Pain

[Downbytheocean]

Currently feeding ds2 who is 5 days old, he's feeding lots, every hour and half for 45 mins in day with some longer gaps at night. I thought all was going well, some pain when latching on and nipples peeling a bit but nothing unbearable, until tonight. Since 7pm my right breast has started to hurt all way through feeding, a stabbing pain in the nipple. I carried on feeding but it hurts so much i am wincing through the whole feed and the pain continues to throb when I change sides. I'm not sure I can take the pain of feeding on that right side again tonight. I thought latch was fine, had it checked by mw, I feed lying down at night and he just latches himself on. Is it likely to be a latch issue that i should get checked tomorrow? I know shouldn't avoid feeding on the right but it's agonising now. TIA

I am also quite uncomfortable with afterpains tonight and lochia has increased. Could this be connected? Is it normal or should I get checked out at docs?

I had those shooting pains you're talking about with ds2 and I've heard others complain of the same. Right through the centre of the nipple and deep into the breast? I was concerned it was thrush but we had no other symptoms and it just passed after a week or so. I wasn't sore while I wasn't actually feeding though. Do you think it could be your milk coming in?
As for increased pain/bleeding, I remember when I tried to do too much the bleeding would get brighter red and heavier. Could this be the case?
I'm sorry that's not overly helpful, I'm sure you'll get some great advice soon, hang in there!
Congratulations btw

Thanks weedoll, milk cane in two days ago. Will read up on thrush. Have tried rugby ball hold and its not quite so painful so could be a latch issue maybe.
I'm finding this a minefield again, not sure if I'm doing it right, which breast to use, how many times to change, whether ds is getting enough ( not much poo despite endless hours of feeding), why it's hurting so much....etc....I need RL support don't I!

Highly unlikely it's thrush already (it's almost always in both sides too) unless you are prone to thrush infections, have had anti-biotics recently or have health conditions that make you more like to pick up random infections (e.g. suppressed immune system). It's much more likely that the latch is a little bit 'off' and a small tweak will get you back to pain free feeding esp as you mention hours of feeding but not much pooing (a less than optimal latch usually means baby is getting less than optimal milk hence the constant feeding).

By not much pooing do you mean baby isn't pooing at all, doing a 'skid mark' or two a day or just not pooing every feed? By 'endless hours' do you mean cluster feeding all day (just going from one side to the other and back again with no break all day) or is there periods of time (perhaps evening?) where baby feeds an awful lot but the rest of the time has feeds 1-3 hours apart? BF babies need to feed 8-12+ times a day so it can seem like they are feeding all the time even if they are just feeding a normal amount.

Are you still under the MWs? Could you ask to see the Infant feeding co-ordinator or BFing Specialist MW to help you get a better and more comfortable latch?

Thanks truthsweet, have been to see mw today and we think latch has been off as you mentioned. Ds2 typically did a big poo as we arrived at the mw appt, right down his leg and up his back. Maybe lack of poo on wed was due to the latch issue. Anyway I'm working on it, still painful on right side but I guess that's because the damage is done.
Mw suggested expressing off right side for 24 hours, is it ok to express when ds2 is only 5 days old?
Feeding has been less regular today, perhaps because we've been out. Constant feeding was only an evening/night thing, he falls asleep for an hour at a time during the day, but I have been feeding at least 12 times in 24 hours, although I don't know how you count switching from breast to breast for hours from 7pm to 2am.

Was the expressing to 'rest' the nipple? There are a few issues with that advice as :-

a) expressing isn't as effective as bfing so could lead to lowering supply in the 'rested' side or you could get a plugged duct/mastitis from not being able to get as much milk out as normal,

b) you then need to wash the pump between expressings (so 8-12 times a day if you want to keep supply ticking over!) or store it in the fridge (but then you still need to wash the collection bottle or put a new one on each time),

c) if you aren't bfing from right side how will you get the latch sorted on that side?,

d) either you just bf from the left side (so increasing supply by a lot and possibly leading to over supply when you go back to bfing both sided) or you bottle feed the expressed milk which won't help baby latch well as bottles use a very different tongue action to bfing.

Would implementing what the MW suggested to improve latching be achievable for you? (I am assuming she did tell you ways to improve latching on rather than just suggesting expressing). If she didn't give you any ways to improve latching then a call to one of the bfing helplines would be probably your best bet for tonight.

Well that's expressing off the list then, far too much trouble right now. Thanks for info. I would rather feed through the pain.
Mw did give me a booklet with pictures showing how to latch but I am sure i'm doing as the pictures suggest, big wide mouth etc. His lips seem to curl in though, not flanged. I fed ds1 for 7 months and had same problems with him for first week so hoping this is soon over! I will go to mw led unit tomorrow for advice if I can't improve things tonight. Thanks again.

look up the breastfeeding network website and find one of their counsellors. go and see them for a feed. they were defo the best people i saw with problems and i saw a lot!

they also have leaflets you can download on thrush and mastitis that are excellent.

i had similar pains with thrush but more around 4 weeks. although if you are prone to it or had PROM you could maybe have an early case. otherwise i got very very tender early on and when i had early stage mastitis for which warm baths, frequent feeding, massage and ibuprofen helped.

anyway make sure you see a counsellor as they are specialists and can spot things midwives dont sometimes.

good luck

Down - Jack Newman has some good videos on latching which may be more help than a booklet (I guess it's the bright yellow one - the name escapes me for the minute) - have a look here. I am seriously shocked though that you went to see a MW about pain when bfing and you got told to express and got given a leaflet! That is very poor service indeed. Even if the MW doesn't know much about bfing, she could at least refer you to a colleague who does rather than essentially fobbing you off.

When bfing has finished does your nipple look the same (though it might be elongated) as before the feed? Or is it lipstick/bullet/wedge shaped or change colour (maybe white/purple)?

You might find biological nurturing positions more comfortable to feed in for the time being - see here - at least until you can see someone tomorrow.

Hope tonight is easier for you and baby.

Thanks again for the excellent advice. I watched a Jack Newman video on youtube this morning at 4am (link didn't work but I googled) and for the first time I managed to feed on the right hand side without constant pain. I am just looking at the rest of the videos on the breastfeeding Inc website now. This will be really helpful.
The midwife did offer to get someone to come over this weekend if I needed it but I'm sure I can work on the latch myself after watching the videos. Until now my nipple has looked very lipstick shape when ds finishes with a definite colour change.
Hoping for continued improvement. Many thanks

Down - glad it helped, Jack Newman videos were what saved bfing with DD2 (I didn't really bf DD1 until she was 8 weeks old but as she was still bfing when DD2 was born I didn't get any help with DD2 - it was assumed I knew what I was doing!). DH found then at 2am on day 2 and we sat in the study with DH coaching me through latching DD2 on! It worked and DD2 is still bfing at 4 1/2y Thank heavens for Jack Newman that's what I say

The lipstick shape indicates that not enough breast is in baby's mouth and baby is squashing the nipple against the hard palate rather than the juncture of the hard and soft palate (if you run your tongue along the roof of your mouth until it goes soft - that's how far your nipple needs to go in baby's mouth). A way to latch on called variously 'deep latch technique', 'the flipple' and 'exaggerated latch technique' here & Russian animation to show DLT'.