Close to giving up!

[TippetyTapWriter]

Gave birth to dd 4 days ago. Second dc but couldn't breastfeed first time round and was hoping this time would be better. It's not!

Had a planned c section, but did some skin to skin in recovery and dd latched on. It was uncomfortable for me but my ds never managed to latch so no idea what it was meant to feel like. Dd cotinued skin to skin in ward, latching often then falling asleep. Over 24 hours it got more and more painful for me until nipples were cracked and bleeding and I was in tears at the thought of it. Google suggests shallow latch is the problem but saw multiple midwives and breastfeeding peer support worker who all said latch ok and gave same suggestions. Tried nipple shield but my nipple tore the minute dd latched on to it and the whole thing was full of blood!

Decided to rest my nipples for a bit and hand express colostrum and give formula top ups as dd very hungry and slightly jaundiced.

Saw lactation consultant today who didn't seem to approve of this and had little sympathy for my pain. Said I needed to put dd to breast or pump every two hours. Today my milk also came in and my breasts are engorged and painful. LC watched dd feed and said she isn't even feeding just 'nibbling', so all that pain and she hasn't even been getting any milk! I've tried pump to reduce engorgment but can only get a tiny bit of milk from one breast and nothing from the other. Even hand expressing which worked before isn't working. Scared my boob is going to explode! Or more seriously that I'll get mastitis. And my dd is still living off formula...

LC has diagnosed a tongue tie but said it isn't restricting movement of tongue so isn't causing the problem and nothing can be done anyway until dd is 1 week

Argh. Sorry this is long but what should I do? Nipples are too sore to latch dd, hand expressing and pump aren't working, my breasts are so painful and I just can't see how this is ever going to work!

HOw are you doing OP?

Thanks for asking namechange. Still persevering though actually decided to give up yesterday morning. But had a lovely midwife home visit and her basically saying it was ok to give up made me realise how much I didn't want to. Tried a warm bath and eventually managed to hand express a couple of drops which inspired me enough to keep going with the nipple shields. They help a bit but still very sore and bleeding. Also dd either knocks them off or they slip so finding them quite frustrating. Also when she latches they seem to unseal around the edges and I'm wondering if she's sucking in air because she's really really windy and uncomfortable after every feed. She also hiccups when feeding and makes a sort of wheezy sound? Still not sure how much milk she's getting. I see drops in the shield when she comes off but can't tell if she's swallowing.

I don't think it's going to improve until the tongue tie is divided. Have you considered trying to find an NHS tongue tie practitioner (using the link I shared)?

Do check you're using the correct size nipple shields - there is a guide here:
blog.medelabreastfeedingus.com/2015/05/medela-breastshield-sizing-guide/

I'm going back to the breastfeeding clinic next week so they'll reassess the tongue tie then. I did find some local people on your list but money is tight right now. If I get no help at the clinic I'll consider it because I suppose a year's worth of formula won't be cheap either.

I'm glad she's at least getting some breast milk, even if it doesn't work out long term she's had colostrum etc.

I'm sure she just needs to get a deeper latch. I keep watching videos about the flipple technique etc but I just can't get my breast to be that malleable!

The link I shared was for NHS practitioners, i.e. free not private! You will just need a referral whether you can self refer or get a referral from your HV, midwife or doctor.

The lactation consultant might refer you I suppose but I'm not confident based on your previous experience with them - I'd hate for you to get fobbed off again and really think you need a second opinion.

That's just my two cents of course, but my DS had tongue tie which was not spotted by any of the midwives, health visitors or supposed breastfeeding experts we saw in hospital or at the NHS-run breastfeeding drop-in. It was actually someone at a charity-run breastfeeding drop-in that spotted and diagnosed it. We went straight to the GP who referred us for tongue tie division on the NHS.

Sounds like you're doing amazingly op. I had this exact issue re cracked nipples and I remember just crying if baby wanted to feed again, it was just so painful.
If you do choose to continue it does 100% get better. Turned out my dd had tongue tie and I had a lovely midwife who fasttracked me to the tongue the clinic as if said I'd had enough.
If you do continue all I can say is once your nipples have healed it's so bloody convenient to breast feed over formula. I did it to save money and I definitely noticed the difference to my pocket once I started dd on formula! All the best. Ps your Midwife's right it's also ok to stop if it's too much!

Have you got any NCT breastfeeding sessions near you? You don't need to be a member to go usually.

Sorry namechange, my mistake. If I don't get any joy when I see the LC I'll try going directly.

Thanks turtleduv. It's tough isn't it! Things have got slightly better on the pain front. Managed a few feeds that were uncomfortable rather than painful. The shields and cream seem to have let things heal. And the engorgment has gone down so I think latching is slightly easier.

Dd just wants to nurse constantly though. I know they do a lot. But it's 10.30 now and she's been on since 6am this morning bar 5 mins here and there when I went to the loo. Every time she comes off and I wind her she starts rooting again and within a minute is crying if I don't put her back on. She's done similar before and I've topped up with 30-60ml formula which she'll drink all of and not posset despite being quite refluxy after bf. She also only poos after having formula which is another reason I worry she isn't getting enough from the breast.

Yeah babies with TT usually feed constantly because they're not efficient. Exhausting for mum and baby.

Constant feeding and mastitis were the telltale signs for us. DS was actually putting on weight ok but that was because of the constant feeding. I was really suffering though with exhaustion and mastitis was the final straw!

Glad things have improved slightly though, less pain and engorgement is good.

Am update to my sorry tale...

Saw LC today. Seems I have low milk supply and dd isn't getting enough. Lost 9% birth weight at day 10 and is hardly pooing anymore. LC said I have to be producing more milk before they'll snip the tt as they only snip them for breastfed babies and baby needs to be feeding well to help clean and heal the cut.

Been told to get a prescription for domperidone from gp. To feed for 20 mins both sides but no point doing it longer as it's not nutritive sucking and isn't going to stimulate supply, and to pump every two hours. Have to supplement with formula after every feed to prevent weight dropping further.

Feeling pretty despondent to be honest. Been trying so hard but it's just not going well!

Oh for Fuck's sake. That makes no sense whatsoever. Of course your DD isnt feeding properly or getting enough milk, she has tongue tie FFS! How on earth can they blame you and your supply, before they divide the tongue tie there is no way of knowing is there?! If she was feeding properly your boobs would produce more milk. Supply and demand.

Please please please please get a second opinion. If you tell us which area you're in we could tell you about the breastfeeding support available near you.

She did say it was a bit of a catch 22. I was confused as she said she's made the referral but they won't do it until dd is 'frenulotomy ready' and this has something to do with my supply as the breast milk and tongue action is needed to stop the bleeding? It sounded like this was the policy at the hospital clinic. I'm in east Kent if you know anyone else I can see? The hv came today and saw the tt and said she'd be surprised if they didn't snip it.

I'm not keen on taking medication. I just tried the first pumping session and got 30ml which I know isn't floods but it's half a feed and at least I know I definitely have milk. I'll tell the LC and see if it changes anything because previously I was getting nothing when expressing.

Now I'm really confused as the tt clinic has just called with an appointment for Monday!

"tt clinic has just called with an appointment for Monday!"

Yay, that's brilliant news! Although the lactation consultant hasn't been great, at least she has referred you. I'm hoping she wrong in saying that they won't divide the tongue tie - luckily you don't have long to wait before you find out. Fingers crossed!

Maybe wait and see what they say on Monday before asking for any medication from your GP.

Thanks namechange. Can I ask what you remember from having your dc's tt snipped? Just wondering what to expect on the day.

Really hope it does help, but scared I'm going to get my hopes up for nothing though I know even without a tt breastfeeding can be really tough.

Sure. We got it done privately rather than on the NHS, so we actually had a tongue tie practitioner come to our house, but I imagine the actual process is very similar. First she asked lots of questions about our breastfeeding journey and DS's general health. Then she assessed DS's tongue function, this was a gentle physical examination where she looked at his tongue and how well he could move it in different directions. I think she also observed a breastfeed. Then she confirmed the diagnosis and explained that she recommended tongue tie division, explained what it would involve and gave us the option to think about it or have it done straight away. We wanted to do it straight away. The actual procedure was very straightforward and quick. She asked us to hold DS still while she cut the frenulum. I was a chicken and asked DH to do it! But he said it was fine. DS did cry a bit but I breastfed him straight away and he calmed down immediately. There was no anaesthetic involved because apparently it's not really that painful for the baby and administering the anaesthetic is actually more unpleasant for them (and not ideal for such a small baby to have anaesthetic). After I had fed DS, the tongue tie practioner gave us some advice - basically keep feeding him as normal, and also encourage him to move his tongue around by placing a clean finger in his mouth, and also sticking out our tongue at him and seeing if he would copy (he didn't!) She also explained how it should heal and offered follow up support if we had any concerns or needed any help with his latch or anything.

Hopefully the process is pretty similar if you get it done on the NHS - do ask all the questions you have at your appointment.

This is a really comprehensive guide to tongue tie, including assessment and division:
sarahoakleylactation.co.uk/wp-content/uploads/2015/12/tongue-tie-booklet-version-3.pdf
(This wasn't the person we saw but I found the guide very useful!)

Sorry you're going through this. My DCs had difficulty latching. No TT. What worked was to hold them under my arm like a rugby ball so they were latching on at the side rather than underneath. Weird but it worked.

Thanks again namechange. I appreciate all the support you've given. Keep worrying they're going to say no when I get to the hospital as it says on the form the LC gave me 'frenulotomy not ready'. Still don't understand it. But maybe they perform their own independent assessment and decide on the day? I've started taking the domperidone and I'm pumping after every feed so hopefully my supply will go up or at least not decline by Monday.

ideserveaholiday I've tried the rugby hold but neither of us can get the hang of it. Dd gets upset and claws with her hands. So far I've only managed to latch her in a slightly laid back cradle hold.

IM so sorry you’ve had such a rough start and you being post operative AND having a toddler to care for. Bloody well done you! Bravo!

I had my fourth baby after successfully breastfeeding the others well past their second birthdays. I figured I was an expert. Well he had a “mild” TT and oh my Goodness the pain! It was toe curling, tears down my face, glass shredding my nipples, OMFG causing pain the like of which I would never want to undergo again.

Thankfully my friends are NHS breastfeeding support workers so they picked up the TT quickly and he had it snipped at 5 days. It was only because I had fed the others for so long and felt I absolutely HAD to do this for him too that I persevered. I actually cried before and during most of the (nearly continual) feeds those few days.

Imagine my distress when the dentist (who performed it) said he doubted the snip would make any difference!!! The procedure itself didn’t even waken DS and my dad took him in as I was a wimp.

The difference was instant in feeding. It wasn’t pain free but it was so manageable. After that he fed like a wee dream, the lansinoh cream worked its magic and we fed for over two years.

Wishing you all the best and please fight for the chance to do this as you sound very determined. X

"maybe they perform their own independent assessment and decide on the day"

Yes I'm sure that's what they'll do, they must do their own assessment rather than take the word of whoever has made the referral.

You're welcome btw, your thread has hit a nerve as it reminds me of how much I struggled with TT in the early days! I just wish everyone got proper support to diagnose and treat it.

By the way, if your nipples are still very painful, I can confirm my earlier recommendation of the Breast Angels silverette cups. I've been using them myself and they're pretty miraculous! Expensive but I found a bargain on eBay.

Glad to hear the tt snip really helped you isadora. Just had a different midwife visit today to reweigh dd and she said it was doubtful they'd snip dd's! But the hv said she thought they definitely would! Anyway at least I'll find out tomorrow.

The formula top ups seem to be working as dd is now pooing lots (yay) and her weight has gone up so she's only 5% under birthweight now instead of 9%.

The pumping regime and/or domperidone seems to be helping too as I'm beginning to get some engorgment overnight when I don't pump and starting to leak milk too when dd wakes up for a feed. I still don't think she's able to get much from the breast as her feeding doesn't seem to help my boobs get softer and she's still hungry after feeding just like before. I'm normally able to pump 15-30ml each time and milk dribbles from her mouth when she does feed so I know now that I definitely have milk. It's just getting dd to get it out! If they don't snip the tt I don't know what else will make her feed efficiently. I keep trying to get her to latch properly but it's always quite shallow and she always stops sucking properly after a minute or two and falls asleep.

Excellent news about your milk supply! Definitely tell them about the pumping success and engorgement at the appointment tomorrow. Hopefully they will observe a feed and see that the milk is flowing but she's struggling to get it out. I have everything crossed for you, hoping they will agree to divide it!

The LC you saw sounds awful, no wonder so many women feel they have to stop when they don't want to. Well done for persevering in keeping going to see people. A good LC can make a huge difference.

If you're not already, make sure you are doing 'paced bottle feeding' with the bottles you do give, it will help with the breastfeeding in the long run.

Look up biological nursing position, if you are comfortable in slightly laid back cradle hold, this will probably suit you.

I know you said money is tight but if you can see a cranio osteopath as soon as possible after the tt is cut, that can make a big difference to latch and make sure it doesn't reattach. The tt can give the baby tightness in neck,shoulders,etc. Again, a good one can make a big difference so look for recommendations. Maybe if your local area has a Facebook breastfeeding group.

Milk dribbling from her mouth would indicate a milk transfer issue so hopefully the tt cut will sort things.

I have b/f 3 DC and never leaked a drop, didn't feel letdown and found it hard to express. I know the LC has stated low supply but just so you know, some women don't leak, etc and it doesn't always indicate supply problems. Just incase you were relying on leaking/letdown as a sign your supply had improved.

Good luck for your appointment tomorrow.