ELCS 48 hrs ago and failure to breastfeed - can I still make this work?

[HardCheese]

Hi everyone,
It's taking an effort to even post this, as I feel so awful about it.

My beautiful first baby is two days old - was born via ELCS on Tuesday morning at 42+1 - and I haven't been able to breastfeed at all so far. My breasts are awkwardly large and have flat nipples, the baby doesn't seem interested and won't stay on for more than a minute, and despite endless advice from the midwives on the postnatal ward, and desperately trying to express colostrum and failing, I've ended up giving him formula because he was obviously hungry, and I couldn't give him anything. I ended up crying my eyes out on the postnatal ward the night he was born because everyone else was feeding nonchalantly away, and I was in agony from trying to hand-express colostrum unsuccessfully, and having my nipples pinched by the midwives.

Will my milk still come in, or have I ruined everything by introducing formula? Shouldn't the milk have come in by now - this is day three...? I'm still putting him on the breast before every formula feed, but he just comes off again, and cries from frustration - he is a big baby and has a big appetite for his bottle feeds. My husband has gone to buy a breast pump, and I'm oping that even if I can never get my baby to take the breast, I can at least express and feed him my milk via a bottle...?

Is expressing via a breast pump difficult, assuming my milk does come in OK? I've lost faith in my body's ability do anything - though I think part of this is disappointment about not having given birth vaginally in the MLU. I must also have unusually sensitive breasts, as my and the midwives' attempts to hand-express were painful.

Any advice very welcome. Sorry about the length and self-pity. He's a goegeous baby, and I want to do my very best for him.

Hi, didn't want to leave you all alone, though others who know more should be along soon. I totally understand about the bruising - my midwives didn't get it till I pointed out that the bruises from their man-handling of me actually hurt more than the c-section scar. It took 5 days of pumping with the "industrial" machines in the hospital before my milk came in, so don't be put off by 48 hours (apparently 5 days after a c section is not that unusual). But you have to pump frequently, and it is bloody dispiriting (my colostrum was coming out about 3 individual drops at a time, which had to be sucked up in a syringe and added to the formula DS was receiving by tube) . It's also exhausting - 3 hour cycle of aittempt to feed, express while paed nurse tube fed DS, settle DS, wash and sterilise kit ready for next time - didn't allow a lot of time for sleep. Can't help vis-a-vis flat nipples but hopefully others (Tiktok?) can help with this. Good luck, and make sure all around you make a fuss of you.

sorry no helpful advice, but bumping for you

:( :( ;(

Hard - never apologise for longing to breastfeed! And it is early days - you have not ruined things, and I do suspect from what you say that you are just not in the right place. No one should be pinching your nipples, or causing pain when expressing - what are they playing at? Can you/your DH find someone who knows about getting bf going, and who will understand and accept that you need some gentle, and if possible hands-off, help?

If there has been a lot of baby-handling and head holding and pushing and shoving - get them to BACK OFF. Just hold your lovely boy close to your breasts and forget about trying to get him on, keep him on, wake him and all the rest of it. Let him, and you, enjoy the closeness and the snuggles, and if he needs formula 'cos the bf is not working at the moment then that's ok - he needs to enjoy being close and the bf will happen more easily and gently in that sort of atmosphere.

You can get colostrum with a syringe or pump, and he can have that - no fighting at the breast!

Have a bath with him - see if he gives feeding cues, but don't panic or be despondent if it still does not work.

It is early EARLY days!

Oh, and yes, your milk will still come in (this happens whatever else happens).

Congratulations on your new DS and becoming a mum. Didn't want to read and run but am not an expert, hopefully someone will come along with expert adice soon. Just wanted to tell you I had a EMCS and my milk didn't come in until day 4 or 5 so am sure it will appear soon.
Are you having plenty of skin to skin time?
Are they suggesting different holds so you're not compromising your wound?

Please be proud of yourself, you just grew that big baby yourself, strip him down to his nappy and pop him on your chest for a snuggly cuddle, you never know, he might just do a breast crawl and surprise you.

Yes - I'm sure you can make this work. Not the same situation, but when my little one was a week old I effectively gave up trying to breast feed because I had to go back in to hospital and have an Op and couldn't look after him. A few days later when I got out I decided I really wanted to and tried again. Obviously he had been formula fed in the intervening time.

He had to have formula and breast milk for quite a while as there just wasn't enough, but I ended up feeding him almost exclusively myself for a year after this - it can be done!

With regard to the expressing - this was the other thing the midwives tried to get me to do while in hospital and it didn't work at all. I also have flat nipples and was in complete agony. I know some midwives believe its actually too early to express effectively and that was certainly the case for me although I managed later (months and months later!).

Good luck :)

Have you tried nipple shields? Got my baby to latch when otherwise couldn't.

I had to use nipple shields to get DD to latch as my nipples are flat. This was on the advice of a midwife though so perhaps you could ask what they think?

I do sympathise. DD couldn't latch and I was on the pump in hospital and it made me feel very down and like a failure. I also cried at the thought of not being able to feed my baby. The shields made the world of difference to me and DD is still EBF.

Congratulations BTW.....

Congratulations on the new arrival and don't despair!!

I am not an expert but I think you have been getting slightly poor advice. Try the helplines either at La Leche or the NCT for more help.

As far as I know milk takes 2 to 7 days to come in regardless of the method of delivery, so don't worry! Colostum is enough for the baby at this stage (unless your baby is premature, low birth weight, or other medical complication). You should be able to express colostum with a pump and feed with a syringe if needed. Don't let the MWx pinch your nipples!!!! Totally unnecessary! Just have loads of calm skin to skin with your baby and let him find the breast and figure it out for himself.

Good luck!!!!

Congratulations on the birth of your son.
Please don't be sorry. You're doing the right thing in getting as much advice as possible.
Is there a lactation consultant at the hospital that can come and help you? i agree with other posters in contacting la Leche league for advice. They are excellent.
Some thoughts that may help:- try feeding lying down if you are able to lie on your side without pain, a plastic shringe (nipple width) from the hospital with the end cut off and inner bit turned around can sometimes help to gently suction out the nipple a little, supplementing via a feeding cup would be a far better idea than using a bottle, keep trying to express regularly but try not to be disheartened if there seems very little colostrum- every drop is worth it.
Throughout all this, lots of skin to skin cuddles will be lovely for both of you.

My DS1 didn't feed much for 48hrs after CS. I struggled to get him to latch - he would have to be screaming to open his mouth wide enough etc. Midwives kept trying to do this hold and that hold - but the easiest was the straight forward cradle hold with pillow underneath. If you can - keep him in the bed with you - and when he cries try and get him to clamp down!!! He will get the hang of it I'm sure - mine did - some just take a bit longer. (DS2 knew straight away what to do - but DS1 had to learn - both CS). Your milk will come in, just hang in there and grit your teeth. Honestly you will be fine......fed DS1 until 30 months - but we learnt together!

Has the baby been checked for tongue tie at all? DS really struggled to feed, he'd latch then give up after a few half-hearted sucks. After a day and a bit of feeling terrible I asked the paed to check if there was a reason and it was total tongue tie. It's worth getting it checked just in case.

Thanks so much everyone, individually and collectively. You've made me cry (which admittedly isn't that hard at the moment!) at the sheer niceness and generosity on here.

I've just been getting terribly dispirited, as expressing colostrum just didn't work at all. The only time a few drops appeared it was from the most brutal pinching from one of the midwives - Lurcio, you're quite right, it was more painful than my scar - which I've never managed to replicate myself because it hurt so much. Normally I'm good at telling people to back off, but I was feeling terribly vulnerable.

No one meant any harm - it was just a terribly overstretched unit, where all staff were supposed to be trained in breastfeeding support, so no specialists and everyone terribly busy. I think I probably need to try to find someone who will come and do a home visit (we came home this afternoon, as I felt I'd had all the help I was going to get from the maternity unit, and thought I might be less tense at home), but it's not a good weekend for that, with Easter. I will try La Leche League and the NCT line. There is a breastfeeding support group somewhere locally, but it doesn't meet till next Wed - is that too late? Will he have become a bottle-fed baby for good by then unless I manage to turn things around over the weekend?

However, we will have a breast pump by tomorrow afternoon, and I will pump with that until something happens - and hope something comes out - and also try for more calm skin to skin, as I suspect that opening my bra at the moment has become more about feeling a failure and being terribly anxious than pleasure - thanks for reminding me that this is supposed to be about good sensations.

Do other people think we should use a cup rather than a bottle in the interim?

Pastabee and NoMore- nipple shields sound like a good idea, will investigate. John Lewis sell them, I think? Lou - I have a syringe and that did work briefly to perk my nipples up, will keep trying. Tiktok - would love to bathe with baby (who is a little love), but scar won't let me step over bathside at the moment. But delighted to be reassured my milk will come in - I was wondering whether I simply didn't have any...

Rufous, that's really encouraging, thanks.

Hard, you will see the midwife tomorrow, almost certainly, and you can share all your concerns with her - tell her they hurt you when trying to 'help' on the ward, and how much you long to breastfeed.

There's not a huge amount of evidence that giving bottles at this stage is any worse than a cup - so no need to delib. avoid bottles, though your midwife may disagree. Just keep on taking every opportunity for snuggles and love - there is no deadline before which you 'cannot' breastfeed ever.

Pleased to hear you are home hardcheese. Made me feel much better. You are vulnerable after having a baby and emotional and that's really hard to deal with especially is breastfeeding is an uphill struggle.

John Lewis do sell shields as do Boots. Ideally you want Medela half contact shields if you are going to try them.

Shields are not without their controversy as studies have linked them to a lower / loss of supply but there are ladies on this forum who feed exclusively with them (including me) without problems so it can be done. The idea would be that you use them to help your baby understand what to do and then wean him off them although I never managed the weaning bit!

Before I used the shields I expressed colostrum (horrible I agree, expressing milk is easier you'll be relieved to know), tried pumping before feeding the baby to try and bring the nipple out and tried the 'flipple' or 'exaggerated latch (see YouTube).

The person who was invaluable throughout this was DH. I couldn't really see what was happening and for the first 36 hours after leaving hospital he latched her on. He could kneel right up next to us in the bed and had a really good view of when she opened mouth etc so please don't just struggle on with the LO as it both of us to get DD going.

I agree some RL help would be great so please do try LLL etc and hopefully someone will be about over the weekend.

I was in the same situation as you so hugely sympathise. DS wasn't interested in breastfeeding for around 2 weeks so had formula to start with while I was increasing my milk production to replace it in his bottles. I can be quite sanguine about it now but I was desperately worried and it was such a hard slog. A breast pump (hospital grade one) will be your best friend. You can hire a Medela yellow one for as long as you need. Midwives in my experience are not very knowledgeable and can give a rather wrong advice because once you've given birth the one thing they need is your bed on the postnatal ward. I would investigate any breastfeeding support options within a wide radius as not all consultants will "click" with your DC's problem. It will be hard but it's doable.

I had trouble starting bfing and the mws in the hospital were useless and pinched me. I also got told that I probably couldn't breast feed due to flat nipples but we "couldn't all have perky page 3 girl nipples"

My friend is a lactation specialist told me that a) your nipple is just the spout that the milk comes out of and b) your baby only knows your nipple so won't be comparing the flatness. This really helped me to relax as I was feeling like a total failure. I had never realised my nipples were flat!

My community MW was wonderful and she stayed with me for hours on her first visit until we both felt happy I had cracked it. I really hope that you can get someone tO give you the support you need, it made all the difference to me.

Also, you have already taken care of your DS for nine months and I bet he's perfect