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?

Carabosse, I was thinking of you today and am sorry to see your post just now that your bf is still so sore
I can completely empathise, bf was still painful for me at 6 weeks with both DSs and it is miserable dreading each painful feed.

I also had a flattened nipple with DS1 despite what appeared a reasonable latch, not so much with DS2 although I realised this time that my nipples were definitely cracked which I think was causing a lot of the pain.
Regular applications of Lansinoh helped with that.

Although I'm not a great taker of painkillers usually I took regular paracetamol and added ibuprofen when needed and this did help quite a bit, especially the ibuprofen when I was really sore.

IME things just settled quite suddenly without any particular change on my part; at about 9 or 10 weeks with DS1 and a bit sooner with DS2, literally one day bf was 'a bit tender' rather than the toe curling experience it had been the day before.
I really think it was just that their mouths were bigger and that improved the latch.

I'm not sure a lactation consultant could add anything if you have already seen a number of bf counsellors and HVs and would be tempted to advise trying to stick it out for another week or so if you possibly can as IME things might suddenly improve

Really hope things improve for you, you've done so well to stick it out this long you really deserve some lovely enjoyable painfree bf.

Hope your DS is giving you some gorgeous smiles to reward your valiant efforts

Expressing for some feeds may give you a break . I had to do this when I had thrush as it was so painful.

Hi Ecuse and Carabosse: reading your posts has reminded me so strongly of my experiences when DS was tiny (he's 17.5m now). I had terrible pain while BF and the cause of it was never really resolved. I think vasospasm plus poor latch were the real culprits! What cracked it for me was simply DS getting physically bigger, and therefore able to open his mouth a bit wider - so even though the latch was poor, it hurt less. And I think my nips just got a bit more desensitised! I know that it's cold advice when it's 3am, the baby's wailing, you're in agony, sleep-deprived and generally ready to say "sod this for a game of soldiers" as you crack open a carton of SMA - but things may well get better with a little more time. I ended up both BF and FF (EBF all the way was just not an option - my little lad would probably have died of dehydration and jaundice - he was really ill as it was) but by the end, I was managing with only one bottle a day, and that was usually EBM. (We cracked it completely by 12 weeks!) I found a hospital grade double-sided pump invaluable, and if I'm blessed enough to have another baby I'll hire one from the outset.

Like LakeFlyPie, I found Lansinoh amazing - slathering it on before feeding as well as after. I also found that one nip got more sore than the other - not entirely sure why - so I would often let him feed from the good one, give him a bottle if he was still hungry and then express from the sore one. (Though the amount of expressing I had to do was a right pain in the chuddies, I'll be frank.)

Besides, while I'm a big fan of BF, formula saved both my and my baby's life (I was FF from the word go as a very prem baby back in the 1970s - my mum's milk failed totally due to major health problems).

Hi Carabosse - sorry to hear you're still suffering. Some people won't like me suggesting this but I wondered if you had considered combination feeding? I had a very similar experience with DD (wasn't TT or thrush, tried loads of different holds, latching techniques, creams etc, got help from a BFC to no avail etc etc) and by 10 weeks I felt like a broken woman. I had already been giving her one FF a day and at 10 wks I upped it to 2 FFs (breakfast time, which got the day off to a less painful start and made me much more cheerful, and bedtime). I expressed after both bottle feeds and used the EBM for a dreamfeed or froze any extra. So I was doing about 5 BFs a day, rather than 7 or 8. Just doing 2 or 3 feeds a day less really helped with the pain (sore nipples had longer gaps between feeds) and psychologically made feeding feel a lot more manageable.

It's really up to you - I read a lot of negativity about combination feeding, but I was ready to stop completely and taking this approach meant that DD got about 75% breast milk for nearly 6 months which I felt was not a bad compromise in the end. Giving bottles can affect supply but expressing instead will help with that.

The other thing that helped me was feeding out and about, at baby groups etc. It took my mind off the pain and DD fed more quickly if there were things to do and see (in the early days she had 45 mins on each side every time, and never got down to much below 30 mins each side, but quicker if we were out so 1 quick feed a day also helped).

I don't think BF counsellors etc recommend mix feeding because they think that once you introduce any bottles you'll gradually give more and more and stop BFing completely - but for me it was just enough to make continuing BFing bearable. What bemused me was that my BFC and Health Visitor both separately said to me "it's not the end of the world if you stop, you know", because they could see what a state I was in, but neither would recommend mix feeding. I don't get it.

Anyway I hope that helps, but feel free to ignore if mix feeding isn't for you - you're doing brilliantly to persevere, and congrats on your DS.

Just checking in again at 8 weeks. Have been combo feeding 1-2 bottles of formula per day (well midnight usually!) and bfing the rest of the time, which I'm finding is working OK. Still having pain - some days quite bad, others just mild discomfort.
I took a 10-day course of fluconozole for thrush (after a battle to get the GP to fill the scrip - what an arrogant a-hole) plus treating DS but I'm not sure if that really helped much or not. Still not 100% convinced about the thrush diagnosis.
And I finally got hold of the area breastfeeding coordinator (NHS) who said DS does have a posterior TT so am waiting for a hospital appointment to further diagnose and operate. Again, I'm not convinced this will completely fix the problem, but I'm willing to try everything.
I suspect I'll end up doing what heidipi above did - about 75% bfing up to six months. ~But REALLY hoping that it might become pain-free around 10 weeks as happened for some of the rest of you. : )
Once again thanks for the support, it's been a big help to know there are fellow sufferers out there and that it does get better for most!

Really pleased to hear it's going better for you. I'm in a similar position - finally got an appointment through for the specialist TT clinic which we had on Weds and DD also had a posterior TT. They snipped it on the spot. However they did say it's not a panacea and she won't necessarily just go easily back onto exclusively BF. And I have to say I can't see any improvement in the way she feeds so far - if anything her latch is slightly worse, although I do wonder if this is because her mouth 'feels' differently and she has to learn how to do it again. I was looking at this page on kellymom which links to a chart to help you to track the baby's formula and BM intake as well as wet/soiled nappies so you can gradually reduce formula and wean them back onto the breast. At the moment I'm just filling it in based on our normal pattern which is BF at every feed then top up with a bottle (but the 'top up' is pretty much a full feed). The plan then is to reduce total formula intake over the course of a day by 30ml/1oz every 2-3 days as long as baby seems happy and is producing a similar amount of nappies. Don't want to hijack this thread, but may start another one to see if anyone has any good advice on re-establishing BF after having a TT snipped.

I've had all sorts of trouble trying to get this TT appointment. They are now saying end of July but I feel like I can't wait that long (have had a painful few days) so I'm going to pay to get it done privately. It makes me angry that there is such a long waiting list (and also the incompetence of various people along the chain - losing faxes, never calling me back etc). And I live in London!
TBH if snipping the TT doesn't help much, I might have to switch completely to formula - I just can't have the constant pain mar my time with my lovely DS any more!

Carabosse you've done so well to get this far - it's crap that you're having to pay to get the TT snipped but at least then you'll know you really have tried everything.

Whatever you decide after that, every breastfeed counts and your baby has had a lot. And one way or another, you won't be in this pain much longer.

Fingers crossed for the TT, and good luck from here on. It does get more fun as they get a bit bigger and it's not all about feeding