How can damaged nipples ever heal if you continue feeding?

[SmilingHappyBeaver]

I have had problems with the latch since day one, DS3 is 13 days old today.

With DS1 and DS2 I had the same problem and moved to expressing and formula top ups by day 3.

But this time (I thought) things were going better, my bleeding nipples seemed to recover slightly and I lost the scabs, however now my nipples look like they have cracks so deep you can actually see inside the nipple, and the pain is becoming unbearable. DS3 will not latch on properly (refuses to open his mouth, and grabs my nipples with his hands unless I swaddle him). I have seen a bf counsellor and really feel there is nothing else I can do. I am in tears writing this.

Last night I accepted defeat and offered a bottle of formula, so far today I am alternating ff with bf, and have started expressing breastmilk. I know this will cause nipple confusion but I really don't know what else to do.

How can damaged nipples heal if they continue to be in use all the time? I really don't understand how women overcome this problem, but I feel like a total failure.

Any advice appreciated.

My Dss both bit me when their teech came in. I swear one poor nipple was almost bitten right through. Feeding was absolute AGONY for a while, with blood in the milk and everything, but they would not take bottles so I had no option. The nipples did get better once the boys had got bored of biting me.

firstly, you're not a failure - you've managed to 13 days with bleeding and scabbed nipples? I take my hat off to you!! I'd have folded at the first drop of blood myself.

secondly, have you considered nipple shields? I know some folk claim they are the work of the devil, but in all honesty, if they keep you breast feeding (and you want to keep breast feeding), then they can feel like a life saver. Also, do you have copious amounts of lansinoh to hand? slather it on at every single opportunity! or an equivalent nipple salve. you can stop using shields once the latch is better/nipples are healed - but I do know of one friend who used them for 3 months as it was the only way she could feed. she kept going to 9 months in the end. I found the first 4 weeks pretty bad on my nipples, but used lansinoh all the time - I was pretty much swimming in the stuff. I'm convinced it helped me.

thirdly, do you have another bf counsellor you can see? or a bf support group/la leche league nearby? it's always nice to speak to other women who have been there/done that, and you may find a different counsellor gives more appropriate advice (I found one local bf counsellor useless for me, but she helped others, and vice versa)

good luck, and congratulations on your new baby :)

also, has thrush in the nipples been ruled out? it can often be associated with cracks. it's worth looking into, as feeding with thrush is EXCRUCIATING, as is feeding with a crack, so the combination is bloody awful.

If the breastfeeding counsellor hasn't worked I would recommend seeing a qualified lactation consultant if you can afford it mor find one at a nearby clinic. I saw and spoke to loads of people who said everything was fine, they couldn't understand why dd wasn't gaining weight, was feeding for hours, I had cracked nipples but my lactation consultant took one look and was able to correct the latch. If you google 'board certfied lactation consultant' there's a list of all those in the uk with numbers. It wasn't cheap but it was the best money I ever spent. Good luck.

I am so sorry that your nipples are damaged, my LO now 19 weeks, had a >75% tounge tie and totally trashed my nipples so I bled every feed(!) I had lots of different advice but in the end, this is what worked for me (and healed them after a week or so), enabling me to continue BF till now:

1. Lanisoh After EVERY feed! You can ask your GP for a prescrition if your nipples are damaged (saves a fortune!)
2. Expressing for the evening feed so DH could do it and give the nipples a bit of rest.
3. Getting the Avent plastic breast shells (with the holes in the top, although don't lean forward after they fill up!!), so that my nipples weren't rubbing against my clothes(!) if I was out and about in the day.
4. AIR THEM. Now I had mixed advice here and tried both covering up and airing them and for me, airing them at every possible opportunity worked best (e.g. If I was at home or at night in bed- although had a towel on the bed for leakage!)
5. Get checked out for thrush. Used cream on my nipples and gel for LO in mouth, took a good month to clear but made a real difference.
6. Get your latch rechecked. It might be a simple slight adjustment you need but it can make all the difference. Even when I bled, it wasn't too painful once the latch was sorted.
7. Get checked out for tounge tie as the can stop LO latching. I swear my LO's first words are going to be 'big wide mouth for mummy!'
8. Google Jack Newmann for great videos about latching!
9. Take regular paracetemol for the pain just before feeding.

10. Eat lots of chocolate as a reward for getting this far, it's b*ly awful at the start if your nipples get damaged but it is worth hanging in there I promise. We are now at 19 weeks and I can't believe that we got here (I never thought I would) or how easy BF now is... Well until she gets teeth!!!...... Good luck.

if you get the latch right then any damage should heal regardless of feeding

you need to see a better breastfeeding counsellor I would say, if the first one hasn't helped.

whereabouts are you?

Have you tried biological nurturing? It's also called laid back feeding and it is a way of bfing where you use the baby's own feeding reflexes to aid latching. It's also very reassuring for baby as they get to be in close contact with mum.

These feeding reflexes can often interfere with traditional nursing positions which can make baby and mum frustrated. The reflexes are only present for abou t6 weeks post birth so if BN works for you, you don't have to feed semi-reclined for the rest of your bfing day

Try googling 'moist healing' and you should get some advice on how to heal nipples as if you do dry healing scabs form which then get ripped off with nursing/removing breast pads/expressing causing more pain and damage.

Hats off to you though you have done really well for persevering. Hope you get healed up soon.

Thanks for all the advice - I am following up on all the suggestions. I am in Gloucestershire, the nearest lactation consultant is Bristol but I haven't made contact yet... not sure if i've left it too late. I am feeling slightly less of an emotional wreck today, and still managing to give breast milk directly for about 2 feeds in 6, expressed breast milk for 2 feeds out of 6 and ff for the remaining 2/6.

DH works away all week and I have 2 other sons under 5 in addition to DS3, so i am really feeling the pressure at the moment...

I had a terrible time with my son in the first 3 weeks, terribly cracked nipples, mastitis in one boob and screaming in pain with every feed. He's 17wks and ebf. Things that worked;

1. Lanisoh or Kamilosan cream after every feed

1. Breast shields saved my nipples, the avent ones were good. My son didn't get confused, I held the shield at a slight angle to help him and using them was the only way my nipples healed. I think I did 2 full days of expressed milk to allow the boobs to heal. I was also bloody stubborn.

1. Try expressing a little milk and rubbing into the nipple then letting the air to them, must be hard with 2 other children about but try when you can!

1. My problem was a latch one and my son wasn't tipping his head back enough or taking a full mouthful of boob. I bought a brest friend pillow around 3 weeks and saw a bf counsellor and it turned around from that day. Over a week and I was getting pain free, it got better with every feed.

Really hope you can see a lactation consultant, I feel your pain! x

I'm assuming by the 2 in 6 statement you are feeding about 12 times a day? The good news if you are doing 4 feeds and 4 pumpings you should be doing enough to keep your supply ticking over (usual recs for excl. expressing is 8-12 times a day) so you definitely haven't left it too late to contact a bfing advisor. While there's milk there's hope is a old bfing adage so you doing a third of all feedigs directly at the breast means there is a great deal of hope .

i would def see the lactation consultant
or give these guys a ring La Leche League Gloucestershire

www.kellymom.com/bf/concerns/mom/nipplehealing.html

moist wound healing - info on the link above

good luck

Oh SmilingHappyBeaver, I really do feel for you. Your description was me 4 months ago, your DS's behaviour at the breast and everything. It was pure hell.

It is possible that your DS has tongue tie - I had dreadful problems with my DS and this was eventually diagnosed as the problem. But my DD does not have a tongue tie and she was almost as bad.

I totally get thisisyesterday's point about a good latch solving the problem, but IME with a baby that behaves like the OP's this can be impossible to achieve until the nipples are healed and a lot less sore. A bit of a catch 22.

People have mentioned Lansinoh - for me this has never worked, but what did work was the moist wound healing that EldonAve mentions. I was given some Jellonet (sp?) pads by the MW and they really helped. But the problem was that every time DD fed the cracks opened again, and it was far too painful to keep unlatching and relatching - in fact it made the damage even worse.

The way I solved this problem was nipple shields. Like kveta's friend I used these for many weeks (12 weeks for me too). That comprised time for my nipples to complete heal plus a good few weeks to get my nerve back to latch DD without them. I am surprised and disappointed that the BFC did not suggest these - anything is worth a try to prevent you having to give up. Incidentally, if the bottles are causing any nipple confusion, which they might but not necessarily, nipple shields can help bridge that gap.

With the family circumstances you describe I think you are doing amazingly well to have perservered this far. If you can get to see a lactation consultant that would be the best thing. But if you can't, here's my happy ending. We had all the problems you describe, I was so close to giving up many times, but here we are at 19 weeks breastfeeding without any nipple shields and now exclusively. HTH.

Happysmilingbeaver. You are doing just BRILLIANT. I don't know how you have persevered esp with 2 other LOs to look after and no partner during the week.

When dd was 4 weeks old, I can remember posting in tears at 5 in the morning cos my nipples were in bits and I just didn't know how I was going to do the next feed. I thought dd would starve. Stubborness prevented me from even having formula in the house so that wasn't an option. I got in touch with lactation consultant in hosp where I gave birth & she was brilliant. Double checked latch, postion hold etc. She actually diagnosed thrush. Diflucan was only thing that resolved it. My absolute saver was nipple shields- the agent ones are good. I only used them for few days cos dd fussed on them but they gave mebreak I needed. Dd is now 15 wks and bfing has been pain free for last five weeks and is so rewarding. Get help from anywhere u can and keep posting for support. I really feel for you.

Airing the nipples, going around topless for a few days (close your blinds) was how I sorted it. The latch is really important. Try to squeeze your boob as flat as you can with the hand that's not holding the baby, then poke the nipple and areola into the baby's mouth as far as you can, so the nipple isn't being rubbed so much by that little tongue that can feel like sandpaper.

I thought DS would choke to death when a bit of my skin came off and he swallowed it; I was raw (sorry if tmi) -- but correcting the latch and airing helped soooo much.

OK - bit of an update... I have now been diagnosed with deep breast thrush, after a trip to the out of hours GP when I noticed white spots on the roof of DS3's mouth. At least I now know there was a reason for all the pain!

However the GP has only prescribed me with a topical cream, which from reading up on the subject I am not sure will be enough to clear the whole breast of it, but we'll see. The GP said she didn't want to give me anything orally as it will go through to the baby. DS3 has been prescribed oral drops.

I have also stocked up on nipple shields and nipples shells. All very romantic... DH is most bemused .

I am still not sure i am going to be able to get back to exclusive breastfeeding, but some of the posts above have given me some confidence that it might be possible.

Have you found the Breastfeeding Network's leaflet on thrush? Very useful to print out and take to the doctor.

Glad you've got things sorted with the GP. I went back to exclusive breastfeeding after mixed feeding for awhile, nipples actually had a piece chewed right off [bloody hurt emoticon]. Breastmilk is a great healer, I found that just smearing a little around the nipple area heals it very well.

Summer whereabouts in Glos are you - could you get to Cheltenham as there is a brilliant bf group there with a fabbo lady called Elizabeth Mayo who saved my SiL's sanity when she was having the same trouble as you.

The group is called BAPS look here

You deffo need to take the BFN thrush leaflet to the doc, underline the bit that says give fluconazole for deep breast thrush. Ignore what they say about it going through to the baby. Leaflet here

Good luck, SiL got over mastitis x 3, thrush, ungelpful xp, baby with silent reflux undiagnosed and PND and carried on feeding for 16 months until DN self-weaned.

Megapixela, I know how that felt, and yes, rubbing breastmilk on the nipple does help.

I totally agree about breastmilk. Miles better than Lansinoh or any other expensive cream.

I think lansinoh is an ok preventer and soothing for nipples that are being fed from a lot but no good for real problems. I'm allergic to fluconazole so had to make do with just creams for a nasty thrush infected cracked nipple at 12 weeks. I got gp to prescribe Jack Newman's all purpose nipple ointment - find recipe on google. After every feed I soaked in saline, covered with apno and then jelonet and thenclean breast pad and then hid that nipple. I fed from bad nipple as long as I could bear, then finished with other side. When it was a feed from good side I just fed from that side for the whole feed so the bad side got as long a break as possible. I also made sure I fed from the bad side last feed before the biggest gap when dd slept and from good side in the night. This gave a gap for healing too. In 5 days it was almost healed. Dd had daktarin oral gel too (bought from chemist - told them it was for dh as they won't give it to little babies but nystatin utter waste of time).

For me, Lansinoh and airing each nipple between feeds, rather than popping straight back into bra.

I used to hate rubbing past DH because of the pain! It does get a lot more comfortable.

BfN information about moist wound healing of nipples. Preventing the scabs forming significantly reduces the pain.

List of breastfeeding support groups including lots in Gloucestershire

I'll just say that if you're near Stroud the day/ time for MOBS has changed to 10-12 on Tuesday. I can thoroughly recommend them having made use when DD had taken chunks out of my nipples. The NCT breastfeeding counsellor is great and will visit at home if you need her to.

I found that nipple shields were an absolute life saver, although I only used them for just over a week. Also trying different positions so that they are latching onto an area with less damage (that certainly made it less painful)

If you are concerned that your treatment for thrush isn't right, I was advised to specifically request a doctor who believes in it as there are some who don't.