Struggling with BFing

[MeadowHay]

DD is 15 days old and EBF. I wasn't that set on it antenatally, I thought I'd give it a go and if it didn't go well I would switch to formula. For some reason once I'd started I found I didn't really want to stop, despite the agony. I've had breastfeeding support workers out to me at least 3 times since I was discharged from hospital the day after the birth. DD was checked for tongue tie in the hospital and one of the BF support workers also checked her and didn't think a referral necessary. Last time they came out was about a week ago and she said by this time she would expect my pain to have resolved itself and if it hadn't she would discuss other options with me like potentially expressing and bottle feeding some feeds to help my nipples heal and referring DD for tongue tie check just to be on the safe side etc. I've had tons of help with checking the latch and positioning etc. But it still hurts, and I don't feel my nipples have really healed much in the past week, if at all.

Actually I feel things did get a bit better but the last 2 days or so seem to have got worse again. DD initially cluster feed from around 8pm-11pm and then had a few short feeds every 2-4 hours on a night. For the last few days this has changed to cluster feeding all morning from say 8am-11am/12pm then again from about 4pm until about 11pm then she wants a long feed/cluster feeding again in the middle of the morning around 4-6am. This would be exhausting anyway but is especially difficult when I am in so much pain. I am crying at every feed again, partly due to the pain but just the emotional burden of it all.

I also think she might have reflux as she has some of the symptoms - DH and I both think her tummy is swollen but neither the HV nor MW nor my DF who is a Dr have commented on it. She gets hiccups 2/3 times a day and is getting increasingly fussy/crying more each day. I also think I have a very fast let-down which is causing problems - she gags/coughs and comes off many times during a feed, there are clicky noises at lots of the feeds, she pulls funny faces when she unlatches multiple times as if the milk is coming out too fast and often I then leak a lot everywhere. Over the last day or so this seems to be making her very frustrated as she latches and unlatches lots of times and then gets frustrated and cries which makes it more difficult for me to get her to feed again etc.

I am really at the end of my tether now but I feel like after persevering for the 2 weeks it would be such a shame to stop now. Everyone keeps telling me it will get better and that's helped me hang on but it's just not getting better, if anything her feeding seems to be getting worse! I have the BF support worker out again to see us tomorrow and will discuss my concerns regarding let down and reflux with her now I'm more clued up but my God I just want a rest. I don't know whether to just combination feed with formula now to help my mental health and this would help reduce my supply which would help the too fast let-down, no? But I know the BF support workers will tell me not to do that as they only help/promote EBF. But I'm so close to sacking it off altogether and just moving to formula and maybe combination feeding will enable me to continue BF.

Have you tried nipple shields? Some breastfeeding specialists don't like them but I found them useful in order for my nipple to heal (only took a couple of days in my case)

I assume you have Lanisoh?

Could you express and your OH do some feeds? (I really struggled with expressing so I understand if this is not an option) .

Imo a bottle or two of formula isn't going to destroy all hope of breastfeeding longer term and you may feel more able to continue breastfeeding if you have a rest.

No, the breastfeeding support workers said not to use them for now although my midwife recommended them, so I've held off for now. I contacted the BF support workers again and they've given up on me as instead of coming to see me again they've just redirected me to the infant feeding team at a local hospital. Unfortunately it's not my local hospital, not the one where I gave birth but the infant feeding team there only have a once a week session that you need an appt for whereas at the other hospital it's a drop-in session tomorrow so we will be going to that but it will be a trek as we don't drive so will have to get the train. Hopefully they will be able to help and offer some support but I feel like my confidence has been knocked even more now that the community BF support workers seem to have given up on me .

I use Lansinoh after almost every feed. Not sure if it is helping or not but I guess I wouldn't know as have been using it from the start.

I have a Medela hand pump but the BF support workers told me not to express for now either because of the risk of nipple confusion if I give a bottle, so have not used it yet. Will discuss with infant feeding team tomorrow as I really want to try this ASAP tbh. I'm not sure nipple confusion is even a real thing as loads of people successfully combi-feed right from birth, DM did with all 3 of us.

Use the nipple shields! Pumping and nipple shields are your best hope of healing. Best of luck. It is really fine to stop though so do whatever feels right :)

So what do they expect you to do having 'given up' on you?! That's pretty lousy care OP. Is your baby having plenty of wet and dirty nappies? Is the baby gaining weight?

You need to see a qualified lactation consultant. Not a breastfeeding support worker. Not a midwife. Not a health visitor. Etc

Please go here to find an LC and arrange to see one ASAP. They will be able to diagnose any tongue tie and give you help on all other parts of your feeding

In the meantime you can hand express a little before each feed (into a cloth or a bottle) which will mean your let down is calmer for when you latch your baby. If you have sore parts on your nipples ensure you’re using lots and lots of lansinoh before and after feeds. If you’ve got bad cuts/splits try something like these Compresses - Intensive Nipple Treatment for Breast-Feeding Mothers (Pack of 12) [[https://www.amazon.co.uk/dp/B005KJ3DSC/ref=cm_sw_r_cp_api_i_9.JpBb1YH6FG?tag=mumsnetforum-21T]]

If there are sore parts of your nipple try changing your latch position so the baby’s tongue is away from the sorest part. Let your nipples get air. Try laid back feeding for a really deep latch.
(I’d personally not recommend trying nipple shields at this stage as they can cause more issues - see what your LC says)

In terms of baby crying more - they do start to cry more once they come out of the newborn sleepy stage. Frequent hiccups in babies is common and not an inductor for reflux

Good luck. Please please get to see a LC ASAP

I am hoping the infant feeding team at the hospital tomorrow may be helpful, they are all qualified HCPs whereas to be fair to the BF support workers, they are trained but they are basically just peer-supporters and only volunteers.

Baby is absolutely thriving - at her first weigh-in she had surpassed her birth weight and had put on more at the second weigh-in. Plenty of wet and pooey nappies too. Definitely getting milk just fine, it's just me that is suffering!

There is an LC here that we were thinking of booking for an appt, but my DH goes back to his uni placement on Tuesday and I can't sort it and have her here on my own because I have an anxiety disorder . Will have a think, the uni have been great with him so maybe could get permission take his half day study leave off-site or something.

I can try the hand-expressing at the beginning of each feed but I always feel like getting her latched on is a race before she cries and stresses me out . I hand-expressed colostrum antenatally (albeit with difficulty) so I imagine I should be able to hand express milk more easily? DH can help me too initially, he helped me with the colostrum expression.

I was trying to use the Multi-Mam compresses once or twice a day initially and found them soothing, however at the moment she is almost constantly cluster-feeding so I never get around to putting them on as I never know whether she'll decide she wants to be fed again 10 minutes later and then there'd be next to no point in applying them iyswim. Today I don't think she's slept for more than 2 hours in one go and that was only one slot. The rest of the time it's been 30 minutes or less bursts and then she wants to nurse again!

I don't feel confident to change BF positions because I was having so much difficulty and pain before - it is slightly better than it was when she was a few days old, I guess. I feel most comfortable in rugby hold and have been doing that but maybe I should try the first one holding her across me and side-lying again too and alternate around. I did side-lying once this morning so I could lay down as I was so exhausted, this was what I found easiest and most comfy for the day of her birth and the day after in hospital but I guess I had forgotten how to do it properly because it took me ages to get her latched on and then my arm went all tired and floppy after being stuck in awkward position beside my head.

I struggled a lot initially, I know just how you're feeling. The first few weeks for us were clusterfeeding hell, and my ds was about 2 weeks old when we first gave him a bottle to give me a break. I also used nipple shields to protect my nipples as they got so sore. My baby's latch was checked multiple times, and was fine, we also had him checked for tongue tie as I have it and again it was fine. My midwife advised that sometimes you can do everything right, and it still be painful as your body conditions to doing this new thing. For me it eased at about six weeks, and now at nearly six months it's very easy and comfortable, and my ds is very content to take breast or bottle with no confusion.

For me things that helped were the nipple shields, cold compresses on the nipples occasionally, bucket loads of lansinoh, and paracetamol for the pain. That and gritting my teeth and taking it one feed at a time. I'm glad I kept at it, but there were plenty of times I could have given up and switched to formula, and that would have been absolutely fine. As long as baby is fed and well, and you are well, then that is the important thing.

A qualified HCP is a long way from a LC. The difference between the breastfeeding knowledge and training is huge

Can you call the LC. She may be able to do a weekend visit or even a Skype consultation.

I don't feel comfy with the idea of a Skype session, makes me anxious, I don't know why, and I have family visiting this weekend who live in a different city so not really free for an appt. I appreciate what you're saying though and will see if DH can get an afternoon off sometime and we can make an appt for then.

Lady at the infant feeding team was nice and more realistic than the BF support workers, she recommended I try expressing to bottle feed for some feeds and also to try nipple shields, and gave me some advice on getting comfier when I'm feeding and how to feed without my Boppy cushion. I burst into tears at one point so think she could tell I'm really struggling and getting to the end of my tether. Discussed combi-feeding too with formula if expressing doesn't work out for me. So lots of things to try before I throw the towel in. She said my nipples were very red but not how she'd expect them to be if it was a latch issue and wondered whether I'm having an allergy to the lansinoh as I have eczema, and also whether I have thrush so has told me to see GP re: thrush. I called GP and had a telephone appt and they have booked me in to get checked by the nurse about it on Tuesday morning.

I feel a bit more positive with more things to try iyswim. Any recommendations for nipple shields? I dunno where to start with them. Also what do you store expressed breast milk in in the freezer?

I used medela nipple shields, they worked just fine for me. Also I use pouches to store milk in the freezer. Lansinoh do them or you can get generic versions on eBay.

Im sorry you're having a tough time op, but glad the infant feeding woman was more positive and useful.

Just wanted to add that you can give ebm via a feeding cup, spoon or supplementary nursing system (SNS) if you're having problems with baby taking a bottle.

I think being checked for thrush is a good idea, ask them to take a swab because if not thrush it may be another skin infection. My friend was treated for thrush a few times then when they swabbed it was a different infection. I've also heard of women being allergic to lansinoh.

I also had a few problems starting out- including a fast let down. I would block feed ie feed on the same side for 1 to 2 hours then switch, and fed more regularly so that i wasn't becoming too full. It did eventually settle and I'm now still feeding at 14 months!

Wishing you luck op

I also used medela nipple shields. Just beware they come in small, medium and large. DP bought them for me and bought large - they were far too big for me.

Morris How do you know which size fits best? Sorry if that's a stupid question. I've started using the Medela Harmony hand pump and the shield on that is the medium, it seems to fit but then I'm finding it painful so...the pain is the same kind of pain as when DD is breastfeeding, I'm so confused as I thought expressing wouldn't hurt and would give my nipples a chance to heal but it hurts just as much . I don't know what to do.

I think if it was an allergy though my nipples would be itchy? I have eczema which is one of the reasons the lady thought I might have an allergy to it because she said she also has eczema and lambs wool irritates her skin, but when I get eczema it's really itchy and they're not itchy at all. They are red and in some places dark like bruising, and the BF support workers said they were blistered, and they're weird deformed shapes now. I can't honestly remember what my nipples looked like before now but they definitely weren't like this!

Also, if the pumping hurt which basically has a Medela nipple shield on it, does that not mean that BF with the Medela nipple shield will just hurt the same?

I was thinking that maybe it's just me as I have Asperger's Syndrome and have weird sensory stuff so interpret pain oddly compared to other people and maybe it's a normal feeling but I'm feeling it as pain cos of that, but then I think that can't be the whole story because my nipples are visibly damaged, so there is something organically damaging/hurting them. At first I thought it was still hurting just because they had not healed yet but I've seen no significant healing in the past week, they're pretty much the same as they were over a week ago when the BF support workers last came out to check them. I'm doing everything they're telling me to do so I'm so confused. I also doubt it's an infection because the soreness in my nipples first began less than 24 hours after I started BFing so surely I wouldn't have an infection that quickly?!

The lady at the infant feeding team said DD had a 'high palate' which might be part of the reason but that this was normal and would resolve itself as she got bigger, I don't know what means but could that be part of the problem maybe?

Also with expressing, she told me to express from one breast whilst feeding DD on the other and if DD wants the other breast, to then switch etc. Should I be doing this at every feed? I'm worried about overstimulating my supply. Also how do I know when to give her the bottle of expressed milk, as this will skip a feed, will that lead to engorgement?!

BF is so complicated!

I just bought the medium after dd bought the large as the latter was far too big.

I forgot, but my dd had a high palate. However, it is sounding like breastfeeding is much more painful for you than me. I found it tender for the first week (I used nipple shields from day 6-8) but then it wasn't too bad.

To state the obvious, have you been taking paracetamol? It can help to take the edge off the pain.

Ok, we measured my nipples and looked at the diagrams on the Medela website and we think I might need a large so we have ordered the large nipple shields and the same for the pump. They should arrive on Monday but I will be out all day so probably won't be able to try them til Tuesday. Need to get through the next few days first though, eek .

I have two feeds worth of expressed milk in a bottle in the fridge, thinking of doing one of today's feeds with one of them to introduce the bottle today as DH is at home and we're just at home all day so can do it in a relaxed atmosphere at home and DH can do it. Any tips on how/when to do that? Maybe on an evening before bed to try and get a block of sleep? She normally cluster feeds most the evening and then we get some blocks of sleep on a night so thinking maybe that's a good time to give her a bottle to fill her up a bit before bed and then I'll BF as normal for the night feeds as I know night feeds are important for supply.

I don't understand the significance of the 'high palate' and when that changes?

Not been taking paracetamol religiously but taking it sometimes and ibuprofen sometimes too because I still have significant pain from my episiotomy .

Larger breast pump funnel size much less painful than the medium, so I guess that was why I found it so painful. DH gave her a bottle of expressed milk last night which she took, but she drank the whole thing in two parts over like an hour or so and then still fussed and cried for more so I still had to BF her and was up until 1.30am feeding her . She had like a little over 2oz which I thought was a decent sized feed so why did she still want to nurse for ages afterwards?! I know you can't overfeed a BF baby but it seems to excessive and she has been putting on weight at an alarming rate . We get some peace with the dummy but trying to only use that when we are out if I can't feed her or temporarily whilst she's getting changed if she's screaming until I can feed her etc so it doesn't affect my supply too much but ugh it's so tempting to just give her the dummy more for her to sleep and me to have a rest. She hardly seems to sleep, I thought newborns slept most the day!