Feeling really low - struggling to keep bfing going

[PrincessScrumpy]

dtds were born at 36w +5 and had to be tube fed/cup fed to start with in SCBU to top up bfing. BFing took off and was great up until 3 weeks in when we all got thrush - only a tiny bit on the nipple but very painful inside the boob (especially the left one). We are all being treated but a week in it's not improving and I can't take the pain much longer. Being told it can take 3 weeks and two lots of drugs to treat it hasn't reassured me. Expressing is less painful so I was thinking of expressing and bottle feeding but with twins and dd1 (3) I feel like I'm making even more work for myself and setting a near impossible, overly stressful, task.

At the moment they have expressed bottle feeds once a day (about 3am) so dh and I can share it. I'm wondering if I can combine bfing and bottle feeding (some expressed and some formula) without completely giving up bfing, but at the same time without expressing every hour of the day.

I went to the bf support group today where I was told to "persevere". I feel completely bewildered and totally down. I really enjoyed feeding dd1 but with twins, the pain of thrush is too much, my boobs feel like they're constantly out, and they struggle to latch on so are on and off a lot which is very stressful and tiring (mw checked the latch and feels it's the babies rather than anything I'm doing - at least if it was me I could improve my technique). dd1 took to it so easily, this time part of me wants to give up and part of me feels guilty as they are gaining weight and being prem, breast milk is even more important, but I'm so unhappy and lost. I really thought the support group would help but they didn't seem interested.

Any advice? What would you do? I know I have to decide but I'm hoping there's a compromise so I don't give up completely but can give myself more of a break.

I dont really have any advice, sorry, but just wanted to say that you have done amazingly well to get this far breastfeeding twins. Whatever you decide you're obviously doing everything possible for them, and that's the main thing. Good luck.

Oh golly, I do feel for you. Things might seem pretty bleak atm but as the babies mature I'm sure things will get better.

My dtws were born at 29 weeks, tube fed/cup/expressing same as you. I went through a pretty depressing time which seemed to last for ever and ended up after 3 months bf one and mainly DH ff the other, not something I'd recommend (worst of both worlds). Also seemed to spend all evening with boobs out, as you say, but look at it this way - won't last for ever, is a special time with your babies and if you persevere you'll be v. glad that you did. My dtws are now very strong and healthy, despite their poor start, so you can be confident that things will turn out well.

what treatment are you taking?

What treatment are you getting? I found that the only thing that really worked for systemic thrush was Diflucan, but it can sometimes be a bit of a struggle to get it prescribed. Once you get that it should clear pretty quickly, and things should get hugely easier, but if they insist you keep messing around with topical stuff only it can prolong the whole experience unnecessarily.

I've got cream and tablets flu... something. and dtds have drops.

miconazole cream and fluconazole? Should be Ok but what dose has been suggested you need a dose of 150-300mg as your initial loading dose the up to 100mg twice a day and at least 50mg. Sometimes it is under prescribed and the cream needs to be used after every feed, if any can be seen when you go to feed again just remove first.

Have you more symptoms of thrush than pain in the breast? Do the babies have any symptoms? Thrush is rare before 6 weeks and often misdiagnosed by those who aren't well informed enough. Pain, discomfort and difficult feeding is so much more likely to be a result of an improper latch/poor positioning.

I suggest you find another BF support group or go and see your HV or ring the national breastfeeding helpline who can talk through positioning and attaching over the phone with you and can also point you in the right direction of another BF support group. You need some face to face help and support. 0300 100 0212 National Breastfeeding Helpline.

thrush has been diagnosed by hv, mw and gp. pain is not on nipple but inside and constant (not just when feeding). It may be improving as sharp pain is less, but feels bruised now. Latch has been checked and dtd2 is fine, dtd1 is a problem - she latches but then lifts her tongue and starts a clicking noise. She's better in rugby ball position but not great either way.

It's getting me so down and I can't read to dd1 while feeding as I have to keep latching them back on, plus the pain is too much to tandem feed so it all takes much longer.

hv is coming tomorrow so I will talk to her (she's been great so far) but I wanted to see if anyone here has mix fed with success.

I had twins after my first ds (he was 2) they were 34 weeks, I really struggled with bf even though I had no problems first time around. I eventually gave up with direct breast feeding around 2 weeks in and expressed they got about 2/3 breast milk and 1/3 formula.
It meant DH could help with night feeds and I could cope with daily toddler activities. I kept up the constant feeding changing expressing until 12 weeks when I just couldnt survive on about 3-4 hours sleep in 24 and went onto formula.
I now have 2 smart, funny, healthy 8 year olds. Twins are about survival not being the perfect mother. Good luck with what ever you do

I came back to say what Rightupmyrue did - she is right. Your hv may well be great but it would be rare if she was super up to date about bf, likewise for your mw and gp.

Could you speak to a bfc or lactation consultant, the number above or nct etc.

I'll try that. The mw I saw was the bf guru apparently - she was useless and just said to keep doing what I'm doing.

Thank you.

just reading again, was the thrush visible on the nipple and if so what did it look like?

Mw Bf guru my bum.

I've certainly had thrush before six weeks, so I wouldn't rule it out on that basis - and the constant pain sounds like it too. I would do everything you can to treat it even if there are also other contributing factors - it won't hurt. The Breastfeeding Network info sheet is excellent.

You need to be really obsessive for a while about washing bras, sheets, everything you or the babies come in contact with, at properly hot temps, to prevent the cycle of reinfection. All bottle and pump parts need boiling too - the steam sterilisers aren't hot enough for long enough. Natural anti-fungals like grapefruit seed extract can help too. If it still is difficult to shift some people get really good results from cutting out sugary stuff for a while - the last thing you feel like doing in the ravages of breastfeeding hunger, but you shouldn't have to do it for too long.

I know it sounds like a lot to get to grips with, but it really can make an enormous difference, and if you can get the thrush under control you won't feel anything like so sore and exhausted. Then whatever decision you make about ongoing feeding can be because it's what suits you best, not because you feel forced down a particular path.