engorgement, constant feeding and pain

[WantAnOrange]

DD is 4 days old and I'm struggling with BF. She latched on and fed immediately after birth for a long time. She feeds for two hours at a time! She then falls asleep at the breast but if I put her down she wakes up and starts rooting straight away, and screaming if I dont fed her again.

My milk came in on day two and my breasts have been really engorged. They still feel hard and full even after her monster feeds. How do I reduce my supply?

I cant bear the feeling of anything against my skin. I have been covering my nipples in Lansinoh and only have one small crack but I hate the feel of the sticky stuff.

I get toe curling pain when she latches on. Sometimes this caries on throughout the feed but most times it gets better. It hasnt felt completely comfortable yet.

I've had my latch checked and apparently its really good. So why does it hurt?

I'm in tears because I just dont think I can do it another minute .

Keep strong, do you have someone in RL you could ring? I had my big sis for times like this. If you say to yourself it is just keeping going until tomorrow, and the see how you feel it might make it reel more manageable. Establishing feeding can be so hard, but can be so worth it if you can get through it. It is rare that the latch pain lasts longer than 10 seconds, so try counting down. If it still hurting after the 10 there could be an issue with the latch. X

DH is here and is great. DS is here to so I feel guilty that he is seeing me cry.

Oh Orange you have my full sympathies, it can be bloody miserable can't it (voice of recent experience here). I will try and break this down into manageable chunks as will prob have quite a lot to say.

The most immediate problem is the pain. Are you taking painkillers? You can take both Paracetamol and Ibuprofen whilst BFing. They really help to take the edge off and make feeding a bit more bearable until you get it cracked so I would do this as your first step.

Next you need to tackle the source of the pain. This is most likely to be a latching problem. You say you've had it checked and been told it looks good but pain of the toe curling variety you describe is a sign that there is something going wrong inside. There are two things you need to do:

First, make sure your LO is latching as best she can at every feed. To do this you need to be able to manoeuvre her really well. Google Dr Newman's leaflet "When Latching" and work through this step by step guide. It gets you to use your elbow as a pivot against DD's bum, supporting her head with your hand and moving her with your whole forearm. You can then control her really well and attach her quickly to the breast when she opens really wide.

Next you need to ensure she's getting a good mouthful of breast underneath your nipple. Pain and a squashed or pinched nipple when she comes off would be a sign this isn't happening. I get more boob into DS's mouth by putting my first two fingers on the edge of the areola where his chin would be when latched on, my thumb directly opposite again on the edge of the areola and pinching my thumb and fingers together to squash the boob a bit flatter with the nipple forming a point. You can then really aim the nipple towards the top and back of your DD's mouth as she opens wide.

More to follow...

Second, you need to get your DD checked for tongue tie. I'm no expert but I think many of the things you describe are totally consistent with a tie - the pain, plus the length of feeds, engorgement and seeming hungry straight after feeds are signs that something could be stopping her feeding effectively. If you're at Day 4 today will you be seeing your CMW over the weekend? If so, ask her to check for a tie. But be aware that lots of ties go un-spotted even by HCPs so even if she says there's no tie I would be getting a second opinion next week from a trained feeding advisor - try the infant feeding coordinators at the hospital or see if you can get to see a BFing counsellor - your MW, the hospital or the BFing helplines (NCT, BFing Network or La Leche League) may be able to put you in touch with someone.

To deal with the engorgement, try expressing a little either by hand or using a pump, before feeding until the breast feels slightly softer. This may also help your DD to latch as it's easier to latch onto slightly softer boobs than rock hard ones. Also try breast massage to relieve the engorgement - take a hot shower then start by pushing your breasts up and together and hold for a few seconds. Then spend a couple of mins massaging each breast firmly with the flat of your hand all over, kind of as you would if checking yourself for lumps.

For the crack you've got keep going with the Lansinoh. Try to jam some right down into the crack itself. Wipe off any excess that gets onto your areola before feeding because it could cause your DD's latch to slip which you don't want.

If you can't bear anything to touch the nipple get some breast shells to wear inside your bra. They keep your bra off the nipple which will give some relief, allow some air to the crack which should help it to heal. Shells can also help with engorgement by exerting pressure to cause a gentle leaking of milk between feeds so I suspect they would really help you.

Sorry it's a complete essay but I really hope some of these things help. I know how demoralizing and bloody painful it is - I have been the person sat on the edge of the bed yelling on pain, sobbing and dreading every feed so I know what you're going through.

Hope it improves for you soon, have a HTH in the meantime, and do let me know how you get on.

tongue tie i reckon. im seeing it everywhere at the moment!

I would check for tongue tie too. I had problems with engorgement with DS who was tongue tied. Engorgement & oversupply are really common with TTied babies as they stimulate the breast but can't drain it.Do make sure you express off to prevent mastitis.

yorkshire has given lots of great advice. Le leche league have good support & can be contacted on 0845 120 2918

wow thankyou I will work on this today! I'm feeling a little brighter. She was checked for tongue tie i hospital but I will ask for her to be checked again. Midwife is coming on monday.

I thought about expressing a little but Im scared I'll increase my supply. I have been hand expressing a little before each feed.

I struggle to get her to open her mouth very wide for the latch and she gets herself in such a state.

I'm going to Mothercare today so I'll try some breast shells too.

Thankyou so much for taking all that time to reply. x

Shes just fed for half an hour. It hurt when she latched on but then was fine so thats a good sign right?

I tried the cabbage leaf down the bra trick it felt lovely! I do seem to have cooked them though and I smell like cabbage....

I second expressing before a feed. The other thing that helped me the most were nipple shields as mine were rather flat and this helped baby to got hold properly while shielding cracks a bit. The pain is awful and it always is worse around day 4 when you feel low anyway, i hope it improves soon.

Yes, any diminishing of the pain is a good thing and no doubt a blessed relief for you too!

If she's getting herself worked up and you then struggle to get an open mouth try downloading a baby white noise app onto your phone. You want one of the ones that sounds like a hairdryer or the Hoover, not the ones that play birds tweeting and whale music. I think the one I've got is called Baby Sleep Lite or something like that. Or just get your DH to play the hairdryer in the same room when you're feeding. If you haven't heard about the effects of white noise on babies you will probably feel bonkers for doing this, but it can really work to calm them down and when she's calm she can concentrate more on feeding properly and is more likely to do a nice wide open mouth.

It's important to make sure you're getting that wide mouth every time so take her off and re-latch if it's not quite right. I know this can be a PITA, esp in the middle if the night, but it's like husband dog training using positive reinforcement: if you only let her feed when it's right, she'll very quickly learn what she needs to do to get the milk.

Oh and I would still get her checked for tongue tie. Who did the check in hospital? The engorgement you describe could be your supply settling down and it's common for new babies to feed for a long time but two hours at a time does sound on the very long side, it must be exhausting for you. Is she windy after feeds? Does she make any noise when feeding? Does she fall off and have to re- latch during feeds? Is your nipple squashed or mis-shaken after feeding? Again, any or all of these things could point to a tie.

Do ask your MW to check on Mon, but if she doesn't think there is a tie and you're still getting any of these symptoms, the engorgement, long feeds or pain I'd go for a second opinion - try a BFing clinic at your hospital if they run one or try a local baby/BFing cafe if you can find one as there should be a counsellor there who can check.

Glad it's showing signs of improving for you though! x

PS sorry for typos, typing one handed on phone while feeding DS!

She does pull of several times and have to re-latch and my nipple is squashed and mishapen when she comes off. She gets windy but brings it up fairly easily. Shes not very noisy, just gentle swallowing.

This morning she fed from 5:30 til 6:30 ish, then 8:00 til 8:35, 11 til 11:45 and shes back on now (about 12:30).

I'm not in as much discomfort as yesturday.

How old is your little one?

Ive just put the white noise on. Its like an off switch . Amazing!

Oh WantAnOrange, you have my complete sympathy. I'm in a very similar situation, DD is 4 days old today and I'm really struggling with painful feeding. It's eye-watering when she lacthes on and the pain subsides a bit but never really goes away through the feed. My problem is that she's not sticking her tongue out far enough so she clamps down on my nipple with her gums. My nipples are cracked, scabby, bruised and tender. And my boobs are rock-hard and painful too! I tried nipple shields but they didn't help much, and when I took her off to relatch at one point the milk inside was pink from my bleeding nipple :( I was also told by a MW at the hospital that she doesn't have a tongue tie, but I think I should maybe get a second opinion.

YorkshireRose your advice sounds great; I've just Googled the Dr. Newman articles and looking at "When Latching" has made me cry! I just want to be able to feed my baby. Gah, hormones.

Earnest it's hell isnt it? I've had a few good feeds so I know she can do it but then we get set back again.

DS heard me crying this morning and got upset so I feel guilty aswell.

Midwife is coming tomorrow so I'm asking for a second opinion on the tongue tie.

She doesnt seem to be able open her mouth wide enough and her tongue doesnt stick out far. The advice to squeeze my breast so its flatter helps.

I had dc3 in July and suffered like above- really scabby nipples, pain worse than child birth!
I ended up expressing for 4 days or so until cracked nipples healed - worked a wonder...

Hello ladies, my DS is now 8 and a half weeks, BFing has been a long and at times v difficult journey for us but things do improve and we are getting there - some feeds still a bit sore but most are good and I don't dread the feeds like I used to.

The main problem for us was that DS had a tongue tie that was diagnosed at 5 days, we were sent to hospital for it to be cut but they said it wasn't severe enough to interfere with feeding, even though my nipples were already cracked and bleeding by then. So we went away and persevered, feeding and the damage to my nipples just got worse and worse until after some advice on here I went for a second opinion on the TT. They immediately diagnosed a tight posterior TT and cut it there and then! Things did get better but it wasn't an immediate cure-all: because DS had by then learnt to feed with the TT and his tongue in the 'wrong' position too far back in his mouth, getting him to do it right has taken a lot of patience and hard work (and a good few tears). Because of all this I was left with a large open wound across much of my left nipple which had been a bugger to try and heal, still not completely healed hence some ongoing soreness but it's getting there. So this is why I'd urge anyone suffering ongoing pain to get a second opinion on TT if ANY symptoms of TT are present, because they DO get missed and the quicker they are sorted, if present, so much the better for mum and baby.

As you can prob tell my ordeal has caused me to read just about everything I could get my hands on to do with BFing and try all of the different techniques to try to find anything that worked for us. It makes me sad and a bit cross that at no point before having DS was I warned that BFing could be so hard, either within the NHS or in my NCT class, with the result that I really thought for a while that I must be the only new mum out there who couldn't feed her baby. Luckily I quickly found this board and realized I was far from alone (sadly for all the others who were going through similar experiences)!

Glad the white noise has worked for you Orange - an off switch was exactly how I described it too!

Having some good feeds and then a couple of bad ones is totally consistent with my experience - it sometimes felt like two steps forward, one step back. After a painful feed I'd think of that as one painful one down and promise myself that the next one would be a good one. Gradually the sore ones become fewer and further between which gets your confidence up and I think when that happens you can deal with the painful ones better anyway. Hope you find this happens too, and you Earnest!

The midwife has just gone. She checked for tongue tie and didnt find anything, just backed up advice about getting a good latch etc. I'm still getting toe-curling pain when she latches on, but its mostly comfortable throughout the feed now. MW is coming back thursday to check and I've found a breast feeding support group on wednesdays I can go to.

Well done for getting to 8 weeks! I made it to 8 weeks with DS1 then hit a wall and gave up. I didnt have mumsnet then.

link for you

You are describing classic tongue tie behaviour. As the thread linked to shows, there are many HCPs out there who really don't know how to diagnose tt.

You need an expert. Start with Milk Matters who can help you identify if there is tongue tie with their virtual service. And then they can point you in the direction of the nearerst knowledgeable tongue tie people.