Probably very silly questions about breastfeeding

[AntoinetteCosway]

DD never breastfeed despite good intentions (and manhandling) from a lot of experts, an enforced stay in hospital and much blood, sweat and tears from me. Well, no blood, but the sweat and tears definitely. She had a hugely traumatic birth and was just not interested, never latched on at all, screamed around a boob if it was put in her mouth and generally refused. I was very sad and am only just forgiving myself for not being able to 'make' her do it.

Now pregnant again and I understand all babies are different! So maybe this one will be more interested.

Anyway, first stupid question is this: when they say the baby needs the whole nipple in it's mouth, what exactly is meant by that? Does that include the areola? Because mine are about 8cm wide and even when erect (is that the right term for a nipple?! hard?!) still not much less. I just don't see how that's possible...

Also, my nipples don't really go hard anyway and last time round one HV cut a syringe in half to try and make it happen. I'd rather avoid that humiliation (and agony, with serrated plastic against my boob) this time. So second question is, do they need to be hard to begin a feed or does the act of feeding draw them out? Or do they not need to be?

Thanks in advance and I'm sorry, I know these must seem absurd to someone who's done it. I just want to be as educated as possible about all the little things that are useful to know/assumed knowledge so I can be as prepared as possible.

OP, I can't answer your questions but I would recommend you read The Womanly Art of Breastfeeding. Could you go to a local bf cafe before the birth? LLL meeting?

Have a look at your local sure start centre they should have a breast feeding support group you can attend before dc arrives :)
Ds1 wouldn't breast feed but ds2 and dd both did so as you say every baby is different.
Dd takes the nipple but not the whole aerola.
Best bit of advice I can give you is to buy Lansinoh nipple cream and use it religiously. Good luck

I was put off the local bf cafe as when I was trying desperately to get DD to feed they told me to stop giving her formula in a cup so she'd starve until she 'agreed' to breastfeed. She was about a week old at that point and had had no milk at all so we'd given formula on the advice of the hospital who were concerned she was going to end up on a drip; we gave her a cup only after each attempted BF and attempted express (which also never worked, despite hospital grade machines). It just felt like very blasé advice that if we carried on and starved her it would get better rather than taking into account the fact that she was point blank refusing to even look at a boob!

I will def get that book though and see if there's an LLL group locally-thank you.

i agree with stargirl get in touch with la leche league and get some face to face support worth knowing who to call when dc arrives. ,i am certainly not an expert but think in answer to your question baby should have large amount of nipple and some aereola in mouth, but probably not all, think ds was so tiny my 'normal' sized nipples seemed huge, but as he grew more went in.
as for reshaping boob you can buy nipple shields, think its recommended you feed without them if possible but some people find they need them and breastfeed much more easily with them. worth a quick Google.

Not silly questions at all! Sorry to hear you had such a traumatic experience with your first child. It is great that you are seeking out information to hopefully help you have a slightly smoother ride this time around.

In the case of the nipple in the mouth, it is different for every mother/baby pair. Babies have different sized mouths and areolas are all different as well. What the baby needs in a nice wide open mouth, rather than a specific amount of breast in the mouth. This is because a baby uses its tongue and chin a lot to 'milk' the breast, and also because the actual nipple needs to be at the back of the baby's mouth so you can have pain free, sustainable feeds.

I winced reading about the chopped up syringe, ouch! Flatter nipples are very common, and it doesn't mean breastfeeding will necessarily be more difficult. The nipple is essentially a target area for a baby, rather than the part of the breast that is really fed from.

I hope that made a bit of sense! The best thing for you to do would be to read as much as you can, and maybe scout around for what practical support is available in your area

Babies who have had a traumatic delivery do sometimes find it difficult to breastfeed. Sometimes they have, for example a sore head, or neck, which means getting into breastfeeding position can be uncomfortable. It's not inevitable that it will happen again

jimble that gives me hope that your subsequent babies did it!

I really wish someone had said to me last time, 'it's not up to you, you can't make her do it.' So many people have told me about how they carried on despite cracked nipples, pain etc in a way that implies it's worth carrying on and I should have kept going and prayed for a miracle. I'm sure it is worth carrying on-if the baby will attempt to latch on in the first place!

Meant to say, when a baby is well latched a vacuum is created between their mouth and your breast. So the nipple is sucked right back to their soft palate. And it's a strong suck! I had flat nipples and did struggle with little support when I had my first dd, but they're now not nearly as flat and I didn't have as many problems the second and third times.

It's a shame you had a bad experience at your local group. Sometimes black and white advice like that can work for a specific mother/baby pair but it is important to take into account all variables. A baby who has not breastfed at all in a week should, of course, be getting milk from an alternative source while the mother is supported to get the baby back to the breast.

Will get some pre-emptive nipple shields just in case, thank you!

Char that makes sense about the nipple being a target. One of the midwives last time said because my breasts (and, accordingly, areolas) are so large that maybe DD was frightened of them, which in retrospect I think was absolute bollocks and a pretty ridiculous thing to say, but the idea that my nipples are just too big has stuck with me.

They're not silly questions!
A good way to remember it is that it's called breastfeeding, not nipple feeding. So yes, the baby does need a good mouthful of breast. Think the mouth you do before taking a bite from an apple, rather than the mouth you do when sucking up spaghetti - that's how the baby's mouth should look, and in that way they will get a good amount of breast in their mouth. Your nipple doesn't need to be hard before starting.
The national breastfeeding helpline is v helpful - 0300 100 0212 and you could give them a call. Arm yourself with the numbers of local BFing support groups before baby is born so you'll know where to go if you have any issues this time. As CharChar says, it's not inevitable this will happen again, hopefully you'll have an easier time this time round.

I can't say I've ever seen a baby who was frightened of a large breast! But a baby who has been manhandled a lot, especially after a traumatic delivery, could associate being at the breast with discomfort and stress. Sometimes the situation is entirely beyond our control, we can do as much as we can to figure it out but we can't fix everything.

I did a really good breastfeeding class as part of my NCT course (the only useful bit!). They did a demo with a knitted boob.

I think it's the bottom half of the areola that needs to be in their mouth, like in this diagram:
kellymom.com/ages/newborn/bf-basics/latch-resources/

My god. What on earth was that HV doing to you, you poor thing!!

I second the recommendation for the (ridiculously named) LLL bf'ing book. Also a lighter read with very helpful illustrations is The Food of Love by Kate Evans (I think that is her name).

Also if you can afford it and are really keen you could find a local lactation consultant, see her before you give birth to chat things through and make a plan and then she could be on hand afterwards if you need her. They are not that expensive and I found it fantastic to have someone around to help with practicalities!

Good luck and congratulations.

It doesn't mean all the areola. All of the nipple and some of the areola.

The feeding will itself draw the nipple out but some babies don't seem to get the initial idea of sucking if nipples are flat. Its a bit of a chicken and egg scenario. You need the baby to feed to draw the nipple out but some babies need the nipple to be out to feed.

One thing I pick up on though is talking about your baby been manhandled and then crying whenever a boob was near her. Afaik current advice is to be "hands off" for health professionals when helping with breastfeeding. Too much manhandling can be traumatic for babies and turn them into a breast refuser according to the infant feeding counsellor where I work. She's very keen that as midwives we help show mum how to correctly position baby at the breast but there's none of the grab a boob in one hand and baby's head in the other and connect them.

The syringe trick does work but the HV should have turned the syringe round so the serrated edge wasn't next to your breast.

You can grasp your nipple at with a thumb and finger opposite each other to make your nipple stand out more. You'll need your fingers at 3 o'clock and 9 o'clock rather than 6 o'clock and 12 o'clock if that makes sense. So that you're squeezing your breast/nipple into a vertical line. That will line up with baby's mouth as they lie across you.

Just because it didnt go well last time doesn't mean it won't this time. Some babies are born having read the textbooks and some don't have a clue!

Good luck.

The only thing I remembered was tummy to mummy, nose to nipple. Like a mantra

good diagrams

I think the thing about leading with the chin is important. Then kind of rolling the baby onto the rest of the nipple if that makes sense?

And make sure baby is in a straight line, not having to turn their neck/head to the side to get the nipple. And that they're free to move their head back a bit if they want to.

Thank you all so much for these replies and suggestions. I'm going to write them all down, read everything and talk to everyone I can! A lactation consultant is a really good idea-Tiktok suggested that on another thread (someone else's that I didn't want to derail) so I've got a couple of websites to look up of local people.

Viva I think the manhandling was a definite problem with DD. There was a lot of shoving her head to the breast, attempting to shove breast in her (usually totally shut) mouth etc. At the time I was grateful that so many people were trying to help but looking back now I do wonder whether it just made a bad situation worse.

Those are really useful diagrams-I had no idea so much breast had to be in the baby's mouth.

Google the analytical armadillo. Lots of supportive info.

OP, different babies can be totally different. DD1 was a delicate little flower who gently licked my nipple and lost weight. It was so hard

Then along came DD2 who was a little milk monster, latched on in 1 second and sucked for England! I thought of all those times I had been so discouraged and depressed about DD1's feeding when really, it was more her than me.

Good luck x

If you have complications in Labour/birth/afterwards, your milk will be a bit delayed coming in. I was so thankful a midwife told me this- I was seriously ill in ITU afterwards and they told me then so I knew what to expect. The best thing you can do is keep trying, get the latch right, and the milk will come in quicker- and give formula if you need to- it won't hurt. Even if it's just to top up until your milk comes in. Good luck OP. Xxxx

Oh and if you have a sleepy babba, like mine, you can try to hand express into syringe (easier tHan it sounds) and slowly inject into their mouth to get them to realise that they are 'hungry' if that makes sense. (DD slept for about 7 hours straight on her first day and the midwife was getting quite concerned )

And most importantly (then I'll shut up!)

Don't stress! Just because it didn't work out for you the first time it doesn't mean it won't this time. Be calm xx

Be calm is probably the best advice of all-and the hardest to follow!

Thank you all for your help. I'm sure I'll be back!

My first wouldn't feed at all. Absolutely heart breaking and was made to feel a failure by stroppy midwives who wouldn't let me go home till he'd fed. He never did and so we signed ourselves out on day four. It was pretty dire.

And so, with number two, i had a real bee in my bonnet throughout pg. the Laleche league run bf classes before and after birth, they were invaluable!! Would totally recommend.

Second birth better, baby straight on, midwives fully supportive. All good.

My nips were also quite flat- you can get see through 'nipple shields' which you pop on top of your own so baby has something to grab on to. Won't be long before they're no longer necessary because own nipple has stretched out a bit.

Try not to panic. All babies are different. As a second timer you will also be far less interested in other people's opinions and willing to put your foot down if necessary. You will also know that, if it doesn't work out as you hope, then a bottle fed baby is absolutely fine too.

LaLeche = highly recommended.

Good luck. Xxxxx

It might be worthwhile buying the nipple expander (?) from Lansinoh, it's like the little pump thing that brings the nipple out, just incase you need it