Latch not improving despite help. Nipples agony

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DS is 4 weeks and latch has been poor since day 1. He does not open his mouth wide enough (I know that he can - he screams regularly). He is not tongue tied. I have been in touch with LLL who have provided advice and i have tried everything i have bern told repeatedly. Very occasionally, we will get a great latch which isn't agony but DS will thrash about until the great latch is ruined and I'm in agony again. I'm desperate to BF - I have worked so hard to try to make this work but I don't know how much longer I can keep going at this. In time I guess that my nipples will get tougher and that DS will grow so his mouth will be bigger which will hopefully improve the latch, but I don't know if I can wait for that any more....., help!

To give some background, DS was born after 28 hours labour and emergency CS (I was induced and didn't dilate beyond 4cm). I don't really remember the first 24hrs after he was born which is v sad - I am told that I fed him in this time.

We were in hospital for 3 days after the birth during which time a stream of midwives gave us various conflicting advice about BF - there was no continuity or consolidation of what we were being told / shown to do. My left nipple was inverted and I didn't manage to latch him onto that side at all whilst in hospital.

At home, I started expressing immediately as nipples do raw and painful by the time I left hospital (we had bought a medela double electric pump for use when DS was a bit older - so glad that we had bought it early. Is excellent). We use bottles to feed expressed milk using the medela calmia teat which makes DS work for the milk (can turn the bottle upside down and shake it and nothing will come out - he has to suck to get anything). The pump has helped with my inverted nipple and I am now able to feed DS on both sides.

At one point I was expressing 8 times per day so supply is great - no probs there. Now I am mostly BF and giving expressed feed in evenings. I have DS in bed with me at night to try to make things easier. Sometimes we latch and relatch 15 or more times during a feed - I've read and been told not to persist if it hurts - this doesn't make any difference - in still in agony and DS is screaming with hunger / frustration.

Sorry for long post. Please help....

Sorry you are having a tough time. I found all that helped was perseverance. Take one feed at a time and wait for baby's mouth to get bigger. With mine the first eight weeks were agony but after that it was fine and my boobs did three years service for my two children.

It sounds like you've done brilliantly so far in spite of the conflicting advice.

Has anyone actually sat and watched a whole feed from start to finish? They may spot some little thing you are/aren't doing and that can be altered to help.

Are you SURE he doesn't have a tongue tie? I know you have said he doesn't but people can get it wrong. Does any of this sound familiar: feeding problems

Sorry if you have been through this already, but TTs are so often missed by people who are supposed to be experts.

Otherwise you can try the exaggerated latch. This is an animation of it. Its hard to get it right at first, but really helped me with nipple pain/damage - although I was shown it by a lactation consultant and it was much better seeing it in person than the animation shows, if you are able to see a lactation consultant or feeding specialist. Its also called the flipple if you want to google it.

I found two things that helped -

Lansinoh on the nipples before and after every feed helped immeasurably.

Getting a one to one visit from the Breastfeeding Network support people. If you have them in your area they're fab. They came out and watched from start to finish and also gave advice.

Do you have a local bf group? They helped with me a lot and after a couple of weeks things 'clicked' and I fed DD for over a year.

I remember how hard it was at the beginning though, so don't beat yourself up.

Thanks everyone. I am on my second tube of lansinoh! How people breast feed without it is beyond me!!

The midwives who I've asked have all been certain that DS doesn't have tongue tie, however having read the link you posted TIYS, I am convinced that he does. He feeds constantly, never seems full, sleeps terribly, bobs on and off the breast in frustration etc. am going to speak to BFN, LLL, GP and anyone else who will listen to find someone who has some expertise in the area. if anyone knows of any experts in the south Manchester area, please let me know....

Night time is the lowest point - I feel better able to grin and bear it during the day. My original post was written earlyish this morning having been awake feeding from 5 and not having had much sleep before that

Check out 'The Analytical Armadillo' blog - she's a bf/ lactation specialist with a lot of info on tongue ties and I think does home visits. If memory serves me right I think she's based not too far from you.

You've done fantastically well to get this far, does it help to think of it in terms of just getting through the next feed? Also, I was in a lot of pain initially (I cried before each feed knowing what was coming) and I promise it dies get better - I'm still bf at 9 months

Would nipple shields help? I never used them so completely shooting in the dark.

Analytical Armadillo is the same person who does Milk Matters breastfeeding clinic, Charlie who is wonderful. She should be able to help you find someone local who has TT experience near you, you can try for free help first and if not go private. My DS's TT was missed by a certified lactation consultant, and I didn't find out until he was three months, by reading that blog. Although things were better by then, having the TT divided made a huge difference and don't believe anyone who tells you otherwise!

Good luck - and even though things are hard at the start, it gets much much easier and is much more convenient later on (and I've done both).

Thanks again everyone. Just to give an update - I've been given the number for the specialist midwives at stepping hill (Stockport). They have a team of 3 and specialise in tongue tie (if anyone would like the contact no, please let me know). I'm taking DS for assessment at clinic on Wednesday. V pleased that someone is going to have a look do quickly (yes it's nearly a week away, but I class that as quick for nhs!). The midwife on the phone was great and said that lots of the symptoms do sound indicative of TT. Also DH only just decided to let me know that he has posterior TT!!! (why didn't he mention in all the discussions we've been having about this?????). Trying not to get too excited at the thought that DS might be able to settle better and my poor nipples might stop hurting if there is positive diagnosis and it is corrected. Fingers crossed though.....

You are doing to well to persevere as the pain can be so depressing. I had real difficulties with my wee boy at the start and very nearly gave up on many occasions within the first month as it was so painful and my nipples were in shreds. I think babies can sense that you are stressed and uncomfortable when you're feeding and this can unsettle them and put them off! I managed to feed him for 16 months in the end but only with the help of nipple shields. I got a wee bit of hassle from the HV for using them but it was either that or stopping breastfeeding and I absolutely didn't want to stop. There are a few different makes so you can try different ones as some are more comfortable that others depending on your nipple size. Maybe you could try them for a few days before you go to the clinic just for some relief?

Other than the lansinoh, getting fresh air to your nipples once you've fed can also bring some relief. Other than that, you can get some moist dressing from your midwife or health visitor which is quite soothing too.

Best of luck and you will get there, it might just take a little while. Your boy will be all the better for it when you're sorted.