwat first. Have you asked hv for someone to come out and help you? Sounds like you are doing well but I understand it sounds a faff!! I have used breast shields with my first dc as was unsure and nipples were sore!!

mummabubs Sat 02-Dec-17 16:55:51

Yup, we have input from lactation consultant plus team and my health visitor who is coming out once a week or so. She advised me to do as much as possible to let my nipples heal but they just don't seem to be and get freshly sore with every feed. She also told me to feed DS for an hour on the breast and then top up after that as it wouldn't be effective feeding if he was still trying to persist after that. I just wish it was getting easier but it just feels like we're stuck.

OrangeJulius Sat 02-Dec-17 18:00:24

My DD had trouble latching for the first week, midwife suggested she had a small mouth. She was also sleepy baby and kept falling asleep instead of feeding. I cup fed expressed milk until she latched. After that I solely BF as expressing wasn't as productive.

It hurt for the first two months or so. I learned that the damage done from a bad latch took several days to go away, so even if I had good latches for the next few days my nipples would still hurt. As DD got bigger there were less bad latches and the pain got less and less until most feeds didn't hurt. We still got the occasional bad latch but I fed her until she was 14 months.

I'm now feeding DS, 5 weeks, who has always been able to latch strongly but he does the sliding down to the nipple thing, so Bf him is painful too! I'm just ploughing through.

I've never had mastitis though, thankfully.

knaffedoff Sat 02-Dec-17 18:10:41

Feed underarm (or underarm) its the same thing, use exaggerated attachment to get a deeper latch and keep baby really close holding behind shoulders. With practice, baby will do it automatically.

You are doing really well and hopefully it will start to get easier soon x

mummabubs Sat 02-Dec-17 19:09:55

I definitely get that @OrangeJulius, even when we have a "good" feed they still hurt afterwards which is slightly demoralising! It does give me hope though to know that you found a way through it. When the pain is bad for me it's literally toe-curling so I don't think I could just keep doing it if you see what I mean. At the moment I can express 120-150ml per sitting so I'm just about keeping up with him.

@knaffedoff is that the rugby hold position? We've tried that both at clinic and with the health visitor and it just doesn't work for us it seems. Cross cradle is literally the only position DS has ever latched with, we've tried rugby, biological, lying down... he's stubbornly sticking to our original position! 🙈 I definitely keep him close and apply pressure, I think part of my despair is that the professionals have all told me I have really good position with him and am doing all the right things and it's just a case of waiting until his mouth grows bigger... but then I was wondering when will it be big enough? 😩

eeanne Sat 02-Dec-17 19:15:43

They are expensive but try Silverettes.

PourquoiPas Sat 02-Dec-17 19:21:39

If your nipples are pink, it would suggest thrush rather than a bad attachment? (Could be both of course)

Has that been ruled Out?

thegirlupnorth Sat 02-Dec-17 19:27:15

Personally I'd be inclined to give up, you've suffered enough and tried your best.

mummabubs Sat 02-Dec-17 20:00:23

Those look interesting @eeanne, I'll do some research into them, thanks for the recommendation.

@PourquoiPas Yup, they questioned it at clinic a couple of weeks ago but the paediatrician who was there looked in DS's mouth and saw my nips and said no so I assume we're good for that?

@thegirlupnorth, don't get me wrong, it's immensely hard at times and is getting me down. After a difficult pregnancy and traumatic labour I'm definitely ready for things to go smoothly but equally I do feel that if there's hope that it might improve I want to persist at the moment. Whilst I don't believe formula is 'evil' and wouldn't judge others for choosing to use it I do believe that nutritionally speaking breast is best and I like the feeling of closeness that I have with DS on the rare good feed that we have and I'd feel very sad to lose it. I think if supply was an issue then I'd be much more inclined to switch but at the moment I have enough milk- which is why it's so upsetting and infuriating to have the goods but seemingly not the ability to successfully or painlessly transfer it into DS! 🙈

MagicSeeker Sat 02-Dec-17 21:40:10

I second the Silverette things. Made a huge difference to my poor sore nipples within three days. A visit to a cranial osteopath really helped my son (failed forceps, then EMCS). His face had been quite tight so he couldn't open his mouth fully. She really helped. I do think it gets better as they grow too, tbh. I felt more confident getting a decent latch with my second son after all sorts of problems feeding my first, but it still hurt initially just because his mouth was so small. It's completely comfortable and lovely now and I'm glad I persisted both times. But I do completely sympathise. It will get better. Silverettes, honestly.

CaptainsCat Sat 02-Dec-17 21:52:19

Breastfeeding a baby with a small mouth does get better, but it was a long and painful wait for me. The fabled six weeks came and went and I was still in agony - it took until DD was 3 months old before feeds stopped being painful and my nipples could heal properly. We carried on after that until she was 2.5, it was very very easy after those first months, and I only really stopped because I got pregnant again! I’m hoping I’ll find it easier this time round, one reason being that my once quite flat nipples are no longer flat at all from breastfeeding for so long! I’m also sure they aren’t quite as sensitive as they once were grin

mybreastsarentbest Sun 03-Dec-17 04:01:26

My experience has a lot of parallels with yours. I have fairly flat nipples and DS has a fairly small mouth and couldn’t latch at all for many weeks.

We’re still going at twelve weeks. I can’t say it’s a breeze but it is much easier and continues to improve (though it is a bit two steps forward, one step back). Our current status is - mixed feeding but mostly breast right now (but last week there were a lot of bottles too, but not the week before or this week) and I finally stopped expressing recently. For me, it continues to be worth the effort.

We did use nipple shields for a while and they helped.

What made the biggest difference to the actual latch was using the koala hold and the flipple technique (there are many videos online). Lately, I sometimes let him latch on the nipple for a split second to pull it out and then immediately break and redo the latch - pretty painful for a moment there I’ll admit but it is effective.

Another thing to really look into is other things that could be exacerbating the nipple pain. A bad latch definitely causes pain, but there can be other causes too. I discovered I have Raynaud’s of the nipple and treating that has made a big difference. I also use Jack Newman’s All Purpose Nipple Cream and it helps my nipples a lot - you can find the “recipe” online and your doctor should be able to prescribe it for you and you can have it compounded. It can help treat thrush - for me that and washing my bras and breast pads and towels on super hot did the trick.

I also feel your pain on the emotional front. I think you need to decide for yourself if you’d like to persist with breastfeeding for now and then simply shoot down everyone else! It’s you going through the pain and the effort and you need to decide for yourself what you want to do. I found it helpful to commit to myself to re-evaluate at six weeks, eight weeks, and twelve weeks, with the caveat that I’d stop at any point if the pain became truly unbearable.

Good luck. It’s good your baby is growing well, I hope you can take some comfort in that.

mybreastsarentbest Sun 03-Dec-17 04:02:49

That should be All Purpose Nipple Ointment (APNO).

NanooCov Sun 03-Dec-17 04:26:59

I'd be tempted to ask to be swabbed to check for thrush in case the paed missed it if your nipples are still pink. It's a bit bugger - have been treating it 3 weeks now as it's v stubborn. Not painful now it's being treated though.

Cupoteap Sun 03-Dec-17 05:34:45

Might worth looking at the recommendations for tongue and lip tie guidance.

Ds has an upper lip tie which made it challenging but he's 6 now so I can't offer specific advice really about all I can remember is holding the nipple to kind of flatten it to be able to get as much in as possible.

Mixedupmummy Sun 03-Dec-17 06:08:13

Hi OP just to say you're doing all the right things and it does get easier.

I found each feed toe curling too. I had huge cracks both sides. My dd2 had shallow latch, tounge tie and I had very flat nipples. I wish we'd known to look into cranial osteopathy or a chiropractor for babies. Have heard since, as a pp said, it can really help with a shallow latch and generally make babies more settled. Things started to improve from 6 weeks for me despite this. By 8 weeks there was a marked improvement. I ended up feeding dd2 for 13 months.

In the early days I was taking regular painkillers (for c-section) but helped with feeds, used nipple shields, varied feeding positions and lots of lansinoh.

When I read you're feeding for an hour I thought that sounded like a long time. I thought after 15-20 mins most babies will be done feeding.

A friend used those silver things and thought they were fab.

Although having said all that didn't manage to bf dd1 and she was exclusively formula fed from 4/5 weeks. I genuinely believe there's been no negative impact on her either short or long term (if anything she was and is a much better sleeper than dd2!) After switching to bottle with her I relaxed and enjoyed her much more.

Good luck with whatever you decide flowers

Mixedupmummy Sun 03-Dec-17 06:17:25

I almost forgot that an nct breast feeding councillor showed me a technique for opening dds mouth wider when she was latched. It was brilliant but difficult to do yourself. My dh or mum did it for me when they were around. They put their index finger on the groove between her chin and mouth and gently pulled it wider as she was feeding. Not enough to break the latch but so she was latched on better with more areola in her mouth. It instant helped make the feed more comfortable.

scrivette Sun 03-Dec-17 06:51:48

It does get better. My 3 have had a shallow latch due to a small mouth/recessed chin but as they have got bigger it's got less painful.

TuckMyWin Sun 03-Dec-17 06:58:49

Have you tried using nipple shields? They can really help a baby 'anchor' in these kinds of situations. I also have flat nipples, and my first was a forceps delivery with small mouth, high palate etc. We fed with shields for 3 months before he was suddenly able to latch without, and we went on to feed for 18 months. It does get easier as they grow, promise.

TuckMyWin Sun 03-Dec-17 07:01:26

Oh sorry, re-read and see that you have. They aren't for everyone (they didn't work at all for my second, he just didn't seem to know what to do when they were there!) but might be worth another go, just to help protect you and give you chance to heal?

PersisFord Sun 03-Dec-17 07:17:24

I did what mixedup did in combination with the flipple. Could only do it in rugby hold though. So held baby’s head in left hand, body in my left armpit (lots of cushions), squish left nipple with right index finger and thumb and push his chin down with back of index finger as I flipped the nipple in. Was easy as he was my 3rd though and I had loads of milk and loads of confidence.

I personally wouldn’t express to feed as I think that feeding a baby (breast or bottle) is lovely and snuggly and very important for bonding, so I would want to be doing that rather than expressing and sterilising and stuff. You have to think about yourself and the baby as a little team - there’s no point making yourself unhappy and ill by breastfeeding because that won’t help him at all. As long as he is fed and cuddled he will thrive. And honestly, however good your mum or me or anyone is at breastfeeding we haven’t fed your baby with your breasts, so we don’t know what you are going through. It’s not giving up, it’s makibg a decision for the benefit of your family. Whatever you decide.

Spink Sun 03-Dec-17 07:25:22

For us, nipple shields, expressing every other feed (so my nipples weren’t constantly being retraumatised) & cranial osteopathy were the 3 keys, and with time DS ‘grew into’ my boobs. Have you tried a smaller size shield?
Good luck & well done for getting so far!

MrsFigg Sun 03-Dec-17 07:36:22

I have/had flat nipples, managed to feed 3 and still feeding a 2 year old.
I used shields with them but my third one she latched on naturally after 4 weeks of the shields.
I ended up formula feeding my middle one.
Also pressure from family re feeding initially but ultimately forget everyone else and do what's best for you.

My main concern is the pain here for you, I had thrush with my first and bright pink nipples and yes, the pain is toe curling!!
Please get checked for this.
If it is this, I remember the pain vividly.
thanks breastfeeding is hard! Your doing amazingly, good luck

woundedbutwalking Sun 03-Dec-17 07:58:32

I'm in exactly the same boat OP, have tried everything to get comfortable feeding my 21wk DD. I'm still going & the pain is finally subsiding. The flipple technique as PP mentioned helped, as did tongue tie separation (before it healed back in exactly the same placeconfused) my HV wondered if I might have ductile thrush, which causes deep tissue pain, but doesn't have visible symptoms. That was my last option when things started to improve (around 18 weeks).

The only advice my GP would give was take paracetamol or give up hmm so I took it when the pain felt overwhelming & persevered. DD has one bottle of formula at night but is otherwise completely BF. It's completely up to you if you want to continue- no one knows what your experience is like & you've been amazing to continue with it when it hurts like hell thankscake to you!

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