Painful nipples (already seen specialist) Please help!

[Matilda128]

I'm absolutely desperate at the moment. I really really want to breastfeed but my nipples hurt so much that at the first 'bite' I feel I need to throw up. My baby is 2 weeks old and absolutely loves to suckle my nipples. She does latch on correctly but after a while slips off to a more shallow position mainly because she cannot cope with the rapid flow. I take her off a lot and try to reattach but we get so frustrated that it's just becoming hell. At times she will also pull her head backwards while sucking causing more pain. I have a deep fissure in each nipple which don't seem to heal.

I recently moved to the Netherlands and here you pay a lot for a specialist to come round and advice you on feeding. So someone came round advised me to adopt a more laid back approach to feeding and watched me feed my little girl. That feed went relatively well (it was still quite painful) and I was so relieved I didn't have to stop. I tried to explain some of my anxiety around feeding (my baby was born after 7 years, many rounds of ivf and multiple losses and I'm terrified of something being 'wrong' with her. For example when she starts coughing I panic because I think she may get an airway infection) and she really focused on that rather than my painful nipples, referring me to therapist to help with bonding with my baby. But there is no problem with bonding, I just constantly cry because I'm in so much pain and the only solution seems to stop altogether. After one relatively pleasant feed after the specialist left, we are still struggling and my nipples are also extremely sore between feeds.

I don't know what to do anymore. I looked at so many videos, I tried lanolin cream, hot compresses, expressing some milk before a feed, squeezing my breast into a hamburger- nothing helps.

Meanwhile the baby is growing super fast and glows with pure happiness when she is placed even near my breast. I'm desperate to keep breastfeeding but I also feel like a complete idiot for being unable to do it right and continuing to carry on when it's clearly not going to work.

If you have any advice- I would be so grateful xx

I know you say your baby latches correctly but has she been checked for a tongue tie?
I was seen by numerous midwives in the hospital after I had to stay in there for a few days due to tearing and they said he latched absolutely fine but it always hurt and could see my nipples bleeding afterwards.
Cut to a a few days later where I tried a nipple shield and took him off after a couple of minutes to find it filled with blood and a chunk of my nipple. I had one the breastfeeding people come that same day and found he had a tongue tie that the hospital missed and that’s what was causing all the pain.
Unfortunately for us the referral for it to be fixed is weeks and I’ve already got rubbish supply due to blood loss but if you have a good supply, getting a check for tongue tie could be your solution and you can carry on.
That or try the nipple shields. As I said they didn’t work for me but my baby has a tongue tie. If your little one doesn’t they may help with the soreness

Thank you for your reply @Pizzaandsushi. No one has properly checked. One midwife briefly peered briefly into her mouth and said there's no problem there. I don't know who to ask to properly check. The next doctor's visit is at the end of March. It sounds like you've had a really hard time and hope you can get the tongue tie sorted soon. Can I ask what you did in terms of feeding? Did you express milk or add formula feed? Thanks again xx

Have you got a health visitor coming at all or try ringing someone from Bambis if you can as they were both very quick to see the tongue tie for us in comparison to the midwives as it’s more their thing, especially the people at Bambis.

So unfortunately I’ve had to give up on my dream to breastfeed. Our baby has pretty bad reflux which has taken an added toll on me and any free time I would have to try and pump my already poor supply but if you have a good one as it’s already established I would try pumping.
The infant feeding team at my hospital said I was to pump every 2-3 hours to keep a supply going (hold baby whilst doing it if possible to trick your brain into thinking it’s baby) then give them that and top up with formula if he’s not getting target amounts. They also said to try and breastfeed where possible especially if your baby is happily gaining weight as again that will keep your milk going but only do if not too painful and give expressed milk to make sure baby is fed.

Flipple technique might be worth a look
Also worth checking if you or she has thrush as this can be a cause of nipple pain..it would prob be more visible in her mouth than on you xx

I think it's a myth that it doesn't ever hurt if it's done 'right'. Personally, my nipples had to toughen up and it was very painful at first but then after a few weeks they had sort of adjusted. Definitely worth trying nipple shields though as it can give them time to heal.

It does sound a lot like tongue tie. If you can, use nipple shields to give your nipples time to heal. It really can be very very painful once they get damaged.

Another vote for nipple shields here. I used them with my DD until she was two and am now using them with DS. I have tried frequently to feed without them but my nipples just won't stay in the right shape. Some boobs just aren't well-designed for breastfeeding!

Firstly don't say your bf isn't working. It is. Your baby is putting on weight, loves to be near the breast and is thriving. So from that perspective please give yourself a massive pat on the back.

BF was really painful for me at first. There were a number of things I did wrong.....I read that baby would unlatch when full. Mine suckled for ever....like 45 minutes....so I thought he was still drinking. He wasn't he was suckling for comfort. (I didn't have a lot of sensation around flow so couldn't tell myself). I should have popped him off after 5/10 minutes. - future babies filled themselves up this quickly. In fact that was the biggest thing I did wrong. Plus I used book to settle him lots when actually he wasn't hungry in hindsight think he had trapped wind or was just over tired. So the boobs had extra suckling they didn't need. Finally I was stressed out by the whole thing thinking I wasn't doing it right because it hurt and it wasn't this perfect process. I needed to chill and trust the process. Gradually my boobs toughened up. We got into more of a routine and it did get easier. Good luck.

I just couldn't cope with the pain and had to stop. Both times. Second baby I breast fed morning and evening feeds only so 2x a day and that was better so I went on a bit longer.

Hello, second time breastfeeder here, about a week behind you on the feeding front.

Just wanted to say your experience is totally normal, I have had excruciating pain both times. Three midwives have checked the latch since I left hospital and all have said it's perfect, but I still have to do that kicking my leg out in pain when the baby latches and crying whenever anything brushes past my nipple. However I do know from experience that by week 4, the nipples will magically transform into bulletproof hard skin and I won't feel a thing. The question for you is how you can get to that stage in a couple of weeks. Last time I was so bloody minded I just suffered through the pain (although my MH probably took a slight hit in those weeks). This time the damage is so bad on one side that I've decided to pump it for a day instead so it has a break to recover and can see myself doing this intermittently until I get to week 4 on both nipples. I'm not sure what any lactation experts will make of that, interested to know actually if there's likely to be any impact but atm I'm pumping a good 50-100mls on that breast each time so I'm not overly concerned about supply at this stage and baby is still latching well on the other breast. I personally couldn't get the hang of nipple shields but others swear by them.

Good luck, but please know the torturous pain is temporary if you do decide to persevere.

So if you run your finger under baby's tongue is it smooth or is there a catch of skin? Another thing is does baby stick tongue out? Do you see it moving a lot when crying or does it stay around same place?
These aren't fool proof methods to check as you really need a TT specialist but all the boxes were ticked for my son. He had a partial cut by NHS at 8 weeks then a specialist (in a volunteer format) checked and suggested there was still some tongue tie as there was lack of mobility. NHS refused to cut as they said it wouldn't effect feeding. This was at 15 weeks and although the pain was bearable now something still wasn't right. His weight was faltering, reflux and fussy feeding. A private dentist cut the tie for me and I was able to feed him pain free for the first time ever. We fed until 2 years.
Best of luck. I'm sure there is an element of "toughening up" at first, but pulling off, dropping to a shallow latch, actual bleeding and pain definitely point to tongue tie. In America they also seem to consider a lip tie too but I think the evidence for that affecting feeding is much weaker.

Sorry you're having such a rough time.

The first 2 weeks are painful, very painful. Especially the first time. I kind of mentally set myself a target - mine was try for 6 weeks - and by then it wasn't painful anymore.

With one kid it was sooo painful for me and I was bleeding, it didn't get better, turned out to be nipple thrush - very common for run down mums.

Sorry you're having such a difficult time. I had a very similar experience with both of my DC and like you I had a very fast let down so they would slip to a shallower latch in response.
Like a pp said, it does seem to just get much better around 3-4 weeks in. I never found any tongue tie or latch issues with my babies, they just seemed to only be able to cope with the flow as they got a bit bigger.

I found a couple of suggestions online which i think helped. I spent a couple of days using a different hold as much as possible. For me I normally fed in cradle hold so I switched to rugby ball or upright holds for a couple of days. This meant baby was latching the other way around which stopped the constant pressure on the fissures so reduced the pain a bit. I also block fed for a couple of days to give each breast a longer break between feeds to help with healing too. I did have an oversupply though, that one is not advisable if you're trying to build up your supply.
And lastly, I introduced one bottle feed a day which DH did around midnight. For me, combi-feeding helped my mental state enormously and helped me push through the pain for other feeds as I knew I had a decent break coming later in the day.

I want to thank everyone for their comments and experiences! It's really invaluable to know I'm not alone in this struggle. I'm going to ask about the tongue tie but when I look myself it seems fine. The frustrating thing is that sometimes she does seem to latch on really well (I did try the flipple technique) but she lets go relatively quickly or starts pulling at my breast while drinking. We were making some progress and I could see the fissures were healing a little. But last night we had a terrible one- she wanted to feed more than normal and I was too tired to get the latch right when she was so restless. The next morning one of the fissures was bleeding again and I was so sad. I never realised breastfeeding was going to be so hard. Once again thank you everyone xxx

I breastfed my 3 DC and it was agony for the first 3-4 weeks each time. I did everything you did, was told their latch was fine etc. I think it sometimes takes time for the skin to toughen up. If you can bear it keep going and I bet within a week you'll see an improvement. Keep up with the nipple cream, try a different one if what you've got isn't working.
I also agree about tongue tie, it's so common it's worth getting it checked by someone professional.

Have you tried different positions? Being in a laid back position might help?
Silver cups might be worth trying to heal your nipples.

Do you know any other mums locally with small babies? or are there local breastfeeding support groups?

I really recommend using nipple shields. My DD never really got her latch right but everything was much better with nipple shields because (i) they protect your nipple a bit and (ii) the nipple on the shield is bigger and easier for the baby to hold.

I second trying rugby ball hold or lying down for a couple of feeds. Just to change where the biting is happening (I don't mean biting as such.. but not sure what word to use).

You've said you think she is struggling with the fast flow which can definitely cause these symptoms but also babies can pull on the nipple to stimulate a let down so on the off chance that she is actually frustrated for more milk you could try breast compressions to encourage more flow?

Good luck, it is so hard but once over the initial hurdles it's so much handier than bottle feeding when out and about etc. That's what got me through in the end as a chronically poor organiser haha!

I'd echo what a few people said - my nipples were sore and cracked for the first few weeks, I do think it was because they needed to toughen up. I used Green People's cream which worked really well.

But do follow up on the tongue tie issues too.

I had a really really deep fissure with my second (currently 11 weeks). It was the worst at 2 weeks.

What helped was keeping it really moist. I applied something called Jelonet dressing then silver nipple cups after every feed.

I also gave the worst nipple a break every day for 12 hours and pumped/bottle fed from that side instead. Did that for 5-6 days and that helped.

It took 2 weeks for the deepest one to heal. I took pictures every day so I could see the progress.

I'm at 11 weeks now and zero pain. I was much better at 4 weeks.

I'm so sorry you are going through this. It was almost more painful than labour!!!

Once again- thank you everyone who has replied! I'm still hanging in there but only just. There were lots of tears this weekend because after it finally going a bit better with the nipple pain, I started getting mastitis. It was so painful. I started using silver nipple caps and was so impressed with how fast my nipples where healing and the pain was finally starting to go. With the mastitis I tried to empty the affected breast as much as possible. Perhaps not a coincidence but the baby also decided to cluster feed so after 24 hours my nipples were terrible again. It does mean my flow is less strong (no more coughing) but the baby now seems to have a different problem staying on. Luckily the fever has gone and although my breast is still sore, it's much better. Tomorrow I will speak to the lactation consultant again and ask about a tongue tie. I'm wondering if I should continue using the silver nipple caps just in case it caused the mastitis. I really like them especially because it protects my nipples against rubbing on my clothes. But the instructions says you need to wash your nipples before every feed which is not very handy. How did others do this when out and about? Thanks again everyone! Xxx