4 weeks in bfing is still so painful - any advice?

[Carabosse2010]

I'm finding bfing my 4 week old DS is still really painful. Have been to the GP twice who gave me antibiotics for mastitis. But I don't think it is mastitis as I don't have any flu-like symptoms. I suggested thrush but GP was dismissive saying more likely blocked duct. But it hurts all the time - when he's feeding and for 1-2 hours afterwards, keeps me awake at night with the pain. I don't know what to do, I feel like a big failure and like I'm selfishly putting my needs above my child's - DS seems fine, healthy and growing and loves his milk. Have tried giving formula at the end of the evening (when it's most painful) a couple of times but this seems to make him vomit more and get a bit colicky. What should I do?

Do you think it could be nipple vasospasm? I have the symptoms - sore after feeds and nipples change colour when exposed to cold air (for me the worst is after a shower). There's lots of info on the web. Basically, keep them warm, don't air dry, a poor latch will worsen the pain. Many report that the problem lessens or disappears in time.

Firstly you have to stop beating yourself up! I would get a second medical opinion. But don't feel like you will be a failure if you have to cut back or cut out breast-feeding if you are finding the pain unbearable. You've done so well to get this far. You are allowed to stop whenever you want. Your DS will be fine either way.

You say DS vomits after formula - is that right afterward? It is possible that particular formula doesn't agree with him, in which case, try another. My DS didn't tolerate Aptamil well, but was fine with SMA.

I think it could be vasospasm and have been trying to keep it warm as they're very sensitive to cold atm. I think he's got a bit of a shallow latch but I'm finding it hard to get him to grab a big bite of boob too! : (
GP seemed to think the vomiting was probably due to the antibiotics. sigh
Thanks for your support and advice, it really helps.

Have you considered it might be tongue tie in your son which is causing the vasospasm in your nipples?

Has your son's mouth been checked for an oral abnormalities such as a high palate or a bubble palate as well as TT (TT can occur with or with out HP or BP but they often go together).

Tongue tied babies often have problems opening their mouths wide and also can have problems getting a deep latch.

Is there a bfing counsellor local to you or a bfing group e.g. LLL or BFN or ABM nearby? IF you aren't sure then if you let me know the area you are in I can send you a list of ones that you might be able to visit (doesn't have to be an exact town but county would do).

This advice on deep latch helped me:
www.pumpstation.com/pumpstation/dept.asp?dept_id=3228

Also, I hold my hand over my nipple if exposed to the air (e.g. after feeding, DS can be a bit on/off while deciding if he has had enough) and I use breast pads plus a few layers of clothing to keep warm during the day. (Being outside in the wind is painful too.) I also use a hot water bottle after night feeds. I've found that the standard hold (cross cradle?) helps as the baby's tummy keeps one breast warm while the other side is used for feeding.

My son is also 4 weeks old and I can already notice a difference - the symptoms were really soul-destroying just a week ago and I couldn't see me being able to continue BF indefinitely. It was very much dealing with one feed at a time (the symptoms were worst while I had a cracked nipple, so there was probably a latch problem on that side too which wouldn't help.) Of course FF is a sensible option but I wanted to feel that I'd done "everything I could" to make BF work for me, I suspect you feel the same.

I hope you get some good ideas on your thread and find something that helps. Does it help that there are many others in the same situation? I thought I was prepared for BF to be difficult as in "it doeasn't work out for everyone", but I have found the help from this site to be instrumental in keeping me going. We're all in it together .

Anyway, be kind to yourself. Ultimaltely, your needs and your son's needs are in synch. What's good for you is good for him too. However you feed him.

You could try putting your postcode in here. It's not exhaustive but it should hopefully have a bfc/bfing group near you.

One of the hospital midwives said he didn't have tongue-tie and he seems to be able to open his mouth pretty wide - just doesn't seem that inclined to do it when bfing! He does do some noisy sucks and slip down a bit... particularly towards the end of a feed.

I went to a local bfing drop-in session and they said his latch looked ok, until the end when she saw my nipple was quite misshapen and she said hmm maybe not. Have called the helplines a couple of times as well. I guess I feel like i know what should happen but doing it 100% of the time is tricky, and it hurts afterwards anyway.

It really does help to hear others are having similar issues. Why is it so damn hard?! I know I have to go easy on myself but I just hate not being good at things - especially when it's so important. I probably need to "man up" ("mammary up"?) but I'm finding it very upsetting.

ps: thanks Orchidee for the deep latch link - I will definitely try that - might do the trick... fingers crossed

When you say noisy sucks do you mean slurping or clicking or something else? When the MW checked for tongue tie did she look or use her fingers to check? Not saying for definite it's tongue tie, just that it might be good to get it checked out by someone trained in TT (very few MW/Drs/even some BFCs aren't trained to spot nything but the most obvious TTs). This article is very good and has a list of symptoms that might help.

Very interesting on tongue tie. He does have some of those symptoms such as gagging/coughing during feed, hiccuping and farting a lot! I wonder...

So does mine! Ok with this and the vasospasm symptoms there's enough for me to stalk this thread. I've just read the tt article- very difficult to diagnose it seems if there's no definitive test.

Good luck and keep us updated

My DS has a TT, when he cries the tip of his tongue goes heart shaped as the tie pulls the centre backwards. That might make it easier to spot for you.

Because of the TT he cannot latch without shredding my nipples. So I've been exclusively expressing for the last 4 weeks. We have a paeds appointment on Friday to get it snipped. I am hoping and praying that it sorts out his latch problem and we can get on with conventional BFing. If it doesn't he will have had 5 weeks of my best offerings and I'll be returning my hired pump. I've cried over making that decision but there is only so much pressure you can put on yourself. You've made it this far, you have not failed in anyway.

Good luck!

Some tongue ties are not obvious as they are posterior - tied at the back of the mouth, sometimes even under the mucosa. No NHS staff spotted my daughter's tie, so it is worth getting someone experienced (maybe a lactation consultant from LLL) to look at your son. Misshapen nipples are one symptom of TT.

You will forgive me for saying I really hope it's not TT. Having enough trouble getting help on the bfing! From what I've read here, it's a complete nightmare battle to get TT diagnosed... argh.

I experienced this with both DC and found it really stressful with DS1, convinced myself it was thrush (which in retrospect I don't think it was) and / or vasospasm as had pain after / between feeds, sensitivity to cold etc.
It took about 8-10 weeks (sorry, probably not what you wanted to hear) for bf to be pain free and I don't think there was a specific reason other than DS and I just got better at it.

With DS2 it was toe curlingly painful for 7-8 weeks but I was more positive as had confidence that it would get better.
I realised 2nd time that cracked nipples definitely played a part in the pain I got (I got weird pains shooting through to my shoulder blades / back) and Lansinoh helped a lot with that.

I took regular paracetamol and ibuprofen if discomfort was really bad and tried to practice physical relaxation techniques (which I'd originally learnt for childbirth) during and after bf; all of which helped.

I found the support from my local bf group helpful with DS1.

IME bf is really difficult in the beginning but so worth it when it all settles down.

Good luck hope it gets easier very soon

Almost a week on and things seem to be getting better... Like LakeFlyPie, I'm now starting to suspect the problem IS mostly just sensitivity/poor latch that will improve over time (fingers crossed).

I'll still see my GP and try to get someone to check for TT but hoping it will all come good with more practice.

Still shocked how painful/upsetting the whole thing has been but knowing that others have experienced the same is comforting. Local bf drop-ins and the bf helplines have also been a great help.

Will keep you posted!

Thrush is a real risk when a bfing mother take ABs so don't rule it out. When I had to first take ABs, my (amazingly good) HV pretty much told me I would get thrush and she was right!

If there are no particular signs of thrush in me or DS, do you think it's still worth trying to get treated for it just in case? I honestly don't know anymore. Bfing still painful but seems it could be so many things!

I would check out the less obvious signs. For example, I thought my nipples were fine when I had thrush but actually they went pink and shiny. It was gradual (and at a time when everything was changing and I was sleep deprived) and I just hadn't noticed the change. When the thrush was treated, my nipples suddenly went more normal and I realised how pink & skiny they had been.

DD never had the yucky white discharge in her mouth - it was very very slight for her.

So yes, I'd say it's worth pushing for proper treatment if you have any signs of thrush (including a typical pain pattern that can't be explained by something else like poor latch), especially as you have had multiple AB courses.

I am still having a lot of residual pain - up to several hours after feeding. I think my nipples do look a bit pink/shiny/weird. But I also reckon there's still some latching issues.
I just wondered if being treated for thrush might be worthwhile... to rule it out if nothing else. But maybe the treatment could cause more problems?!

carabosse, I still had a lot of pain at 4 weeks and your situation sounds very similar (v sore, after pains, pink nipples, some vasospasm). I couldn't really pinpoint any one thing so I:

• got two courses of thrush treatment from GP and also did all the "alternative" treatments (probiotics, gentian violet, etc). GP was v sympathetic and willing to give me the treatments based on me basically saying that I had thrush with DS1 and was desperate to avoid it - the BFN pdf document on thrush to print out was very useful here - perhaps take it to your GP and explain that there are different symptoms to the ones he/she might be more familiar with
• took DS2 to see a MW trained in bfing at the local bf group to check TT - she said he did have this (not excessive, but enough to warrant treatment) and this was snipped during there and then (I think I am v lucky as it sounds like different areas have different policies)
• concentrated on his latch and prioritized feeding over everything else really, DH took extra days off work
• read about "exaggerated attachment" and used that technique
• hassled MWs to come out and see me several times

By 7-8 weeks feeding was pain free and DS2 is nearly 8 months and I'm really enjoying bfing and it's so easy now. Good luck!

Thanks CamperFan. I'm pretty much doing what you did - trying everything!

Went back to my GP yesterday, took the BFN Thrush pamphlet and got her to prescribe treatment. Today I'm on operation anti-thrush, washing everything at 90 degrees and sterilising bottles, breast pump etc.
Also taking acidopholus, vitamins and painkillers... and next week I'll corral the local TT expert to check that too!

Still bfing in the meantime, with the occasional FF when it gets too painful. But I'm so glad I'm persisting as I realised I already love feeding my DS and I know I'll love it even more once the pain is gone!

Good on you Carabosse for battling on, it's really tough at this stage when it's so sore.

It will get better and one day soon you'll suddenly realise bf is pain free and it's completely fantastic

My goodness I could have written this post myself. I have very little helpful to add, but I'll be lurking... I'm at 6 weeks now. Thrush is (fingers crossed) abating and I'm waiting for an appointment for the tongue tie clinic to have DD assessed. Until then I'm offering the breast at almost all feeds and then feeding her formula. Realistically, though, she's getting the majority of her calories from formula, she's increasingly disinterested in the breast, and my milk supply seems to be rapidly dwindling. Have just hired a hospital grade pump in the hope that if my supply gets back up to speed she'll find it more worthwhile breastfeeding but, frankly, if thrush or tongue tie weren't the problem and she still can't latch efficiently enough to get enough food (she dropped a lot of weight in weeks 3 and 4 on exclusive breastfeeding) then I think I'll have to give up breastfeeding too. The thought of it reduces me to tears, but if it's not either of those things then I don't know where to go from there.

I'm also at the six-week mark now. Finally got treated for thrush but it's not the panacea I'd hoped for. The TT expert in my area has been on a 3-week holiday but the Health Visitors and GP I've seen in the meantime say he doesn't have TT. She's back next week so maybe she'll be able to detect something they didn't. The other option is paying £80 for a lactation consultant (does anyone think this would be money well spent?) I've tried so hard to get him to latch on better but it doesn't seem to work. Again, the HV and bf counsellors I've seen said his latch looks good, until the end when they see my "lipstick" nipple. Sometimes if I get a decent latch the feeds are less painful but never entirely pain-free. I'm seriously considering giving up altogether now, I just cannot deal with the constant soreness : (