please help - problems feeding 12 day old

[potas]

Hi
I have a 12 day old baby who I have been breastfeeding - things were going pretty well - my milk came in and he was latching on well and feeding well. He always seemed to find it slightly harder to latch onto the left breast though the latch has been checked several times and midwifes think it is fine. The nipple is a slightly different shape and a bit bigger than the other. I have started using the rugby ball hold for this side and he finds that easier although he seems to suck a lot harder on this side and the breast never feels as empty afterwards though he does seem satisfied. 2 - 3 days ago I started getting deep stabbing pains in that breast during feeding and for an hour or so afterwards - the midwife though possibly thrush so I started on fluconazole thursday afternoon - there has been some improvement with this but I am also taking a lot of paracetemol and ibuprofen so not sure what is having the most effect. Over the last 36 hours Ive developed an ulcer on the nipple and the whole nipple is now excruciatingly painful. I am literally in tears the whole 20 mins etc that he is feeding. (and the majority of the time in-between and am dreading each feed on that side) I can't carry on like this. I want to start expressing on this side and just feed directly from the other but at 12 days old I don't know if Im going to cause baby to become confused with nipples vs teats - i can't bear the idea of cup feeding him - it seems so pitiful. I have a pump but Im worried to use it incase it make my nipple more sore.
The other breast is fine - I could literally fall asleep with him suckling and he latches himself on and off quite happily.
Basically I am a wreck and need some practical advice - ever where I turn people are so pro breastfeeding that they can't seem to give me any advice other than try to continue but I can't and I don't know what else I can do. I don't want to change to formula - I want to feed breast milk.

I started expressing when DD was a few weeks old due to a very painful latch, and still continued to breast feed some of the time. I found expressing much less painful, so it would be worth trying, at least to give yourself a break to heal. Nipple confusion is a risk but it's not a given. If you're worried though you could express to keep supply up but dump or freeze the expressed milk and just breast feed your baby for now. Maybe express from both sides (from the 'good' side between feeds, to boost supply if you'll be relying on one side only). It sounds like you're doing really well, it would be a shame to give up now :)

And much sympathy by the way; I remember getting to the point where I'd dread DD getting hungry, as feeding was so painful. It was horrible. I hope you heal quickly and feel better soon.

Have you been to a breastfeeding clinic as well as talking to a midwife - they can help you with all this sort of stuff.

And - sorry to hog your thread! - another option would be to try nipple shields. They're a pain to sterilise, it means a 5min or so delay before feeds, but could provide enough of a barrier to let you heal a bit. And, once you're healing/healed, you could try different feeding positions, maybe side-lying for example, so the latch isn't always on exactly the same part of the nipple.

I think the risks of nipple confusion can be exaggerated - so many babies are given a bottle for one reason or another, but carry on bf just fine. And it sounds like you do have bf well established.Basically you've got to do something to give yourself a chance to heal. Poor you. Remember, you're doing a great job, and one day soon this pain will be a distant dream.

If the nipple pain/breast pain is one sided then it's highly unlikely that it's thrush (thrush is incredibly contagious and would be passed between breasts very easily). The most likely explanation is that it is a latch/position issue and a tweak/change in latch or positioning would help resolve the pain especially given you now have a wound on the nipple.

Do you know where your local bfing group/breastfeeding counsellor are? You can call any of the bfing helplines (blue box part way down the page) over the weekend for help and support too if there isn't anything local to you (if you call from a landline the helplines put you through to the most local on-shift bfc so you may find you get someone local) don't be but off if you have to leave a message or call back later - bfcs on the helplines are volunteers - as the lines can get busy.

Moist wound healing dressings are brilliant at healing up wounds without causing scabs to form (if a scab forms the baby can suck it off during feeding which causes a bigger wound to form with a bigger scab and so on). Ask your pharmacist for these dressings (one brand name is Jelonet but they may stock other brands/have a generic version).

Some info that may help nipple pain help hereand deep latch technique here, biological nurturing here.

Poor you. I had loads of problems BFing initially too. Can you find some RL support? I eventually saw a lactation consultant at 6 weeks but wish I'd done it sooner. You can find one locally here www.lcgb.org/consultants_local.html

I had mastitis two weeks in & ended up feeding from one side & expressing from the other for a couple of weeks, so it can be done. My left nipple was larger from the inflammation so I bought a larger shield for the pump which helped.

I also v much doubt it's thrush but a latch issue. Has tongue tie been ruled out? A cranial osteopath may also be able to help.

Kellymom is my bible & has loads of great advice kellymom.com/bf/concerns/mother/nipplehealing/ really hope it gets better soon

Just an update - thanks for all your advice. I spoke to someone on the NCT helpline who advised expressing and trying to rest that breast from direct suckling to give it a chance to heal. I managed this for about 12 hours which helped with the pain a lot but in the end he wouldn't take expressed milk from a bottle and my other breast couldn't provide enough so I had to just bite the bullet and go for it - I expressed a bit to make it easier for him to latch on and although it was still sore it was tolerable. Since then its getting better and better and the deep pain has cleared swell. Not sure what caused the problem but giving my nipple a rest, and letting the air get to it, helped a lot. Thanks for all your advice - I am also going to a breastfeeding clinic tomorrow to get my latch on technique checked and get some more support.

That's brilliant! So pleased things are starting to get a bit better. Well done for persevering. It tough when you're in so much pain.