Ongoing Nipple Problems

[Easha]

Hi all,

I am having ongoing nipple problems and general BF questions and would like your advice.

Jaida is 8 weeks old and now weighs 4.7kgs. (weighed 3.1kgs at birth). She now feeds only 4-5 times a day as she is a great night sleeper, sleeping the night through (7pm -6am). Although she feeds 4-5 times she takes 1 -1.5 hours. Give there is such a long period of time between her 1st feed of the day my BB are quite engorged and sore. After the first feed my BB ache terribly. The pain is really deep and comes in waves. I have to take panadol to settle it and it is difficult to hold Jaida. Will this settle? Any ideas what this is??. How long will it take for my milk to catch up with her needs - ie will the engorgment settle too?

My other issue is nipple pain, my nipples have previously blistered and have cracked after I attempted to BF at a BBQ without all my paraphenalia. It is taking a long time to heal and reopens every few days. The first 10-15 sucks are torture. I am using Bepanthan at night - any other suggestions??

Thanks for your help

[Junglemum]

Lucky you on having such a good sleeper. Not sure about the deep breast pain. Do you have a fever or any redness on your breasts?

Things that helped my cracked and sore nipples were Pure lanolin after every feed. (no need to wash it off, fine for bub to eat. )
Lots of airtime. Free boob-ing i like to call it.
and making sure you have good attachment every time. Just one feed with bad attachment would re-crack my nipples.

[megsmum]

Easha

Yay for Jaida sleeping through the night You are so lucky LOL I was up to Em about 5 times last night it was so hot the poor little thing was so thirsty.

Anyway...to answer some of your q's. I have had the deep breast pain with both my DD's and it settled by about 8 to 10 weeks. Same with the excruciating pain when they first latch on - hopefully you'll be the same I've got no idea what it is, I've not been able to find someone who can answer that question.

The blistering and cracking though - sounds to me like you may have an attachment problem if its not getting better. I had the same early on and once I got the attachment sorted it healed within a week. Can you get some help at all from either the ABA or an LC?

And as for the engorgement problem, sorry I can't help there - I'm still getting quite full and sore if Em goes for more than 3 hours without a feed

All the best hun and HTH

[MantaRay]

Congratulations on your DD hun. The first few weeks can be really confusing and it sounds like you are doing a fantastic job. I am a little worried though that Jaida is only having 4 - 5 feeds a day. Most babies at that age would be needing a minimum of 8 feeds in 24 hours to be getting enough milk - sometimes even 12 or more. Some babies do thrive on fewer feeds and it's a good sign that she's been putting on weight well, but it's around this time that the hormones stop controlling your milk supply, and frequent feeding is the best way to maintain a good supply. How many wet and dirty nappies would you say that Jaida has in a 24 hour period (and are they cloth or disposables?)? If she is having less than 5 heavily wet disposable nappies or 6 - 8 clear wet cloth nappies in 24 hours, or less than one dirty nappy a day, or the poo is hard, then these are signs that she needs more milk.

One thing that might help you is to take her off the breast after 20 minutes. Babies generally get most of the milk out in the first 20 minutes or so, and then it's more comfort sucking. This extra sucking is probably not helping the pain, and could be why she's not feeding more often (which I know seems like a good thing now, but I'm worried that it's going to cause you some problems down the track). After 20 minutes on the first side, many mums find that it works well to change the nappy and then offer the second side for up to 20 minutes, and then stop again.

As far as your pain goes, it would be worth getting it checked out. It sounds like it might be thrush in which case you would need different treatment. Until you can get to a GP, it would be a good idea to stop using the bepanthen, go without a bra as much as you can, and put a little bit of expressed milk from the end of the feed on your nipples after each feed. If you need to wear breast pads, change them as often as you can - thrush thrives when there is moisture around the nipples.

Best of luck hun. It does get easier as you go but it's so hard finding your way at first.

[Easha]

Hi All,

Thanks for your input. I also had a check up for Jaida today and the early childhood nurse was also concerned about the 4-5 feeds a day. We went through Jaida's weight gains over the past few weeks and although she is in the 50th percentile she has only gained 200gms since 25th Oct - 3wks.

So...... I am going to wake her at 9pm for an extra feed and see how her weight gain progresses. I have also coordinated another BF appt so I can tell when Jaida is feeding and when she is comfort sucking.

Felling pretty down about it all... have I done the wrong thing by my baby??

[marcellus]

Oh no hun, don't feel bad! You've done nothing wrong, you're just learning is all. Babies aren't the best at telling us what they need... makes things very hard for mummies!
When you say BF apt, do you mean with a Lactation Consultant? A good LC can be such great help!

The ABA has a 24-hr helpline that you can always call if you have any concerns too.

If you try taking her off the breast after 20 mins or so you might find she asks to feed more often on her own. Perhaps also try to squeeze an extra feed in during the day (maybe you can keep the sleeping time... though overnight feeds are great for your supply).

All the best - and remember: You have not done anything wrong! All mummies need help fine-tuning these things

[megsmum]

Don't feel bad Easha

Its not too late to get things back on track and you sound like you're doing all the right things with your BF appt. I definitely recommend seeing a good LC - they can help in so many ways.

I feed E to sleep during the day too - do you do that at all? It is another good way of getting a bit extra into them, E drinks quite a bit before she nods off And it gives me a chance to relax for a bit too.

Good luck xx

[Easha]

Hi All,

The extra feed has kicked in and is going quite well. I have been focussing on perfect attachment and nipples seem to be much better. Not sure whether Jaida is so happy with coming of after 20 mins. There has been several times when she has been quite upset and crying when I take her off. Jaida also makes a 'nah' sound when she's hungry and this continues after taking her off. I have also put her back on cause she has been so distressed. I dont want to make this terrible for her.

Do any of you let your bubs feed for a little longer... particularly the first feed of the day?? I also have notice my BB have not drained completely until after the 2-3rd feed so am worried about blocked ducts etc etc.

Any further words of advice?

Will be seeing a baby nurse Monday and will atke about referral to a LC if thing haven't improved further

Thanks

[Kmn]

If you think she is still hungry then swap sides again and go back to the first boob.
The shorter feeds are mostly to ensure that she gets maximum milk for minimum damage to Mum - what you want to avoid, at least until feeding is comfotable, is her sucking without drinking much.
I have certainly let my bub feed for longer - several hours when I fell asleep with him attached! But I was pretty sore afterwards...

[marcellus]

Good to hear things are going well with the changes.

If she wants to feed longer, I would say let her go for it. If she switches to small-sucking (as opposed to the big-jaw-movement, regular sucking when they're drinking) and/or she's drifting off, maybe pop her off then (if you want to). Typically, babies will sometimes have short feeds and sometimes long ones.

After the first month or so I started limiting the length of DS' feeds cause otherwise he'd literally be on there all day and that was a bit much! So I'd give him 30 mins on the first side, then switch him. Usually he'd have 10-15 minutes on the second side and come off himself (or fall asleep).

All the best~~

[MantaRay]

Easha, that sounds like you are making good progress.

I agree with the others - if Jaida really wants to feed for longer than 20 minutes then it is ok for her to do that, especially if the pain is better. If she seems to be comfort sucking though, you might like to try changing sides after that time - this way she'll get more milk and is less likely to hurt your nipples again. There is no problem with comfort sucking if it's not hurting and she's getting enough milk though. You can tell comfort sucking from the suck/swallow pattern as Marcellus described. suck-swallow-suck-swallow is drinking, flutter sucking is more comfort.

I also agree with Jennifer about trying to get even more feeds in too. 8 -12 feeds in 24 hours is the normal number, so even with the 9pm feed that is still on the low side. Babies don't tend to space these feeds out exactly - as others have said they tend to have one period where they feed frequently and then one longer sleep per 24 hours. By feeding more frequently when she is unsettled you might find that you kill two birds with one stone - reduce the crying and also increase her number of feeds in 24 hours.

With regard to still feeling full, that is still common at Jaida's age, but it should settle down soon. It can lead to mastitis so keep checking for lumps. If you find one, put a warm compress on and gently massage it toward the nipple while feeding or expressing in a warm shower, then put a cold compress on. If that doesn't work in a day or so, try feeding Jaida while you are on all fours on the ground, so that gravity can help to dislodge it - I know it sounds odd but it works! To prevent lumps and mastitis, you could try giving Jaida a top-up feed about 20 minutes to half an hour after those first feeds in the morning when you are feeling full.

I hope this helps hun. I know it all seems so confusing at first, but it sounds like you are doing really well.

[~clover~]

Just thought I'd let you know that the average time between feeds for most BF babies (not all) is around 2 hours. My DS fed 2 hourly til he was nearly 1. But he slept through most nights.

He would also cluster feed in the afternoons sometimes. Feed almost non stop for a few hours straight.

Maybe you could also offer her an extra feed through the day also? Lansinoh is a God send for cracked nipples & the sun & air works miracles on them.

My engorgement completely settled down between 4 & 6 months. If you feel very uncomfortable you can express just a bit off to relieve the pressure

Your doing great! Good luck

[Easha]

Hi Again,

Thanks for your advice. Weighed Jaida today and she has put on 120gms in 5 days so the extra feeds have been helping. Given the awfully hot weather she has also feed 7-8 times which is a lot for her. Jaida also feed 4 hourly through the night last night and again put this down to the weather - 34 degrees until midnight - aarrrgghh.

I think she is also goin through a growth spurt as she has already feed 7 times today and there is still 1 to go.

Only down side is the good ol nipples are raw from going from 4 to 7-8 feeds... will perserve.

Got to admit I hope she has a long sleep tonight... was awful doing a 9pm, 1am and 5am feed... was just like when I brought Jaida home. (selfish I know- very tiring)

Thanks again

[MantaRay]

That sounds good hun. I know it seems like a lot of feeding but it's really good news that she's drinking more. It can seem a lot like all you do is feed in the early days, but before you know it they are too busy looking at everything going on to feed much. And believe it or not, you'll miss it LOL!

[~clover~]

Your doing great!

[marcellus]

That's great Easha!
Are the nipples getting better or worse? Or just tender?
It really is hard work in the early months. The good news is that as she gets older she'll get more and more efficient at feeding and you'll spend less and less time doing it.

[Easha]

Hey,

Just an update... I have created a milk monster !!! Jaida is feeding 3 hourly during the day and 4-5 hourly during the night. She surely has put on heaps of weight a I can see it in her face - an extra chin has grown LOL.

Nipples are just tender - bought the Lanisanoh and that is great. Still having the deep pain on occasion but more so when the BB are overly full which is not so often now given she is feeding so often.

Another question whilst I am at it - how do I get Jaida to shape her mouth better? She is able flange out her top lip without much issue except when she is tired it tend to be more flat (hope that makes sense) and as for the bottom lip I dont think she flanges it out at all. I think this results in her using her gums to hold on atleast that what it can feel like at times. Her attachment is certainly much better as I have been quite forceful pushing her right on but I think it could be even better.

You all have been so helpful... thanks for that, much appreciated

[MantaRay]

Easha, that's great that she's feeding so well. She will start to sleep longer soon.

With regard to the attachment, you might like to try Baby Led Attachment - there is some information here. Many mums find they get much better attachment this way.

Other than that, make sure her legs and bottom are tucked into you nice and close so that her chin is against your breast but not her nose.