bfing probs and need advice

[slowangels1]

Ladies I'm stuck and not sure what to do. I had DD a week ago and while in hospital post birth for 2 days I made sure I got mws to help me latch to bfing. However, they all had different ways and different advice and within the first 3 feeds I had a blister on a nipple. The mws/nurses just sort of did it for me without getting me to do it and were really rough and so now I'm back at home I really can't get a grasp on it.

Things got bad as on leaving the hospital I was told by a mw I wasn't making enough milk for DD (how did she know - she never saw me bfing) and gave DD a bottle . After that, DD refused bfing for a day and would only take bottle.

We have now got her back to bfing but I have very sore and bleeding nipples. Have been using a nipple guard (or whatever it's called) for the past day as it's the onlyt hing I can manage at the moment and I really felt like we were getting there but engorgement in one breast still and earlier it kept bleeding alot during feed and DD refused to take milk from it.

Am now stuck with one breast where she feeds from with guard which is working out OK but the other one is really agonising the whole time and bleeding etc and she refuses to feed from it - it's been early hours this morning since she took anhything from it and then she hardly took much so it is getting really hard.

Have tried hand expressing and can't get the nac - watched tutorials online and rang bfing helpline for hints but just can't do it. Sent DH out now for a manual bfing pump in the hope this will help but no idea if this will prove too painful or if it's the right thing.

Tried everything - lanoish (or whatever it's called) warm flannel, attempting hand expressing, relaxation techniques, nipple guards etc etc etc and don't know what to do and feel so close to giving up but really don't want to - never had such horrible pain!

ANy help really appreciated as I'm sitting here in tears on my own with DD for first time alone as DH out to buy pump and so scared she'll wake up and need feeding and I'm here alone. Is a pump a good temp measure to get me through? Have told DH to get manual one as elec so expensive and hopefully won't use it alot but no idea what he'll come home with other than told him not the cheapest of cheap.

Sorry this is so long.

Hi there. I think you need RL help. Is there a bf cafe or drop in centre near you? Can you call a breast feeding coordinator at the hospital who would see you? Can you call one of the Bf helplines (La Leche League for example) who might be able to assist.

Sorry got to go - school run but there is plenty of help out there and I'm sure one of the BF experts on here will be along later....

xx

Have rung la leche tryharder and they said about the hand expressing, which I can't manage . I have mw coming over tomorrow to help so it's a case of getting through till tomorrow at the minute. Local bfing help group meet on wednesdays, which isn't much good afraid!

Hopefully more experts will come on here soon to help [sonfused]

Ask the midwife if there is an infant feeding specialist/lactation consultant person within your trust she can refer you to... or do you have any contacts for someone like this in your antenatal info? Someone who ran bf workshops perhaps?

You really need someone in RL to help you - the mw may be able to but as you've had bad advice/support from mw's already I'd not nec pin everything on this.

Try ringing the other helplines? NCT? They may have someone local to you? Do you know any other bf women?

Get mw to double check for a tongue tie while she is there tomorrow too.

You are doing a great job perservering with this. You will overcome these problems with a bit of help and it'l; get soooo much easier.

Poor you! Sorry to hear you're having problems. I'm sure you will get some valuable advice on here very soon.

A couple of thoughts from my experience and what I've read here before...

1. Does up on painkillers - paracetamol & ibuprofen are def allowed and you can take them overlapping.
2. Feed her as much as you can in any way you can manage it. Try different positions because her mouth will put pressure on different parts of the nipple. Eg. rugby hold, and lying down (takes a bit of getting used to and get DH to help you get her close enough while lying down. A different position may also help you to get her feeding from the other side. Top tip is to use enough cushions to support her whole body in a good position (tummy to mummy etc) so she and your arms can relax - then your arms are free to help with details like her head/your breast etc until she's settled.
3. For any kind of expressing or relieving discomfort, try your best to be relaxed - and look at DD or a picture of her. They say sitting in a hot bath helps with relieving the engorgement too - if it's really bad you won't need to hand express really - get warm, think of baby and the milk will let-down itself. You can also massage gently all over your breast, working from the very edge inwards to get the milk moving and relieve the engorgement.
4. Apparently savoy cabbage leaves in your bra relieve some of the discomfort. Sounds crazy but people have found it really relieving.
5. With the pump it will take a bit of getting used to. I seem to remember the instructions were quite specific about a series of quick pumps and then slower - I remember that did work to help the let-down... imagine the baby trying hard to get flow going, then easing off while it flows.
6. You mentioned online tutorials for hand expressing, but try these sites for good info and also videos on latching. The best way to resolve this will be to latch DD on and let her get the milk out! www.drjacknewman.com/ has fantastic videos about latching, and www.kellymom.com is also good.

Good luck!

thanks titty I will do that. The visiting community mws seem pretty good, it was the hospital mws that were a bit rubbish. COmmunity mw did check for tongue tie and said maybe a slight one but nothign to cause too many issues. Whenever I'm latched on with her they al say I have lots of milk and she is feeding really well -she's just so strong with her suck and we must have something not right or it's just not letting the bleeding recover etc due to feeding.

slowangels - you poor thing it sounds like you're having a right time of it.
Do your hospital not have a BF counsellor attached?

I think the pump is a good idea, a hand one is fine. When you pump, you need to mimic the baby - so quick 'sucks' until your milk lets down and then slower ones once it is flowing.
There is a triple benefit of doing this 1) it will relieve your engorgement, 2) it will help to establish your milk supply, 3) you will have milk that you can cup feed to your DD if she won't latch for a feed.

You need to get that nipple healed up, and it will heal faster if you keep it moist. Don't let it dry out and then it scabs and when the scab comes off you are back to square one. Put some breastmilk on it after you have expressed or fed from that side, and then Lansinoh as that will keep it moist for a good while.

I would maybe ring the NCT line as well and see if there is anyone in your area who could come out and see you.

NCT usually have local breastfeeding counsellors.

MWs are hit-and-miss as most aren't bfing experts in any way. A good BFC is often better. An infant feeding specialist/lactation consultant is best.

Def get someone to check for tongue tie.

A pump will help with engorgement and can help with supply, but think of it as very temporary if possible - if your LO isn't feeding off you much at all you need to pump at least as much as LO should be feeding, so at least 8-10 times a day including at night. It's very time consuming - I needed a double electric pump (borrowed from NCT BFC) when I was expressing most of DD feeds (after a scbu start).

Dr Jack Newmans videos on youtube on latching are good.

This really will pass - it feels like forever at the time though I know!

x-posted! If you're having major issues still in a day or so, I would insist on a referral for tongue-tie. They are very hard to assess and what can look like a minor one can still cause real issues.

As usual I agree with japh. Get the TT sorted, if feeding isn't going right then it could be this causing the issues so get it snipped asap so this is ruled out as a cause of the problems. My DS TT was snipped at 8 days, not traumatic at all.

If you are sore and feeding is causing cracks/bleeding etc then something isn't right so someone sying it all looks good isn't helpful... if thats what they say get them to refer you to someone else. That much pain/bleeding isn't normal. What I mean is don't think its just something you need to put up with.

I've heard ppl on here mention jelnet to help heal cracks more quickly, it's a dressing type thing I think. I think you can buy it over the counter at chemists.

if you can get in a deep bath that might really help to clear the engorged breast. Did for me :)

good luck and it won't be this hard for very long. promise.

I'm sitting here in tears on my own with DD for first time alone as DH out to buy pump and so scared she'll wake up and need feeding and I'm here alone. I know that feeling! I found that getting in the bath with the baby (you will need help) really helped me. While she is feeding on one side, the other leaks and I managed to work out a block doing this. I never managed to hand express except in the bath. Also, the baby seems to feed better in the bath. Skin to skin and reminds her of being inside I suppose.

Good luck and get as much help as you can in the early days. It will get better. I still have to use nipple shields with DD but she feeds wonderfully and the nipples are entirely healed.

thanks all - fab advice. I tried the hand pump this afternoon and in 2 attempts and lots of tears got 30mls out which has helped the engorgement and so will try and keep this up until see mw for advice and see about being referred to someone who knows more what they are talking about. Just off to try the hot bath tactic...

just an update to say hot bath made me drip quite a bit of milk and managed to get baby to feed from sore breast twice overnight using the nipple shield :) however, I was yelling out in pain and lots of tears going on from the pain.....I hope mw will help today as I'm feeling close to jusgt trying to express and feeed this via bottle.

Are you taking painkillers? Paracetamol is usually considered fine when bfing and after my CS I also had ibuprofen and codeine without issues - really helped with the boob pain!

yeah japhrimel I've been on various codeine/paracetamol/iboprofen mixtures (all in the right dose/combinations though so don't worry!) as had a csec and still need them for the pains from that.

Well that is good, because the last thing you need is mastitis on top! :)

Yes definitely take some ibuprofen. If you have got a blocked duct or anything going on contributing to the pain then the ibuprofen will help reduce any swelling around that and help it release.

The other thing that can cause cracked and bleeding nipples is thrush - which you are more likely to have because you had the GD in pregnancy (suppressed immune system etc). It is worth raising all of this with your midwife.

Are you managing to keep your nipple moist in between feeds?

x-posts about painkillers :)

Definitely ask about thrush - antibiotics make you more prone to it too and presumably you had some with your CS? It's excruciating.

And actually, I found that feeding with nipple shields was always painfree except when I had thrush.

interesting alibaba as not only did I have GD but I had thrush (as in the usual sort) throughout my pg. Assumed (hopefully) this wouldn't be an issue due to csec so baby not getting it via vaginal birth but maybe as it's in my system is can still go to breasts.

Am rubbing milk on after feeds to nipples and using lots of the lanolish whatsit cream too.

You could well have thrush in your breasts/nipples in that case, which is why the cracking and pain is so bad. Do you get pain in your breast after a feed?

Here is a leaflet which gives the relevant info around what your GP should prescribe for you if thrush is diagnosed.

Make sure to change your breastpad after each feed, and to thoroughly wash and sterilise your nipple shields between feeds - I would use the Milton cold water method that only takes 15 mins. And wash your nursing bras/feeding vests etc on at least a 60 degree wash to kill the thrush.

Really hope things improve for you, it is miserable when you are having problems but so so brilliantly easy once you get it cracked that it is worth persevering - IMHO of course! :)

If it is thrush make sure you get treatment for your LO even if they have no symptoms, otherwise you'll just keep passing it back and forth between you.

Can you make a gp appt asap?

Milk for moist healing won't work if you do have thrush as you'll be rubbing thrush into the cracks .

just had mw and baby weighed and has now lost more than 10% of weight so have to express to top up feed. mw has told me to give more painfuil side a 24 hr break and just exspres from that side and do same to other side if needed after. didn't seem to think it thrush...

Did she have any advice on helping you get a less panful latch? Did you ask if there is a bf specialist you can see?

yeah she told me to go to bfing drop in next thurs and in mean time just use the guards and showed me how to try and get a better latch with it - the tricky bit is getting the baby to open mouth wide and simoltaneously (sp) get the nipple in before she closes mouth again to get her mouth as wide as poss. So I'll keep going and hope I can just keep it up until I go to support centre next thurs.