I think i've had enough

[anne74]

I just don't know if I can take any more.

Just when I think things are turning a corner, they go downhill again. I've posted other threads with the issues I've been having but I guess it all came to a head tonight when DS vomited blood. While he was feeding I noticed my left nipple was bleeding, but when he vomited it was really scary. I then was able to calm down when I realised it was probably just the blood he had swallowed when feeding.

His latch had been getting so much better, with a nice wide mouth (on occasion) and pain free feeding. One nipple had completely healed which was so exciting but this is now the one which is bleeding. It doesn't even look that bad, there's just one tiny spot in the centre of the nipple. My other nipple however just doesn't seem to be healing but we were at least managing to feed pretty much pain free. I really thought we had turned the corner and were on the home straight.

But he's been so unsettled all day today and wanting to constantly feed. After every feed he has been screaming for more and I have kept putting him back on the boob but there is only so many times I can do that given the state of my nipples.

I've been trying to feed as much as possible to boost my supply but despite my boobs feeling pretty full, he just doesn't seem to be getting the milk. He seems to be using his tongue in the same way as he does when he has a bottle, curling it around the boob, rather than massaging the boob to get the milk to flow. He's then getting frustrated as the milk isn't coming. I can feel my right boob heading towards mastitis so have just expressed to release the pressure a bit. It is just so frustrating when I can see the milk is there but he doesn't seem to be benefitting from it. He also seems to be rubbing the areola with his tongue which is getting really sore. That's what stops me being able to carry on with a feed. It feels like such bad friction. It keeps surprising me that the skin hasn't actually broken down on the areola.

We've been trying so hard to get this whole breastfeeding business right. I've been breastfeeding for 7 weeks now despite 3 tongue tie ops, being 5 weeks prem, and being generally tiny and with nipples that wouldn't be recognised as nipples. I don't really want to give up after all we've been through but I just don't know how much more I can take.

I have had to give him a bottle of formula this evening to see if that helps him settle and straight away he has calmed right down. he had the whole 90mls and has then lain down beside me on the sofa very calmly and now has drifted off to sleep. That just proves to me that he hasn't been getting enough milk all day. I have been reluctant to give him a bottle as I don't want to encourage this issue we're having of how he uses his tongue. If I don't give my boobs a break though there will just be no way I can continue.

I plan to give him bottles all night to give myself a break but I just don't know whether to call it a day, express as much as I can so he gets breastmilk whenever possible, and move to bottles or try to push on through. I was hoping that as he gets a bit bigger he will latch on better but I don't know how much longer that will take and if I can last that long.

He is so much more content this evening having had a bottle and I just feel so selfish for not having given him a bottle earlier in the day.

I just don't know what to do. I've been to 4 breastfeeding clinics, seen a private lactation consultant twice and feel that there's nothing else anyone can do to help.

i'd just written this long post one handed with ds on my arm and it disappeared!

thanks so much for all your advice and suggestions.

we've just been to the day assessment unit at the children's hospital here which was requested by the a&e doc due to his constipation and slow weight gain. he has put on 160g this week so is now 8lbs but they think he has a milk protein intolerance. they have prescribed the formula feed nutrimagen and told me to avoid any dairy in my diet. he hadn't pooed since wednesday but they did a rectal exam and that stimulated him to do a big poo. it apparently had blood in it which is indicative of a milk protein intolerance (whether it's an allergy or intolerance i don't really know).

with regards the feeding, the docs did say carry on breastfeeding but they also said that we must make sure he's getting a good calorie intake before his appointment on wednesday with the surgeon (he has an inguinal hernia and fluid is apparently leaking into his scrotum).

we rarely get through a day without needing to give him a bottle as it doesn't seem that he gets enough. i am just wondering if he would be better off being bottle fed with ebm and formula where necessary. at least i would know that he's getting enough. much as i want to breastfeed, my nipples are in a state (there are definite issues with the latch still and really i was partly waiting for him to get bigger and partly hoping we would just get better with practice) and his intake is so crucial, i don't know if i can afford to breastfeed. my milk is what is most important and i can do that by expressing. i guess the other thing is how long i can go on with a dairy free diet.

i don't know. i'm so torn.

my right nipple is so damaged at the moment. there is a huge crevice in it which actually seems to be a good thing. it was totally white tissue on the nipple which i now think was dead tissues. i've been slathering on the lansinoh so i think this crevice is actually a positive thing as it is pink tissue. i did manage to get back to the breast after 3 days of bottle feeding before the last tongue tie op so maybe we can do it again. i wonder if i should just bottle feed until my nipples are completely healed and then try again.

crikeybadger - the gp decided we didn't have thrush, and i think he was probably actually right as the pain has settled down.

providing i express at least every 3 hours that would maintain my supply i guess. with regards double pumping, i was using my feet to do the controls on the machine but it's not ideal! i think the idea of the vest is a good one so will look into that a bit more. i did try tucking one bottle in my arm but it just feels like the suction isn't very good when it's double pumping as opposed to just one side.

we did bottle feed overnight and when i tried to feed this morning, it was terrible. he just wasn't sucking properly at all. the second feed was much better this morning but he didn't settle at all after it and ended up having to have a bottle of formula at the hospital. so between 8 and 1 he had 3 feeds, the last one being 100mls of formula.

what would you guys do in this situation? my priority has to be his nutritional intake and i will do whatever i need to do to maintain that.

so summary is - 8 weeks old, 8lbs, hernia, constipation, possible milk protein intolerance

i think i see my options at the moment as being:

• bottle feed with formula and ebm for forseeable future
• as above but just until nipples heal completely and then try going back to boob
• persevere with the boob and try aids or give at least one bottle each day to ensure intake

i think the second option looks the best to me at the moment although i will miss putting him on the boob, despite the pain and difficulties we have. even while i write this though i hate the thought of not putting him on the boob.

aaaargh!!!!!

Sounds like you're going through similar thought processes as I did. You are totally right that his nutrition is the priority and whilst the ideal situation would be a baby that breastfeeds beautifully that isn't always possible and feeding ebm is an excellent alternative with almost all the benefits to the baby as breastfeeding.

It also has the advantage that you know exactly how much they are taking. Although with a normal term baby this isn't so much of an issue I think it really helps when you have a small/prem baby who has issues with weight gain. I found that as I always knew DS was taking more than the guideline of 180ml/kg/day I didn't stress about his weight and always knew that he would have put on weight at each weigh-in and would have crept up the centiles.

I did keep putting him on the breast until about 3 or 4 months and saw lactation specialists etc but he never really took to it. I found that really sad and always hoped he would suddenly get the hang of it. But he was getting what he needed. And in fact he had a pretty easy time of it with lots of breast milk available without him really having to work for it. I have to say though at the time I was just really emotional about it all and not as logical as I'm sounding now. Think the post partum hormones were a factor.

Good luck with it and remember things will easier.