Breastfeeding hell!

[Taranta]

I'll try and keep the woe is me to a minimum, but here's the thing: am really struggling with the BFing since having my first child, DS 9 weeks ago, and I'm hoping some nice souls can give me a gee up cos I'm feeling pretty low about things at the mo...
To precis my history: I had a speedy but rough delivery after IOL, it was v busy in hospital (so busy in fact that i had DS in antenatal ward as no room in labour ward) so was sent home very quick and before I had managed to successfully breastfeed DS ('you can stay if you like but there's noone available to come and help you so you may as well go home'). Following few days tried really hard to get a good latch going with my boy, went to some BF caffs, but it really hurt, and I ended up with a cracked nipple unfortunately. DS then lost a worrying amount of weight due to my crap milk efforts, so ended up going on to the formula (SUCH a depressing moment). DS picked up the weight nicely, but I got a nasty bout of mastitis, alas. Midwife then clocked DS had a tongue tie at 4 weeks, which he had snipped and a couple of days later big improvement in the feeding! Yay I was thinking! (Was also on domperidone which may or may not have improved my supply). I've been gradually trying to decrease the formula as I breastfeed more and more, and was getting to the point of only one formula feed a day until last week when my right boob has been painful and lumpy. I'm guessing its blocked ducts as there's no 'sunburn' and flueyness like I had before, so I'm really trying to keep with the BF so DS can help me work out the blockages. Thing is my nipple is so so sore again (throbbing as we speak...) and my supply seems to have dwindled now my course of domperidone has ended, so I'm back to having to increase the formula. DS will take a bottle and I do manage to express, but nothing like enough for a decent feed...

sigh.

It just feels a little like I'm fated not to BF, and I so want to be exclusively BF if I can! I'm sure its a very common experience I'm having, but HELP! I feel like I'm stuck between a rock and a hard place at the moment...

2 things until someone useful comes along.

What you can express isn't a guide to what's there. Baby is much more efficient.

After a few weeks some women don't do the up/down of the breasts filling. So that doesn't mean your supply is dwindling. The best thing to stop it is to feed feed feed!

Sorry you're having a hard time of it. Have you tried nipple shields? I havent personally used them but I know people who have at the bf group I go to. They had sore, cracked nipples too and used these which really improved it. They slowly started taking the shields off so their nipples weren't constantly getting tugged at so its a more gradual way. Dont forget, your nipples have never done this before even though thats what they are designed to do.
Have you got nipple cream?

Lastly, keep going as best you can :)

Thanks Harriet & DH21 - I do try to offer Ds the boob any time he's passing, as it were, tho he does have a tendency to fuss a bit and whack me about with his fists at times which is suppose is what is making me think he's not getting enough, like he's impatient...Nipple shields, gave them a go early doors, but couldn't get with them unfortunately - seemed difficult to keep on and DS not impressed. Still have them though so will dig out and try again...

Babies are like octupuses at this age, you could try swaddling to feed. I had to do that in the early days. Have you seen someone like a bf councillor in rl?

It sounds like you are doing so well, persisting in spite of all these hurdles.

I'm not a BF expert like some on here but a couple of tips until an expert comes along!

1. I found lansinoh nipple cream really good for cracked bleeding nipples. After a few days of latching very carefully and applying it on the cracks after each feed and sometimes in between, they healed very well and I stopped crying in anticipation of the huge pain.
2. my breasts stopped feeling full after about 6 weeks but I do have plenty of milk so it is really hard to judge supply. Expressing doesn't give an idea either. I couldn't express at all with DS1 but I did have milk.
3. to relieve the lumpiness feed as much as poss, if you can massage the lumpy parts while feeding that may help. also you could try alternating a hot cloth on your breast with cold (I used frozen peas wrapped in a cloth) swapping over after a few mins and expressing, which might hurt your nipples less.
4. to stop him hitting you ( which he's not capable of doing deliberately yet) you could swaddled him to feed or just wrap a muslin around his arms and body.

Hope some of that helps and wellmdone!

Also when my baby is fussing at my breast and keeping coming off, I usually find that he has wind and a burp makes him relax again. Or swapping sides also helps.

Sorry you are having such a hard time and have had so little support from your HCPs so far. I had a really bad time with TT in the beginning and found it extremely painful too so I know how it feels. DD would not latch on and got very distressed at the breast. It took about 6 weeks of pain before I got anywhere near comfortable. You might already know all this but if not hope some of this helps.

You can get Lansinoh lanolin on prescription from your GP to help with cracked and sore nips. It really helps if you apply before and after feeding.

If you are getting sore and lumpy breasts definitely keep feeding even if it hurts. Same thing happened to me, It's the best way to unblock but you can also very gentrly massage by walking your fingers over the lumps and rolling your breast between flat palms, be VERY gentle though. Hot flannels can also help especially before expressing. As can expressing in the bath!!

Ask for more of the domperidone if you think it helped or get some fenugreek extract from holland and Barrett. It makes you smell of curry but can help with supply. As has been mentioned expressed amount is jot a good indication of how much your baby will be getting as he is more efficient. Especially if you are a bit anxious about it that will effect how much you can pump. Also around this time your boobs start to stay softer so its not an indication that supply is dwindling just because they don't feel full. The best way to increase supply is to feed feed feed but I know it can feel like that's ALL you are doing and it's hard when it hurts!! Shreilds didnt really work for me either but they might be worth another go.

My DD is also 9 weeks and has recently started messing about at the boob. She doesn't flail but wriggles and pulls away (often with my nip still jn her mouth!!) much more and it made me question my supply too. I think it's just that they go through a bit of a stage around now as their field of awareness increases. Swaddling is a good idea also feeding where there are few distractions.

I'd definitely see if you can get to see a proper breastfeeding councillor or lactation consultant. Ask your HV if there is a feeding clinic you can go to or ring some of the help lines. You are doing brilliantly to persevere for this long you know? You should be really proud of yourself!!

I'm definitely no expert but for what it's worth, do try again with nipple shields. I've had similar issues, and ended up with a really nasty crack....abandoned nipple shields after a couple of goes in week 3 but then tried again at week 7 in sheer desperation and DS was fine with them all of a sudden. Still a faff, ansd I hate looking like some kind of silicone fembot, but completely saved me from giving up BF altogether. Now 10 weeks and the crack has just about healed completely, so slowly taking them off again.
He punches me too....I think it might be related to wind rather than supply as according to my HV I have the milk of three women!
Good luck.

Cross post with zippety who covered it all much more succinctly!

Sorry bout that delay, DS woke up for a bit of cry/boob.
Rocketleaf - I have actually been lucky to find a really good lactation consultant at a breastfeeding clinic - she was the one who spotted the tonguetie, she says it 'looks' like a good latch, and it doesn't hurt on the left at all I have to say - its the right one that hurts, had the cracked nipple and mastitis - maybe its just one of those things...the crack has sort of healed I suppose (did use the fabulous lansinoh) but its weird i now have a natural crevice - attractive! I think maybe this has all left that boob particularly prone to blockages...
Zipety thanks for the pointers - will definitely try the swaddling - i do that at night to stop him waking himself up with arms a flailing, but not for feeding before...was actually going to hold fire on the expressing for a bit and just concentrate on feeding to up the milk, but its interesting what you say about not getting much out with your DS1 - I think the most I've ever expressed is about 40ml. I did think maybe I was overstimulating my boobs to produce and that's contributed to the blockages, I do still get engorged but only middle of night if DS has slept for longer than his usual 4hour stint.

Marwoir - have located nipple shields - medela ones i think - and will give it a go tomorrow I think when DS is in a nice calm mood (has been mithering a little since 8 weeks injections so I don't want to start adding to his woes, bless him...)

It does make me cross (albeit retrospectively) that I couldn't get the BF support at the hospital, for a first baby n'all, I literally had to hand express colostrum into a pipette. Anyway, that was then. I will carry on feeding, I've got this far I'm damn well not giving up now. Your collective help is very much appreciated, for something so 'natural' BF is really bloody hard - wish I'd paid more attention in the antenatal class but I was more worried about the delivery at the time!

Sorry for short post but... could you ask the lactation consultant just to check that the tongue tie hasn't re-grown? That happens sometimes.

Taranta, glad you are feeling determined to carry on, how are things today? I had the same thing with the left/right boob. I think because I am right handed it was easier to get the latch right on the left side. I think its fairly common to have a good abd bad side. And I ended up with soreness/blockages in the right because I was only expressing that side instead of feeding. How is it today? Once I realised feeding through the nipple pain was the only way to unblock it things cleared up really quickly. Even now when things are pretty established the right nip gets a bit sore although id rather call it uncomfortable compared to the pain of the first weeks!!

I also had the same experience of hand expressing colostrum and syringe feeding. Not only did babyleaf have TT but she was very sleepy and didn't want to wake up for feeds. In the end she just got a really negative reaction to the boob as well as it hurting me. It was really hard but we got lots of support on here and things got a better gradually and now it's so much better. Some of the lovely MNers who helped me said it took them up to 3 months for the pain to go so I am sure it will happen for you! Sometimes if felt like 3 steps forward and 2 backwards though so I do understand!

Oh and I don't think paying mote attention would have made a difference so don't worry about that. I thought I had done my research but nothing can prepare you for the reality!!

I am not an expert at all.... If you want to get off the formula feed, you might like to consider using a supplemental nursing system (sns). Little one gets formula, but they are also feeding at breast so there is stimulation to up your supply.

Plus it is such a tricky thing to get working right, not much fun to use, it is very good for not heading down the too many formula feeds slippery slope because you will probably be pleased to stop using it and getting off the formula asap (my experience).

Not sure how it works with nipple shields though.

Thanks rocketleaf things are same as today really, am feeding through the soreness on the R hand side and well, DS is sprawled on my lap sated as we speak so that's a big comfort. Have also taken a couple of nurofen and that does make it a hell of a lot easier to bear. I'm going to have to think of a better way to hold him I think as had a fab widgey cushion to start but now DS is too heavy for it - he's a long 13lbs - and slumps off it. Will head back to BF caff I think...will also ask LC to look at the TT situation but really hope its not recurred for DSs sake!
Bizzbee know what an SNS system involves but will investigate - don't want to confuse DS further tho as rhe's had few fussy sessions over the bottle as it is - I put it down to his age and becoming more aware and realising he prefers the boob...
Thankst again so much for your help - I am thinking its just 3 steps forward 2 back as you say but I am making progress, even if its slow...x

That's great that he is looking 'milk drunk' :o I know how reassuring that can be and glad the nuerofen have helped too. I have had to ditch the feeding cushion except to prop my elbow on now that DD is bigger so she fits on my lap with her legs hanging off. I still hold her in quite tight with my arm along her back and hand round the back of her neck/shoulders, then prop that on my other arm and cross my leg so that lifts her up to the right height without the cushion. Maybe try that or a thinner cushion?

What bottles are you using? I started with Tommy Tippee but switched to Medela with the Calma teet because it replicates the action of BFing more. But then I was super paranoid about nipple confusion (they are pricey though) Also I was advised to feed DD in as close to the BFing position with the bottle on its side so that gravity doesn't force the milk down too fast (as opposed to on her back as you would naturally do with a bottle) and I found this really hard with the TT bottles because of the shape.

Hope things improve a bit today, you will get there in the end!

Am using a Dr Brown anti colic bottle at the moment - started off with Avent but DS was so windy thought I'd try another. They're okay so far - have tried holding at nipple level and you're right it does seem to get a better reception that way, but sometimes he will only take it when sitting in his swing seat (ie when he's not being held). Its the same when DH does it.
Will try that positioning at next feed - he's such a wriggler - mindful of not hunching too much over him too...