Sore boobs - help please! Express or move to formula?

[SJ1994]

Hi all, just looking for some advice!

My little one is coming up to 3 weeks old and he has been breastfed since birth. I’ve had a few issues with an engorged left breast which had started to get better, however the last few days both breasts have been extremely painful - to the point I’m crying at every feed. My nipples are so sore, cracked on one side and my boobs are generally sore/full and the right one has a hard lump. (No red marks and I feel well)

I had a telephone app with GP this morning as I was worried it could be thrush or start of mastitis and they said to just see how we get on over the weekend.

Baby is a very hungry boy and was 9lb 14oz at birth so he’s a big baby! I’m not sure he’s really satisfied after feeds and he’s been cluster feeding a lot. The last few days he’s been very agitated and crying before and when he’s on the boob too. I’m really struggling and just don’t know what to do next as I can’t continue with this pain. I’ve been applying nipple cream, tried shields etc.

Should I express to give my boobs a break from him… and if so, when should I do this? Every few hours or? I’m worried I’ll make the problem worse and create an over supply…

I’m not totally precious about BF so I have been contemplating moving to formula but again, not sure how to go about this as had mixed advice from midwives/health visitor.

Any tips / advise appreciated :)

Sorry you are having a hard time with this, and that the GP didn't offer you any further help. Is there a local peer support group? Or you could try the national breastfeeding helpline (Google it). If breasts are sore/full and with a lump (probably a blocked duct) I would be worried about mastitis, if you develop flu like symptoms get straight back onto the GP to get antibiotics. Or like you say could be thrush if baby is unhappy too (I don't know much about Thrush but know all too well about mastitis!). Feeding is probably the best way to sort things out, using shields if you need them, but if that's too painful then yes express. I wouldn't just stop and switch to formula it needs to be a gradual process unfortunately or you do risk blocked ducts / mastitis (saying this as a mixed feeder nothing at all against formula here!). At 3 weeks old I would get onto your health visitor or even try the midwife to signpost you to local support.

Give the NCT infant feeding line a ring. You can speak to a qualified person who can help.

In general, if he's having plenty of wet nappies and putting on weight then he's getting enough.

Cluster feeding doesn't mean he's not satisfied. It's natural way of getting your supply to match his demand.

If you're feel a bit engorged, you can hand express to comfort. You can also use something like a Haakaa.

You can express to give your nipples a break and should aim for at least 8 a day at this stage to maintain your supply.

It's totally fine to move to FFing if that's what you want, you don't need anyone's permission but I'm just wondering if you want to seek some support and try a fed things before switching?

Do you think it could be Tongue Tie causing the problems? If it is, he might still have problems if you FF although obviously it won't be as painful for you. There a good article, including symptoms here.

Kellymom has some advice on cracked nipples here which you might find useful. Don't forget to take paracetamol as well

Definitely not worth continuing if the pain is making you cry. Switch to formula and take advice from your health visitor?

Hi

Firstly, congratulations and well done for getting to 3 weeks. What you’re doing is incredibly hard and you sound to me like you are doing fantastically.

As some one who has very recently (8 week old baby) been through this I wanted to share some thoughts.

1. I would urge anyone in your situation to feel empowered to do whatever is best for their family. There is no generic ‘best’
2. Treat all the dogma around BF e.g nipple confusion, supply drying up, you must feed 12 times a day, you need to pump/take fenugreek, your baby has a posterior tongue tie etc etc with a huge pinch of salt

Much of the advise is based on zero or at best weak evidence. People who share their experiences also tend to be a self selected sample. For example people who combo feed and reduce their stress significantly tend not to talk about it on forums, whereas those who battled with ebf do…

full disclosure, Im ebf and got drawn into the world of breast feeding consultants, cranial osteopaths, tongue tie release and really wish I’d done things differently! now I feel I’ve come so far it’s hard to change x

I had this a couple of weeks into breastfeeding and it was agony. I recommend the mam compresses and/or silver cups to heal your nipples. They are miracles. I found the cream wasn't enough.

In my experience using those and keeping going resolved everything in a couple of weeks but if it's too much then that's also absolutely fine.

When I moved from pumping to breastfeeding I had a lot of engorgement as my supply regulated. The advice I had was to hand express for comfort (not an electric pump as it can increase supply), and everything settled after about a week. Hand expressing didn't take long - a few minutes made everything much more comfortable. Apparently engorged breasts are much harder for a baby to feed from, so hand expressing before a feed might help with the other issues?

I could have written your post a few days ago…and although I have to say….I’m not all the way there yet…but we are getting there.

As others have said- it’s such a personal decision, but one piece of advice that helped me…don’t give up on the worst day (or worst middle of the night)….it will get better.

From a practical point of view….if breasts are hard…you need to try and get the milk flowing. I has engorgement on both sides twice, the first to the point where I literally couldn’t Hand express anything! The midwife was even in the shower with me trying to push it out! In the end….baby worked best…he was the most efficient way to get the milk flowing. I used nipple shields the first time to handle the latch, as my boobs were just too hard for baby to latch on. Then my husband massaged my boobs like crazy as baby was on to help with the lumps and to get us mich out as possible. I got rid of the shields after a few days….and the engorgement was back…..so called on husband again to do the same! It was amazing how quickly it helped.

i was feeling so overwhelmed and emotional (and still am some days) but I what really helped was some practical advice to help with current situation. Improve your latch was the only advice I kept seeing online…was not the most helpful…

The early days of bfing are so tough. I found calling the NCT breastfeeding line really helpful as the women there were always so kind and caring and knowledgeable. Good luck and hope you don’t feel too despondent. Hopefully it will get easier for you soon

If you are engorged you could try and hand express before feed so baby isn’t being overwhelmed at the breast to begin with as that will affect latch which in turn will be the reason why nipples are sore. It can be really uncomfortable at the stage you’re at as your body hasn’t regulated your supply. When I have engorgement I concentrate on ensuring the latch is right feed baby and once baby is fed I then express with a pump as that’s the only way it gets better for me is by ensuring the breast is completely empty just have to be careful not to pump too much as that will increase supply which could lead to being more engorged. It’s a mind field at this stage I know! If you want to carry on you could look at getting some professional feeding support, do you have an infant feeding team in your area?

I think your supply is still getting settled so cluster feeding is to be expected, as well as a bit of engorgement. I would echo the above about hand expressing for comfort.

The crying on the boob might be a strong and forceful flow which might be too much for bubs so keeping a towel handy to catch the first let down spray might help.

If to do get the start of mastitis, look at updated advice:

• cold compress or icing the area is now advised, not heat. I froze bananas and the were great to fit the curve of my boob
• ibuprofen to act as an anti inflammatory.

I've taken that advice on two occasions and prevented full blown mastitis.

Good luck, you're doing well, it does take a few weeks to get established. Obviously goes without saying that you don't need permission to ff though so if it really doesn't work for you or your family to ebf then make that change.

And congrats on the birth of your baby

Seek help from a breast feeding consultant.
I like Twisbe's advice above.
Engorged breasts are much harder for the baby to attach correctly so hand expressing before having baby latch on can be helpful.
If I were in your position (I have fed four babies) I would get medical treatment for Mastitis (which can happen very suddenly and needs treatment) or Thrush from your GP and have a consultant make sure the baby is latching on in a way that doesn't have your nipple chafing in pain with too much friction.
Take a painkiller, rest, shower etc and seek the help you need.
Refrain from any alcohol as it increases engorgement by relaxing you and causing let downs of milk.
Breast feeding might be natural but it doesn't come naturally and it takes a few weeks to be super easy and comfortable.
For me, the worst was over at about six weeks and then it was very managable.