As one PSP member writes:
“Is anyone having a difficult time with breastfeeding and want to swap strategies, or just commiserate? I know it can be difficult for everyone, and I've committed to giving it my all for at least 6 weeks. Our daughter is our first baby, and despite doing a lot of research and attending a LLL meeting before she was born, I feel like I'm fighting an uphill battle -- we didn't get great support in the hospital (after a challenging delivery) and left without having achieved a proper latch. I've been pumping and seeing consultants regularly; we've gotten her latched with a shield and have been syringe and SNS feeding, but it's still an all-consuming struggle and very demoralizing to have to supplement so much. Anyway, just figured I'd see if I wasn't the only one, or if any of the non-first-time-moms had overcome similar challenges the first time around?”
Related reading on PSP:
Breastfeeding Support Groups and Classes and Maintaining your Breastmilk Supply
Replies:
Try pumping and bottle feeding:
“I can definitely relate and was just about to send a note to the group to see if anyone had any tips for neighborhood groups, such as LLC, that were helpful.
I will share a few things that have worked for me so far. One is some the advice that my sister (who has a one year old) reminds me of frequently - that the first month is the hardest. She also sent me this article from Time magazine that I found very helpful.
We all get a lot of social pressure to breastfeed as the best thing but really we need to do what is right for us and our babies. Our babies will not be benefitting if we are stressed out trying to force nursing to work if it just isn't.
Our baby was also born in October and is our first. She has been able to latch okay but it is often very painful when she nurses. The lactation consultants I met with at home were able to help improve her latch but I have still have days where it is so painful to nurse that I want to give up. I have tried cool gel pads, cream, hot compresses before nursing, DYI saline pad, even breast milk to soothe them and have completely given up on bras. I can't say that I have found a solution that works consistently.
My daughter is also a very slow nurser and tends to get sleepy. We have to take frequent breaks to keep her awake and to continue to eat which can be exhausting when we get to 1.5 hours in one sitting and I start to realize she will want to eat again in 1-1.5 hours.
As my insurance no longer covers lactation consultants, I was hoping to find a support group or other moms who might be able to help me figure out why I am having so much pain and to help troubleshoot keeping her up so she eats enough.
In the meantime, I decided to pump more often as it is less exhausting. My daughter will happily drink a bottle of pumped milk in a quarter of the time it takes to nurse. She also does not fall asleep with a bottle only to wake up 45 minutes later deciding she is till hungry. I have found that pumping can sometimes be less painful. I have a Spectra S2 which allows me to adjust all the setting to do what feels best on any given day.
Thanks again for starting the conversation. I welcome any advice from the group and am happy to hear from anyone who would like to commiserate!"
Similarly, give yourself a break! It’s okay to supplement with formula:
“My nipples were super sore and the feeding was really painful..,, but one thing that helped was taking the pressure off by giving myself a 36-hr breastfeeding break where I only pumped and supplemented a bit with formula. We’re back on the boob today and much more comfy... nipples got a chance to recover!!”
Lots of tips from this PSP member:
“I'm sorry to hear the difficulties you're having. I was definitely in the same boat. I get the sense that nursing is not easy for very many women at first.
Nursing was very painful for me as well. It turned out they had tongue, lip and cheek ties, which we had addressed, but it has taken the girls weeks to re-learn how to use their muscles better so it doesn't cause me pain anymore. I can now say, almost 6 weeks in, that it's the rare nursing session where it hurts. Mostly it's just uncomfortable, and even that is starting to becomes less so.
Some tips that worked for me, which we learned from our lactation consultant:
We were also supplementing at first and used strategies that supported breastfeeding, since bottle feeding can be so much easier for babies. The idea is to make the bottle as similar to the breast as possible. We held the babies almost upright so the milk didn't pour into their mouths and they had to work to get it out of the bottle and so they controlled what they got by sucking, like at the breast. We used a Haberman bottle (got it off Amazon), which has 3 flow rates. You change the flow rate simply by turning the bottle. The idea was to get them to use the slowest flow rate so it it was most like the breast. When feeding, we also helped them use the best latch possible (lips flanged). Also, to mimic breastfeeding, we'd start a bottle feed on the fastest setting, then move immediately to the slowest, then go back to a faster setting, in order to mimic let down. This teaches the babies to wait for the let down on the breast and not get frustrated/fall asleep. Even if you don't use this particular bottle, perhaps you could use some of these ideas.
As for long feeds and falling asleep, have you tried hand expressing milk while nursing (from the breast your baby is nursing from)? This should get more milk into them. Just be careful to watch for signs of distress like a shocked expression, baby backing off, or coughing, and slow it down or do softer compressions if need be. I only pressed very gently with one or two fingers. I also used this when they were starting to slow down over the course of a feed. Also, only use it when they're actually sucking, not in beteeen sucks, because they need that time to rest.
Do you use strategies to keep them awake while nursing when they start to slow down? Tickling their feet, hands, or ears, blowing on their foreheads, or taking their clothes off?
Finally, the best nursing position for me was laidback breastfeeding which uses gravity to help the girls open their mouths more. Basically, I lie back in a recliner and the baby is tummy to tummy on me. It's important for them to have their head tilted back a bit as if they're looking up, which helps to open their mouths more. I do nipple to nose and rest their chin on the bottom of my areola, and do the 'flipple' so the nipple gets pulled up a bit. This helps them come 'up and over' and open really wide to get the best latch. And it's been mentioned by Lisa, to wait some time for the latch to ease up a bit. Importantly, make sure the baby is really well supported in their body because if they feel like they're falling, they'll clench.
And here's the link for LLL: La Leche League Park Slope + Windsor Terrace (If the link doesn't work, you can Google it).
These things can be hard to discuss over email so if you have any questions or want to discuss further, I'd be happy to try to clarify or even chat about it. Just let me know.
Good luck guys, and hang in there!
Find support in the neighborhood:
“You are not the only one.breastfeeding is hard, especially the first month. I’m a third time mom and I had trouble with all three. You’d think I’d be a pro by now. Nope!
There are weekly support sessions on tuesdays at Brooklyn Methodist. Sam, the lactation consultant is wonderful. She’s full of tips I hadn’t heard in my previous two breastfeeding times (I did 13 months and 18 months after ROUGH starts so there is hope.)
My daughter tore up my boobs in hospital. I had two lactation consultant visits there and again at home. I had her checked for tongue and lip ties, she didn’t have them. One lactation consultant told me sometimes their mouths are just small and pinchy and it would be better at a month. I pumped and bottle fed with the Calma nipples and followed lactation consultant recommended practices. I gradually added breastfeeding in one feeding at a time until she was back on the boob 100%. I had low supply in the evenings and ended up giving formula once a day.
My son had a bad tongue tie. He destroyed my nipples. We had his tie lasered at 6 days and that fixed a lot. I still had to visit a lactation consultant a couple of times to get the latch right.
This baby tore me up and has no ties. We’re working on his latch but it’s improving as he gets older. Sometimes I think my boobs just have to grow calluses.
I wish lactation classes didn’t set us up to fail by telling us it’s easy and painless. I’ve yet to meet a woman who had no pain and found it easy.
Hugs to you, mama. You can do this!
Keep going to consultants and getting help.
Pump if you need to. Formula feed if you need to.
Feed that baby and take care of yourself. Yes to the gel smoothies. Put them in the fridge not freezer.
Mother love nipple ointment when pumping or nursing. Can leave it on.
Make sure your flanges / shields are the right size. I thought I had small nipples. Turns out I need the extra large Medela flanges (30 mm). Lactation consultant said almost no one has nipples small enough for the 24 mm the medela pumps come with.
Check out Newman’s all purpose nipple ointment. It’s a blend of things that help soothe and cure nipple problems. Their website give the ingredients and proportions. You can make it yourself from other ointments or go to a compounding pharmacy.
Get an ENT or pediatric oral surgeon to look for ties. Some pediatricians aren’t good at spotting them.
If you run into supply issues try fenugreek pills or mothers milk tea.
Kellymom.com has good info on meds and breastfeeding as well as tips for increasing supply.
One book: the Womanly Art of Breastfeeding. It’s the gold standard.”
Try different latches and nipple creams:
“I had huge pain and difficulty with my first kid breastfeeding, and ultimately figured out that in addition to bad latches/poor sucking technique, I had some circulation issues that made my nipples especially sore. I had to be careful not to let them get cold (e.g., avoid air drying) and took a daily supplement of evening primrose oil that seemed to help.
You might want to try a bunch of different nipple creams. I had people swear by all different ones—earth mama angel baby, just plain olive oil, etc., but the one that worked best for me was Medela tender care lanolin (much softer and more spreadable than regular lanolin).
Also bear in mind that every person’s supply and flow is different. I found that the advice to feed 15 mins each side simply did not work for me—I had oversupply issues and a very quick let-down, so he didn’t need to eat that long to get full, and I was just adding to the pain and stress trying to keep him awake and eating all that time.”
and:
“I also had a lot of difficulty and pain with breastfeeding at the beginning. I had a lactation consultant come to my apartment around 2 1/2 weeks and noticed a huge improvement immediately. To help with my breast pain, I have alternated applying the following after feedings: olive oil, Vaseline and Apno (needed a prescription from my OBGYN and needed a pharmacy that would do compound prescriptions). The pain has significantly decreased and now it's more slight discomfort with baby's initial latching. Cole is now 4 weeks old and we are having an easier time feeding.”
Use a nipple shield:
“I also had trouble breastfeeding as Theo wasn't latching (apparently my nipples are the wrong size ??) so I've been using a nipple shield which has helped enormously. I'm hoping to transition off it over the next couple of months, but for now, it's doing the trick.”
#freethenipple:
“Breastfeeding is hard. My best advice is air out your boobs and rinse them off after each feeding. Also wear a nipple shield if your nipples start cracking.”
Really useful resources from PSP (we linked to it above, but in case you missed it, here they are again):
Breastfeeding Support Groups and Classes
Maintaining your Breastmilk Supply
All articles in our Breastfeeding Section