BF newborn with a one-track mind

[orchidee]

DS is now 3 weeks old. For the first two weeks he would feed then sleep - very easy baby! For the last 4 days now he just won't settle for me. All he wants to do is feed. At first I thought it was a growth spurt and he wanted to up my supply but he will settle for DP (e.g. being walked around the room for 5 mins.) Whenever I hold DS he just wants to feed, he will root around and cry incessantly unless I let him latch on. And I can't do that all day (HV was a bit at how often he wants to 'feed', usually within an hour of ending the previous feed, plus my nipples are in agony- I'm at the stage of wondering if nipples shields or expressing and using a bottle are appropriate.) I'm trying to approach BF as one day at a time but even thinking of the next feed is depressing - my nipples are now agony when he latches on (and he is often on and off a few times initially) then uncomfortable for the rest of the feed and also after feeding. They seem to stay erect for ages too which doesn't help (very sensitive.) In 3 weeks I have used about half a tube of Lansinoh and read what seems like every webpage on positioning and attachment. Any ideas? Thanks

Has he been checked for tongue-tie?

I'd get checked - and check the symptoms yourself - for thrush. Pain between feeds when you don't have actual cracks can be a sign of thrush.

Feeding that often during the day is pretty normal tbh. As is wanting boob when with Mum - my DH settled DD for bed for weeks because of that.

Maybe try using a sling?

RitaMoran - he can poke his tongue out of his mouth so I don't think he has tongue-tie(?)

japhrimel we don't seem to have thrush.

If your nipples are hurting, that generally means his latch isn't ideal.

If his latch isn't ideal, then he won't be getting as much milk in a feed as he would normally - which means he would want to feed all the time. (Although gaps of an hour aren't that unusual.)

What part of the country are you in? I can look for local support for you?

I know you say you've read every webpage on positioning and attachment, but it's possible fiddling with these may improve matters (both the pain and the constant feeding). When DS is on the breast, is his nose pressed into your breast? Clear of the breast? And his chin - can you see it?

have you been to any bf group? sometimes you need someone trained in bf more extensively than most hv are to help with positioning to find that sweet spot for pain free feeding. also I found a sling really helpful for letting my babies be held close and not feeding. sometimes they wanted to settle but were too full for comfort sucking, the sling and a bit of dancing around worked wonders.

NotQuiteCockney

I think incorrect latching is definitely an issue, though I've had it checked by 3 people (2 MWs and 1 HV) since getting home from hospital. There is a once-weekly breastfeeding cafe locally, so I may try that although I think it's mainly peer support. I can't say for sure about his position re: nose and chin, I'll pay more attention at the next feed, but I'd say his chin is pressed in and his nose, it sometimes seems closer to the breast than at other times, I think I see your point about positioning, the chin should be close and the nose not?

You can have symptomless thrush. Are you getting stabbing pains in your boobs after feed? Can you get to a support group for advice on positioning. Books and videos can only be so useful. You are really close to the day when your nipples finally 'toughen up' so stick with it. If you need to express a bottle to give yourself a break then do so. One bottle every now and then will give you the break you need. I found a glass of wine in the evening also helped.
Your LO is being perfectly normal - there is a big growth spurt coming up so he is just 'putting his order in' by suckling a lot.
Only half a tube of lansinoh??

MW and HV are not always THAT informed beyond the basics of breastfeeding. I'd try the bf cafe too, you will also get to chat / moan to others in the same position which always helps!

You can search for other local groups here

I'd definitely try the breastfeeding cafe- a peer supporter is hopefully all you need, and if not, they'll know of other sources of support locally.

The chin should be really shoved into the breast, impossible to see. The nose should ideally be clear - maybe touching the breast at most. The cheeks should be really full, stuck out.

Many mums with new babies who are having latch issues find the cross-cradle hold is best. You hold the baby with the opposite arm to the breast you're feeding on, supporting his neck between your thumb and index finger, letting his head tip back. Aim for nose to nipple, look for a big gape, and push him on with the neck/shoulders.

Tongue tie is also a possibility - you say he can stick his tongue out - when he does, is it pointy? Or flat at the tip? Tongue tie would also explain the symptoms you're describing.

Has feeding always hurt?

What shape is your nipple at the end of the feed? More pointy is to be expected, but if the tip is at all 'shaped', either into a mouth shape, or like the tip of a tube of lipstick, then something is up with the latch (or there is a tongue tie or similar).

And yes, as others have said, MWs and HVs are not necessarily that good at latch issues.

If he's crying a lot and your nipples are sore, I'd suggest that the latch isn't right and he isn't feeding effectively and therefore getting tired and not getting what he needs.

Try repositioning him, relax and don't worry if you spend all day feeding him. He's so little, this stage won't last forever. It's important though that you get his latch correct otherwise you'll be exhausted and in pain and could end up getting engorged and mastitis.

Also - pop along if you can to a breast feeding support group, such as BfN or La leche (or call their helplines) and see if you can get someone to help you. And I agree, some health professionals are necessarily good at bf/attachment issues.

Thanks everyone for your comments.

Cockney
^he can stick his tongue out - when he does, is it pointy? Or flat at the tip? Tongue tie would also explain the symptoms you're describing.

Has feeding always hurt?

What shape is your nipple at the end of the feed? More pointy is to be expected, but if the tip is at all 'shaped', either into a mouth shape, or like the tip of a tube of lipstick, then something is up with the latch (or there is a tongue tie or similar).^

Tongue is pointy
Has feeding always hurt? 90% of the time - Yes
On one side (with cracked nipple) the nipple can be squashed into a line. This nipple often shows signs of blanching / vasospasm after a feed and is the aaargh-gony one.

Re: MW and HV - each have given slightly different advice on how to attach the baby, so I see what you mean there.

Orchidee - when you say it's mainly peer support, you'll find that the training peer supporters do, if often more than the midwives/GPs and HV do.

Well - the lipstick shape nipple indicates a definite position prob.

As a BfN peer supporter, I'd say give the helpline a call. The number will go through to a local supporter near to you who can either talk you through it over the phone or come out to your home and sit with you and help whilst watching you feed. This would not be a peer supporter but a training tutor most probably.

On feeding - he has put on 12oz in 7 days (at 2-3 weeks old) which the HV thought was "amazing". He is definitely getting milk!

His sucking seems very strong at the start of a feed (which coincides with the most pain) then the sucking and nipple pain can subside. The issue is that he often pops off at this comfortable point and relatching causes more pain.

It sounds like one-to-one support from a BF cafe or support group will help so I'll look into that, thanks again

Orchidee - my DS was like this - from 2-10 weeks he wanted to feed CONSTANTLY. I spoke to everyone I could find to see what the problem was, and they all just said to go with it - so I set up my laptop within reach of the sofa, and just fed all bloody day and night for those 8 weeks.

He was a very overeager feeder too - so his latch was a bit crap most of the time as he was so desperate to feed! He would lathc on and off a lot before finally settling down to a feed. He was likened to a barracuda by the BFC :o BFC showed me the 'rugby ball hold' to feed him, and that helped his latch immeasurably, and thus my nipples too. Lansinoh was also invaluable!! Plus a support cushion was great. I went to a weekly support clinic, which was wonderful, met a lot of lovely people and got a break from the feeding for the 20 minute walk there and back! DS was born just under the 75th centile btw, and within 3 weeks was up to the 91st, and then above it some weeks - the child just ate and ate and ate and ate all the time. My nipples stopped hurting by about 6 weeks IIRC, and I'm still feeding DS twice a day at nearly 20 months!

But the best thing was the laptop within reach :D

vintageteacups
I hope I didn't sound ungrateful about peer support - I thought peers meant other mums who may have some ideas but are not trained any more than I am (i.e. self/MN-trained!) That's useful to know.

KvetaBarry
A lot of what you've said strikes a chord. Same centiles on the growth chart, desperate to feed (he bobs his head from side to side a lot before/when trying to latch on), and latcing on and off a lot before settling into a feed. It's good to hear you got through it.

Everyone:
Any idea why 6 weeks is a magic age for BF? Practice, bigger mouth, supply established? In theory I am halfway there time-wise but I don't know how to get from now to happy, painfree BF.

Yes all of those reasons, I think also you just get used to each other's little ways and you feel a little more like a pro.

Just keep going. Keeping an eye on what you are doing, keep getting help. Its worth it once you get those easy painfree convenient feeds everytime.

Nope - some groups I guess might be like that but with the BfN, NCT (I think), La Leche League, you have to do a course.

My BfN course lasted 12 weeks (2 hrs a week) and then you have monthly supervision sessions to check your practice and keep you up to date of changes etc.

When I did my course 3.5 yrs ago, HVs didn't get the same amount of training and midwives and GP only 15 mins or some ridiculous amount.

The proviso is that we have all breast fed our babies for up to 6 months I think. The courses cover not only breast feeding techniques but how we support people (support not advise) and how to be non-judgemental etc. It focuses a lot on how we behave when providing information etc.

It wasn't 6 weeks for me, it was 11, but I know most mums crack it about 6 weeks. It doesn't happen overnight, but one day you suddenly realise it's not hurting anymore.

Well I've had a couple of non-painful feeds on each side today. I tried the deep latch technique described here www.pumpstation.com/pumpstation/dept.asp?s_id=0&dept_id=3228 who knows if the compression is what helped, or just a reminder of positioning and attachment (after spending more hours on the internet).

Anyway, after feeding I still have sore nipples even though they were fine when feeding. Warmth seems to help, so I'm hugging a hot water bottle.

do they go white and feel like they're burning after a feed? if so, this could be vasospasm. happened to me both times, but got better with time and as latch improved. that is, they still often go white, but doesn't hurt. don't recall how long it took, but it was a gradual process, where it got just a bit less painful each day.

MamaChocoholic - Yes, I've read about vasospasm and it seems to fit my situation. There's some info on KellyMom about it that seemed relevant. I'll keep working on getting a good latch and hope that the pain disappears in time. It's good to hear that it happened for you.