4 weeks struggling - is there any hope?

[TryingToStayRational]

DD is 4 weeks now and we’ve been through the mill a bit - long labour, forceps delivery, wouldn’t latch at first so had to express, milk not in til day 5, then became jaundiced and ended up on formula top ups after a readmission. Lots of nipple pain, got all sore and bloody, diagnosed with posterior tongue tie which was divided at 2 weeks and again slightly further 3 days ago. So we are now about 80% formula, 20% EBM and still trying to breastfeed at least 8 times a day but it is almost always sore and given half a chance she will chomp right on the end of my nipple. When I do get her latched in the best way she can manage we have a few mins of pretty comfortable feeding before it becomes really sore again. And she’s soon crying, head bobbing, rooting and sucking anything she can get her chops on so is clearly hungry.

I’ve had loads of support from NHS, tons of people have seen her but often advice has differed so I’m not sure who to believe. I feel really sad that w

How is she on formula in a bottle? maybe you would be better just doing bottle as she may not like the switching from bottle to breast And if ur in pain then bottle would be better

We are fortunate that alternatives are available if breastfeeding is very difficult.

This is not a situation where a difficult first week can be worked through with some support and a quick intervention. This continues to be very hard a month in and the attrition of that will undermine your own postnatal recovery.
I think that you are entitled to say, "I've done everything possible but it's not working". Trying to mother through pain and exhaustion is miserable.
You can express milk to add to the formula.
Or you can switch to formula entirely.
Your baby will thrive.

There is a lot more to mothering than breastfeeding.
I'm a midwife and that's what I would say if you were my client.

This might not be a popular view but if it so painful and hard you don’t have to solider on. Breastfeeding didn’t work for us. I decided to bottle feed to save my sanity so that I could actually enjoy my baby rather than being miserable. Formula isn’t poison. My son is 14 weeks and thriving and giving him formula has not in anyway impacted our bond. You have clearly put everything into trying to get breastfeeding to work for you both. There is no shame in stopping if you need to.

There is hope, absolutely!

I think at 4weeks you need to decide are you going for it with EBM or are you happy to do mixed feeding or just formula? ALL ARE VALID, it's just helpful to make a decision and a plan.

If you're planning on doing solely EMB then can you replace the formula with expressed milk? This will help your supply come in.

If not, well you're already succeeding at mixed feeding so well done! Breatfeefing is hard, and sore, especially in the early weeks. It takes around 6 weeks to fully establish and then it gets A LOT better.

Honestly, what ever you decide will be the right decision

I’d say yes it’s possible it’ll improve, but you do have choices if it’s just too hard to hang in there any longer. So the below isn’t a “you must keep trying” message, it’s a if you want to keep aiming for ebf this is what I would do...

If you do want to continue breastfeeding - get a lactation consultant out. Listen to them (and nobody else as conflicting advice isn’t helpful). Hire a hospital grade (ardo double) pump. Depending on how bearable the feeding pain is either continue with the feeds or stop feeding for two/three days and exclusively pump. If you’re continuing to feed then breastfeed first, then top up, then power pump. And repeat. (Use lansinoh hydrogel pads between feeds/pumping to help healing). Expect over the course of a week to be able to gradually increase the top ups with breastmilk as your supply responds to the pumping.

In response to what you’ve said about latch - if it’s possible to get it comfortable for the beginning of a feed and then it starts to hurt - have you been checked for thrush? Or is she slipping (unable to hold suction on the latch) during a feed?

You’ve done ever so well to get this far, and anything you choose to do now should take into account your needs too.

Have you tried Nipple shields? They were a lifesaver for me. My girl stopped them herself at around 16 weeks and I have continued to Breastfeed until now and she's nearly 13 months.

First of all congratulations for getting this far with all those complications - it's so stressful when you cannot feed your baby so please be kind to yourself
It is absolutely not too late - I would recommend getting a lactation consultant , they are specialized in all area of breast feeding - you would be surprised how many doctors are not and the advice they may give is outdated even if you have found a lot of support with the nhs . They may suggest SNS and can show you paced bottle feeding .
It sounds like the most pressing problem is the sore nipple - what worked for me is Silverettes - it took 3 days for the nipple to heal but it was the only thing that closed the wound . Another friend got laser treatment .
It's important to keep up your supply so as hard as it is try and pump every couple of hours even if it's for 5 minutes - don't get disheartened if not much milk comes out it is not an indication of low supply
Finally i also found taking baths with my newborn helped with skin to skin and a way of him seeing my body as a source of comfort - and for me a way of bonding without all the stress of bf as that was becoming a bit of a trigger for pnd .
Good luck and as others have said , your mental health is lost important so do whatever you need to feel strong

Just wanted to echo the “well done” comments - you’re doing so well. It’s so hard in those early weeks with intense emotions and exhaustion. We had a real struggle to start with, but it does feel worth it now (12 months in). I reckon it takes at least 6 weeks for those initial difficulties to resolve. Lots of good advice on here and I’m sure you’ll make the right decision for you. X

Thank you for all the responses

I was feeling quite alone and it really has helped just to write this down and to have people take the time to write back. I absolutely agree that choosing to formula feed would be logical and sensible, and I wouldn’t ever judge anyone else for doing so, but at the moment I just feel for myself I need to try just a bit longer before I go down that road. I never thought I’d feel so attached to breastfeeding (awful pun!) and I can’t really even articulate why I do, but there we are. I did try shields but they didn’t help with the pain and my daughter basically just sucked on the nipple part of them so had an even worse latch than she does without. I haven’t been tested for thrush - is it something you can see?

Will try to take on board the other advice - have had a quick read but not much time before next feed due so gotta dash. But generally am
Thinking maybe I stick it out as I am til 6 weeks and then review, as it will be new year then and getting to see anyone over Xmas will be tricky.

I could have written this post myself about 6 weeks ago.
I had such a tough time breastfeeding! Every single day I said I was going to quit.
But similar to you, I felt quite attached to feeding her and for some reason could never fully make that change, even though that's what I would have advised someone else to do! And I was actually advised by my midwife to stop as it was making me so miserable and hindering my recovery.
I have to be honest, it was quite sore and not enjoyable for maybe around 4 weeks but then suddenly it all just changed.
Feeding is now completely pain free and actually I really love feeding her.
My OH does give a bottle or two in the evening so I can rest.
In the early days this really helped my nipples recover & allowed me to get a chunk of sleep.
It is still quite demanding so I've given myself a goal of around 3 months. And then I will start to wean her.
It does get better so if it is what you want to do then carry on.
But don't feel you need to, if you don't see an improvement then don't continue to make things more difficult than they need to be.

Also just to add- I have my DS who is 7 and was completely formula fed from day 3 as I had so many issues. He is a really healthy, clever little boy and we have the best bond! He was also a great sleeper! Don't know if it was to do with the formula?
So if you do make the change, don't worry about anything.

@cr1479 I've just logged on and read your post, it's so lovely to the OP. I had so many issues in the beginning which meant my 16 month old was formula fed and she's doing so well also. I'm so pleased for you that you've overcome so much to continue feeding. I think having a second really gears you up to what's expected as I felt the classes didn't in my case. Hope you get to 3 months or beyond, whatever works for you 💕

Hi OP, massive hugs to you - I’m 3 weeks ahead of you and have taken the difficult decision to stop breastfeeding.

I also had a traumatic birth with DD arriving at 34 weeks by EMCS (she was breech) and spending a week in SCBU. I was obsessed with getting my milk in and establishing breastfeeding, was pumping around the clock in hospital and was so proud of myself. Although I have plenty of milk, almost every feed was exactly as you described - painful and extremely stressful. I started dreading the nights and felt my stomach drop every time I heard her stir as I knew it would mean a feed which would mean pain, stress and a v unhappy baby.

7 weeks down the line I’ve decided to call it quits as I was heading for full blown PND - this is on the advice of my GP (and the rest of my family). I went to numerous different drop in clinics, bought 2 nursing chairs, watched a million videos on YouTube - sometimes she would latch beautifully but I just couldn’t get her to do it consistently and the dread of it was killing me.

Not saying this to worry you as I’m sure you will crack it and you don’t sound like it’s getting to you as much, but just wanted to say it’s fine to give yourself permission stop if it gets too hard (I had to hear it from my GP).

Your mental health and relationship with your baby is more important.

Best of luck with it all!

@loveautum ah thank you! It is such a tough time these early days & breastfeeding is really hard work on top of everything else.
I think it's important for women to know that formula feeding is completely fine if breastfeeding isn't working.
Sometimes we can put too much pressure on ourselves.
I really enjoyed my time with my DS when he was a newborn, finding it a lot harder with my DD as I'm feeding her.
Thank you, I'm going to try to get to three months! But if it doesn't work, then I will be ok with that.
I completely agree, the classes to prepare you at all! My OH actually joked that I should start doing "realistic" antenatal classes!

My baby also had tongue tie and really struggled to latch and would get very frustrated- have you tried nipple shields? He is a dream when I have them on, it will protect your nipples from getting sore and also the teat is quit long to help them latch easier and will be similar to the bottle. Saw a lactation consultant who told me to buy boots own shields as they are much thinner but have been using those and a variety of other brands. Good luck it’s so tough

I take my hat off to you OP with my first ds I gave up after 4 weeks as the pain was just unbearable and with dd I literally just breastfed her three times in hospital and had to stop. You are doing an amazing job and please don’t feel like a failure if you do end up ff. for me it was like a weight had been lifted once I allowed myself to ff but i also envy those that persevere with bf.
My midwife told me that my mental well being was more important than my babies being bf as I was close to pnd.
I did hear from lots of hv’s, gp’s and midwives though that 6 weeks is key and if you can make it to then the pain should subside and bf should become easier, I just couldn’t make it that far unfortunately.

This was me 4 years ago. I found breastfeeding massively traumatic and still pressurised myself to continue because if felt I should. My only regret is not stopping sooner. My mental health really suffered and I realised I hadn't bonded with my baby and resented him for hurting me. You will hear lots of people say it gets better but only you can quantify how much pain you're in.
When my second came along I said I would try but stop if I so much as shed a tear over bf...which I did 5 days in. Those first weeks were glorious and I saw how lovely the early days are if you're not worrying about feeding.
Just do what is best for you and baby will be fine :)