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!!!! :)

Apparently she does have an effective sucking pattern on the finger which is frustrating! I do think she's getting better though as my nipples are definitely coming out more elongated and although they're mainly odd shaped, sometimes they're not!!!
Re staying at home, I find being out a bit more helpful to be honest as at home I spend too much time obsessing about feeding!!! :/ I know she may pick up on my anxiety sometimes but today is completely not that as if anything I've been getting increasingly more relaxed about feeding since my first post! :)

The Facebook group would be great thanks :) I have quite a few breastfeeding cafes near me including one which initially suggested she might have tongue tie, and I am planning on going back there next Monday!!!
Sorry for so many separate replies, on my phone with sleeping baby on my chest and I can't scroll back through responses whilst replying!! :)
Keep your fingers crossed that we have a successful feed when she wakes up!!!!!x

I think you are doing brilliantly to still be going, I may be missing the mark completely but I had a fussy ds2 who we eventually found out had reflux (silent) he could be absolutely starving and not feed, I used a technique which is used for 'nursing strikes' to get him to feed, by standing up and swinging him around my body (imagine the lack of elegance, with one boob out and him in a read to feed position with head near nipple and his tummy against mine.) not one to try when the in laws are round for tea, but I found it would sometimes get him started or at least take enough milk for me not to be fretting about him becoming dehydrated! The other thing I would do is feed him as he woke. Whilst still a bit sleepy and disoriented? Do hope you are ok, sounds like you've had a very hard time if it X

If more baby led laid back feeding doesn't work then you might find attaching her traditionally then leaning back works. Shaping the breast also seems to help babies who slip. Keep going, one thing I've found tends to be true with babies who do this they get better as they get older! (Not that this helps you now)

Also really tilting them when they've latched (tuck bum and chin right in) so they've got that head extension often makes it better

DS used to pull back on first latching, my local BF midwife told me to take him off the breast (using little finger in the corner of his mouth) and get him to latch on again, until he stopped pulling back. I thought it sounded mean but did it, and it worked for us.

OP my experience BF DS1 was exactly the same except his tongue tie wasn't diagnosed until he was 3,5mo. But yes, thrush, clamping, nipple blanching, shallow latch, strong let down, nipple shields and all.
I am still BF him now at 14mo :)
What worked was:

• slowly cutting the tip of the nipple shield, a bit more everyday to get him used back to bare BF
• fluconazole for 3 weeks (yes!) + daktarin on nipple before every feed to treat us both
• hot breast pads straight after each feed (the lansinoh ones are really good) to avoid nipple blanching
• oversupply protocol, you'll find info on LLL (empty each boob then block feeding for 6-8hours)
• pacifier (latex with massive shield) so that he could suck but without food coming
• BF on my side in bed or on my back with him perpendicular on top of me
• and of course tongue tie snip (same here, was told lip tie doesn't need to be dealt with)

Good luck

She just woke up and has a small but peaceful feed, thank fuck!!! :)

Oh you poor thing, I can relate to nearly everything you've written about with ds. He had severe tt, was snipped at 4 weeks but not much improvement in pain for me and still nipple fed mostly. Thrush diagnosed repeatedly (incorrectly imo) nipple shields, forceful letdown/oversupply and 91st centile baby dropped to 2nd. Excruciating pain for about 11 weeks and then it got better and we fed until 15 months. I think he just had a tiny mouth and it needed to grow. I have vivid memories of both of us in tears during feeding, with me unlatching and relatching him trying to get the 'perfect latch'. So much conflicting advice was handed out that was the most stressful part! I tried formula when he was about 7 weeks old, and he refused it (and never did take a bottle). I believe his tt grew back a bit as we had a nightmare weaning him onto solids and issues with holding food in his mouth.

I'm glad we continued BUT for me it really fucked up our bonding for the first few months and has had a long lasting effect. He's 4.5 now and we're making good progress with bonding happily. That may well have been more about me than the situation, but I would say do what is right for you and your family. It's ok to not breastfeed. Welcome to pm me if helpful.

I went onto have dc2 and similar issues re tt unfortunately, but less pain and we also fed until 15 months.

Good luck and congratulations!

Offering sympathies. I have been through similar levels of bf hell twice and both ds were bf to 20mo for ds1 and over 2yo for ds2 (eventually I was like 'no more boobie!)

So it does get better and I reckon you will start to see improvement over the next 2 weeks as her mouth gets bigger it gets easier.

There are lots of very useful youtube videos with tips on how to get a good latch. Like you I have tried every style possible. Eventually something sticks and it gets better. I wish I could remember the titles but I've recommended them before so perhaps do a search on my name posting in feeding.

I don't mean to contradict what you've been told but for me constant Lansinoh was the only thing that saved me from going down the route you have with the cracked nipples. I would in your shoes go back to Lansinoh before and after feeds and as much air as possible to the nips. I hate sitting around boobs out so would lie around with a muslin cloth draped over the boobs and air really does seem to help heal.

I did throw in one or two bottles of formula when things got really bad (ds1 was 'prescribed' it at birth due to low blood sugar so I was more relaxed about it for ds2 and when the shit really hit the fan (mastitis, abscess, grim) I handed him to dh and ordered him to give him formula and I went to bed for the night (I don't know why I feel the need to justify it like this but there you go). So I guess I'm saying if it gives you a break then an ad hoc ff won't hurt if your dd doesn't react badly to it. Just try and keep up supply and don't let it replace a regular feed as it's a slippery slope to losing your supply.

So mainly here to offer sympathy. And to say it can be done and that it's worth doing for many reasons that aren't all health related, I think whilst it is good for you and for her the convenience of bf is worth sticking it out for. It gets a hell of a lot easier once baby weans as well and in the meantime the fact that you can personally sustain a life for 15 months (pregnancy through to weaning) is so amazing.

for doing so well so far.

Thanks guys :) she has just slept for 7 hours and now feeding well!! I've read an awful lot of people saying about their little ones mouths just needing to grow so I'm hoping things naturally get better in the next few weeks. I have started using lansinoh again and also a herbal nipple cream an American friend sent me and have struck a combo of herbal first to moosturise and soothe nipple then lansinoh on top to protect! The only thing I find is that her face gets covered in a sticky mess and she is already so spotty bless her I don't want to make her skin worse! How do ppl get around this? Just wiping face after feeds I guess?

Please make sure that the herbal stuff is safe to use when feeding and does not have to be removed for baby? Not all creams are suitable for baby to ingest. Lansinoh is. I'd doubt two different creams are required as just Lansinoh and some breastmilk air drying would hopefully work but like I said please check the baby can eat the other stuff

It says its safe to ingest. It's mainly olive oil. I don't really find lansinoh on its own soothing at all and find rubbing it on hurts :/

Come Nurse With Me - Breastfeeding Buddies Uk is the fab group.

I certainly found it got better as she got bigger. During growth spurts my milk would be so fast flowing she would pull on and off continuously and I would be back and forward in different chairs and positions and feel like I was going crazy. Have you also tried feeding lying down? I struggled because she had poor head control but it then meant that the milk flow wasn't as bad for her, pop a towel under you if you try though.

I used to kick furniture and use my labour breathing for ages.

How are you doing today OP?

You are doing great. Just one thing which was helping to latch both my boys when they were little and too tired or too hungry to latch nicely and just cry (usually evenings). I used white noise created by my hairdryer, full force. I'd sit in bed, dark room, kept it by my bed, and would turn it on before trying to latch. It worked magic. No other white noise (I tried various apps) made difference. They did not need it for most feeds, but it worked magic when they were too overwhelmed/tired/hungry and just screamed instead of latching. Maybe worth trying?

Doing much better today thanks ALongTimeComing. She slept loads overnight and has a couple of long naps this morning with some nice settled feeds in between. I think the poor thing is still suffering a bit with wind ( which I ironically had thought was less of a problem since stopping using the nipple shields! Although maybe that's part of the problem as maybe I stopped winding so vigorously!) so have bought some infacol and trying to feed her lots today to make up for the last two days of fussiness. Latch wise she seems to be doing ok , still not hugely wide but it's not painful, unless she I latches for a second and flicks her tongue over the tip of the nipple where it's still sore - ouch!!
I might try the white noise thing, I have an app but maybe need real live noise like hairdryer, I'll give it a shot thanks!
Thanks everyone for all the support and encouragement :)

Brilliant! I remember thinking there was no way I was going to make it to three weeks let alone six weeks and now nursing a one year old.

One more thing for now- Google the flipple technique for latching.

Ouch, fussy baby and lazy latch overnight.= sore nipples :(

You have been through the mill op, I've nothing useful to add as I'm new to this mother/nursing thing to. I use a boppy pillow when I nurse, more for my sore arms than anything else. Hope everything goes ok for you

Apparently nippleshields are so thin and flexible nowadays they can be used long term, if you want to.

I'm pg with DC3 and have had limited success with bf in the past. This time, I've shields at the ready!

There's also loads of videos on YouTube that might help. I've been watching them in preparation.

Give yourself a pat on the back for getting this far!

I had heard of the flipper thing but thought it was just the nipple sandwich thing. Turns out I've been doing quite a similar thing so maybe that's helped things. I'm encouraged by all the nipple shield users as I can know that if it gets too sore I've always got them as back up! For now I'm stubbornly going without as I don't want to ruin any progress with her latch... Even if the progress is only in my mind!!

Keep going, it does get better! Have you got a boppy cushion?

Yeah I have one but I don't really use it as it seems to make her fall into me which makes it really hard to latch her correctly as she already has a tendency to lean forwards and burrow into my boob rather than tip her head back like she's supposed to! I was looking at the my Brest friend pillow but they're so expensive and no idea if they'll be any good or not!

I used it for rugby ball position so was different but was a god send. Don't feel bad about using cushions and pillows. I thought I'd never manage it outside the house but you learn and they get bigger.

How's it going today op?