Breastfeeding struggles - advice/encouragement?

[MentalMum1]

Hello all,
This is my first time posting and I am a first time mum to a gorgeous 6 week old little girl. I was adamant throughout my pregnancy that I was going to breastfeed for the first year and tried to prepare myself by reading books, signing up to NCT. I'll admit that I had always been (secretly!) judgemental of friends who gave up breastfeeding after a few weeks, assuming that they just weren't trying hard enough. I think I am being taught my lesson now!!! Apologies in advance for a long message, I want to try and write all the facts to get any possible advice! :)
From the first night with my daughter my nipples got really sore. My latch was checked by lots of different midwives who all felt that it looked okay, but it continued to be painful. My nipples cracked, scabbed and bled and I started using nippleshields as it was the only way I could bear to feed her.
I tried different positions - mainly the football hold and laid back position, but neither significantly improved her latch.
Eventually on the recommendation of an NCT breastfeeding counsellor I went to see a tongue tie specialist/lactation consultant, who diagnosed a posterior tongue tie, and we chose to have this treated when she was just under two weeks old. This did seem to improve the latch slightly, but not completely, and I continued to use nippleshields because it was just too painful without. We've had follow up appointments and she now has good tongue mobility after the op.
We also used novogel dressings to try to heal the cracks.
The day after the tongue tie op I saw the LC again as I was in so much pain and she diagnosed thrush as I had constant burning and throbbing in my nipples, couldn't bear them to be touched by anything, and I have hypopigmentation on my areola. She prescribed me a 10 day course of fluconazole, Daktarin cream for my nipples, Canestan for my baby's bottom (which had a red rash) and Nystan for her mouth (she had no symptoms but it was to prevent her catching it orally from me). I finished the fluconazole and continued to use the cream for a couple of weeks. We have now both finished treatment for thrush.
A recent nibble swab and milk culture at my GP didn't show any thrush or bacterial infections, but my nipples are still sore and hypopigmented (although thinking back I actually think they have been this way for some time, starting during my pregnancy).
I've now been referred to a breastcare clinic to see if there is anything else going on, but I haven't got an appointment yet.
I've been feeding pretty much exclusively for the past 3 weeks using the nippleshields. A week ago I fed her for a day with no nippleshields and ended up with what looked and felt like a friction burn at the base of my nipple, where her tongue had been moving. I then used the nippleshields constantly again for a week and this week started again trying to introduce some feeds without the nippleshields (After going out without them and being forced to!).
Initially she seemed quite confused the first time I tried to feed her without the nippleshield, so I'm now trying to do at least one feed a day without nippleshield, but today have managed a few. She now seems to open her mouth wide enough, but will immediately pull back so that her latch quickly becomes shallow. I can feel her tongue again at the base of my nipple, but I'm very aware that I've lost all concept of what a good latch should feel like and that my nipples/areola are still so oversensitive sometimes it's hard for me to localise what I feel where! She still sometimes becomes extemely fussy when I feed her without the nipple shield, pulling back, twisting around, pulling off but then immediately screaming until she latches back on. She has had a few issues so sometimes I think this is due to wind, but it definitely seems to happen more when we aren't using the nipple shields. I think I do have a strong let down, (and sometimes feel it very painfully) but I don't think that's the issue as it doesn't always bother her.
Oh, and we have started having cranial osteopathy on the recommendation of the LC, had two sessions so far, I think it might have helped a little but then again I may just be imagining things/wishful thinking!!
Anyway, this post has got far too long, congratulations to anybody still reading!!! I guess I'm just looking for some advice about improving her latch, what I can do to help my nipples between feedings (the LC told me to stop with Lansinoh the first time I saw her, as it was preventing the cracks healing and allowing the thrush to breed) and just general encouragement if anybody else has been through a similar situation and it got better!!
Oh and also I express milk (which I also find quite sore!) and my husband gives her a bottle in the evenings to give me a break, particularly if she wants to clusterfeed which I find very difficult and painful. She is gaining weight, although slowly and is on the small side (25th percentile and today it seems from weighing her myself she might have dropped down into the 9th).
Thanks in advance and sorry for the rambling!!!! :)

Good on you for keeping at it, it's not easy!

I would maybe exclusively pump for a few days to give your boobs a break. I had some problems at the start (nothing like yours by the sounds of things) but got through it with nipple shields and expressing. You need to give your nipple a chance to heal.

Chocolate will also help

I can't help much with advice, but just want to say you've done bloody well to stick at it this long, and I hope you find a solution soon.

Not that it helps much with latching, but l love multi-mam compresses - so soothing. Especially if they live in the fridge! Boots do them, you might have to order online unless you're near to a bigger store though.

Well done for continuing. While I didn't have thrush, the first 6-12 weeks with my first were very difficult with various issues. He also dropped centiles and ended up on the 9th (which as a now 12yo is probably his natural line). I did breastfeed him for a year and it got easier month by month. Don't worry and remember that different scales can give different weight when they are tiny a small difference can put it all out.

Kellymom.com is a great online resource and it is well worth trying different holds to see if that helps with an improved latch. The time spent in getting the latch correct is well spent IMO. Do you have local breastfeeding groups you could go to? Go to as many as you can, even if you go to one a day there will be friendly supportive faces. The ABM have good online resources too and there is a lady on here TikTok who gives the most amazing advice. Good luck.

Thanks for all the encouragement :) I don't think I could be organised enough to exclusively pump for a few days but next week we're staying with my parents for a week so whilst there are plenty of hands to hold baby I might try to express a bit more and do a bottle or two more per day to give my nipples a bit of a break! I've been trying the football hold too but not sure it's much better, I think one of the main things is her pulling back no matter what I do! I wondered if it might be strong let down but I tried a few things suggested on Kellymom and La Leche League but it didn't make much difference so maybe not!! I'm really hoping that as she grows her mouth will just get better and make it easier naturally! I did go to a couple of breast feeding places and did find it useful, I haven't been since I started seeing the lactation consultant but it might be a good idea to start going again to see if anyone can show me the miracle position!!! ;) have a lonely Easter everyone X

Wow so many interventions in such a short time :(

How about returning to shields and just using them for the forseeable? They are a nuisance but your dd has thrived with them. They are a practical tool and there is nothing inherently wrong with them if they are working for you.

Cranial osteopathy, thrush meds, tongue tie treatment, loads of attempts to check latch, creams and gels. The only thing that's helped have been the shields, as far as I can see.

Well done so far! Just to say I bf DD1 successfully for a year using nipple shields, if it saves your nipples and makes your life easier it's always an alternative to stick to them. Think it helps with fast letdown too - am currently feeding DD2 without nipple shields, and suddenly I'm spraying milk everywhere...

Well done for doing so well despite all the issues.

I too had thrush in the breast / on nipples which added to the pain. I too started expressing to give myself a break. However from a friends advice, she thought the expressing might be contributing to the soreness. I stopped expressing and introduced a bottle of formula in the evening at cluster feed time!! This was the best thing I tried, it gave me a break for about 6 hours, the soreness went, and a very content baby. She is now 4 months and we have continued this regime.

Tiktok; I had actually decided to just continue using the shields and not worrying about it for as long as needs be, but then it started to really hurt with the shields! I think that sometimes she ends up clamping down around the "nipple" of the shields which then clamps on the base of my nipple, and ends up very sore. And I found it hard to encourage her to latch better onto the shields because the nipple bit was so big. However, I am still using them if it gets too painful and am making sure they are always in my nappy bag in case! :)
Scandichick; thanks, that is encouraging to hear as you hear/read so many things about nipple shields being evil etc and at one point my supply suddenly dwindled in one breast and i was convinced it was the shields (of course it wasn't, and it had evened itself out now!) which freaked me out! It's always encouraging to hear that it does work long term so I don't need to stress about that. I've also had a lot of milk spraying everywhere in the last couple of days!!! :/
Danger mouse; I was also thinking too today that at some point I might start combination feeding to give myself a bit of a break sometimes, as I do find expressing can make me sore as well. So good to hear it's working well for you :) I think I'll give it a few more weeks just to ensure my supply is really established.
Thanks again for all the encouraging words :)

Different shields might help? Some types come in different sizes. Check internet. Sounds like yours are too narrow at the end of the nipple bit and maybe too short.

i had similar issues though nipple shields didn't work for me. You said you've tried laidback position (biological nurturing?). I found that doing that but almost upright, so sitting in a chair rather than bed, worked better for getting baby to position well and go for a big latch. Only worked for us while he was little once bigger we changed to other positions.

I had similar issues with feeding my first baby. I gave up around 8 weeks, as it was just making life so miserable all round , so you are doing really well to keep at it and stay positive.

Just a word of caution about expressing. I found an electric pump just gave me an over-supply and made my violent letdown even worse. My DS was pulling back spluttering and choking at every feed.

I would also say - stick with anything that works. So if thats the shields, thats fine. I also had masses of intervention - NCT BF counsellor, La Leche, HV etc - and none of their suggestions helped. Breastfeeding is definitely an art, not a science, and what works for one person might not work for the next - no shame in that.

Tiktok, I think I have every variation of nipple shield going!! ;) my favourite is a Medela one and although I was using the medium I also have the large, which the LC said was too big for baby's mouth but she still got a decent feed through it so I guess I've the option of using that again if the medium is still hurting. It's easy to forget all the choices/tools I have when in the throes of pain and frustration!!
As it is I've managed to feed exclusively without the nipple shields for I think three days now, and although her latch is still uncomfortable, verging on painful at times, it's nowhere near how excruciating it used to be, and using a combo of this olive oil based stuff and lansinoh seems to be keeping my nipples in reasonable shape. We've just come away for a week and I was planning on upping the expressing a bit whilst I have my mum and dad to help to give my nipples a break, but Sod's law I broke my pump this morning!!! :/ I have a feeling I'm going to survive though, and I have some bottles of formula if not! :)
Thanks everyone, feeling an awful lot more positive than when I first wrote this post!! Enjoy the rest of the long weekend X

Both times with my two babies it was painful for first fortnight of feeding. Even though I was repeatedly "it shouldn't be". But it just got easier, becoming less painful - I guess as baby feeds more efficiently and nipples toughen up (nice!). Stick with it!!

I used nipple shields continuously for 6 months! I desperately wanted to bf and dd wouldn't feed without the shield, then one day at around 6 months, she knocked it off and she continued without. If you are in pain I would advise to continue using the nipple shield, I didn't get any pain or problems with nipples, I've heard they don't advise it but using a shield long term worked well for me and dd

Just as I thought we were starting to get the hang of it.... The last day or so she has been ridiculously fussy at the breast. Sometimes she'll have a good ten mins or so of a good feed first, and sometimes switching sides snaps her of it, but other times it's right from the beginning of the feed. she'll cry and open her mouth to latch on but as soon as she feels the breast in her mouth she'll pull away and cry again. It's not my let down as this is before I've felt the let down and there's no spray or anything. It's on both sides so not her usual preference for the left side. We did have a long car journey yesterday to visit family and then another long onward car journey today to visit my parents, so two new environments in as many days (although seemed to cope v well yday aside from the fussy feeding and slept for 5 hours straight last night which is almost her personal best!). I know she's hungry as I managed to express almost 90mls milk for my husband to give her a bottle and she guzzled it down with no problems... Any advice? I'll try to express again so we have a bottle to give her overnight if this keeps happening but I'm worried that too many bottles will make it harder for her to accept the breast. She's been crying constantly for about the last 45 minutes which isn't like her usually :(

She's hysterically hungry and actively fighting when I try to feed her. I'm trying to express but hardly anything is coming out so I'm having to give her formula for the first time :(

Do you have a breastfeeding support team nearby that you can call?

I found feeding very painful for the first eight weeks and then afterwards it must have been about 4 months before it was pain free.

Instead of formula can you hand express and try a little cup or syringe feeding to take the edge off her hunger and let her settle.

You have my sympathy, we had big challenges and it was very tough but we made it through. I can see why people stop.

Also. Have you had a look at Reynauds syndrome and breastfeeding- can make feeding really painful unless you stay really warm.

When I was struggling with feeding j just decided to stay at home until we had feeding established and people could just come to me. A few friends/family thought I was a bit odd but now I'm so glad I did it. Something we don't really do in our culture.

And....if you are on Facebook I can recommend a group for breastfeeding buddies?

I am a la Leche league peer support worker. You have a lot of knowledge and have done a huge amount in a short space of time. It's pretty difficult to relax with all this going on but try not to over think everything and see if you can try to keep things simple for you a baby.

If baby pulls off a little, it sounds like she may have developed a bit of a habit which effects her latch even though she is opening her mouth wide to initially latch, her mouth should remain nice and wide and full of nipple.

I have bf 3 babes, have endured thrush and much anxiety about it. With my 3rd, she would pull back a little (readjust herself) and would just suck the teat (sorry technical name not coming to me right now!) part of my nipple, so she wouldn't have a full mouth of nipple and this was evident by her cheeks not being full AND excruciating pain! I just removed (using a little finger to break the seal) and reattached over and over again until we got it right. If it wasn't painful I could continue the feed so worked on the premise that we had a better latch. This went in for quite a while and I had moments of lost hope, having fed my other 2 I felt really disappointed at the thought of not being able to continue. But latch is everything and imo the greatest reason for sore nipples.
We are still at it now and she is nearly 2!

I have never had to deal personally with a tongue tie but a clicking sound (taking in air/poor seal) is a clear indicator, if u don't have that this may just be hyper worry. You know so much about bf and are probably too subjective to a analyse it properly. A good be advisor who you trust and feel confident in is a great support, try not to source too much info from too many places. Try to rest, concentrate on you when baby resting, don't rush around too much, there is nothing wrong with staying at home, keep trips out short, have people come to you so you can socialise and relax, feeing in your home environment where you can repeatedly reattach with the freedom of being in your own home.

That's all I can offer in the advice department. Think you are doing very well so far, you are clearly a dedicated mum who will raise a happy healthy child regardless of breast milk or not. And even though I advocate for bf, it's really not the be all and end all. Look at the adults around you, it's impossible to know if they were bf'd or not. In 6 months time baby will be eating real food and in one year cows milk will be a regular part of her diet.

I wondered if you'd tried some laid back feeding. What I find with babies that 'slip' to the base of the nipple is that gravity really works against them. Lying back whether with them in an upright position or more traditional or side lying seems to reduce the effect of gravity and stop them slipping.

Some babies also seem to learn a more bitey (up and down) style of suck on nipple shields and bottles and this is not so effective on the breast and they get frustrated and cause nipple pain and slip. Sometimes it seems finger feeding helps them practise a more effective sucking pattern (could your LC show you if you wanted to try)

Do not beat yourself up about the formula. A fed baby is the first priority.

Thanks guys, once again lots of really helpful comments :) thank goodness I am at my mums this evening so she has been helping me and my husband weather the storm the last few hours!! She had a few mouthfuls of formula then refused the bottle also. I gave her some gripe water and finally she has done two huge burps and literally passed out (she hasn't had a proper nap for the last 8 hours either apart from a short nap in the car so is also grossly overtired).
I don't think her tongue tie has grown back as I can see how much more movement she has in her tongue. She does have an upper lip tie but our LC and the surgeon who did the snip (who also runs the clinic at Kings College Hospital) said there isn't a strong evidence base in the uk for that making much of a difference and apparently there's only one guy in London who does treat lip ties.
The tip to give her expressed milk in a cup is brilliant, I managed to give her some gripe water with a spoon so if she's still fussy when she wakes I will try to spoon feed her some expressed milk. I'm really hoping that she'll have a long sleep, pass some more wind and wake up ready to feed again!!
Re Reynaulds my LC did briefly mention this as the tips of my nipples do go white but I think this is to do with baby clamping as they also go white if they get squished in a weird position inside my bra!! Doesn't seem to be particularly affected by hot/cold. I did get some of those lansinoh things, more thinking for the cold soothing element but might try them hot too to see!!

I have tried laid back feeding but she just bobs her head around and can't find the nipple even if I place it in her mouth!!! I've also tried with her sitting up on my knee but same thing. Sometimes I try a kind of football hold with her at an incline which sometimes works for a short while...