Reassure me....Is nipple confusion real? I am worried about my new born

[MademoiselleDuPont]

My baby is ten days old and I initially started breastfeeding. at teh hospital I told the midwives it hurt a lot but they insisted the latch was great etc. We come home and I have a huge crack on my right nipple. the left nipple is inverted so he cant latch on there either. After five days of agony midwife advises to use a nipple sheild when feeding and expressing from left breast to allow breast to heal. In effect my baby is feeding from two artificial nipples and seems to choke often on the nipple shield as the milk comes in too fast and pools at the tip.
I am very worried about him refusing the breast when I offer it to him after its finally healed. Also how long will a badly cracked nipple take to heal? I am putting breastmilk on it, lansinoh and the midwife also advised putting carrots on.
Any advice or experiences will be appreciated

Carrots? wow. :) my little one spent a week in scbu being first bottle fed and then combination fed, shes 9 weeks and has been EBF for about 3 weeks. shes a total boob monster. :D I hope that helps. One bit of advice, phone everybody and their granny. Grab as much help as you can possibly find, check their credentials and generally make a nuisance of yourself. I cant count the amount of times Ive said "check the latch". Also see if theres a breastffeding support group, cafe, clinic or drop in near you and go. (my local sure start have one, if not theres a good chance they know where to find one). I dont know about the healing time Im afraid.

You need to see a bf counsellor asap. Your nipples should never crack or be inverted like what you said! That sounded so incredibly painful. Someone can probably post you the hotlines of the various groups like NCT and Le Leche League, so you can get in touch with someone local to help you. Unless you are lucky, midwives and HV aren't the best trained to help with bf problems. (I had a midwife who tried to ram my babies head onto the breast). There's something wrong with the latch.

As for nipple confusion. It's real. My DD have the reverse where she calms instantly when she sees my boobs, but getting her to take a bottle is very much hit and miss. And if she's screaming, I don't stand a chance for her to drink from the bottle! But I wouldn't worry about confusion with the nipple shield tbh.

That is comforting to hear shuckle. I have contacted a breastfeeding counsellor and hopefully she will get back to me soon. I have only been combining the bottle and shields for a few days so am hoping it will not do long term damage.

lilham was your DD very young when she got confused? I am hoping it will not get to that if I sort out the latch before he is three weeks old

You poor thing. I had a similar experience when I started bfing. It was agony and the HV was very against nipple shields. I used them in the end, they made things bearable and bf till DS was 2 in the end. I used them with DD too. Both mine had bottles of EBM at a couple of weeks old and dummies. They never had any nipple confusion.

With regards to healing time, the crack did take a while to heal. I used some wet healing plasters that seemed to help, and breast shells to keep my bra from sticking to my nipple. I also at one point expressed from one side and fed from the other to allow things to heal. It does get easier honestly although it did seem hellish at the time, but I'm so glad I stuck with it.

Thanks for sharing your experience trixy, its reassuring to hear from other people's experiences. I am relieved to hear they didnt get nipple confusion. Sometimes we do need a break when breast feeding is so difficult but you do beat yourself up if you offer anything but your nipples IYSWIM

if it helps I mix fed from birth and have had no problems with either DC going from boob to bottle and back again. Can't really help with the healing q though the little bit of sore scabbiness I had at very start went within a couple of days once milk came in. BF counsellors are great - do make use of them and don't worry if you cry - you won't be the first!

Hi. I breastfed mostly, but also gave some bottles (I had twins) and they were absolutely fine switching between the 2 from day 1. It did take my ds2 a while to 'get' breastfeeding (I think it was at least 2 weeks, possibly 3) and he'd get frustrated, and so would I. I don't think it was the bottles, just some babies take a bit longer to get the hang of it, as they only had 1 or 2 per day and after that they still had bottles, but he coped fine with both. Anyway, in the end I managed to breastfeed them for 20 months, so it's totally possible! I'm sure it will all work out fine. No specific advice, but just wanted to reassure you that it's possible.

DS is bfed, but lost too much weight by day 3 and we were out on a feeding plan whereby we had to top up after a bfeed with formula. We only did this for around 2 weeks as he quickly caught up with his weight, but he has been having bottles of expressed milk and the odd bottle of formula ever since with no problems whatsoever. He also has a dummy (introduced at around 5 weeks if memory serves), again this has caused no problems. He is now 20 weeks.

You have to do what you have to do, and I think it probably depends on the baby TBH. Can you try a nipple shield with a slower teat (don't know if that exists BTW as never used them) so the milk doesn't flow too fast for him?

Hope you get things worked out soon!

For 4 weeks, I used nipple shields for the reasons you have stated and also topped up DS with EBM in a bottle. We gradually got the hang of BFing and, although feeding was actually going well, I stopped anything involving an artificial nipple for fear of nipple confusion. I didn't try him again with a bottle until he was 3mo and spent the next 3 months trying every bottle, every milk, every technique possible trying to get him to take a bottle. At 6mo, I gave up - it was too stressful. IMO, he didn't get nipple confusion, in fact it was the opposite. He'd got used to one thing and he was perfectly clear about the fact he didn't want anything else!!

I'm very happy that I BF him for just over a year, but I really wish he'd taken a bottle of EBM, too. I think I panicked about nipple confusion unnecessarily. I agree with advice about seeking a BF counsellor and take it a day at a time. You sound like you're doing a fab job, so give yourself a pat on the back, too!

Never heard of carrots being used on a cracked nipples , but you could try something called jelonet which you can buy from a pharmacy.

You could try cup feeding if you are worried about the nipple confusion.

Regarding fast flow and milk pooling in the shield, you could try hand expressing a little bit off first just to slow things down a bit.

It is harder, but perfectly possible to feed with an inverted nipple. See the link from Dr Sears here for more info.

Hope the bfing counsellor gives you some good ideas- don't forget the helplines if you need more advice in the meantime. They are printed on the right hand side of this website.

Hope things get better for you soon.

I used nipple shields and EBM in bottles. DD did get a bit confused and we had to work to get rid of the shields (about 4 months she just decided she could feed normally!). Now she will happily drink from a bottle, boob or shield and is very unfussy, which is great.

I wonder if you are sore because sometimes with a fast flow babies clamp down on the nipple to stem the tide of milk coming at them. Feeding in a Biological Nurturing position can help as can hand expressing off the first let down (most women have 3+ let downs but they get progressively less forceful as the feed carries on).

Also, not leaving it too long between feeds so you don't get over full and engorged helps.

Good luck and congratulations on your new son.

Some great advice here - I would just add that I also used nipple shields for a little while when my nipples were just too painful to continue without with no ill effects. Try not to get reliant on them, keep trying without, but as a short term measure they are a lifesaver.

I used Lansinoh religiously for 8 weeks on my incredibly sore nipples - till one day I thought I'd just stop using it to see what happened. Within 48 hours my nipples had healed and I have been happily BFing with no problems ever since (now at 10.5 months). So if there's any chance you could be sensitive to lanolin, try stopping using it.

Thanks for all the replies! They have been very reassuring. Today I tried the Biological Nurturing position and he fed just fine and although it was painful when he first latched on I wasnt in agony the whole time. We have used the bottle only once today so I will stick with that for a while and see how it goes. I am applying Lansinoh a lot as well and it soothes the sore after feeding him. Hopefully it will heal pretty soon.

Carrots? REALLY? You sure she didn't mean cabbage? Cabbage leaves are used to ease engorgement and make the breast more comfortable but carrots is a new one on me :)

Some babies have no problems going between breast and bottle but other really do find that they prefer one or the other (usually where there's a preference they prefer the bottle/teat).

But at this point you need to do what works for you to keep your BFing going and if nipples shields help, then use them. The NCT breastfeeding line is 0300 330 0771 and it's best to give them a ring and talk through everything, including managing nipple shields so you can wean off them.

Sounds like you're going through a tough time and you need some professional help to get that inverted nipple side feeding ok. However you also sound very positive and determined which is wonderful. Do keep us all updated on how you get on and throw questions at us, or phone the helpline.