How can I break this downward spiral

[smilingcl]

Hello,

DS is 5 weeks and had tongue tie which was corrected nearly 2 weeks ago. The TT caused a difficult latch and he has only been feeding from one side which meant that the nipple he is feeding from became very cracked and painful to feed from as it is/was getting a constant battering.

I think the latch is better now, he sometimes goes on wrong but we correct it so it isn't painful while he is feeding usually. My problem is that the crack isn't healing I think due to the constant feeding from one breast and the occasional bad initial latch.

In addition to this he feeds very frequently during the morning every 2 hours, and in the evening wants to be fed almost constantly I guess because I'm producing less in the evening and he wants to stock up for the night.

My problem is if I let him feed for as long as he wants, my nipple is very painful afterwards and he sucks so vigorously and then gets frustrated with the lack of flow that he starts banging his head about which hurts even more.

The last 4 nights I've been only feeding him every 2 hours and topping him up at 10pm with 125ml of expressed milk from the other side, which he gulps down and that knocks him out. I'm worried though that doing this means that the right boob won't ever produce enough for him.

In addition, for the last 4 days his poo has been green which I think indicates he's getting too much foremilk? I'm concerned that the expressed milk and frequent feedings mean that he's not getting enough hind milk?

He's been putting one weight well 5kg last week from 4.2kg at birth.

How can I make my nipple heal? I've been using lansinoh, and was prescribed gel pads by the TT clinic but they've run out, I'm going back for another prescription Monday. Do you choose either moist healing or dry healing? Someone recommended air to the nipple but I don't want it to scab over as he'll just suck them off?

Oh, and I keep trying him on the left breast but he just gets frustrated even though there's milk literally running out of it and into his mouth.

What would you do/suggest?!

Hi! Didn't want to leave your post unanswered as I know what hard work and worry bf problems can be! I am not knowledgeable enough to answer but would thoroughly recommend a call to the bfn or lll helplines they are brilliant! Get to a bfn group or baby cafe near you when you can. Real life support so important!

Your nipple shouldn't crack just because he's been on one side more than the other. The cracking shows something still needs addressing. It may be related to the tongue tie, or perhaps a more general positioning/attachment problem. Is there anyone that can take a look at this for you? It would be worth checking that the TT hasn't re-grown.

Feeding every 2 hours is normal at this age (it will pass :) ) as is the constant feeding in the evening. It's not so much that you're producing less, although it feels like it, but as you say he's topping up as much as possible :)

But the problem seems to be that going with what's normal is still causing you pain as you work through untangling the damage caused before the snip, and that's horrible :(

It's ok to express for him while you heal, and if possible try to express off the right boob as well. Even if there's little milk coming from that side the stimulation will help. Trying to put him to the right breast first might also help to get it to start to increase its production. I'm slightly confused over which nipple is damaged so I'm sorry if I've got this mixed up.

I'd not be worried about the green poo thing at the moment. It's usually quite normal and as he's putting on weight that sounds fine.

Moist healing would be my preference with Lansinoh to keep the scabbing soft. Is it showing any signs of healing? Is there any sign of infection stopping it healing?

TT etc: I'm wondering about a secondary infection causing healing to slow and pain within the breast?

I had a very similar problem a few weeks back. DS had his TT snipped at 5 weeks and following that 5 weeks of poor latch, one nipple was completely ravaged. I tried pretty much everything to heal it once i knew we'd got the latch sorted. However it was so damaged by that point that even a good latch reopened the wound each time.

The only thing that worked in the end was resting that side. I fed exclusively from my 'good' side for just over 2 days, and kept a patch of Jelonet (which you can buy/order from chemist) over the 'bad' side. In order to keep up supply and avoid engorgement on that side, I hand expressed - that way I could avoid angles which would open the crack up again.

It was a difficult couple of days. I worried about over stimulating the good side and under-using the bad side, also worried about green poos, also had a fussy baby pulling away from a free flowing boob! I'm SO glad I persevered though as I honestly don't think my nip would have healed without serious hours of rest.

That's my experience anyway - and as Organic says, all this is a bit redundant if the TT has re-grown (booooo) or the latch or positioning still isn't quite right. Best of luck with it though, I really sympathise!

Hi ladies,

Thanks so much for the advice. I'm going to go to a breastfeeding group tomorrow am to get the latch checked. I think it's good 90% of the time, the trouble is when he first goes on and kind of stretches my flat nipple into the optimum long sucking shape, it's excruciating. I've started using the pump to gently draw the nipple into the longer shape and then putting it in his mouth. I need it to heal in it's new longer shape!

I've got my 6 week check up with the gp on Tuesday so I'm going to speak to him about a prescription for jelonet. They did give me Novogel moist dressings but 10 days worth didn't work. Also I was soaked all the time as milk came running out at all angles and missing the breast pad!

I'd like to try expressing enough milk to bottle feed for 2 days to rest the nipple fully but am slightly worried he'd end up preferring the bottle to the boob after 2 days?!

Will continue to try to get him to take the left/healthy nipple but he seems resistant to even going near it now.

Onwards and upwards, I imagined I'd be all earth mother by now, sticking him up my jumper for a casual feed in a cafe, instead I'm popping paracetamol 20 mins before a feed and curling my toes and swearing through my teeth.... poor baby's probably getting adrenalin in his milk!