Confused by contradictory advice from breastfeeding experts

[ardenbird]

DD 3 days old, nursing almost constantly, EMCS, milk just coming in.

We're having some problems with the latch and I am frustrated by conflicting advice from those who are supposed to be breastfeeding experts. I've happily ignored some really bad advice from MWs who were clearly not expert, but there are still those who are meant to be experts and who give different advice.

So far I've talked to four women billed as BF experts. All seemed competent and knowledgeable. Here are the players:

MW1 - some kind of breast feeding/nursery care representative for the maternity ward; she came by specifically to teach breast feeding and other baby care
MW2 - experienced MW in maternity ward and former BF consultant (who 'really knows her stuff', as reported by BF1)
BF1 - BF consultant from breastfeeding help centre in hospital
BF2 - community BF consultant who does home visits

And here are some of the conflicting bits of advice:

MW1 told me I needed to pinch below my nipple to help get more into DD's mouth and showed me a little 'shove move' to accompany this. Following this advice produced the first non-agonising BF sessions and began healing of my nipples. Both MW2 and BF1 observed me doing this and I specifically mentioned the advice to MW2. Neither provided negative comments. BF2 observed this and told me 'bring baby to the breast not the breast to baby' and refused to let me do it.

BF1 said don't hold her neck, hold her upper back and around her shoulder. BF2 said hold her neck.

MW2 said put a pillow behind her head to help support it. BF1 said don't put a pillow behind her head, she won't be able to pull off when she wants to.

MW2 said hold DD such that nipple is pointing into her mouth when the breast is lying naturally. We were working on the rugby hold on one side, which resulted in DD coming up from under the breast. BF2 observed this position and said DD should be on her side, not so much on her back, and as her bent chin was making it difficult to suck. BF2 also was unconcerned that my nipple was pointing skyward when teaching me the side-lying hold, and had me use one finger to point the nipple towards DD as I brought DD to the breast.

I know that the latch still needs work, as while it is no longer agonising and producing a lipstick-shaped nipple with sores along the edge, it is still somewhat painful and the nipple is coming out oval and a little lengthened. So I'm going to have to continue to get advice. It disturbs me that even the experts are telling me contradictory things. And it especially concerns me that the one I have best access to - with home visits - contradicts the one piece of advice that helped most so far. I'm not quite sure what to do.

Which bit of advice seems to result in a more settled baby and a painful breast? Which feels best to you?

Sorry, q mor settle baby and a less painful breast?

I think the problem with positioning is that we are all a little different, babies and mums. This aspect of BF is more of an art than a science. I would take the advice that works for you and go with it.

It's awful in the early days when you are new to it and everyone is manhandling you and confusing you with their own personal 'expertise'. Little by little you will become the expert for your baby. The main thing is keep feeding frequently.

Ime people will say 'if it hurts you are doing it wrong' but it just hurt me with each of my 3 in the early weeks no matter what i did. But soon it stopped hurting and became easy.

I'm not saying you should suffer in silence, please do everything you can do improve latch etc. I just think its misleading to say the above.

That's the thing - bfing supporters aren't supposed to give instruction or advice but provide information and help the mum find what works for her (there are exceptions e.g. Don't hold baby's head as that triggers a birthing reflex and can make baby throw their head back as they are about to latch on or don't feed your 1 week old on a 4 hourly schedule with 10 min feeds regardless of what your grandma says as it almost certainly won't be enough!).

If a bfing supporter shows you a technique and it doesn't work or isn't right/comfortable then you don't have to do it. The idea isn't to have 100% of mums feeding identically but to find what works for each individual dyad. It may take some time and lots of practice to find out what is best for you and baby - that isn't going to be what works for the lady down the road as she doesn't have your breasts/nipples or your baby's mouth!

If they tell you you shouldn't do X, Y or Z ask for the rationale behind it - if it's something like 'baby won't be able to get a deep enough latch with their chin tucked under' or 'baby won't be able to swallow with their head twisted' then it's something to consider, if it's something like 'I found it uncomfortable' or 'I got mastitis doing that' it's probably not evidence based and safely ignored. If they are offering non-evidence based directives a word with their supervisor may be in order as they may need a refresher.

I think the problem is that breastfeeding is a bit of an art. What works for one mum might not work for another.

I am going to completely throw a spanner in the works and show you another method.

breastcrawl.org/video.shtml

www.biologicalnurturing.com/

I think the newborn stage is the toughest part of establishing breastfeeding because the baby has so little head control.