Four day old baby, no idea whether I'm doing this right, please help

[msnovember]

This will be long - apologies.

We had such a difficult start after a hoped-for waterbirth, wasn't able to initiate bf at the start as firstly the placenta wouldn't deliver, and when it eventually did, a 3rd degree tear was discovered and I had to go to theatre for an epidural and repair.

I have flat nipples, and the first time she latched on was about 5/6 hours after birth. A mw latched her on in recovery, and although it was painful I assumed it was because my nipple had never done this before. Sure enough, when she came off it was cracked and bleeding. Couldn't get her latched onto the other side at all, as my right nipple is SO flat it wasn't triggering her suck reflex. Support down on the postnatal ward was so awful, I was catheterised and immobile, and they kept trying to get her onto the right nipple when it clearly wasn't going to happen. The left nipple, meanwhile, just got more and more cracked as I decided to ignore the right in favour of the left. She eventually got a cup feed of formula at about 22 hours old.

The following night was worse, I was half mad with sleep deprivation and I either got a disinterested mw who stayed for five mins and told me she wasn't latching because she wasn't hungry, or someone who promised to come back to me and then didn't. She got another cup feed of formula at Saturday lunchtime because a long time had again elapsed since feeding from the "good" side.

I then came across a wonderful, supportive student mw who recognised that I was a good candidate for nipple shields, who sent DH out for some. They've made a massive difference - she can now latch onto both boobs, although I know the latch isn't perfect as they are both sore even when I use the shield. But at least she was latching! I was encouraged to stay in hospital an extra night to improve the feeding, which was a bit of a joke as the person tasked with helping me that night never returned after about 9pm. Thank god they allowed DH to stay with me (I had my own room), otherwise I probably would have broken down.

We were discharged yesterday. Still wasn't feeling particularly confident but there was nothing at all to be gained from staying. I've spent the last 24 hours feeling confused as to when she wanted feeding and when it's wind. Maybe I'm labelling her fractious behaviour as "wind" when she's hungry?

The fact she seemed to be breastfeeding quite well, albeit with shields, has been such a relief to me, maybe I've relaxed TOO much.

Milk only came in last night. Don't know know much weight she's lost as the community midwives didn't visit as planned today. I plan to hit some BF groups, but I'm still very sore and physically/mentally delicate and I'm not sure I'm up for leaving the house quite yet.

Now to the pertinent questions:

She pooed quite a few times from soon after delivery to about 30 hours old, but nothing since. I put it down to milk coming in, and difficulty with getting colostrum when in hospital. When can I expect to see this improve? She has wet nappies, although the wee seems dark which is a worry.

She has really smelly farts - can this mean anything? This is why I often don't know why she's crying - is it wind or hunger? If suckling comforts her, should I just let her or would it make any wind worse?

I know using nipple shields isn't great, but it's either that or no boob at all

First, congratulations!

Secondly, lots of hugs (not very Mumsnet, but I also had a 3rd degree tear repaired in theatre after a natural delivery, and it was no fun )

I'm no expert on feeding, and I'm sure you'll get proper answers, but I think the best thing for now is to feed whenever she is willing. The more you feed, the more milk you will make. I always found the first sign of hunger was when the baby twisted their head, as they were rooting for a feed.

Don't worry about going out yet, just take to your bed/sofa, biscuits, telly, a good book and baby and just feed. I found it easier to feed lying down to start with, as I was do sore.

Sorry "so sore".

What you are going through sounds worrying. Especially the no poo bit. I see tiktok gave you a link to kellymom.com already. There's a page on newborn feeding there. (can't link as I'm on my phone). Have a look at that. Are you feeding at least 10-12 times a day? This is about every 2 hours. They have stomachs the size of a marble so they need to feed very often. A baby not feeding well will sleep more to conserve energy.

And you need to get someone trained in breastfeeding to look at your latch. There are hotlines run by NCT and le leche league. They are run by volunteers so may take a few times to get through. Do try to go to the bf group you mentioned. Its important to get any problems solved quickly. Most failed bf is due to lack of support in the early days where problems are left unsolved.

Hopefully someone can post you links to the hotlines. But you should be able to find them by googling. Good luck.

Also you say your LO is feeding well. Can you hear him swallowing or gulping milk? Does he come off looking all satisfied, like a drunken sleep? The problem with bf is that unless you are trained you cant judge if it's feeding well by length of feed. We usually tellby number of nappies and weight gain.

Congratulations! I'm no expert so do seek out a proper breastfeeding counsellor. Tiktok knows her stuff, so get expert advice from people like her on here but do try and see someone too.

What I found lovely with both babies was to take to my bed, cuddle up and get lots of skin to skin. Feed lots, on demand and don't even entertain notions of creating a rod for your own back and things like that. Newborn babies really just need to feed often. You can have a nice doze together and get some rest.

I remember those early days; day 3 seemed like the end of the world both times and life got a lot easier quite rapidly, but in the beginning it can be really, really hard but honestly, it does get easier. Promise.

Lilham, didn't mean that you aren't an expert, I hope it doesn't read like that!

I've not got any great advice but just wanted to echo the little and often feeding in these early days. I always felt that I had worked hard for 9m to keep her safe and the first 4 weeks are for feeding and snuggling.

I found le leche a great support and I also designated my DH in phoning and geting advice and some one in to help I spent a lot of time in the first weeks eating and feeding

You sound like you are doing your best from a bad hand and you will find lots of better than mine support on MN.

Blimey, what terrible 'help' from the maternity unit and why no visit today from the community midwife??? When the dust settles, copy and paste your post and send it to the director or midwifery - four day postnatal mothers ending up using the internet for support 'cos of a lack of it in hospital and at home... it's shocking

You really, really need to see a midwife. You can call them tomorrow first thing and ask when you can expect someone. Your baby needs to be weighed and you need the chance to show someone what's happening. Don't be afraid to ring the maternity unit overnight if you are worried.

Please, please don't worry about your baby and wind. Just hold her close and ensure she gets as much chance to practise at the breast - feeding will not make her worse and most young babies need the closeness, comfort and reassurance of a feed.

The lack of poo is a concern, as it can mean the baby needs to feed more often/more efficiently, but it does not mean panic stations at all.

Shields can sometimes be a v. useful tool, but it's inevitable that the person who suggests them is not the person who sees their problems....they interfere with a good, effective latch, or they can do. This results in poorer feeding. This is something for the midwife to check tomorrow. If the shield tip is a long way from your own nipple tip when the baby draws the shield in (ie if there is still a gap of 1-2 mm between the end of your nipple and the shield when the baby is feeding, and you can see this immediately after the baby releases the shield) then the baby is not really being helped to latch on by the shield.

And yes, call a breastfeeding helpline, but the best help for the moment should be from the visiting midwife (and lets hope she knows her stuff).

Hope this helps :)

The rule of thumb at this age is feed, feed, feed and if you're not sure then what to do - feed. It's not really worth worrying about what is wrong as long as she's clean and warm - it's really just milk or suckling, and being held that they want as newborns.

You need some specialist help in your own home. Your midwife may help - but bear in mind midwives have virtually no breastfeeding training as standard so unless she's done additional training all she can do is give you the benefit of her experience - which may be helpful, or may be worse than useless.

I would suggest that you find your local NCT breastfeeding counsellor, or ABM or LLL BFing counsellor and ask them to home visit. You need someone who has done the breastfeeding counsellor training - not a peer supporter in this case as you need a little extra help with you having to use the nipple shields. They will be able to work out a plan with you to stop using the shields, and also to ensure that your little girl is getting sufficient milk through the shields.

I wouldn't hesitate to do this - the sooner you get things towards being settled, the better.

Hope you're recovering from the traumatic delivery/post natal stay :(

Oops X post with TikTok and I also realised I didn't word things about the midwife as well as I might. I was referring specifically to the breastfeeding and working with the nipple shields... not in any way to undermine her knowledge and how she should help you as TT says. Sorry.

Sorry, I meant the gap between shield and nipple is seen when the baby releases the breast...

Congratulations :)
I too have flat nipples and found breastfeeding very difficult and painful to start with. I used nipples sheilds for a bit until the cracking stopped. I found lanisoh cream very helpful for this. I also had a break by expressing for a bit to let them heal. This didn't really help my dd learn to feed though so only do that if you're desperate!
My main help was from local NCT ladies, they were amazing and will come to your house, just call them up, they are worth their weight in gold. The awful conflicting boob shoving advice I had in hospital was utterly depressing. Don't even think about going out yet, just snuggle in your house with your new baby, seriously there's plenty of time for groups etc.
Just wanted to reassure you; you can do it with flat nipples! I fed my dd til she was 1 :)
Best of luck :)
Just read the above posts and see they say phone the NCT too x

organiccarrotcake - you're right that the OP may be able to ask for a home visit from a bfc, but these are not always possible, as you prob know :)

Bfcs don't cover all parts of the UK by any means. Or they may live miles away from the OP. And they're volunteers, so it's not possible to expect a home visit immediately.

Best not to raise too many expectations! Help on the phone is available for all, of course.

Oh god, I'd no idea things were so bad. With the shield, I think the left nipple probably reaches the tip of the shield, but the right nipple is nowhere near reaching it, it goes halfway if that. I can't bear to think of my baby suckling away for ages and not getting nearly enough.

But without a shield, I'm screwed. She just can't latch onto the right, and the left is so badly cracked.

What can a phoneline do if they can't see me feed?

Sorry for brief answers, typing on phone and crying.

Don't despair! Of course they can help over the phone. Just like tiktok did about the breast shirlds. Hopefully the mv will visit today and get your baby weighed.

msnovember - a lot of help can be given over the phone, and in any case you may be able to get a home visit. The midwife should come today.

Shields are not a 'bad' thing - they can be a useful tool to get over serious latching/attachment problems. But they have drawbacks, and the midwife today needs to help you work on these.

It may be you need a different shield, for instance. Or you can try different positioning that does not hurt or hurt so much. One option to explore is biological nurturing positions - www.biologicalnurturing.com/ - easy, comfortable and effective, even for women with 'difficult' nipples.

Hope today goes better.

Of you poor thing. It must feel very rubbish for you. Re the poo thing, my milk did not come in until day 5 so once DD had had the last meconium poo it was ages until the first transition poo then bf poos so this could be the same for you. She more than made up for this by having many many poos everyday and still does at 11 months! If the shields work for you then keep at them until you can get help with the latch. If you go online and look for your local surestart centre, they often run breastfeeding support groups weekly. I know you won't feel like going out but it may really help. Good luck

Do still investigate the possibility of getting someone to visit you to help, or if you find out there is a group meeting near you phone ahead to ask if you can get some one-to-one time with someone experienced (pref a trained counsellor) before or after the meeting to make sure it is worthwhile for you going. To improve the chances of finding someone near you that could visit, you could try a local doula or independent midwife or asking the local group.

Hopefully you will find the visiting midwife to be helpful - if you don't get on with them tho don't be afraid to ask if there is anyone else they could send with more experience or for a second opinion. One of the most important factors in bf-ing is the desire to do it & you sound like you have this in spades & have made a great start despite some unfortunate circumstances, so keep going as long as you feel you can.

Hi MsNovember Congratulations on your DD! Hope today has been a better day for you and you are getting RL support from someone who knows their stuff. Saw your post yesterday, really felt for you and was writing something but then PC battery died, then DD wanted feeding...

Hopefully you will get some reassurance from wet and dirty nappies soon. Just wanted to say I'm another one using nipple shields. Used them to ebf DS for 8 months (he wasn't very good at latching on and I got lots of comments about the length of my nipples, not paranoid at all ) I'm now using them with DD, 9 weeks. She was tongue tied and shredded my nipples in the first feed and couldnt stay latched at all without them. Tongue tie now sorted and she is gaining weight well after a slow start. I will try and wean off the shields if possible as they're a pain to clean etc, but if I don't manage it then so be it. Anyway, don't beat yourself up about the nipple shields unduly.

TT yes of course :) And I must remember to word things better about HCPs (slaps own wrist).

OP, how are things going? Did the midwife come?

This may be of no help as I don't know how effective this product is, but don't AVENT sell something to help with flat/inverted nipples? Some sort of sucking thing... Sorry, not very helpful there. Maybe someone knows more about these.

I thought flat nipples were a sign of ineffective latch - not a cause??

Think it's a Lansinoh Latch Assist ?

Same sort of product but from AVENT. But either will do I suppose. Don't know how helpful or effective they are though.

I used nipple shields too, for maybe the first 8 weeks or so. People kept telling me that DS would forget how to suckle without them so what I used to do was do one feed every 24 or 48 hours without them. OP you need a good nipple cream - ones that you have to wash off before feeding are no good. The best piece of advice my midwife ever gave was to use Kamillosan cream - it's edible so it doesn't matter if the baby swallows it and you can leave it on, it's soothing and it acts as a barrier preventing further nipple damage. It's also damn good for nappy rash :)

Also don't worry too much! Your DD is just four days old! Relax and enjoy this time. You will know if there is something seriously wrong.

I often didn't know why DS was crying in the early days. I have a theory that sometimes it was just existential angst! Don't forget they can't see very far, they're completely helpless and they're in a world that must seem cold and frightening sometimes when a few days before they were in a safe warm womb. Anybody would cry.

It could be that your baby is hungry. How often are you feeding her? I was told in hospital to feed DS every 4 hours but I soon realised once we got home he wanted feeding about every 2 hours. Anyway it's perfectly ok when they're small babies to suckle them to comfort them (you're just meeting their needs, not "spoiling" them despite what MiLs etc. might tell you - they're not sophisticated enough for that), and just wind them if they need winding.

As you are struggling to feed on the right side you may find it helpful to sit on the sofa, on your right hand side put a pillow at a 45 degree angle to your body, lie DD on it with her head at the left end and her feet at the right end (so she is under your armpit) and try to feed her that way. My right boob was my awkward boob too and after I was shown that I never fed DS any other way on that side.

I didn't know about it when I was breastfeeding but I've heard good things about Biological Nuturing.

Good luck. And remember you're doing a great thing breastfeeding. It will get easier if you persevere unless you're one of a tiny minority of women.