Scabby nipples, constant expressing, nipple shields not working for 2 week old, help!

[GuineaPigMum]

On behalf of my sister, who has her hands full...

She is really struggling with feeding her 2 week old DS, from the start he didn't have a correct latch and her nipples are so so so sore - blistered, cracked and with scabs. She was advised to try nipple shields but even wearing them her nipples hurt. She was also advised to pump and feed him expressed milk in a bottle, which she has been doing, but expressing is taking over her life, she's sometimes pumping for 2 hours at a time. Since he's been taking a bottle he seems to be less able to give a wide open mouth to get a good latch, so things seem to be going downhill.

She was determined to BF but she's really sleep deprived and stressed, and talking about giving up. Has anyone been through this and come out the other side to successfully BF? I really feel so helpless but thought if someone else could tell her that it is possible then she might not feel so hopeless and pessimistic. She's very teary and I'm worried about her mental health TBH.

She's had support from local Homestart charity, NCT and the midwife and HV, so is getting all the support she can, but she needs constant reassurance and needs someone there all the time. I fed my DS for 15 months and I worry that she feels under pressure to carry on when it may break her.

Can anyone offer any words of reassurance that I can pass on?

Your poor sister!

I was extremely sore at the start, bleeding and cracked nipples. I would be in tears at the start of every feed and in between too, not least as the latch was so bad for so long that I started getting pains deep in the breast in between feeds. Midwives etc assurred me the latch was fine, but it obviously wasn't. I took paracetamol and ibuprofen for 4 weeks because I was in so much pain, but I was determined! It got much better after that, a combination of being very fussy about how DD was latched and her just getting bigger I think. I am now still BF DD at 21 months, pregnant and a peer supporter, so yes, you can get through it.

Nipple shields don't usually stop pain associated with a poor latch unfortunately and they can also cause supply problems. What will help immediately is getting the latch sorted and even when my nipples were shredded, if I got the latch right, it didn't hurt at all. Has your sister tried laid back breastfeeding/biological nurturing? (you can google if you're not sure what it is) This can help get a good latch. Otherwise, can she get back to the NCT? Was someone from the NCT able to come out and see her? Or is there an NHS run breastfeeding clinic nearby? (different to a breastfeeding support group)

Moist wound healing also helps and it helps stop bleeding while you heal as scabs don't form. Using lots of lanisoh in between feeds will help with this, don't do any air drying at all and you can also put lanisoh on before a feed too if the baby will tolerate it.

Thanks Midori, it's lovely to hear a success story :-)
I will pass on your suggestions x

Second moist wound healing jelonet and vasaline worked best for me. Also get baby checked for tongue tie as could've cause of the problems.

Heaps of Lansinoh, before and after every feed. Hydrogel pads are great too, lovely and cooling but I turned out to be allergic to them :(

This will totally go against all BF advice but what I found worked was just to FF for a feed or 2 and have a break. Just taking the mental pressure off and giving the poor nips a few hours break made all the difference to me. My nips looked like they had been shoved in a food processor at the start of feeding all 3 of my DC but after 6 weeks they were super tough but my god were they the longest and

Oops hit post too soon! Meant to say the longest and most painful 6 weeks of my life but so very worth it.

Oh your poor sister, I really sympathise. I had the cracked, bleeding and scabby nipples for the first 2 weeks. The only thing that helped heal them were Novogel pads that I had to get on prescription from the GP. They are truly magic :) I gave my nipples a break for a few days while they healed, expressed and gave my DD formula top ups. My DD had a posterior tongue tie which made feeding so difficult, and had it snipped at 2 weeks old and since then feeding has got gradually better and I'm now exclusively breastfeeding (Dd is 7 weeks old now). Has your sister had her DS checked for tongue tie?
A bf counsellor advised me to just spend 10-15 mins expressing and I actually got more milk doing it for shorter periods.
I remember the feeling of utter wretchedness but there is definitely light at the end of the tunnel! Good luck to her :)

This happened to me too with DS1 - I expressed as was too sore to feed and it was totally exhausting. After getting mastitis and never really recovering my supply or getting past the sore point I gave up at 6 weeks. For me I felt do much better after that point as I was in a real state constantly beating myself up about it and crying.

This time round I'm ebf DS2 (5weeks) and although its been sore I managed to avoid all the mistakes I made last time. No real advice I'm afraid just tell your sister to do what is best for her and try not to worry, it's really not that important in the grand scheme of things! At the time I really stressed that DS1 might have lower IQ and get sicker which is insane - he's super bright and healthy. I think this time round it probably worked out also because I put less pressure on myself :)

Thank you all of you... I am feeling much more positive after reading your posts, I'm sure my sister will too. I managed to avoid the sore nipples when I BF so I really did not appreciate how bad it can be - I really sympathise with anyone who has been through that.
Really appreciate you taking the time to respond x x

I had a hideous time the first while with bf. I second wet healing, but if it just seems like things are not healing, especially with scabs, suggest that she maybe gets a swab taken. I had terrible infections in both nipples which needed antibiotics to start healing.

I also did a lot of expressing, and I won't lie it was sore for quite a long time as I don't think we ever got the latch quite right and ds wasn't great at opening his mouth wide. But I persevered because I wanted to - not pressure from anyone else, it was important to me, and eventually it became problem free and I bf ds for 15 months. I'm just saying that because actually I felt quite pressured to stop when things were really hard, and as much as people might have felt they were doing me a favour saying stop, it wasn't actually helpful to me and just made me feel like I couldn't complain. (someone else might have felt differently though)

I'm almost 9 months pg with ds2 now and I am dreading history repeating itself... but I know I can give it my best shot again and there are a few mistakes I made at the beginning that hopefully will mean it will be better - I wish your sister all the best because when it works out it's great.

Yes, and I've survived. Occasional bottle of formula, a lot of tears, a lot of cake. My most distinct memory of the first month is lying in the bath, when DS was two weeks old, crying my eyes out and asking myself why was I subjecting myself to something that hurt more than labour (which wasn't a doddle). So I said I would do it for one more week. I survived week to week, day to day, and sometimes feed to feed (as in: this will be my last feed ever ) for about three months. Was still getting occasional bleeding at 5 months. I'm not sure I'd go through it again but I'm very glad I have (still don't have my head straight about it)

My advice: formula doesn't hurt, particularly if it means that you're more likely to make the next feed bf. go to any bf support you can. And I found it very helpful to think what the pre-baby (ie more rational) me would have done.

I still have my emergency formula in, but haven't used it since August. DS now 10 months.