Breastfeeding - is there a boob shaped light at the end of the tunnel?

[tiggy2610]

Hi all,

DS is only 8 days old and I already feel like a failure with feeding, I'm hoping someone can offer advice or a good old slap to pull myself together. I'll try not to make this too long...

DS was born at 36 weeks via forceps delivery. It was a quick labour but traumatic, with DS born with severe bruising and me receiving an episiotomy and a second degree tear. 48 hours after birth DS's blood tests showed severe jaundice and an exchange blood transfer was discussed, luckily dual phototherapy did the trick and DS spent the next 5 days in an incubator.

During these first 7 days DS wouldn't BF and the doctors put it down to pain caused by the bruising to his face. We cup fed DS and eventually managed to introduce BFing in small amounts, often latching for 5-10mins and 'topping up' with expressed milk and formula to give DS his prescribed '60ml every 3 hours'. While he was in the incubator we were only allowed to have him out for 30mins at a time so being patient and slowly workin with DS to establish BF wasn't really an option, sadly.

Out of nowhere DS started feeding like a superstar. As soon as he was out of the incubator he fed for a good 30-40mins, removed himself from breast when ready and fed well every 3-3.5hours. The past 2 days we seem to have taken a huge leap backwards with feeding and Im questioning whether it's the best thing for us and I feel like I'm letting him down.

He now won't feed for any longer than 10-15mins and I've no idea if this is long enough for him (I'm used to knowing exactly how much he's getting each feed...) so am paranoid I'm leaving him hungry. MW weighed him yesterday and he had lost a little weight so I'm desperate to make sure he has gained for tomorrow's weigh in. I've tried both breasts and swapping regularly and he isn't interested. He's producing plenty of wet nappies but only 1 dirty nappy today. Additionally feeding is now agony, MW and breastfeeding counsellor both checked his latch and can't see any problems but I've sat and cried through the past 2 feeds. My nipples are bloody and I've developed blisters on both (I think they're milk blisters?) and I've ended up stopping after 5minutes in tears and giving DS to DH so he can give him expressed milk and, if desperate, formula.

How can I move forward from this? I'm trying to express as much as possible but the pain is preventing me getting as much as usual. I'm using lanolin but it doesn't seem to be improving. His next feed is in 2hours and I just burst into tears even thinking about it. I know I'm all hormonal and its only been 2 days but I just look at him in his crib and he's so perfect I just feel like I'm failing him by even contemplating giving up BF so early. Help.

It sounds like you've had a rough start here. The first little while of having a new baby is rough, even when the baby's arrival is easier, and breastfeeding is going well. You've had an entirely different experience. Please be kind to yourself.

The fact is, one poo a day, and the weight going down, means milk probably isn't transferring that well. Added to this, the fact your nipples are bloody, means something is up somewhere with the latch.

You say a breastfeeding counsellor looked at the latch, but something must be going on here. So I have a couple of questions.

1. What is the shape of your nipple like at the end of the feed, compared to the shape at the start?

1. What feeding position are you using? If you are feeding on the left breast, how are you holding him? Which arm? Is his nose generally touching the breast, or clear?

1. Does it hurt throughout the feed? Have any feeds been pain free? (not "I can stand it" but genuinely pain free) Is one side less painful than the other?

10-15 minutes, for some babies, can absolutely be long enough - but it sounds like something isn't quite right here.

Hi cockney, thanks for confirming to me that something isn't right!

1. Nipple is 'normal' shaped but when he stops is usually pointing in the direction that DS has been feeding.

1. I'm using cradle hold and the 'rugby' ball. With right breast the rugby ball tends to be the most successful pain wise but the right he is better with cradle hold. We do have a small fight on our hands getting DS to take his hands away from his face/out of his mouth before he does latch. Nose and chin both touch the breast when he's feeding and there isn't anh dimpling of the cheeks. There is, however, the occasional 'click' when he feeds which is why I think there are problems with his latch, even though MW didn't seem concerned.

1. Unfortunately yes, pain throughout feed. If he 'slips' and looses some of the nipple I can tell as it's an immediate toe curling pain, so I use my finger to break the latch and then start again. The pain I feel throughout isnt toe curling but is more than bearable. I have had a few 'OK' feeds on my right but as I've been using this for the last few feeds it seems to be facing the same uncomfortable fate as my left.

Tiggy,

1. Hmm. I don't really understand by the idea that the nipple is pointing in the direction he has been feeding in. Do you mean there's a ridge on it? Or the tip looks shaped like the tip of a tube of lipstick? The nipple should start out pointing in the direction of his mouth (well, really, he should start out facing the nipple, at the angle the nipple is at). Any change in nipple shape suggests a latch issue, which matches what you already worked out anyway.

When your nipples are damaged, it can be hard to tell whether latch is getting better or worse (because even a perfect latch will still hurt a bit, now), so looking at nipple shape is good, because it can tell you how much progress is happening, if you see what I mean?

1. Ok, the cradle hold isn't great with tiny babies. It assumes that our elbows are at the same height as our nipples, and it boxes in the baby's head. Cross cradle is often a lot better, as it does neither of these things.

Rugby hold can be good - are you holding neck and shoulders, or head? Mums often find that if they don't hold the head, and don't have a finger on the back of the head, then the baby can tip his head back better - and like us, if a baby tips their head back, their chin drops, their mouth opens wider, and the latch improves.

Because we want his head tipped back, we want his nose not touching the breast. (His chin should be properly buried in the breast - you would have to shift a lot of boob to find it.) If his nose is touching the breast, if you shift him a tiny bit in the direction of his feet (being sure not to hold or even touch the back of his head), without unlatching, then that should tip his head back and improve his latch.

1. The fact the pain is variable hopefully means this is about latch rather than something more difficult to fix like tongue tie (has anyone checked for that?).

Oh, and 4. What part of the country are you in?