BF 4 day old with bleeding nipple - what can I do?

[digitalgirl]

DS2 is 4 days old. I lost 2 litres of blood in a pph so have been told that my milk might take a bit longer to come in. DS2 is quite a hungry baby (8lbs 12oz at birth) so has been giving it a good old go since day 2.

I probably didn't quite get the latch right on the first night as I was just so pleased that he was feeding that I ignored the pain (and the blisters). However, he's since been feeding so frequently that both nipples became very sore - which I thought was down to frequency.

So, last night I paid more attention to getting him to latch on properly, but nipples have become engorged so no matter how well I bring him to the breast he ends up mucking about with the nipple till it fits in his mouth. I try to express a few drops of milk before getting him to latch on - but don't know what else to do to make it easier for him - am worried that using a pump will make the blisters worse. Should I be hand expressing for a good five minutes in order to soften the nipple?

I think my milk came in last night as I got very sweaty in bed and can feel tingles all around my breast rather than just sore nipples.

However, this morning he went to latch on to one breast - I got the usual sharp pain of him chomping down while waiting for the let down - but he looked a bit puzzled after a few minutes and let go. Cue massive scary looking blood blister emerging. I put him on the other breast and he seemed fine with that and fell asleep after 5 minutes.

What do I do? How long should I rest the bleeding nipple before trying again?
Can I just hand express from this breast till it heals? How long will that take?

It's a good idea to keep feeding or you may interfere with milk supply. But if you try from a different angle hopefully the pressure will be off the blistered part. I had blisters in the early days with dd from feeding her in the tummy to tummy position, and I found that switching to a rugby ball hold helped a lot and allowed me to keep feeding.

Also lansinoh!

I used to use a nipple sheild in thos situations. I bought mine at a Pharmacy.

Feeding from a bleeding nipple will not harm your baby (although it can be a bit freaky if he possets up your blood!), so don't worry about that aspect of it. Ask for some jelonet dressing from your mw/hv, which will speed the healing process. Try to keep feeding or hand expressing, to maintain supply. You could try nipple shields, though for me that just made it harder for mine to get enough nipple in his mouth and that was more painful. You are right that a pump is likely to exacerbate it.

I know full well the hell of blistered/bleeding nipples so I feel your pain. But you a doing a grand job, and it will get better.

If you can get the latch sorted out then it should heal whilst you continue feeding and yes, you can keep feeding with bleeding nipples. In the very short term different positioning or biological nurturing can help (google if you're not sure what BN is) and you may find that the latter helps correct the latch anyway, as it's baby led. Lanisoh encourages moist wound healing will help prevent scabs forming and therefore in turn help prevent or minimise bleeding and you will heal more quickly too.

If you really can't stand to feed from that side (paracetamol is safe for BF if there's no other reason you can't take it and you can usually take it) then expressing is probably the next best option until you get some proper help.

Ideally you need someone to help you with the latch and that means them watching a whole feed. Can you get a local BF clinic or support group? The NHS and LLL runs upport/help groups and clinics are NHS run. Your HV will have details of NHS ones. You could also ask if the NHS have a peer support scheme in your area, which is where women who BF or have BF have been trained to support other Mums with their BF and check positioning and latch etc. They are volunteers, but bound by NHS confidentiality etc and will have the time to meet you either at home or somewhere you are comfortable with and they can watch a whole feed. They will also give you a number to contact them if you need their help again or support and if you need help they are not qualified to give they will know who to refer you on to. In our area this is called 'best buddies' and if there's something similar where you are, your HV should know about it.

Good luck.

DH currently trying to track down a breastfeeding consultant to come over.
No support groups till Monday and I've got a MW coming over for a routine check on Sunday who I'm hoping will be able to help (although I know they can be hit and miss).

Just didn't really want to spend the whole weekend making it worse. I'm prepared to feed through the pain AND blood as long as I know I'm not making it worse.

Currently sat on sofa with boob hanging out, slathered in Lansinoh, hoping it wil heal over the next few hours.

If you are going down the moist wound healing route and using lanisoh, you can use a breastpad and bra if you are more comfortable in a bra? The lanishoh will stop the air getting to it anyway. Of course, if you're happier brasless, then that's fine too.

If there is a 'best buddies' scheme in your area then they may well be willing to come out at the weekend, especially if you can speak to someone today. (I am training as one and would rather work in a weekend than see a Mum suffer or struggle until Monday, I know other ladies also work weekends)

Just to add, I was in agony with bleeding/cracked nipples at first and I found biological nurturing really helped. I was terrified to let DD latch her self on as it was excruciatingly painful to latch her on, so I laid back and braced myself and once she was on I had to look and check she was even latched on, it was completely pain free.

Just spoke to the NHS consultant and she can't come out today as she's booked up so will try mw - however she did give me some advice re: reverse pressure softening before feeding. Hopefully if I can soften the nipple up enough before getting him to latch on I can get it right next time. Till the engorgement settles down. She also suggested a cold compress between feeds, but then heat compress just before a feed to help with flow.