Breastfeeding post c-section

[Ebonythoughts]

First time mum here! It’s been 6 days I had my little girl via c-section and even though I’m struggling with how immobile I am with pain from the surgery, it’s breastfeeding that has been stressing me more.

I’ve had a few professionals and family members check my latch when I feed and since the first day baby has been latching well and feeding but the first struggle was that baby was refusing to be put down and only contact slept and was using my nipple after a while of feeding as a dummy which left me with super sore nipples. I think really struggled to keep feeding on demand because it felt like it just wasn’t filling her with just colostrum and even the midwives at the hospital suggested I top up with formula. I hoped I wouldn’t need it but gave in. I continued topping up with formula when I was discharged and came home because my milk hadn’t come in yet and this resulted in 3/4 formula feeds a day. I felt like I was losing hope for exclusive breastfeeding and when the midwife in the first home visit said that baby was a good weight and to continue doing what I was doing I felt like the weight gain was due to formula top ups and that solely breastfeeding would not have reached that weight.

Yesterday my milk came in properly after 5 days of waiting and for the first time baby started to sleep in 2 hour blocks after feeds and I only needed to use formula to top up once at night. BUT my breasts are extremely sore from trying to breastfeed on demand now milk supply is starting and I feel guilty that I’m dreading the night time feeds awaiting me this evening and the thought of giving in (I know it’s not giving in but it feels like it) and using formula when I have the supply to feed on demand now.

I know breastfeeding shouldn’t be painful and the actual feeds are not but when she finishes her feed she stays latched to my nipple till she falls asleep and uses it like a dummy. Half tempted to get an actual dummy, but I’d rather not use that.

Aldo thought expressing might help increase supply but I bought the Momcozy one and used it today and nothing came out even though my breasts were quite full so I’m assuming I’m using it wrong, has anyone used this brand? Is it worth changing it to another breast pump? How long did you wait from when your milk coming in to pump/express? I might have started it too early?

So basically, (1) latch is good but baby is using nipple as dummy post feed and causing me excruciating nipple pain that puts me off feeding. (2) starting to get enough milk to feed more but still feel formula may be needed until supply increases and feel guilty about it and worried it will prevent my supply increasing. (3) trying to express using the Momcozy electric breast pump and nothing seems to be coming out so I’m assuming I’m just not using it correctly.

Sorry for the rambling and all the questions, I’m just a loss at the moment and lots of mixed emotions.

Sounds like you're doing amazing. I had a c-section and it took a while to get my supply going but once milk came in things got better quite quickly.
Lucy Webber on Instagram is a really useful person to follow. She has a book out now too although I've not read that. She has some great information on pumping. Some advise not pumping until 6-12 weeks so you don't end up with an oversupply. Also, some people struggle to pump because you need to feel relaxed and have good hormones flowing for your let down to happen so looking at your baby/pictures of baby can help.
In terms of the pain, nipple cream is your friend. Also, if you're sure they're definitely finished and not going to flutter feed/come back for seconds you can always use a clean little finger to pop them off. Lucy Webber might also have something useful on her Instagram.

Congratulations @Ebonythoughts ❤️ just putting my little one down so can comment more later, but just wanted to say your doing amazing, and my number 1 piece of advise is get baby checked for a tongue tie by an approved practitioner (found on the association of tongue tie practitioner website) and have baby assessed. My three babies were all missed, only managed to feed my third without nipple shields as I’d learnt from my previous two and gone and had her assessed despite being in NICU 3 weeks and every dr/mw/professional telling me she didn’t. They can be pricey, £2-250 but if you sells etc a tongue tie practitioner that’s also an IBCLC you will get all the help in the world. Also highly recommend seeing an osteopath too- total game changer for my little girl. You got this mamma xx

There is nothing wrong with a dummy! Better than your nipples being red raw.

Thank you all so much! @wannabe123 i’ll follow Lucy now and will probably hold off on pumping and see if my supply increases over the next few days so I can ease off the formula.

@suspiciousmums I’ve never heard of tongue- tie! Thank you for letting me know. I’ll look into it.

@Rubyrubyrubyruby123 in the short term I was told it could affect supply because it can slow down how often baby demands milk because it comforts them. Long-term I work in early years and there’s a lot of research into dummies affecting dental health and speech so I’d rather not start something I have to ween off and possible long-term affects. Just a personal preference.

@Ebonythoughts you don’t have to use it forever, was just a suggestion. I swore I wouldn’t use a dummy until my little one had colic and it was the only thing that gave me some respite. She gave it up at two and has not had any effect on her speech or teeth but I was strict and after one she only had it for sleeping. Good luck.

Sounds like you’re doing amazingly. I BF after a section but milk was delayed coming in - nearly a week - due to haemorrhage and then sepsis. Like you it was sore feeding for a while and I worried about latch but with nipple balm and patience things finally got better and easier, probably from about 6 weeks onwards. I BF until she was 2 in the end and found it a breeze overall once I was past the first few weeks. Well done and keep going xxx

Also I did one feed per day formula for first few weeks mainly because milk delayed so she lots loads of weight and I was getting a lot of monitoring and pressure from health visitors and midwives so to get them off my back I did a formula feed for a few weeks to get her weight back up. It didn’t affect my supply as k only did one bottle/feed of formula per day. Bonus was it meant she would always take a bottle so when I started expressing (after 6 weeks I expressed one feed a day) it meant others could feed her on occasion I wasn't available x

I had a C section too. Nipple balm and silverettes helped me a lot in the beginning.

We topped up my son with formula for a few weeks which really helped my sanity/his comfort and weight gain. He gets a bedtime bottle with daddy at night and always has, which gives us more flexibility and me a chance to rest- I generally do all his other feeds on boob, even now that he's a 19 lb 4 month old and eating probably 1.5L a day! Nothing wrong with a bit of combi feeding, it gives me peace of mind knowing he will accept a bottle. We did syringe feed him the formula for the first 3 weeks though to prevent nipple confusion.

Can't help with pumping as I never got much success with it personally.

You're doing great-- congrats and best of luck!

Firstly congrats. 2ndly your midwife is not qualified to tell you nada. Speak to a IBCLC a proper lactation consultant.

My DS was the same. Long nursing sessions 45mins at the start passyfying and comfort.

Of you start doing formula your supply will drop. It is supply and demand. The more suckling the more.messages sent to the brain. No suckling means no supply is needed.

Please understand nursing is not just food. It is comfort and calming and reassurance and bonding. Look into Emma Picket online her blog is amazing she is a IBCLC and offers support. She is based in North London but does video appts. Fantastic lady saved me from PND.

My DS nursed to sleep and for comfort until we weaned at 20 months. He mever accepted a dummy and he was diagnosed eith a slight tongue tie. They said not worth messing with as recovery is long and waiting list on NHS was 2 years!!!
He is 28months now STTN and eats everything not fussy at all. It had 0 impact on him and he speaks very well for a 28month old.

Would generally agree with PP but just to say my supply never dropped. Jf anything I always had over supply (was lucky), so it’s not automatic that this will happen. And even if it does you can increase supply by increasing feeding :)

@Ebonythoughts I don't have time to read the replies so sorry if this is a repeated answer.

I had a c sec and I've exclusively breastfed for nearly a year now. BF in the first few weeks is tough and your body is learning to adjust. The first 45 / 1 min of a feed was so painful, but it eased greatly. BEST thing are silverettes or silver cups - they're £20 on Amazon. Don't take them off between feeds - cover your nipples in lanolin / breastmilk and it will heal and it will get easier. If you can keep going, I promise it's worth it - no sterilising, no fussing with bottle and pump equipment. Ask your midwives if they can send a breastfeeding consultant over - I had this in the first 10 days and it helped ease my worries massively. If baby is back up to birth weight, I don't see why you need to top up with formula personally. That makes life so so busy and you're busy and trapped under a baby most of the time. Contact naps are so so normal - enjoy the rest. Never miss a pill for the pain relief. It will get better and better and you'll feel more mobile in just 10 days. The body recovers amazingly. Good luck! X

Sorry don't have time to reply more fully but wanted to tell you that silver nursing cups were a lifesaver in the early days for me this time, for sore nipples (despite perfect latch). There's plenty on amazon. First time round my baby had a tongue tie so worth getting someone IBCLC qualified to check that. Good luck xxx

My eldest is 28 this year so it was a long time ago that I had this issue! i had an emergency C section so, like you, very sore for several days and nipples got extremely sore. Son was (in the words of the nurse) a right lazy one who didn't want to put any effort in himself! day 4 (stayed in hospital for a week after a section in those days) the lovely nurse came in with a couple of nipple shields and they changed everything. Baby could latch on properly and it protect my poor flesh until it had hardened off enough. Once the feed was over, I used a cream (Kamillosan??) to help the healing. Used nipple shields for the first few days on my subsequent babies and breastfed them all successfully for a year. if you haven't got any, try putting a teat from a bottle on instead as a temporary fix

You're doing great!!

My personal recommendation would be to give yourself a bit of a break by pumping. It's very normal to only get a small amount to start with, but if you feel like it is not working, get someone to assist you (like a lactation consultant, or the pump company itself!), and potentially try some different pumps too (you can often rent/borrow). If the NHS does not have anyone available for you, it could be a good private investment to see someone just for 1 session. My NHS trust actually was able to send someone around after about 2 weeks though, and she also replied to my questions via email afterward (only once every 2 weeks haha, because that's how much time she was allotted, but still!).

On dummies, I was dead set against them too, for the same reasons - but had a similar issue where the baby was just happiest with a nipple haha. So we used one (my SIL had given us a set 'just in case'). And then baby just quit using it around 5 months, just slowly stopped 'looking' for it and then completely lost interest. So weaning the baby off it does not have to be a nightmare. I think it probably helps though that we did not sort of push the dummy constantly or had it around all the time (like in the baby's cot), we really only strategically used it when baby clearly wanted the calm of a nipple lol e.g. when in the stroller after a feed or nap.

Still continued to contact nap till age 20 months though so that is unrelated! And also totally normal. And I promise, as nuts as it sounds right now, as they get older you'll start to miss it!

Thank you all for your advice I really appreciate it. Had a couple of low moments today and just cried. I know I’m overthinking everything so I’m trying to put things into perspective and try and regain some control. Milk is coming in and my breasts do feel more full and heavy and baby is
feeding for longer. I am still going to need to top up with formulas for one or two feeds a day I think because my nipples are still just too sore and I need family to help sometimes so I can rest. I’ve just accepted that for now and hope that I can maintain my supply even though it won’t be exclusive.

I also thought the Momcozy M5 breast pump but weirdly it won’t pump anything out. I can clearly see my breasts are full but the pump just isn’t getting it out. I might be doing it wrong but has anyone experienced having good milk supply but unable to pump?

It’s fine to pump if you are topping up as you can then top up with EBM instead of formula. The biggest issue with early pumping is building a stash causing over supply.

I don’t know the pump but is the flange the right size for your nipples? Measure the diameter of your nipples and add 2-3mm to get the ideal flange size. Actually your pump has a whole guide on this here: https://uk.momcozy.com/pages/size-guide-all?shpxid=46882047-3c8a-4f3a-a400-bb82e8bc7f3e
too small or too large and you won’t get much milk.

Hands on pumping can also help as can hand expressing before using the pump. http://www.nancymohrbacher.com/articles/2012/6/27/to-pump-more-milk-use-hands-on-pumping.html

keep going, the early days are tough but you will get there!

Remember as well your hormones are going crazy right now so that won't be helping with your mood. I know lots of people that do combination feeding and have long and successful breastfeeding journeys and give formula once or twice a day too. Be kind to yourself x

You’re doing so well, well done. Is the pump definitely put together correctly? First time I tried I got nothing but it turned out my husband hadn’t put it together properly. You’ll find you produce more at different times of day and night. My 4am pump always produced the most which was terrible timing but I was desperate to get a stock of milk in the freezer.
The worst of the hormones usually kick in around day 5 post birth for a while so be gentle to yourself and take it day by day. I supplemented with formula for just under 2 weeks but then breastfed exclusively which was honestly easier. Less faff and less to sterilise so more time with baby.
I remember the worry I had because my midwife told me that breastfeeding shouldn’t hurt but ignore it unless there’s a bad latch which it doesn’t sound like you have. Having your nipples chewed is always going to hurt! The pain for me had disappeared by week 2. Push through this bit and it’s so worth it.

You’re doing great my lovely! I’ve expressed with all three of my babies (donated to the milk bank with all three babies) and theres a couple of important things about a breast pump. You need to measure the diameter of your nipple when errect and then add 1-2 mm on and this will tell you your flange size. Most women need 17-19mm flanges, but the standard size of breast pumps flanges is 24-28mm and so far too big. This will cause pain, reduced output and potentially damage/mastitis. Once you know what size you need you can get inserts for most pumps on Amazon. With you being so freshly post partum, an in bra pump isn’t strong enough for now you would need a proper either electric or manual pump. Can recommend a few if you would like.
also to say if your nipples are sore/damaged then latch isn’t right, don’t trust your mw who 9/10 aren’t an actual IBCLC. Highly recommend getting baby assessed for a tongue tie and seeing an IBCLC as NHS care is so very lacking in this country x

Well done it's so hard! Have you tried using a dummy after baby finishes so they don't have to fall asleep while latched as that causes pain

Ps speech and dental health are months away just get through right now

I had a section and have now almost exclusively breastfed for a year (we give formula when it's convenient, but mostly BF).

My advice is:

1. use a dummy - they are absolute game changers in newborn days and you have plenty of time to wean off it later.

2. get some silver nipple shields (Amazon) to protect your nipples when you're not feeding and help them heal.

It helped me to know that the majority of women see a significant reduction in pain after 2 weeks.

It's hard to believe now, but it will become painless, second nature.

But it does take time for your body and your baby to get there. You're not doing anything wrong, and I think the "breastfeeding shouldn't hurt" narrative is so unhelpful for newborn days when it does hurt!

Thank you all again, I appreciate it. @suspiciousmums My sister mentioned that the flange size of my breast pump might not be the right size and she also bought me the Mendela manual pump today to give a try but it only comes in a 24mm flange so I’ve ordered inserts because that’s just too big for me and hurt.

I’m doing more breastfeeding at night where she cluster feeds and I can just keep her close to me which is what she wants even though it feels like she’s constantly searching for the breast because she’s not full which makes me feel sad. During the day she is a lot more agitated at not getting enough milk from the breast so I’m having to top up with formulas almost every feed 🥺

I also gave in today and gave her the dummy after feeds and she initially refused it but once she accepted she slept with it and I just removed it when she was in deep sleep.

My plans for a vaginally birth went out of the window and I feel like my plan for exclusively breastfeeding might not happen too but I’m doing the best I can and that’s all I can do. Decided today that for the sake of my own c-section recovery and for me to not lose sight of these precious early moments by worrying about getting breastfeeding right, I need to focus on the fact that she well fed, happy and healthy. Hoping the stronger I feel physically as I heal, the more mental focus I can put on getting to a place of breastfeeding confidence.

At this stage (and for a couple of weeks), babies do a lot of cluster feeding, to up your milk supply. I remember mine being on my boob from 5pm until 11pm one day. Luckily I'd read about cluster feeding, so I didn't panic, and she was back to normal the next day. It's just how they up your milk supply. So long as they aren't permanently attached to your boobs, as opposed to it being an occasional thing, you can assume they're just upping supply.

Do you have a local breastfeeding support group, run by peer supporters? Ask your HV about this, as you can attend and get them to check your latch and give advice.

Make sure you use Lanisoh between feeds!