Day 3 wobble, resorted to formula because my nipples are mashed - it'll be ok, right?

[theborrower]

Hello. I had a baby on Sunday (a VBAC following a previous EMCS - yay). My first DD had terrible trouble feeding (low birthweight, couldn't latch, tongue tie etc) but we got there in the end with mixed feeding. Anyway, I'm delighted that DD2 has been feeding relatively well this time round - yay - but last night was tough.

We fed most of day, midwife said this means milk is on its way (can see it becoming white and watery, just not loads) so she's ramping up demand. My nipples were a bit sore and she said they're cracked - yep - but I'm using loads of lansinoh and it's not been too bad. She said latch looked good and suck is strong, but it looks like she's slipping a bit sometimes.

Anyway, lots more feeds early evening then last night we literally fed non stop, bar quick breaks for a breather, between 9pm and 3am. She was getting increasingly unsettled, coming off more often, my nipples were aching and there was no end in sight - so we gave her some formula via a syringe so we could all get a few precious hours of sleep. She settled and my nipples rested.

I know she's lost her EBF badge but it's not the end of the world, and I'm surprised at how calm I feel about that given my previous experience and PND about DD1. She has gone back to BFing this morning - including right now - so she's not refused the boob which is good.

Anyway, what am I asking? It'll be ok, right? Do I still need to get latch looked at? Do I need to express for the missed feed(s) or will those lost few hours (3-4) make any difference? Why are my nipples wrecked??

Sorry it's a long post, thanks for any tips or reassurance. I'll also let midwife know when she comes later today.

Hopefully an expert will be along soon. But all is definitely not lost after one little formula top-up. Don't worry and don't beat yourself up; sounds like you're both doing really well. Definitely worth getting your latch checked out - have you got a BF cafe nearby? Midwives don't always give great advice on this.

Congrats

Hopefully an expert will be along soon. But all is definitely not lost after one little formula top-up. Don't worry and don't beat yourself up; sounds like you're both doing really well. Definitely worth getting your latch checked out - have you got a BF cafe nearby? Midwives don't always give great advice on this.

Congrats on your lovely new bundle.

It's not a problem at all. One feed is not the end of breastfeeding. You're right that you could have expressed when the formula was given, but I don't think it's worth expressing now to make up for missing a feed. Just keep putting baby to breast whenever she shows a cue, and you'll be fine.

Regarding the latch, if your nipples are cracked/sore then there probably is an issue that could be improved. Have she been checked for tongue tie? Also, keep de-latching her and re-latching her as soon as it becomes uncomfortable.

Firstly congrats!

Secondly, sounds all normal to me. Both the amount she's feeding and your despair at her doing so!

Midwife is right it's just baby bringing your milk in and she will settle once it's in and established. No harm in getting your midwife to check the latch but she was probably just getting tired herself. Don't worry about the missed feed, boobs are clever but not THAT clever. I over lansinohed apparently. I wasn't letting my nips harden, was told to only use it when I had active blisters. Def made a difference and they calmed down much faster afterwards.

Please do not feel guilty about that syringe of milk, my DD1 was topped up the first night as I was so tired (after a horrendous birth experience) and I felt like to the whole BF world frowned upon me. So much so I pushed myself to BF for 11 gruelling weeks after suffering with so much nipple pain, when my HV sat me down and told me it was ok to switch to formula. I wasn't enjoying feeding in the slightest. Subsequently I ended up with PND due to exhaustion and guilt, guilt that I now realise was entirely unwarranted. I could scream at your 'loss of EBF badge' !!

DD2, great birth experience. Less tired. Those first few nights I managed in 2 ways. Understood that the feeding was normal. And didn't do ANYTHING else. I was lucky that I had my husband and mum to support me. I took all offers of help. We were not going back to the dark place that was post DD1. Oh and I used a dummy from that 3rd night. I don't believe in nipple confusion at such an early age. IMO they suck anything! If the dummy didn't settle her then she went on the boob, but it did mean that I might get half an hour nipple break. Also I fed lying down at night, would snooze whilst she fed. We got into a good routine by about a week where hubby fed her a bottle at 10pm so I had a chunk of sleep 8-12. Then recurrent mastitis set in, I managed 14 more weeks of pain before giving in. And I'm very proud of those weeks. It was a shame as I was finding it so easy.

Take it one feed at a time. If your desperate and need a rest. Give a bottle. It's not the end of the world and you will probably feed longer in the long run. In my experience anyway.

And I'm sitting here. A teeny bit jealous xxxx (sorry that was a long reply!)

Forgot to say. It WILL be alright. Whatever happens :-)

I would call your community midwives again and ask them to pop back and have another look for you. It does sound like a latching problem. It really shouldn't be shredding your nipples if the baby is latched properly.
They do just feed like mad for those first few days, as you know! Worth trying out a selection of positions too. I could only feed using the rugby ball position on my left (normal position for the right!) for a few days. I fed until 15 months in the end.
Once the latch was right it didn't hurt at all. With my second, more experienced - no pain at all from day 1.
I wouldn't bat an eyelid at the little formula top up. I would have been upset with my PFB, but when it's your second it seems so much more relaxed doesn't it! I think you made a good call to give your boobs a rest.

Thanks everyone

Yes, she's been checked for tongue tie, this was near the top of my notes give my experience last time when DD1 didn't get it fixed til nearly 8 weeks. I don't think that's what it is, but will be sure to get another opinion.

Thanks for tip re the lansinoh. I'll calm down a bit on that. They seem a bit better today.

She also seems to be latching better today, I wonder if she was getting super tired too, she needed lots of help getting on last night. We've tried a few positions but cross cradle seems to be working for us. Lying down too, but rugby hold is awkward. Also tried biological nurturing, which was preferred position with DD1, but doesn't seem so easy this time for DD2.

pharmacistswife I can relate to what you're saying, BFing DD1 was a bloody nightmare sometimes. I saw a mat psych this pregnancy about unresolved issues re her birth and feeding (inappropriate guilt, apparently) and I'm aware he said that a nighttime bottle (ebb or formula) might be a good idea.

Midwife here, will update soon

If you continue to get pain, get someone bf qualified to check your latch, even if the mw says it's ok. You may well have bf cafés or drop ins etc near by with bf supporters. Mws aren't always specifically bf trained so can miss tt or latch issues.

I didn't accept medical help until I was 11 month post natal. By this time my marriage was struggling and I hadn't bonded with my baby. Who was a perfect angel who slept through from 7 weeks! I didn't know mat psych existed, although I had a fab consultant who gave me confidence to go ahead with a natural delivery. Second time round I have a sleep demon, food avoider who constantly teeths sand I'm still enjoying every minute ( ok that's a blatant lie but I have realised that motherhood does suit me!)

It's bloody hard but it all works out fine in the end.

Update - we did the right thing, she has had urates in her last couple of nappies. I'm going to express so we've got some top up - milk still not fully in but def on its way. She checked latch - of course, DD latched textbook while being observed, but did slip after a bit and I was reminded to take her off and start again. Also about making sure she stays alert. She advised putting a muslin or toy, with some of my breast milk on it, next to her in the cot/basket, so she can still smell me. Has just worked a treat as I've been able to put her down to shower and make a cuppa! She is actually sleeping now.

Ok, I'm getting the pump out in a minute, and tomorrow we're going to the BF clinic to check latch, more advice etc, but hopefully today will be a different day.

Thanks everyone, will keep you posted

In my limited experience this will go a whole way to righting itself when your milk comes in fully. DD2 fed like a demon from Day 2 to Day 10. Helped me lose 90% of the baby weight which I may or may not have regained and got her set up very nicely for BFing. Still going at 9 months.

I wouldn't worry too much about expressing. If you can bear it (and I know it's hard with another one to look after), just let her keep at it as much as you both can handle. She's better than any pump.

Many congratulations. This baby making factory has shut up shop but I do get envious of real tinies

Major wobble time, and think my hormones are going, I keep crying

More urates in nappy (not v wet), boobs feeling warm and a lump in one, guessing attachment still isn't correct as it's still a bit nippy and I'm taking herb off to retry, but sometimes she doesn't want back on, then 10 minutes later she does...

Called BF helpline, very nice - advice still to try feeding as much as possible, hopefully milk in soon (think she said it's taking longer than average, is that right?), if I feel I need to top up that's ok (I've got myself all worried she's not doing well) - DH and I have said we'll plug through the night but if we get to top up time he'll do that while I express.

I'm just worried it's turning into a repeat of DD1 who couldn't feed right and lost weight etc

Sorry you're feeling a bit wobbly at the mo. Sounds like you've got a good plan for overnight tonight. Hopefully it will go well, and that your DDs latch will sort itself out. In the early days with my DS I had to de-latch and then re-latch so many times until he got a good latch. We got there in the end though.

Just take it an hour at a time. Having a plan always helped us deal with drama of the hystericals at 2am. Hope you start to see a difference over night. Already bedtime for me!

It's such early days. And the nappies aren't very wet at this stage as they pee so little! I don't know if mine had urates as they were never tested for. You're doing fine. Just get through tonight. Take it one feed at a time.

And yes it's your hormones, which probably means your milk is on it's way in!!

Update - another mad middle of the night run of feeding, so we gave some more formula. Baby was weighed today, has lost just over 9% of her weight, but midwife said we did right thing as the urates indicate she's getting a bit dehydrated, and the mad hours and hours feeding means I'm just not producing enough at the moment. Milk looks whiter and thinner today, but I'm not sure it's there yet - how can you tell?? I'm not engorged (didn't have this with DD1 either). Midwife keeps reassuring me it shouldn't be long now. She observed latch, again baby is great when being observed. She feeds better in day, so I'm obviously letting good latching go to pot in the night when in bed. Will force myself to sit on couch tonight. Nipples still cracked though :-(

Will see how her weight is tomorrow too, as we don't want her to lose much more. Advice is if we have a run of busy feeds to top up sooner in order to give her bit more strength and me some sleep for a couple of hours, rather than waiting until end of 4-6 hour stint to do it.

I'm reminding myself that it's day 5 and she's had a tiny amount of formula, do we're not doing too badly.

I have just seen your other post and have hopefully offered some reassurance as my milk took longer to come in this time but with sore nipples you could try nipple shields. They saved my breast feeding last time as DS2 could latch on and my nipples were psin free during feeds. We used them for a few weeks then when I had healed I took them away mid feed at first then got rid of them altogether and fed for 9 months. I can't recommend them highly enough. Good luck!

I was in a similar situation with DS (now 11 weeks old). Really painful when he latched on and my nipples got mashed and never had a chance to recover. We had a horrific day after my milk came in - just couldn't get
him to latch on to my seriously engorged boobs and bleeding scabby nipples but spent a whole day trying, on the midwives advice that 'baby is best for draining the breast'. Hmm. Not this baby. I was repeatedly told by midwives and bf cafés that his latch was fine but it clearly wasn't because I was in agony. I switched
to expressing and bottle feeding breast
milk until about week 6 when my nipples has recovered - had another go - latch still not right and back to square one. After successive attempts we paid for a lactation consultant to come out and see us and FINALLY in week 7 she diagnosed posterior tongue tie which was treated in week 8 and by a week after the op DS was feeding brilliantly. So a few things I'd say - totally agree about feeding on the sofa rather than in bed - I got lazy about checking his latch when half asleep and in bed. Giving formula or expressed breast milk in a bottle is nowhere near being the end of breastfeeding (expressing is better if you can, as it keeps stimulating your supply) - I bottle fed for 8 weeks and be now feeds absolute fine. Most important things are that baby is fed and you don't put undue stress on yourself when you're already sleep deprived and completely drained after birth! It really shouldn't be painful (I stopped believing people when they said this because it was consistently painful, but once the tt was sorted, that all changed). And I'd say do get a bf specialist to check again for tongue tie including posterior just in case it's that. For your sore boobs in the meantime, and getting rid of the lumpiness, as well as building supply - the Kelly mom website has tons of useful advice in case you haven't come across that, although you probably have - kellymom.com. Sorry for long and rambling message! glad to hear it sounds like your DH is being supportive. It is all such incredibly hard work.

And also you ARE doing brilliantly and formula is not evil, so don't feel that you need to mark yourself down for every bit of formula you top up with! If your nipples are cracked then you do need a bit of a break - don't push yourself to the point where you just can't face feeding or expressing (I say from experience, not having followed this advice myself!) I hired a double breast pump (medela symphony) from our local NCT person which was a godsend, so much quicker and more efficient, and the best £40 per month I ever spent.

I have another thread going, here's my response there
^No, she doesn't have yellow poos yet, they're still in the stage after the sticky muconium (changing, but still dark and looking bit sticky). There are wees but still stained with these urate crystals.

Re the tongue tie - that really worries me, because it was such a source of stress with DD1, I had lost the will to carry on/ PND by the time it got fixed.

Unfortunately all the local BF clinics are cancelled this week - had hoped to attend one yesterday - which is just my usual crap luck, I'm guessing because of the start of the school holidays. There may be one on Tuesday but will need to double check on the day.

Will try and update other thread too.^

I've tried expressing, but only got out 0.5ml. That's right. That was 20 mins pumping, with breast compressions first, on a Medela swing. If I try to hand express, it's dribbles.

My nipples are still very sore. I had to miss a feed last night as it was too much, so DH gave formula via syringe while I expressed (see above).

She is so much more content after formula, I'm seriously considering switching if something doesn't improve soon. I know it's such early days but I'm so conscious of my experience last time I don't want to get trapped into repeating that. I had set myself a 3week limit (of trying if it doesn't come fairly easily) because that's when DH needs to return to work.

I also have some nipple shields somewhere, might be worth a shot, but I can't imagine they work until your milk comes in, right?