Help for a Dad please!

[RobbieR00]

Please forgive if this is a bit verbal diahorrea!

We have a 6 day-old and he latched on 20 minutes after being born, and for 2 days all seemed fine. But, when my wife's milk came in she became so engorged that her boobs were (still are) really painful and rock-hard. 2 days in and little man had lost 11% of his weight, despite appearing to latch on fine and have plenty.

We saw the midwife and she got things moving with a handheld "device!" and some warm flannels. For a day things improved and he put on 1oz in just 24hours by latching on naturally. But my wife's nipples were really sore and started bleeding so at a second meeting we were told to use a manual pump to feed from a bottle instead for 48 hours. Were discouraged from using an electric pump as it would only encourage more milk to be produced.

But now the boobs are still engorged and really hurt to touch. However, expressing is really hard work, only producing maybe 2ozs in 2 hours, and I think this isn't enough (our 3 year-old did have similar problems but 3ozs a time seemed to work).

There is a pack of formula in the cupboard but we haven't opened it and would like to not open it as we believe BF is the best thing to do.

We tried last night to continue with the latching on after a short express but I think little dude is getting too used to the ease of the bottle, latches for maybe a few sucks, but then comes off and just screams. He also gets his hands in the way, and if you hold them out of the way he gets really cross.

It is also getting my wife down and we've had a lot of tears. She feels that she's not good enough as a mum (!!), everything hurts, not enough milk is coming off etc. She's also not very good at asking for advice and would be quite upset if she knew I had registered and sought help here.

But I really need some advice, even if it's just positive encouragement. I don't mind switching to formula, I love helping with expressing and sterilizing where I can, I just want little dude to get enough food and my wife to feel more positive.

This will get me flamed in these parts, but I ff because I had so many problems with bf that I was getting depressed. I was trying to express for 13 long weeks. This combined with ff meant my DS put on weight.
However, 5 hours a day expressing to make 1 miserable bottle was not worth it.

Ff is not bad, nor should it be make you feel guilty. The important thing is that your baby is fed and that you can enjoy them. I regret expressing for so long and it made mine and my DHs lives so much harder.

Hi Robbie. If your wife's nipples are bleeding, latch should be checked again as this is a sign that attachment isn't right. By somebody who is very experienced- a breastfeeding counsellor (there are NHS ones in some places, or you can contact the NCT or la leche League). I think the baby should also be checked for tongue tie as this can stop a good latch and also stop the breast being emptied well. Both my children had it , it's so simple to sort out but not routinely checked for.

I don't know why your midwife is recommending a bottle at this stage as it is likely to cause confusion in such a young baby. If your wife needs to express a bit and offer top-ups to the baby, you can use a little cup, spoon or syringe where there is no sucking required. I has to top up one of mine with expressed milk due to weight loss and I found the syringe least messy, but you have to be careful to do very slowly and down the side not squirting back down the throat. I would also say manual expression would be better than a pump to relieve engorgement, as you are not trying to express a feed, just reduce pressure.

One of the most important things here is going to be your support, and it's great that you are so keen to provide it. Remember that if you introduce formula it will affect milk supply at this stage. So if it's what your wife wants to do then that's of course her decision and absolutely fine, but if she wants to continue to exclusively breastfeed I think there are other things to be explored first.

There are others on here who know more than me, I'm not a professional just someone who has fed 2 of my own, so hopefully tiktok or carrotcake or someone else will be able to add any other thoughts!

I found nipple sheilds helped my dd to latch on when i was too engorged, they can be frowned upon because they are not 'best practice' but it can help, well it helped us for a few days. protected nips a bit, and allowed a better attachment for dd.

JoyfulPuddlejumper (awesome name!), and Elkieb thanks for your comments. Shower has been part successful along with warm flannels. We just haven't got back to trying to latch on after these, as we're only just at the end of the 48hr period. Nipples a lot better, not sore or bleeding, so perhaps another go this morning.

Milk is leaking not spraying everywhere when he pulls away. Amazing that so much leaks but so little is collected in the bottle when expressing. 5 hours for one miserable bottle sounds just like last night. > 2 hours for about 2ozs, really not enough.

Onwards with today, breakfast time and we'll have another go :-)

Agree also with what puddlejumper said. If fast letdown is a problem she can also try leaning back when feeding to slow the flow a bit.

Happy to offer some support and ideas: sounds like your son is not latching correctly now this could be due to simple positioning or something more complicated like tongue tie. Your local breast-feeding group or baby cafe can give one to one support and check both of these but a simple test for tongue tie is to stick out your own tongue - baby should naturally copy you. If the baby has a heart shaped tip at his tongue end then you'll know. Tongue tie can make latching very tricky but can be sorted in a quick little procedure. It's often missed at the hospital

I understand your concern about weight loss and temptation to formula feed but be careful here - if your wife is already engorged to the point it is getting painful you risk her getting a blocked duct or mastitis if you don't drain the milk somehow. The optimum way to do this is by feeding (once latch is sorted) or by hand expressing (not pumping) and then spoon or cup feeding. Manual expressing is surprisingly the most efficient way of getting milk from the breast - your wife can make it easier by having a warm shower / bath/ having baby near her to stimulate let down and using gentle expressing techniques - don't squeeze - its more of a massaging action. Hold hand in a loose c shape and work around the breast keeping fingers about an inch back from the nipple. I recommend expressing into a sterilised cup at this stage rather than a bottle to avoid further nipple / teat confusion.

Robbie, expressing is difficult for a lot of people. A machine isnt anything like as efficient as a baby at removing milk! When you get the feeding issues sorted, she will find breastfeeding an awful lot easier than expressing, so really I would focus on getting that solved rather than expressing. Lots Of people also swear by lansinoh nipple cream for protecting and healing. But it won't help if the attachment isn't good.

I had exactly the same problem when my milk came in, my boobs are like solid baseballs and my baby just couldn't get a grip, I ended up phoning la leche who advised that I should express a little off the boob that I was going to feed off to help him latch which has helped, I also think the baby has just worked out over a few days how to get to grips with the new boobs, re sore nipples I totally sympathise it is agonising and I was biting down on my t shirt when the baby was trying to latch, I found that Lansinoh really helped, we are doing okay now but i was ready and still am with my emergency formula stash too and if we had to switch to formula then so be it, you both sound lovely and I know I'm sympathising rather than offering constructive advice but it is so hard and I've been in tears with a screaming baby at my boob trying to him to feed, maybe have a go at phoning la leche and don't feel guilty at all re formula if you decide to use that instead, I'm sure there is a thread on here about expressing, ff and combination feeding, good luck to you both.

:o puddlejumper

yy to expressing being nothing to do with supply (esp in early weeks). I couldn't express more than an ounce or two, but have fed 3 babies for 3 years each.

With DC1, the first 6-8 weeks of bf was sheer hell - sore, bleeding agony. I think sometimes newborn's mouths are just a bit small and they don't get all the nipple in their mouth, so they're sucking on the nipple instead of on the breast IYSWIM - which is excruciating. As they get a bit bigger, that doesn't happen. One midwife showed me a brilliant way of quickly stuffing all the nipple in his mouth - that was the only painless feed I had in those two months. Unfortunately I didn't see her again and couldn't remember exactly how to do it.

Paracetamol tablets help a bit with the pain, and Lansinoh cream on the nipples promotes healing (and doesn't have to be wiped off before the next feed).

My DC1 also lost 11% of his bodyweight and when he started putting weight on it was very slow (only 1-2oz a week for the next week or two) - then it suddenly increased loads.

I had a supportive DH and my mum as well, which was the only way I got through those early weeks. I basically sat in a chair, they brought DS to me for feeding, fetched me drinks and snacks (and paracetamol), took him away again for changing etc. (I barely change a nappy till he was about 6 weeks!) Also, they learned not to try and talk to me while I was bf in those early weeks (all my concentration was going on withstanding the pain!)

There is nothing wrong with switching to ff if that's what you decide to do. But, just as encouragement if you do decide to continue with bf - for me there was an absolutely magical moment at about 7-8 weeks (after the worst time at 6 weeks when he was having a growth spurt, feeding all the time and I was in agony) - one day it just didn't hurt much any more, and two days later there was no pain whatsoever. As I say, I think his mouth had grown and he wasn't chomping on halfway down the nipple.

From that moment, everything was fantastic - bf was so easy, so convenient and it worked really well. And, for the record, with DC2 it only hurt for two weeks and with DC3 for a couple of days.

Oh, and another thing - don't know if your wife gets a piercing pain just after your son latches on - I used to think of it as like a ring of red hot needles clamping into my nipple! With hindsight, I think that was the letdown reflex, which can apparently be painful. I used to think that was a sign of a bad latch, and take him off and latch him on again - cue pain again of course! Again, that pain just stopped happening after a while.

BF is a huge change for her body, and a lot to get used to. Keeping on doing lots of physical and emotional support, you sound like a fab dad. Sorry about the essay I see I've written here! Your post suddenly took me back to those early days!

Hi, sorry you're having a tough time but well done for asking for help. I second what everyone says re latch but would say its sometimes very hard to get it right. My two were small babies with small mouths and they never got anywhere near this 'whole nipple in mouth' business! As a result I had sore, cracked, bleeding nipples (oh and mastitus, blocked ducts & thrush thrown in for good measure) and expressing one or two (or more) feeds a day got me through & I ended up feeding for 7 & 9 months. I would maybe try a different expressor. I had the medela one & it was worse than useless - about 2oz from the right & couldn't get anything at all from the left. Was in bits & thinking that was that but then made a last chance purchase of the avent manual pump & never looked back. I remember pumping the left one and crying with relief when some came out - I though I had one broken boob! And I know you can't help thinking that baby isn't getting anything if nothing can be pumped but that's not the case. (oh & I didn't use the 'flower' thing that comes with the avent one as, again, when I did nothing came out).

Good luck & for me, expressing worked a treat. The relief of seeing them take a nice big bottle of breast milk when I was so frightened that they weren't getting enough to eat was immense. Hope it all works out for you

Robbie, hope mumsnet can help. I will be brief as there is quite a lot of info here already. I am a bfc with NCT.
using a bottle is fine* - there is an idea that it causes 'confusion' but there is no good evidence that this is the case and many experienced breastfeeding supporters (inc me) don't see it; it helps if the baby is being give 'practice' at the breast during the period the bottle is being use

• a bottle is more efficient at getting milk in than cup, or spoon, and gives the baby a pleasant experience your wife's production of 2 oz is brilliant* at 6 days old - very few women would get more than this at this stafe
• hand expressing might be

Posted in error....

• hand expressing might be easier and more comfortable. Manual pump is hard work. Hand expressing is good when nipples are sore
• this sounds like early days engorgement which passes, but in your case it could be related to difficulties in getting the milk out by the baby - you need expert real life help with this
• why was your baby weighed at 2 days old? This is very early
• don't force your baby to stay on the breast or get involved in struggles with him - it is fine to keep him snuggled and cuddled and to feed him by bottle at present
• your baby should be weighed today

HTH

Elkieb - why say 'this will get me flamed in these parts'?

No one in my experience on mumsnet 'flames' people for saying their bf went badly and they ended up using formula - mostly people find support here, and anything else is a big MYTH and may stop people posting if they think it.

:( :(

re baby getting his hands in the way, mine were like this and somtimes it helped to swaddle them, it calmed them and they could feed better.

i think you should get someone experienced, ie a good bfeeding counsellor to check the latch and see feeding in action and they shoudl then be able to offer advice.

i agree with expressing off a bit by hand before baby latches on i had to do this as well due to engorgment in the early days.

and hormonal and tearful and doubting herself also veyr normal for a new mum even if its not first baby! you sound lovely and supportive which is great.

re bfeeding help i think in the mnet info they have the numbers for helplines? or else i am sure someone will post them on here for you :)

I just came out of the sore nipple phase after 6 weeks: although it gradually got better after the first fortnight. I just gritted my teeth and counted to 20 every time DS latched on. I think it was about the 6 day mark where I woke DH up in the middle of the night and I was crying so much we decided to buy some formula, this plan was only cancelled because he put his t-shirt on back to front/inside out and didn't notice so we came to the conclusion he wasn't fit to drive.

Now I love being able to breastfeed DS: it means that we have nice snuggly feeds everywhere and that I don't need to worry about making up formula/keeping bottles sterile on the go. There are also longer term health benefits, but the first two are what make out lives better now at the 9 week point.

So it gets better if you can get through these days. If not, formula is not poison and its more important that your son thrives.

And for some possibly useful advise: See if you have a local breastfeeding support group/cafe with someone who can look at his latch today. I know that in our city there's one somewhere every weekday and there are breastfeeding counsellors at all of them. You can take your wife to the door if she's feeling shy. I know when I tumbled through the doors of ours, newborn in arms, I was greeted and sat down with a drink for a chat very quickly. They might also have some advise for getting him back onto the breast again.

Hello, just a quick thought on the engorgement....when my milk came in and my DS couldn't latch on cos the nipples were too big, the NCT helpline suggested that I should feed him little and often. BAsically the boobs had decided to make enough milk for five babies and needed to be told to make much less milk, but on a regular basis. Perhaps this is what your wife's boobs need to be told, too. So I would suggest that you express just enough to make things comfortable - if you express too much her boobs will take this as a sign to make that amount all the time and won't settle down to the right amount for your LO.

I second tiktok (of course!) that 2oz is a great amount to express, and your wife's engorgement is a good sign that she will have plenty of milk to feed your little darling just as soon as you get the latch sorted.

If you are getting excess milk, I'd also suggest freezing some - a friend of mine did this and therefore had a nice store of milk to help her have rests in later weeks.

You and your wife sound like you are doing really well, congratualtions. I hope you get some lovely cuddly newborn time today as well as the bf stress x

Oh, and you might like to try putting LO onto his mother's chest and letting him bob about to the nipple - I'm not sure what its called but maybe someone experienced (tiktok ?) can suggest the phrase to google so you can see videos of what I mean. Do call teh NCT helpline, too, they were a godsend to me in early weeeks

x-post loads! The most helpful thing you can do is let her get somewhere comfy (bed/sofa/armchair) and supply lots of drinks, meals, snacks, the TV remote/a book and let her cuddle up with LO most of the time and you handle nappy changes etc. Her job is to keep recovering from the birth and feed the baby. Yours is to do everything else.

Some of the breastfeeding advisers will tell you what she eats has no impact on how much breastmilk she produces, which is probably true. It does however have a massive impact on her stamina and coping resources and these are what will help in the next few days.

Things they don't tell you about breastfeeding: Midwives and health visitors don't necessarily know what they're talking about. They get very little training on breastfeeding, so their knowledge is topped up either by their own experience/opinions, which can include myths or misconceptions, and and other training they've done which varies by PCT, when they joined, personal interest, etc. Added to that they don't have a huge amount of time to spend one on one with new families so don't always get to see feeding problems through to resolution.

What you need is a dedicated breastfeeding support group, you might have one at your local children's centre, or look at these websites to see if they have one local to you listed:

www.laleche.org.uk/pages/groups/county_list.htm
www.nct.org.uk/branches
www.thebabycafe.org/your-nearest-baby-cafe.html

If nothing else, try googling "breastfeeding support " and see what comes up.

A good website for reference is kellymom.com/ - it's American, but boobs are boobs, and it's extremely well researched and informed. Some pages for you:

kellymom.com/bf/pumpingmoms/pumping/pumping_decrease/
kellymom.com/bf/concerns/mother/engorgement/

HTH!

Sorry tiktok Just that when I've seen threads like this before people are very good at promoting bf but are unlikely to encourage a choice. Apologies if I got this wrong.

You may well be right, Elkieb - but that's not 'flaming'.

When someone comes on asking about breastfeeding, explaining that this is what they want to do, then people are likely to take that at face value and offer help with the breastfeeding :) Can't see the problem with that.

Anyone feeding a baby knows they have a choice to offer formula.

My concern was that someone like you indicating they risk 'flaming' may mean someone else is scared to post....