Help with engorged boob please!

[Kione]

DS is two weeks old and has a mild tongue tie, they said the latch was ok and didn't need cutting.
He has been feeding and put on weight but my nipples are really sore and worst is one boob gets really full and sore, the other not so bad.
How do I make them even? I am tempted to just use the full one but I know that's not right as it will just keep producing. I think it is already overproducing as milk just pours out.
Any advice please?
Midwife coming tomorrow but I don't find her very helpful. Breastfeeding group not on til next week and that feels like ages.
Help please!
Thanks.

I'm no expert so maybe someone will be along who knows what they're talking about. I can only speak from experience, I've expressed from the sore engorged boob when that's happened to me. I didn't pump or use stimulating expression around the nipple, I just used to apply gentle pressure higher up on boob wherever it felt full and hard. And only expressed enough to relieve the discomfort then allowed DC to feed from alternate boobs as normal. It's always settled fairly quick within a day or so. Tho I do think one boob is bigger than the other all the time since I BF.

It will take a few weeks for your boobs to settle down completely. It's common to have one producing more than the other. Offer both to avoid blocked ducts and to stabilise the production. Sore nipples at their worst about now. Lanolin is good to help them heal between feeds, or best thing is to put breast milk on them and air dry. I remember latching DD with gritted teeth but it should get easier and feel better from here.

If you get an actual sore lump or blocked duct, get DC to feed from that boob and massage from behind the blockage/lump to the nipple to try to clear it. It's absolute agony but should clear fairly easily.

Hand express a bit - in a warm shower always helped me. Make a large c shape with your thumb and first finger and place it around the whole breast, apply light pressure and draw your hand towards the nipple, kind of taking the skin with you if that makes sense. Make the c shape smaller as you go inwards. It takes a bit of practice at first but the relief is instant.

Any hard bits/blocked ducts then get your son to feed/ hand express until they've cleared. Keep alternating sides as you have before.

Most of the mums in my antenatal group had a 'turbo boob' so don't worry too much, it will even out in time as long as you keep alternating

I suggest you get a second opinion on the tongue tie. My dd had tongue tie that a lactation consultant said wasn't worth cutting, however as feeding was very painful I went to a different one who said she was happy to cut it, it might help or have no effect. The pain INSTANTLY stopped.

Breastfeeding shouldn't really hurt, not beyond a few days getting used to it, if it is then something is wrong.

My boobs became uneven as my dd couldn't latch (before the tongue tie was diagnosed) to the left one at all for a while and it has never evened up despite pumping, giving her that one first, everything. If you are engorged on one side it's best to get it emptied even though you want to even them up, as otherwise you're risking blockages and mastitis.

Good luck, painful breastfeeding can be so miserable!

As a PP said I would also get a second opinion on the tongue tie. My DD had quit w a severe tongue tie and feeding was very painful. I had already fed my DS so knew something was wrong. When I saw my GP, health visitor and midwife they all said that nothing would be done about it unless she started losing weight regardless of the pain I was in! So we went private and saw a lactation consultant who was happy to snip it there and then. The relief was instant and feeding so much easier and better after.

In regards to engorged boobs I use an electric breast pump to relieve the pressure and get off what I can. They will settle after a while but I still get it now in my right breast if my DD sleeps through the night and have to pump a bit off. Hope that helps!

Agree about the tongue tie. It is actually impossible to say a tt is "mild" just by looking at it. It all depends on the way the tongue works with the shape and size of the baby's mouth, your nipple etc. Some babies can feed fine with a fairly "severe" TT, others can't feed with a so-called "mild" one. Please do get it seen by someone else. There is little downside in snipping tongue ties afaik so if in doubt I'd get it cut. (Obviously by someone reputable).

It sounds like you may have fast let down too (I did) - if so, then side lying feeding or laid back feeding works well to combat this. However you do need to have a good latch for these positions so get the tt sorted first.

Watch out for blockages. Constant vigilance and massaging any lumps - especially if they are sore - is the way to go. Hot water or heat pads help. Lecithin as a supplement can help if you are getting repeated blockages.

Can you afford to see a private lactation consultant? (usually about £100-150).

Thanks for all the replies, going through them now.
I am asking the MW tomorrow to tell me who to speak to aboutvthe tongue tie.
We live very rural and I don't think there are private lactation consultants, I will ask tho as I would pay anything if it helps.
I tried massaging the engorged boob this morning and nearly passed out, I am very squeamish. I do massage it while he feeds and feels better after, but it fills up quicker than the other one again.
The evening out I mean so the other one doesn't get engorged too, I couldn't care less about the size or look of them, its just if I keep feeding from the engorged one won't that mess the supply in the other one? That is my worry.
Thanks a lot again... Will read all suggestions slowly now. Thanks again.

Are you in the U.K.? If you are then you can find a registered consultant here: www.lcgb.org/find-an-ibclc/

Sorry I don't know how to do clicky links!

You may be able to get this on the NHS but it will probably be quicker privately, the consultants are used to seeing mothers quickly as it's so important to get care quickly to keep breastfeeding going. The tt cut takes seconds and only a few minutes prep. Obviously it might not be a magic cure and it might still not be possible but it might be well worth a shot!

We live on an island and no private lactation consultants, just checked your link thanks. So only option is NHS.
Can the engorgement be also caused by bad larching/tongue tie? After a very traumatic birth am terrified of mastities more pain and more needles :(
If it wasn't the fear of colics from bottle/formula, I'd give up breastfeeding in a heartbeat, I hate it and its doing the opposite of boding with my son

Bonding

One thing I found helpful was to put a clean hot (damp) flannel on the engorged one prior to feeding - just rinse in hand hot water from kettle. It makes you let down some of the milk so that the latch is possible. Otherwise your nipple can become so taut that baby cannot latch, irrespective of other problems. This was on a MW advice and worked for me.

If you hate breastfeeding and it is preventing bonding, then just stop. Colic isn't automatically a given and isn't associated with eithe type of feeding. Your last post sounds miserable. It makes me sad to think of you in pain and miserable. There is an alternative.

I saw an excellent lactation consultant called Geraldine Miskin. She will do consultations by Skype. Not as good as seeing someone in-person, but she is really good and it might be worth a go.

Yes engorgement can definitely absolutely be caused by bad latch and tongue tie.

And yes, you need to get the boob softened a bit (at least the bit around the nipple) before you try to feed, or else the baby won't be able to latch whether there is a tt or not.

Plenty of babies are bottlefed without colic. And BF babies get colic too. Please do stop BF if you want to.

My engorgement was caused by the tongue tie, after it was cut it went away and hasn't come back.

If breastfeeding is something you want to do, it doesn't have to be painful, and I can help you find online / phone support to get through this rough patch.

BUT. If you don't want to keep breastfeeding that is 100% fine too.

However if you are engorged then suddenly stopping bf completely will probably make it worse. Do you have access to a good electric pump? Could you try pumping and bottle feeding your expressed milk? It might give your sore nipples a rest while also reducing the engorgement rather than stopping completely right away.

I don't want to sound like I'm pushing you to breastfeed. If you want to stop that really truly is fine, but if it is just the pain and engorgement that is the problem then I hope it helps to know that it doesn't have to be that way!

If it were me (this was me actually!!) I'd push to get a tongue tie referral.

1: Our latch was apparently 'perfect' (it wasn't - it looked it from outside but clearly there was a problem inside that wasn't visible!) so YouTube exaggerated latch or flipple technique - that saved us when I was about to give up at 6wks - by just after 7wks we were pain free thanks to this!

2: tongue tie can cause pain, it can cause speech problems etc etc. Midwives kept telling me it would be fine and latch was fine. I demanded in the end to be referred and the specialist advised us to have it cut to improve feeding and speech later on. She said she will never do a division unless she thinks it would help.
Push for it. After a certain amount of time it becomes MUCH more difficult for referrals etc. Ours only do divisions on babies within twenty something days so get on it quick!!!

PS just seen about lactation consultant - we got my sons TT cut on NHS but had to get pretty stern with midwives and demand referral so we didn't run out of time

Have you tried a cabbage leaf in your nursing bra? I had the same problem. My left boob produced amazingly but was constantly engorged and painful. My midwife recommended this. This was a few years ago now so someone correct me if this isn't the done thing anymore! It should help with engorgement though.

Also - if you are struggling with breast feeding, have you considered expressing and giving the expressed milk in a bottle between breastfeeds? My friend even did this exclusively (although it did limit what she could do). I always woke up with one ridiculously full breast and one that felt full but within normal 'limits'. I used to feed from the less full one and express from the turbo boob - this milk was kept for the evening and given by dh before putting baby to bed. Because there was always so much milk, dd always fell asleep very soundly. Sometimes I'd express in the evening too and store in freezer for emergencies. It worked really well for us.

Hope you find a solution. X

If you want to speak to someone on the phone about it, there's a helpline here: www.nationalbreastfeedinghelpline.org.uk

But as I said, don't feel pressured either way, I just know how crap it all was with dd's tongue tie and I was lucky to have had a lot of support, without which I definitely would have switched to formula. Which would've been fine but wasn't what I had wanted before the birth.

Thanks again. See with DD I stopped breastfeeding and colic started immediately after.
DS is very big and we where told to top up with formula, and he had colics 3 nights, so I stopped the top ups and colic stopped. I do think in my babies they are related.
I tried to express and bottle feed but I found it very very time consuming, with having to clean and sterilize bottles too, and I read it gas to be done every 2-3 hour during the night too, so this and feed the baby, I can't see how it can be done and keep sane!
I will push the TT issue tomorrow and let you know.

And I have a Mothercare electric pump that I think is fairly decent.

Just to say that there is also 'Lip Tie' which can cause problems.
Im sure DD has it as her top lip does not touch the bottom one & BF was absolutely painful.

Its definitely tongue tie as it can be seen.
I am apprehensive about the cut tho, if it hurts and then he won't feed at all.
I know I sound so negative with all these worries.

Nothing is quite as wretched as what you are going through now. I have 3 dcs and had a comparable birth, engorgement etc. I did the Cannon, hot flannel, express etc.
a nurse from the Phillipines came in, took a look at me, got ice pads to slow down my milk, rubbed my back and held me as I wept in her arms. After about 10 mins it started to work. And very slowly and gently she swiped her hand, Palm down from my collar bone to the nipple to make sure nothing got lumpy. She was a marvel and oh so kind. DC is 6 now and I still remember her and her kindness.
Most of all though,Moshe went against the grain and it really worked for me. Then do get the child treated. Most of all though op, remember that it will ease off in little bits. But for now, terrible pain. Hugs to you.

And you don't sound negative. You sound like all of us, anxious to do the the right things and worried about making things worse!