Breastfeeding with a flat nipple..... 2nd time around....ADVICE/EXPERIENCES please?

[Shanti]

I had an extremely challenging start to our BF relationship when DD was born. We experienced lots of problems, to give you an idea..... weak suck, very bad attachment for weeks on and off, flat nipple, low milk supply due to the previous mentioned, breast refusal on flat nipple side etc etc.... it took us until DD was 3-4 mths old to fully establish milk supply and BF'ing!! We're still feeding now at 21mths!!

So, I'm pregnant again and recently have been thinking alot about how BF'ing this baby is going to go....given my experiences last time, I have gained so much experience and knowledge so I'm sure it won't be as difficult as it was last time. In saying that, I know every baby is different.

My main concern with establishing the BF again this time around, will be my FLAT nipple on my L side. The R side is fine as DD has always preferred this and it's a great shape now and should be easy for a newborn to attach to! Whereas the L side has always been a problem as it's flat and DD hasn't fed from the L side for months anyway.

Hoping to hear from those who have BF subsequent babies with a flat nipple and how did it go each time? Was it easier the 2nd time around? OR did you still experience problems with attachment on the Flat side? (waaaah! why can't both nipples be the same!!)

Will this baby perhaps have a strong suck and know how to latch onto a flat nipple better than DD did???? Is it possible I won't have ANY problems this time around on that side????

I really would love to be able to avoid having to express on that flat side just because the baby can't latch on therefore my milk supply gets affected etc and until the baby has a mature suck, then I don't have to worry about my supply and pumping anymore. I just don't want to go through what I did last time as it was really really stressful and lots of hard work

Thanks, any advice or experiences from others would be wonderful

[Barb Glare]

You have done the most amazing job, despite the tough start you had.
I bet there's a story behind the story. How did things go with your baby's birth?
Babies "imprint" feeding in the first hours after birth. Under normal circumstances they are born alert and ready to suck - on whatever nature supplies them with. They don't know about "flat nipples". All babies will shape the nipple and breast tissue into a teat with their mouth. But if a baby is born affected by a difficult birth, or drugs taken in labour, then it becomes a much harder task. Likewise if mother and baby are separated during those early hours. As you have seen, patience and determination can overcome these problems.
Do you see yourself tandem feeding?

[AliBaby]

I dont have any advice for you but I do want to tell you this hun,

You had the most incredibly challenging bf journey with DD1. Look at the two of you now! You are just so inspiring and I am completely certain that you are going to make bf work with Baby 2.

ETA- I think you are going have a girl because I automatically wrote DD2 instead of DS2. Had to change it to baby 2!

[Shanti]

Barb - thank you for your post DD's birth was a 9.5hr labour, vaginal, no drugs (not even gas), DD put on my chest immediately skin to skin and not taken off... HOWEVER she was posterior, perhaps that was traumatic for her??? I know it didn't make labour easy for me LOL!!!! AND....I tore badly 3rd degree internal which needed quite a bit of stitching and therefore an hour after DD's birth was spent with 3 people in the room stitching me up (student dr ) besides that, I really had a great experience and can't complain. I do however look back quite often on DD's first breastfeed and how that occurred. My stitches were done and the room emptied so DH and I could spend time alone with DD. Just before that though a midwife asked me if DD had fed yet, I said 'no' but wasn't worried. Before I knew it (i was in a deliriously spaced out state at this stage due to all those lovely hormones circulating !!) the midwife helped DD latch on to my R side and she had a bit of a suck but then came off.... it wasn't baby led at all... she was gentle yes, but I felt it was kinda 'rushed'..... I don't think DD was quite ready ya know?
DD and I were never separated from each other until day 3 when she had a hearing test and I badly needed sleep.

I would be interested in tandem feeding, however at this stage, my milk supply is very quickly dwindling. I feel sad about it but DD doesn't really seem interested in sucking much out anymore anyway. She goes on 3 times a day for her usual feeds (morning, lunch, bedtime) but most of the time only has short feeds and doesnt have that strong suction she once had....if that makes sense? And she doesn't gulp milk anymore either.
I know that if we're tandem feeding later she will be able to draw that nipple out for me for the newborn.....that would help wouldnt it?
At the moment I think DD is doing a lot of "dry feeding" as I've read about it.... its tender when she feeds as there isnt as much milk there anymore.

Alibaby - thanks so much so nice of you!

[Miss E]

First of all, congratulations on your pregnancy! I had a very similar BF journey, with both my nipples being inverted, so I also share some of your concerns about how it will go next time around (mind you that's a little ways off for us for now). In the end, the only way that DS and I could establish BF was with a nipple shield. I know some people are anti them, but TBH in my case there is no way we would have been able to BF. The midwife at the hospital gave me one on day 3 after we still hadn't been able to get a successful attachment. I kept persisting without them for the first couple of weeks, but DS wasn't gaining enough wait and my nipples were horribly cracked, so I re-introduced it. We kept using them till around 9 weeks when I gradually started to wean him from them because his suck was stronger. I started just doing one feed a day on each breast without it, until about a month later when we were able to get rid of them completely. And, 16 months on we're still BF'ing, which I find amazing because there was a time when I thought it would never happen or that we'd have to use the shields permanently.

They are a bit of PITA, but the allow bubs to draw the nipple out into the shield and feed effectively. Over time, your nipple gets used to being drawn out and by the time bubs is sucking well it's easy for them to draw it out themselves.

Anyway, that's just my experience and what worked for me. TBH I would invest in one before the birth (I tried many different kinds, but found the medella ones best because they were bigger and the nipple could be drawn out more) and give it a go if you have problems. ALso, it probably wouldn't hurt to meet with an LC before bubs arrives so you can devise some strategies beforehand and also get their help from day 1 if you are having difficulties.

GL

[Maruschke]

Shanti no advice, but I know how much you struggled in those earlier days with DD1 and I hope you have a much easier journey this time.

[Shanti]

Miss E - well done on successfully feeding your DS after your initial BF challenges also. You have done so well!! Well done on weaning your son off the shields. I feel shields definitely have their place that's for sure. We did try to use one at one stage (early weeks) on the L side (flat side) but DD never took to it very well, she hated it and so did I (which didn't help!) so we gave up on the shield (medela one) pretty quickly and just kept trying her on my nipple until eventually (weeks later) she could coordinate her suck efficiently and could work out the flat nipple. I'm sure I have kept the shields and if not, will make sure I have some in hospital just in case. I'm prepared to have to use it on the L side if that is what it will take for this next bub.... whatever keeps us BF'ing is worth it!!!! also will be taking my medela swing into hospital with me too, as I will not be letting this bub starve that's for sure!!! AND, my LC will be visiting me on day 2 of our stay! I haven't asked her yet but will do she's an IBCLC and also my local mchn which I see! she helped last time!!

PrincessXanthe - thanks for your lovely post, I appreciate it. Nice to have you back

I'm not concerned that I won't be able to BF this time around, as I know, first hand, that I can overcome any challenges thrown at me as I did last time..... I am just concerned it's going to be just as hard on this flat nipple side, as it was last time.... it was just so much work to get DD onto it that's all. With some luck this next baby will know what to do and feed like a trouper and draw out the nipple no worries!

[onthefly]

I don't have any specific advice, but I think the way you managed things first time bodes very well for your next experience, however it may start out. Good luck!

[~ Mylitta ~]

I can't give you any advice about the flat nipple, but I can tell you that even though my milk supply dramatically dropped as soon as I was pregnant, DS is still feeding 2-3 times a day and definitely does not want to give it up. He has one feed during the night, and if we try to get him back to sleep without feeding him all hell breaks loose, lol. But as soon as he feeds (even though he only sucks on each side for maybe 2 mins at most) he'll happily go back to sleep. I don't think he gets terribly much these days, especially now that I'm pretty sure a lot of my milk has changed to colostrum, but he still gets super excited during the afternoon when I ask him if he wants "mumma-milk". Hopefully you're DD will be similar and still want to keep feeding even if she's only getting a little bit here and there

[Shanti]

[Shanti]

I don't have any specific advice, but I think the way you managed things first time bodes very well for your next experience, however it may start out. Good luck!

Thanks so much!

Mylitta - thanks for your post

[belfie]

Shanti - aaah such a good question. I was in a similar boat, having expressed exclusively for my DS after 2 months deteriorating BF'ing using nipple shields. This time around I was determined to try and avoid the same problems. The full story of what happened is here. Our success this time has been using nipple shields the whole time so far, but I hope to get rid of them soon. My DD came out with a strong & vigorous suck. I didn't have any luck attaching her without nipple shields (she would attach, but would have damaged the nipples too much) so in conjunction with my IBCLC we both agreed to use the shields until I felt ready/able to remove them (which hasn't happened yet). So saying, she's feeding beautifully with the shields so I'm very happy with the outcome. I agree that it's tricky when one side is flat and the other isn't! If she only attaches on the flat side with a shield would you want to use the shield on both sides for consistency? (I don't know if that's a terrible idea but I wonder if it would be easier for bub).

I would say that the truth is that it IS harder trying to feed with a flat nipple (or two). But, the difference is that this time you will know what potential problems you'll need to counter, where the issues might be, and you can put in the work to avoid this. I also didn't get my supply up enough to fully feed DS until he was nearly 3 months. This time around.... she's been fed exclusively... and the 5.5 litres in the freezer is going to another hungry bub. I NEVER would have thought I'd be in this situation. The difference is that I knew so much more about how to make sure i got my supply up, how to compensate when she couldn't attach, how to keep our bond strong, keep up the snuggles, keep myself calm. And when you have a midwife tell you on day 2 (or was it day 3 I forget) that you'll never feed with those nipples... well boy I'd love to go back in, wave my feeble little flat nipples in their direction and show then my big chubby gorgeous 5.5 kilo girl and say... can't breastfeed huh!??!

Anyway, I digress , things I did different this time:

• Engaged & saw my LC before I gave birth - honestly would not be BF'ing without her help/support/guidance/information. She was AWESOME!
• Expressed colostrum before I gave birth (I was insulin-dependant GD, so I had some pressure there with blood sugars etc)
• Expressed colostrum like a maniac after giving birth (still no luck attaching on either side) - would you need to be prepared to do this on your L side to stimulate supply?
• Had a BF'ing plan (posted here)
• Went to an ABA class - thought I knew it all (HA!) - but there were some things I'd forgotten/didn't know
• Had a c-section (there's a surprise one!) and was really expecting that to have a negative impact, but she actually came out more alert & vigorous than DS did... she was ready to suck paint off the wall!
• Attempted to remember... different baby, different BF'ing relationship
• Always always always made sure that whatever she drank (early feeds were cup or syringe) - I made sure I got at least that from the breast whether by her or by pump. I had thought I'd hate to pump again, but if it helped me get there, then I didn't mind

I think what you're doing posting & thinking about it now is awesome, you will set yourself up so well. You can do this. I was so nervous about how we'd go, and I have to say that while it was a mammoth effort in the early days, and we still have some work to do in getting rid of the shields, BUT it is amazingly wonderfully worth it. And truly, my little girl has amazed me with her ability to feed. I have fingers crossed that your little bubba will be just the same, and you will be so prepared for a huge battle that the actual event will seem like nothing at all

I'll be cheering for you
Belfie

[MantaRay]

I am so happy that you have another bubba on the way hun, congratulations. Normally I'd advise joining the ABA but I think you have that covered

One thing to keep in mind is that all babies are different. Just because your DD wasn't able to draw the nipple out well from birth doesn't mean baby 2 will have the same problem. I'm sure you've read about my nipple story before - how when DS1 couldn't attach due to a tongue-tie I was repeatedly told I had flat nipples, but when DS2 attached for the first time straight after birth, the mw told me I had great nipples for breastfeeding. Same nipples, different baby.

Also, as has been mentioned, skin to skin at birth or as soon as possible, Baby Led Attachment etc are all very helpful.

I so hope that this is an easier start to feeding for you. I know you are determined enough to make it work no matter what happens!!