Cracked bleeding nippes

[Madigan]

I am really suffering with cracked, sore and bleeding nipples. This is my 3rd baby - he is 5 days old, and I am really struggling with bf as a result. I would be extremely grateful for any advice - I don't want to give up bf, but I can't carry on like this ....

With DC1, I had a little nipple soreness at the beginning which would be sore for about 10 seconds after DC1 latched on and then would disappear. After a week or so, there was no more soreness.

With DC2 no problems at all - she breastfed like a dream.

With darling DC3 I developed sore nipples by about day 3 and was in excrutiating pain yesterday - so much so that I had to stop bf and give a bottle. Nipples bleeding and the skin coming off ... not pleasant.

I am CONVINCED it has nothing to do with baby latching on incorrectly/incorrect positioning ....... I have lots of experience of bf (with my 2 other children). It is DC3's actual sucking action which is causing the problem I think - he sucks incredibly hard and his gums are very hard, so he is almost biting the nipple (or that's what it feels like).

Today I have started expressing every 3 hours and then giving him the expressed milk - but I need to top him up with formula as well, as I am unable to express enough to meet his needs (I have never been particularly "productive" when it comes to breastfeeding).

So, would be grateful for advice on:

1. What I can do to get nipples to heal?
2. How can I keep milk supply up (how often should I express? and what sort of quantities should I be expressing?
3. Is there anything I can do to avoid this situation happening again, once nipples have healed?

Sorry for long post - desparate for some guidance, as I do not want to give up bf with this dear little baby but I just cannot stand the pain at the moment.

Many thanks

sorry - in message below - should say I am not "productive" when it comes to expressing; but with breastfeeding I usually have no problems.

With my DS I had to use nipple shields for a while to allow my nipples to heal in the early stages (I know lots of people on here warn against using them because it's felt they can reduce supply but it was the only option I had at the time!). Once I healed I stopped using the shields and didn't have any problems with supply at all.

With my DD I had terrible pain and bleeding problems, and gave up after almost a month. We later discovered she was tongue-tied. Has your DC3 been checked for tongue-tie?

Hope you can find a solution which works for you - I know how painful and upsetting it is.

You may already have it but if not, get some Lansinoh. I had unexpected problems with cracked and bleeding nipples, just as you describe with skin coming off etc, when DD was born 2 weeks ago (BF was pain-free with her older brother so I was caught off guard) and religious application of Lansinoh after each feed has really helped them heal.

Tried the nipple shields, but just could not see how they could work - my nipple did not seem to be big enough (does that make sense?) -

He has not been checked for tongue tie to my knowledge, but he drinks perfectly well from a bottle (would tongue tie prevent that?).

Yes, I have that cream and am applying it regularly ...... did you continue to feed through the pain? Am I being a wimp?

I know you're sure the problem is not latch - but this sort of problem is almost always latch. Sometimes it is tongue tie.

His gums should not be anywhere near your nipples - your nipples should be very far back in his mouth.

You should be expressiong 6-8 times per 24 hour period.

Can you go see anyone about the latch?

try jelonet dressing (from pharmacy/boots) - worked very quickly for me with dc1. i do sympathise, it can be agonising.

kellymom says 8-10 times a day - it needs to be a lot as he's still so young. see []www.kellymom.com/bf/supply/maintainsupply-pump.html here]] for more.

obviously the best thing would be to get him back on the breast so i second nqc's suggestion of trying to see somebody who can help.

good luck

sorry, link is here

third the tongue tie check. DD had great latch i still had sore nips, had it snipped her latch adjusted (not obviously externally but could tell as nips were much better shape post feed and feeds more comfy!) while the latch changed my nips got worse as it did (as they were used to old latch) but now they are better.

info here: www.babyfriendly.org.uk/items/item_detail.asp?item=439

Thank you for advice everyone -

Anyone know where I can find out about local breastfeeding counsellors who will come and visit me at home? NCT and La Leche appear only to have telephone helplines, and I think I need someone to come see me and see the latch etc.

Anyone have Clare Byam Cook's phone number?

Secondly, who should look to see if DC3 has a tongue tie? Should I ask midwife to look (but she is not back until Wednesday), or should I take him to GP?

With Jelonet - do you keep it on all the time between feeds?

Thanks

With tongue tie try and find a breastfeeding specialist midwife. My doc didnt belive in tongue tie, my postnatal midwife told me DD's tongue tie wasn't severe enough to warrant snipping (but considering since it has been snipped there is a PHENOMENAL difference in feeding - and a reducation in amount of formula she needs- (lost too much weight so formula top ups). Hers was a posterior tongue tie- harder to diagnose and snip.

Whereabouts are you based OP?

This link helped me confirm the diagnosis of DD's tongue tie:
parenting.ivillage.com/newborn/nbreastfeed/0,,91wd,00.html

Locations where tongue tie can be divided:
www.babyfriendly.org.uk/page.asp?page=154

The royal free in north london isn't on the list but is where DD had hers done so also an option.

If you are tempted to pay for breastfeeding help, I hear that board-certified lactation consultants are properly tested and supervised. I think you can get NCT, BFN or ABM people to do a home visit, or see you in a drop in - it depends on your local availability. If you tell us where you live (nearest town) we can dig up drop ins for you, and see what your choices are.

Alternatively, if you call the NCT, BFN or ABM helpline from a landline, they will connect you with the nearest breastfeeding counsellor from their network. Which of those three is best for you depends on where you live, helpfully enough. (I don't think the LLL does as much in the way of latch-fixing, although I could be wrong?)

Hello all, and firstly thank you sooo much for all advice and support. I really appreciate it.

I got the midwife back yesterday to look and see if he has tongue tie and he definitely does not. So that is that.

My nipples seem to be healing a bit, but I did one bf yesterday and it destroyed my nipple again - bleeding etc. I am CONVINVCED latch is ok - I really am, but I do think I need a bf counsellor to come and watch and advise. I am prepared to pay, and my nearest towns are Cheltenham and Cirencester. Would be grateful for guidance as to where to look for a qualified counsellor to come and visit me.

I am really determined not to give up on bf at this stage ....... so am going to do everything I can to get this sorted out.

Have been expressing using a hand pump, but I only get a maximum of 2oz each time - is that ok do you think? Sometimes it is only 1oz. Expressing every 3 hours (but not at nighttime). I am not expressing enough to satisfy DS though, so he is getting formula top ups. My big fear is that I am sabotaging my milk supply with all this messing about, instead of just letting him bf as and when he wants. But honestly, I was dreading every bf as it is it just so agonising .....

Any further advice would be greatly appreciated.

Oh and I tried Avent nipple shields - did not work at all - far too big and cumbersome and baby would not suck on them.

Oh, and i have ordered a Medela Swing electric pump online which will hopefully make expressing a bit easier.

I like the avent shields but I do have some smaller medela ones that didn't work for me- I could post them to you if you wanted?

Probably at 5days old a couple of oz is plenty, but if not satisfying then may need more. Expressing at night is going to get your best yield and also important for supply.

FWIW my dd was fed through a nasogastric tube for first week of life so I expressed all her feeds, then she wouldn't latch unless with nipple shield, she lost 14% of bodyweight, were on crazy feeding and pumping regime and at 7weeks her tongue tie was snipped. it was only then that my supply finally caught up (as she wasn't extracting milk effectively) and at 14weeks DD is predominantly breastfed (she has one formula top up at night)- so although the first 6 weeks are improtant in terms of establishing supply -my story is one that took a bit longer but we got there in the end so try not to worry too much! Cracked nips are agonising!

Are you taking pain relief 30mins before a feed? Also feed first from least painful side and finish off on the most painful as baby wont be as hungry so won't attack the nips as much.

Also maybe consider hiring a hospital grade pump for a month or so (we have had ours for 3months now and they are amazing am going to struggle to give it up!) but you will get maximum yield from them
www.nctpregnancyandbabycare.com/shop/hire-services/breast-pump-hire

Only just caught up with this but wanted to say no, you are absolutely not being a wimp! Hope the advice from others has been more useful than mine

Thandeka, the baby sucks your nipple into the shield - does that make sense?

When i first used them i was puzzled like you as they look far too big for a nipple but just pop them over, shove the whole length in baby's mouth and their suck action makes it work.

Peasplease- I know they work- I used them for first three weeks of DD's life as couldn't get her to latch at all otherwise- then I weaned her off them slowly. But OP didn't like the avent ones so I offered her my smaller medela ones which I found didn't suit my nips at all. (I mean it's all about the nip fashion dahling)

Lansinoh was a life saver for me. You havnt got thrush on your nipple or babys mouth? that can make it vvv sore too...good luck

Thrush is unlikely, this early in breastfeeding, unless there are other health issues.

If you are bleeding, it is not wimpy to compalin about sore nipples. Frankly complaints about sore nipples are always worth looking into, whatever else is going on!

Pumping every three hours should be ok, as long as that adds up to 6-8 times per 24 hour period. I'm afraid that at least one of those times has to be in the middle of the night, for the sake of your supply.

I'll go look for BF help for you in that area now.

This page has local BF groups for you. I realise making it to a group may be tricky for you, but there are some contact numbers there, which might be worth ringing to find out about home visits?

This organisation looks relevant, too.

NQC - which page? could you pls post me the link .... thank you SO much for your help.

Sorry - being completely dim .... you have already given me the link.... THANK YOU xx

Have arrangd for loacl bf counsellor to come and visit - so thank you,
Nipples have improved a lot now - due to giving them a rest (expressing instead and using Medela nipple shields) and buckets of Lansinoh cream. I have fed today normally and it was not toooo bad. Thank you for all advice and support xxx

Bio-Fem nipple cream - amazing

Also they do cooling pads for instant relief

Sleep braless on a towel

Try biological nurturing for a better latch & instant improvement!

x