How can I carry on from here?

[thefurryone]

Hi my DS is 3 weeks old. I have been breastfeeding since birth and have struggled through cracked nipples, but now I have thrush and despite getting the cream for me and suspension for him which has made the pain much more bearable I have been really struggling to feed him all weekend. Yesterday I expressed a couple of very small feeds but this morning have had to resort to giving him a small amount of formula just because I can't bear putting him on the breast again. I feel like such a failure.

I am really stuggling to get the latch right, when I do manage to get it so that the nipple is in the right place then often his bottom jaw rubs against the aerola and it's excrutiating. I do try to hold in him different ways but he hates being in the rugby hold and generally squirms and wriggles so much that the only chance I get to latch him on is by holding him close and tight. Whenever I do get a good latch he lasts a couple of minutes before he readjusts himself to have just my nipple in his mouth and I have to break him off.

I did go to a support group on Monday but no one was really feeding and he latche on really well whilst we were there. This only runs every couple of weeks and I can't find any other support like La Leche League or Breastfeeding network in my area.

I really really don't want to give up breastfeeding but just don't know what to do now.

Thanks

Has he been checked for tongue-tie?

Is the suspension nystatin? If it doesn't work for you (was rubbish for us!) go back and ask for daktarin oral gel.

Yes he has been checked for tongue tie and he doesn't have it.

The suspension is nystatin symptoms are clearing a little but will head back to drs if no better by tomorrow.

I have had similar issues. The suspension only added to the breastfeeding saga that I have had! My DS is now 9 weeks old and the rugby hold never worked for us.

I took him to the infant feeding team in a local hospital and his latch was great and then he reverted back to poor latch as soon as I returned home! I had a BF volunteer who visited the house (through a scheme called homestart). This was much more useful as she showed me how to use my furniture to get good P and A. Maybe there is a similar service in your area.

I nearly gave up at your stage as after the thrush I got mistitus but fed through it. I had lots of people telling me it got better and did not believe them but it is true. The BF volunteer also helped me emotionally. Please don't feel guilty for using formula, I had to do the same for a couple of days

Hope this helps

If he is not getting a deep latch, or getting a good latch but then slipping back, it might be worth getting a second opinion on the tongue-tie. Some of them, especially posterior tongue-ties can be hard to spot and midwives often aren't that familiar with them.

Have you tried calling the National Breastfeeding line or the NCT Breastfeeding line? They might know of breastfeeding counsellors or groups in your area.

Also try googling Biological Nurturing - I found this position really good for getting a good latch.

Would a posterior tongue tie mean that he wouldn't really stick his tongue out?

Thanks KafM the hope that will get better is the only thing keeping me going!!

I'd see a BFC or lactation consultant asap. The NCT helpline can help you find one

You can search for local breastfeeding support here. Hopefully there is another group nearby.

Do try one of the helplines, I found them really helpful and supportive.

what area are you in thefurryone??
i seem to be friends with a fair few LLL leaders and various other BFC's around the country so may be able to point you towards one?

and agree, slipping off the nipple can be a sign of tongue tie, both my tongue tied babies did this! and the pain it causes is very similar to thrush, i was treated twice for thrush with ds1 before finding out it was actually TT

My DD is now just over 5 weeks old. My nipples were like mince meat by week 2 and I had cracks like the Grand Canyon on each. There is a breast feeding support group weekly at our local Sure Start centre. Our latch was checked and the mw said this was fine it was the fact that DD would 'slurp' the nipple into her mouth that was causing the damage. The pain got so bad that I was peeling myself off the ceiling at every feed & dreading her waking up to feed.
As I was about to give up the LC came to see us at home and suggested nipple shields. The relief was instant & DD latched on straight away. Without the nipple shield I would have given up but today am exclusively BF in comfort.
The draw backs are that sheilds need sterilising each feed & can be difficult to BF dicreetly. Also if you wanted to get baby back onto nipple without sheilds at a later stage I have read that this can take some work. However for us the sheilds have kept us going. I use the Medela sheilds - cost around £5/6 and you can get them from Tesco, Boots, Morhercare etc... Good luck whatever you decide to do!

I am EBF my 6 mo (well, a few bits of food started recently). At the beginning I was SO sore, I used to cry through feeds and dread each one. I really wasn't sure I could continue and had to be really bloody minded about it. I think I had thrush too but never had bad cracks. Around 6 weeks things improved. The reason I am telling you this is that once the pain went I was so happy I had persevered, and have embraced the freedom of breastfeeding, especially when I went on holiday and didn't have to take bottles, steriliser etc.

I think i depends how important it is to you to BF, don't feel bad if you decide to give up but do know that it gets easier with time. Definitely phone a BF helpline if you need to chat and get phone advice.

You are NOT a failure, if anyone says the words 'if it hurts you're doing it wrong' ignore them, definitely get help if you want to continue. You're not alone in having a tough time at first.

This mumsnet and kellymom both really helpful too.

good luck!

Thanks Albrect there are a couple of other fairly local groups on there I can try.

Thisisyesterday I'm in Belfast. Did your babies slip off at every feed or did they sometimes manage not to? We do occassionally manage to get it right so was wondering if that would mean it wasn't tongue tie.

Bigmacplease, thanks I do have some nipple shields, tried them a couple of weeks ago when the cracks were painful and found them hard to use but may have to give it another go.

Will also give the NCT helpline a call, there is definitely NCT here so hopefully they can put me in touch with someone. All of the advice I've had so far has been from the midwives, some of it has worked but between birth and now I seem to have had so many people helping that I don't know if I'm coming or going.

we occasionally had better feeds yes, mostly when i was being watched by a breastfeedin counsellor or someone blimmin babies!

i think i also got used to holding them in position to help stop them slipping off.

there is an LLL group in Carrickfergus, though that might be a bit far for you, they meet on the 2nd friday of each month, 10.30am-12.30 at Oakfield Community Centre
you can contact the Leader (Sarah) on (028) 93362387

Tonguetied ds4 used to slip off after latching and like pp he never did it when being watched by anyone - he had a minor tt but it was different after it was divided. Would really second the advice to see someone in real life, who has specialised bf knowledge.

Ok so I called NCT and they suggested trying laid back breastfeeding or compromise position. So I gave it a go and it really seemed to help. Had a really successful night of feeding and then again all of today, fast forward to this evening and he got really agitated started feeding loads and loads and never seemed satisfied my nipples are once again raw and painful and he has had a complete meltdown. This happens most nights and I dread it. AAAAGGHH.

Have you tried biological nurturing or rebirthing (that's not a well known one so probably not)?

Biological nurturing is being skin to skin, with him upright and letting him latch himself.

Rebirthing is where you co-bath (with a helper) take him under the water with his face up and out (we're not drowning babies here!) have your helper gently move him around the water so that he's really calm then bring him to the biological nurturing position, whilst there your helper needs to constantly be pouring water on him to maintain his temperature. Keep the bathroom lights low, maybe some candles and mood music (birthing type conditions really). As strange as it might sound it can really help.

Did the NCT manage to point you in the direction of someone you can see face to face? If your nipples are still so sore then it sounds like there might be a latch issue still.

It is pretty common for young babies to want to feed a lot in the evenings and not seem 'satisfied'. More info here.

Do you think it is new damage that is being done to your nipples or it is painful as they heal? I remember the rubbing and found working on the latch helped but also it just got better as their jaw gets bigger and they can gulp more breast in, rather than hanging on the end of the nipple.

Its great the laid back position has worked several times for you - soon you will be having more and more painfree feeds.

Am I right that only midwives have checked for tongue tie?

If so then you need a TT specialist (unless the MW happened to have been trained in it as a separate thing, they won't necessarily know).

I don't know where you are but there are a fair few of them around the UK. I recommend www.ann-dobson.co.uk who travels all over the UK to see babies, and she's also a IBCLC (the highest level of BFing training you can get) so she's wonderful.

It sounds very TT-ish to me.

Also check out the Breastfeeding Network's thrush leaflet. As was mentioned, Nystatin is not a great product and Daktarin for you both is a better choice (gel for bub, cream for you). If you are getting deep breast pain you may need oral fluconazole - but in a different dose to vaginal thrush so don't buy it over the counter. See the leaflet here:

www.breastfeedingnetwork.org.uk/thrush-and-breastfeeding.html

It WILL get better but you need to get the right support through it. I would suggest taking advice from NCT, LLL or ABM fully qualified breastfeeding counsellors, or anyone who has passed the IBCLC exams, and not assuming anyone else actually has enough experience or knowledge. Local BFing people tend to often "just" be peer supporters (which I am, and while it's great, it's not enough to help more complex cases) or midwives, or health visitors who have virtually no training in BFing as standard.

Thanks once again spoke to the local LLL leader yesterday, read the kellymom link and have arranged for someone to look at his tongue. Had a brilliant day of feeding yesterday still not perfect but hopefully this is things heaing in the right direction.

I recommend probiotics for keeping thrush at bay. The exaggerated feeding method helped me when it was painful - you basically push your nipple up into his mouth. I hope things keep getting better for you, hang on in there, I am at 7 months now with DS2 and really glad I persevered.