Breastfeeding help - 5 weeks and have resorted to nipple shields

[Breastfeedinghelp99]

Hi all,
I have a 5 week old, who is has been breastfed 90% of the time (1 max 2 bottles a day, usually expressed) He was in the NICU for a few days and supplemented with a tube, then bottles while my milk came in. I’ve been trying to wean off them but it’s been a journey.
we got diagnosed with thrush at 2 weeks but it’s not improved so they have now done as a swap as it might not be thrush. Yesterday I saw the feeding specialist and GP who both advised nipple shields due to severe nipple cracking to give them a break. I’ve been using medela ones all day, things are less painful but I can still feel it.
can anyone give me advice about how to heal the cracks? I want to wean off the shields asap as I can see he is latching terrible with them.
i know his latch isn’t great on the breast, been assessed for tongue tie but told its fine. I’ve seen so many people who have said his latch looks fine, I just feel like I’m going mad! Thank you!

Ah sending you support in the middle of the night. What a trial you’ve had. I have breastfed three babies over six years of my life - and one of them (my middle one) I never stopped using nipple shields as I just couldn’t get the latch to work eithout it (he had a tongue tie snipped). So my experience (but note I’m not an expert) is that if it works for you, use them - I did for nearly two years. My other two (apart frol a few weeks with the first, see below) rhe latch was fine.

my first baby’s latch was also terrible and we used them for a bit, but the cracked and bleeding nipples is what first brought me to mumsnet for advice many years ago (that baby is taller than me now!). Once he grew it got better/easier. I also had thrush symptoms but maybe not thrush… in the end my milk got tested and a sympathetic retired GP (not my “breastfeeding isn’t supposed to be easy, have you tried a bottle” normal GP) prescribed strong antibiotics that helped - it was mastitis (in that my milk had an infection) but not presenting with classic symptoms.

sending gentle hugs and congratulations on the birth of your little one xxx

Have you tried the silver cups? I didn’t use them personally but had a few friends swear by them.

When you say feeding specialist, have you seen a qualified IBCLC? If not I would really recommend it. If you can find one that is also qualified in TT division that would be great.

GPs are not qualified and mainly minimally trained in assessing TT. I was reassured by so many people that my LO didn’t have TT, but she was eventually diagnosed when nearly 1. We didn’t actually get it cut but did oral exercises to stretch it and I fed to beyond 2.

Mine wasn’t a NICU baby, but was under the jaundice UV and in hospital for a few days where I was pushed to give her a bottle, so we had a similar journey of weeks before we eventually moved to exclusively bf.

Have you found any breastfeeding support groups near you? Personally I found them really useful for shared experiences.

Wishing you all the best, it’s not the most straightforward journey for everyone and so emotionally charged. But you are doing an amazing job.

I just want to see you’re doing a great job but also remember that your health and wellbeing also matters.

DC1 never ever latched for me (no one ever figured out why, possibly due to me having flat nipples). I did try nipple shields for a bit but as he got bigger, he would become livelier and his moving arms would knock the shields off.

If things get too much, don’t beat yourself up about switching to bottle.

Thank you! Interesting about mastitis, GP did ask about it all the symptoms for it, maybe the swab will also test for that? I was a mess in the GP surgery so wasn’t asking many questions.
thank you for your experience with shields, it’s really reassuring. It’s hard to not read all the information about how terrible it is to use them or a bottle, and then head down a rabbit hole of feeling like a terrible mother!

Thank you! Yes, I’ve ordered some silver cups which say they will arrive today, really hope so - bad timing with Christmas!
the feeding specialist I have seen is IBCLC, although it took 3 visits for her and to check for tongue tie properly and only then because I was crying and begging her to check!

Thank you! In the cold light of day I feel better about combo feeding/switching to bottle but in the night I feel like a failure and end up crying and arguing with my husband about giving any more bottle. I think I’m driving us all mad!

Honestly it’s not worth the cost of your physical and mental health.

I felt like i needed permission to stop trying with DC. It was such a relief one day when i just thought ‘why the bloody hell have i been doing this shit for 5 months’ and gave up.

I didn’t even try with DC2.

Keep going if you want to but please remember that you matter too and your baby will be fine. My kids are 5 and 2 now and no one gives a shit who had breastmilk.

Hi, I am having similar struggles with my 5 week old. Jelonet dressing cut into little squares and placed on the nipple between feeds helps cracks heal and stops any wound sticking to your clothing

@Plantainplantainand @Breastfeedinghelp99you are both bringing back memories of my earliest days on mumsnet, as a crying, emotional, bleeding mess over 13 years ago. Jelonet helped a bit for me.

@Breastfeedinghelp99have they taken a sample of your milk to test for infection? That’s what helped for me eventually. And my middle one used to toddle around finding nipple shields once he was old enough to walk… it was quite funny!

I promise that although this feels The Biggest Thing Ever right now, in a few years you will look back and it will just become part of your parenting story. This too will pass…

I have inverted nipples which never "popped out" as various health visitors assured me would happen! I used nipple sheilds for both my children - both for about 18 months and it definitely did not affect my milk supply so do carry on using them if they work for you

The only issue was an uncomfortable Christmas Eve when DD1 was about 18 months and just having a feed before bed and we were away at a friend's - I'd forgotten a shield and were both so uncomfortable that we ended up driving home. (After that there was always a spare in the car.)

Thank you! I’ve ordered some to arrive on Saturday hopefully!

Thank you! I have not but will ask them to, I feel like I’m there all the time at the moment.

Merry Christmas
My godson's mum used shields for a whole 9 month feeding journey
I know all the advice is they are terrible and not to use them- but I just wanted to share this to say don't panic and make rash decisions based on something that might actually be working ok.

Hi there it's a midwife with specialist infant feeding training and infant feeding support experience.

You have made an incredible journey so far, give yourself credit where credit is due.

I am a little skeptical about the real training and experience of your lactation consultant.

If a woman was to present with cracked and bleeding nipples, every specialist midwife I know would have assessed for tongue tie as a routine inquiry. I have seen plenty missed by hospital midwives.

Most likely reason your nipples might are still cracked and bleeding is plain old positioning and attachment. Again, I have seen plenty of women who have been told it's fine and yet small adjustments made a big difference.

It's always good to be on the lookout for thrush- however it doesn't sound it's ongoing issue (if it ever was).

It doesn't sound from your description it's mastitis either.

My suggestions

1. Try to find another person to have a look at your positioning and attachment and assess for tongue tie. NHS infant feeding midwives are incredible if you can find one locally. I will post some videos shortly

1. Try feeding in rugby hold position- has it been shown to you? If not, please find someone to show. It often works wonders, tongue tie or not. Especially if a woman had a Caesarean and can't really lean forward to get good positioning and attachment in cross cradle position.

1. There's nothing terribly wrong with using nipple shields for a few days. However there's evidence they decrease milk supply in the long run.

1. Breastfeeding Network charity website has a lot of useful links on thrash, mastitis and how to treat cracked and bleeding nipples - in my days we used moist wound healing method- basically lots of vaseline between feeds which needed to be gently wiped out before the feed (to stop the baby slipping onto the nipple- milk is in the breast, not in the nipple).

1. Please try to feed at least once between midnight and 6 am - this is the time when milk hormones are at the highest level. Also, try to pump between the feeds if you can.

1. Finally, I have never seen the woman with cracked and bleeding nipples after 8 weeks. And not because they all stopped breastfeeding (even though many do - the pain is excruciating). It's because babies grow so fast but the size of the woman's breast and nipple stays the same- eventually all babies start feeding from the breast rather than the nipple. I have seen it time and again in our breastfeeding support groups - once positioning and attachment is corrected and the nipple is nicely inside the baby's breast- the woman would tell us "the pain is still there however nowhere near as bad as before". (I would always say to women- count to 10 slowly and if there's no reduction in pain - then release the latch and try again. Once positioning and attachment is corrected women sees a big improvement in the state of their nipples in 2 days, even though it would take 2 weeks for nipples to heal properly).

I hope it helps

https://globalhealthmedia.org/video/

Please check out Breastfeeding videos in English from the link above- they are very good

Especially the first one that will come up - "What to do about nipple pain" - it's 7 only 7 minutes long.

I hope it helps

please don’t beat yourself up over this! I really struggled feeding my first, and used nipple shields the whole 10 months I fed him. I also combo fed him, so he had one or two bottles a day on top of the 6+ feeds. I wish I hadn’t put so much pressure on myself to BF. And interestingly I had two more babies, didn’t have any issues feeding them, didn’t need to use nipple shields, so think it must have been the physiology of his mouth.

For the first four months, I expressed everything for DS. Then I was able to get him using nipple shields. A couple of months later, he could feed without

DD was the same story, but with shorter stages. Don’t beat yourself up. If nipple shields work, stick to them.

Thank you all! Just an update, I stopped the shields for half a day as my nipples felt better, baby latched no problem (so no concerns about the shields causing confusion) but the latch is still bad and my nipples we’re cracked again and felt like someone had sandpapered them within hours. Again the latch looks fine from the outside but clearly something is off. I’m back on the shields purely because of pain.
one thing is that my milk transfer is definitely worse with the shields, baby has dropped weight / this has really upset me and the HV did gently suggest we increase the formula to get weight up, I really don’t want to do this but of course will if it’s a medial need.
baby is falling asleep constantly when using the shields (not happening for the half day I came off them and I have 7 different kinds and it’s happening on all of them), also back to feeding every 45 mins to an hour, so constantly staving off mastitis when I am having a few hours rest overnight.
Ive booked in with a lactation consultant tomorrow, as a throw everything at this situation. Really hoping they help with latch and positioning as I’m just at my wits end!
thanks for all your support, I’m hoping for a more positive turn in the coming days

Thank you for this, I really appreciate the advice!

Silver nipple cups really helped me

Hi there, it's midwife again.

Happy New Year!

Thank you for the update

It sounds you are having really challenging times however ploughing on despite setbacks. Well done.

From your description, it sounds you really need help with positioning and attachment. Please experiment with a rugby hold position.

In relation to tongue tie, have you seen your baby sticking the tongue out long enough to cover the bottom lip? If your baby can do it, the cause of your cracked nipples is poor positioning and attachment, not tongue tie.

Has someone told you to pump between feeds to increase your milk supply? If it's difficult to tell without full assessment however if your baby was putting on weight and suddenly started dropping off centiles my gut feeling is you don't have an underlying issue with your ability to produce milk.

I suggest you get a good pump and start pumping at least 3 times a day for 40 minutes (10 minutes at one breast, switch breasts, another 10 minutes and repeat both sides again).

Pumps are quite expensive however it has to be set against the cost of formula. With this regime you should see improvement in your milk supply after 3 days.

The idea is to keep the woman's milk supply going until other issues are being sorted out. Milk is produced on a supply and demand basis. As babies grow, they naturally demand more.

You say, you keep feeding non-stop to stave off mastitis. What do you mean by that?

Thanks so much for replying. I’m really confident my positioning and attachment is awful, I keep watching videos but just can’t get it right!
i can use rugby ball hold on my right breast and it is the most comfortable for me, just still end up with a squished white nipple after. I have quite large breasts so have cushions positioned but end up holing my breast which I think drops over time meaning the latch drops.

mastitis - im feeling engorged most of the time, baby will drain (mostly) when feeding but then they are full again 20 mins later. I tried pumping a few weeks ago but the breastfeeding specialist said this could create an oversupply and be causing the engorgement issues. I have a pump so might try today, when is best to pump? I feel like I get about 20- 30 mins gap between feeds and am mostly too scared to move for waking him and starting the cycle again.

tongue tie - to be honest all he does is eat, sleep and scream. We get maybe 20 mins a day total of wake time without screaming. so haven’t really checked the movement. Will try and check today.

thank you!

I should add with the lack of weight gain I’ve gone down a rabbit hole cows milk allergy, my husband had this as a child. He does have very watery poos and have a rash on his face while feeding (like hives) but it goes straight away after he stops and it also appears when he’s angry generally so I’m just not sure.