what do you REALLY want to know about breastfeeding?

[LizaJ]

I had an absolute nightmare breastfeeding for the first 8 weeks and got really fed up with the fact that my experience was so different from the one portrayed in a lot of the 'official' information from the NHS etc. Being a nerdy scientist by trade (and therefore having free access to medical journals), I started to look into what the actual, clinical research says about breastfeeding, and was amazed by some of the inaccuracies that are out there.

I have been sharing the info in a blog, but so far I've only really written about the things that have affected me. I was wondering what breastfeeding topics other ladies would like to know 'The Truth' about..?

Sorry bedlambeast, I really can't agree given my experiences of early bf-ing. Or maybe I'm abnormal.

"If feeding really hurts it will usually get worse as the damage worsens until something changes"

Probably true. But the thing that changes might be many things including the nipples adjusting physically to bf-ing

again I'm with Juule

I'not (yet) read whole thread, but feel the need to add:
It would have seriously helped me if somebody, anybody had aknowledged when I was struggling that yes, BFing can be hard.
I had lots and lots of RL advice with DSs 1,2, and 3 and still found it hard. It was only finding MN last year that took the feeling of "oh, well, I must be a particular numpty for finding this v natural thing difficult" away.
So thank you MN.
Liza, yep, your blog bookmarkded here too, thanks .

I'm with Juule too (although I do think shredded nipples sounds rather suboptimal and worthy of investigation and observation of feeding). For me, the pain goes after a couple of weeks. I put it down to being fair skinned with tender nipples.

duchesse - that's specifically what was said though - not just pain, which I know can be normal, but actually bleeding and tearing.
Not rubbishing anyone's opinions, just genuinely confused because I have been told by several bf experts that blood/damage as opposed to sensitive type pain indicates a problem.
Looking for clarification as I am worried about next time bf.

tiktok
I think better catagorising of nipple pain might help. I had sharp, almost pins and needles sensations when my baby latched on, for about 20 seconds, in the early days. Now I just get it in the breast he's not feeding from if I've gone a while between feeds. As this didn't sound like thrush or a poor latch pain, I didn't worry (and used to hum Metallica until it stopped).

Also, MWs letting women know about what shape your nipple should look like after a feed (eg round rather than pinched like a lipstick) would be helpful. I learned all of this from other sources, rather than the people who were supposed to be supporting me (though I didn't speak to a BFC to be fair).

I think one of the other things about bleeding and damage is that IME (and see previous posts about cluster feeding) if the early positioning isn't right, the damage done can be done so very quickly and so brutally. I only really worked out the 'lipstick nipple' thing with DS2 and it also took an experienced BF adviser (a MW incidentally) to know that having already BF a baby, I was 'overshooting' my hold, as if he was older, so too 'high' on the nipple. These were tiny, tiny things, minute adjustments that only someone very experienced could see, but which were not picked up in hospital 'yup, looks good' everyone said. Yet each time, the end of my nipples were being compressed and squashed and damaged. And because all my babies cluster fed so very much in the first couple of days, there was so much damage immediately, it took weeks to heal. It didn't help that I had big hungry babies who fed a LOT. So the slightest, overtired slip of positioning in the middle of the night, would just re-pinch any damaged areas.

That and the thrush. Argh.

So, I would say it is CRUCIAL, even if it doesn't hurt in hospital (if that's where you are) to ensure the position is really right. I just don't believe in 'toughening up'. I do believe it is incredibly easy to damage nipples - and I remember even the tiniest micro spot of damage being incredibly painful.

Whispers- I never ever had any pain bf DD even at the very start. [runs away]

We don't know everything there is to know about nipple/breast pain, that's for sure. Thrush on the nipples can happen; thrush in the ducts is controversial and not everyone agrees it happens.

Any book that talks about preparing the nipples in pregnancy with a towel or whatever is talking utter rubbish - that has been totally discredited years and years ago.

I don't think people should be told 'if it hurts it's your fault for getting the latch wrong' - far too simple, far too 'blame the victim'.

What can I say? I, and my bfc colleagues, see women all the time whose nipples are painful (and often damaged), and who have been told 'your latch is fine'....and it just isn't. With experience, good bfcs can help most mothers like this make a real improvement straight away, and while a total 'cure' in the worst cases does not happen immediately, this improvement does usually continue and the mother and baby 'fit' comfortably and happily.

Some babies have a tongue tie, but far more often than this is simply the baby never having latched in a way that takes in a good mouthful of breast. Self-attachment, skin to skin, lots of getting to know you practice in the first days....it all helps.

Skilled, knowledgable help and support should be given to all mothers who need it. It isn't.

I wish I had known that some BF babies do sleep through, with DD I made the classic mistake of a bottle at night, then added another in the day to 'settle' her, and before I knew it she was FF at 13w. And never slept through till she was 1 anyway, miserable baby all round

DS, BF and now 20w, been sleeping through some nights - not all, but enough that I feel sane - since 10/11 weeks and the happiest baby. I am really enjoying BF him and v proud as we struggled with weight loss and a brief spell on top ups( formula initially then EBM) that drove me demented, he really did just need to get a bit bigger and stronger so he would feed more effectively - thought the HV was talking bollocks but she was right

I also had shredded scabby nipples for the first week both times but lansinoh and getting used to BF seemed to sort it pretty quickly - only get the odd twinge when he clamps on and swings his head round to look at me and giggle during a feed.

I would like to know, is it awful when they self wean, do you feel all rejected or satisfied with a job well done. And if I'm still BF when I go back to work will I really be able to just BF when I'm at home (hopefully he'll be having water/cows milk in a cup by then).

Ok how about this then.

Ive never known the lipstick shaped thing before this thread.
I've fed 4 babies, each time my latch has been the same (or babies has)
Each time I've bled and split in the first week then healed and carried on fine. Each time my babies had put on weight brilliantly (excpeting my premmie but thats a different issue)
this time I had thrush. It has now cleared up. Ive also noticed int he last week odd shaped nipples after feed, lipstick shaped could describe it. I dont have any pain, baby is very content (I have my chilled one at last) and hes putting on weight like a wild thing. So should I be worried about lipstick nipples?

Completely agree with Tiktok .
I can't count the times I've seen women with shredded/bleeding nipples who have been repeatedly told all is well by numerous people despite actual pain and damage. Yet, with skilled help, improvement is often immediate and sometimes dramatic. In fact, almost exactly 4 years ago, I was one of those very women .

For some mum/baby pairs, this sort of nipple trauma does seem to resolve itself after a couple of weeks -perhaps as baby's mouth grows larger, or maybe baby themselves adjusts the positioning. Who knows. The thing is, that many mothers in this position could be helped much earlier, and although some cases do seem to spontaneously resolve, others don't unless they get skilled help, particularly to rule out underlying problems such as tongue tie.

Towels on nipples and toughening them... oh the very thought . Burn that book, it's rubbish .

I don't think it would have made a jot of difference in my case.
By the time I was feeding my later babies at least, I think I knew what I was doing getting a baby to latch correctly. I agree that I had learned to minimise the cracking/bleeding by resting that side but it still happened to a degree. And the toe-curling initial latching happened for all of them.
I do think some of the cracking/bleeding problem is caused by a tiny mouth that is still learning how to feed and as the baby gets a bit bigger and more experienced things ease. But there's not a great deal you can do about that in the beginning really, is there?

But I agree that the help should be there for women who it would make a difference for.

Toe-curling initial latching in the early days is not uncommon and may link to the issue of sensitivity discussed earlier. A slow count of ten and some deep breaths should be sufficient for it to pass, otherwise it's likely to be caused by something beyond breast tissue stretching and the nipple making its way to the back of the baby's mouth... If it does not ease in that length of time, then that is worth a closer look by someone skilled in breastfeeding at positioning and attachment (latch).

Usually the stage of feeling this discomfort passes fairly quickly, although in addition many women do report sensations ranging from tingling, to prickling to stabbing pains as their milk starts to flow more readily during a feed (let-down). The sensation is short-lived during each feed, but how many weeks/months it may be experienced by the mother seems very variable. Whether or not any sensation is felt seems to have no bearing on successful breastfeeing.

I can only re-iterate, that I have observed many mothers with babies sometimes only a few days old being helped by experienced volunteers with positioning and attachment. Babies may have small mouths and sometimes in combination with a mother with large nipples. In many cases small adjustments do lead to a noticable improvement for the mother, even when others have told her repeatedly that her baby's latch is fine or even 'perfect'.

There is also an element of re-learning with each baby, as when we've fed a previous baby, or most recent memories are of feeding a bigger baby. A newborn is a different thing, and each mother/baby pair are unique and fit together in their own way. Feeding each child can be a different experience.

To give you a personal example, I've already said I had nipple trauma and pain with ds that was eventually improved when he was aroung 3-4 weeks old with skilled help from a bf Supporter. Many many MWs and one HV had all told me things looked really good, but it hurt a lot . Basically, I continued searching for alternative sources of supprt until I found someone able to help me. With dd, I never experienced nipple trauma at all and all I had was a few days of sensitivity, which as I've said was just like that I'd had throughout pregnancy. We had qualified bf help from when she was 6hrs old, and yes another person was able to make helpful suggestions to keep us on track as we learned together.

toe-curling initial latching and after-pains... I was very disappointed with ds2 to experience what felt like a 20 minute contraction every time he fed for a few days...
the bleeding nipples may or may not be avoidable, but were by no means the worst of it.
My mum had quietly mentioned that afterpain was worse the 2nd time, so at least i had some paracetamol in my bag instead of having to try and draw the attention of the chatting incredibly busy staff....

I think Grendle made a really important point: that sadly we often have to search around for the right help, sometimes after 3 or 4 or 8 people who are supposed to know how to help us. In that context, 'hurting' can feel normalised, because we feel like we have tried everything. And I think this is why some BF advisors stick to the line that it shouldn't hurt. I agree with them, despite the fact that it hurt for 6 weeks for me with each baby. I didn't seek help earlier out of my own bloody-minded pride and stupidity that I shouldn't need it. First time round I knew no better; second and third time (with big gaps between babies) I thought I bloody should have known better and suffered too much because of it. And after 3 CS I was dependent enough and wanted to be able to work it out for myself

BF is just not only a mechanical thing: lots of different hang-ups get in the way (and not all of them are our own to solve unfortunately)

tried the baby on tummy BFing position and my goodness - so much easier for us both than the positions we had been taught!

One of my nipples is lipstick shaped, not after feeding but all the time - that's just the way it is! and feeding has always hurt a lot on that side where as it doesn't on the other side. is there anything I can do to ease this? surely the latch is fine if I now have no problems with the other side? Was the midwife in recovery right? - do I just have a crap nipple?

Can anyone help out here?

lizaj - I think your blog is excellent, and I've just forwarded the link to my friends.
I would like "The Truth" about breastfeeding prem babies. My last two have been born at 35 weeks, and (despite the signs up in SCBU promoting breastfeeding and kangaroo care) I have had to fight to try to breastfeed them ("surprising" the medics when they managed it and didn't need tube feeding). I have then had to fight to NOT feed them on a three hour schedule, but on-demand. I've taken the medics on over these issues instinctively, having successfully breastfed my first (term) child. If there is some research to back up my instincts it would be fantastic to have it accessible from a site like your so that women can brandish it at the medics.

To add to the sore nipples debate - I've always felt a bit embarrassed that breastfeeding has never been sore on my nipples at all. I'd heard that it "always" hurts to start with, so went to see a bfc to ask if babies latch was wrong since it didn't hurt!

My other "Truth About" question... For about the first 3-6 weeks after each babies birth, I feel very, very teary and emotional just after latching them on, lasting 5-10 minutes. I quite often sob - meaning people assuming its painful, which it isn't at all! I've never met anyone else who has experienced this phenomenon, and would be interested to hear about anything that causes it (hormones?) and anything I could do to avoid it.

I would have liked more info about the first few days. What happens when your milk doesn't come in until day 7 (or later)? What should you do when your baby latches well, but drops over 17% of his birth weight in 5 days? This has happened to me twice now and no where have I found any info on what to do until hospitalised as LO was badly dehydrated.

ladyhelen - it's poor postnatal care for no one to recognise there was insufficient milk transfer before the baby had to be hospitalised

The signs are not difficult to spot - if the baby is not transferring milk, he will have scanty (or no) poo, and/or passing meconium only on day 3-4. He may also wee very little (though dry nappies are a later sign). Someone who knew what to look for should have explained to you how to spot your baby sucking and swallowing and if there was any concern about this, you could have started hand expressing colostrum from about day 2, which could have been given on a spoon.

Saying a baby is latching well is only a tiny part of the supportive check every mother should have.

A loss of 17 per cent off birthweight at 5 days does mean something should have been done before, I think.

V interested to hear your difficulties (or lack of them) bf prem babies hedgiemum. I know of one study that shows babies can gain weight adequately when fully bf at 35 weeks (www.ncbi.nlm.nih.gov/pubmed/18460108) but there is a lot of other research in this area I've yet to look at.

The tearfulness could well be hormonal - has anyone else experienced this?

I know one (!) other woman who never found bf painful. I'm sure there must be more out there...

Hedgie- I've mentioned on mn before my fight to feed my prem baby. It seems to be a regular thing. They like bottles because they can see how much is going in