Flat nipples first time, what can I do to prepare

[kyliealysha]

I found out the first time we tried to attach my daughter that I have flat nipples. She just could not attach. Eventually after a lot of issues we got there and I went on to feed her for 12 months I can remember the midwives telling me that my daughter feeding would fix my nipples for next time. Not true, they're exactly the same

SO I'm wondering if there's anything I can do to prepare myself for this time round. I'd really love things to be a lot easier although I do know from my experience that it is possible, I'd rather not be expressing round the clock/ topping up with formula if I can help it!

[megs]

Hi,

I have flat nipples, I too found out when I went to attach my first baby. I ended up having to use a nipple shield for the first 5 months as he just wouldn't attach without it. Once he was older and stronger he learnt to attach minus the shield.

With DS 2 I managed to attach him without the shield (took a lot of work though) but I reaslied the difference between he and my first son was that he had a long tongue, my eldest son has a short tongue. (So I then realised why I had so much diffculty)

3rd time around, DS was born, I mentioned my issues to lovely midwife, she looked in his mouth and said get out the shields, he too has short tongue and very minor tongue tie. He used the shield until about 10 weeks and I then managed to get him on without them.

I know alot of people have different opinions on shields, but I was lucky in that they did not decrease my milk supply at all. Yes they do mean bubs feeds for a bit longer, but for me it was either the shield or a bottle. It was my saving grace, and meant that all my children have been breastfeed up until they have chosen to wean. I had a very supportive Maternal Health Nurse who supported me using then, and was the one that basically said unless their is a problem with bubs weight gain then keep using them as long as I wanted.

Oh and the shields I used were the Pidgeon brand, I have heard Medala are also good but I couldn't get them where I live. Avent ones were very very large.

[kyliealysha]

Thanks for that It's good to hear others experiences. I have no idea if my daughter has a short tongue but worth looking out for.

I should have mentioned I used a shield to get my little one to attach eventually. But even then I couldnt start using the sheild until about day 5 and I couldn't use it myself until my daughter was two weeks old.

[studymum]

I dont think there is really anything that you could do to prepare them, if this is the way they are then its it. I was told it just makes it a bit harder for them to learn but definetly doesnt mean you cant feed. After all its not the nipple that gets fed from, its the whole aerola.

I don't have flat nipples but when mine extend they do so at an angle, which makes it really easy for bad attachment to do damage fast. Even an lc told me that I was doing it wrong because of the way they looked after I took DD1 off, I got heaps of damage with her until we got it right. With DD2 I fast realised that it was her doing this to me, and that the shape was natural and it was actually her doing strange things with her tongue that was causing the pain. Even when I pump I can see them do it.

[megs]

I was told with my first son that I couldn't use shields til milk supply was in.

This last time my midwife was also an expericed lactation consultant, she said I could use the shields from the beginning just to help stimulate the breast. I was also expressing, both by hand and with pump as often as possible to get colostrum and also help milk to come in. I found this worked really well as milk was in by day 3. Whereas with first son I wasn't allowed to use shield til milk was in and that took a lot longer because he wasn't attaching to the nipple at all.
BTW: Some of the other midwives in the hopsital disagreed with this method, but I stuck withit and it worked.

[Miss E]

I also have flat nipples and couldn't get my DS to attach for the first three or so days until the hospital gave me a shield. Basically those first few days were spent with DS and I crying as they tried again and again to get him to attach, eventually they would hand express colostrum from me and then give it to him in a syringe.

I saw the lactation consultant in hospital and she got me expressing straight away, before my milk came in. Apparently expressing really helps to draw the nipple out. I also started using a shield and by day 5 they were able to get DS to attach to my right side but not my left. Then over the next week or so I developed horrible cracks and went back to the shield, it was the only way I could get him to attach. At the time I thought we would use them for the remainder of our breastfeeding journey. But then around the 8 week mark I started giving attaching him to the nipple a go.

At first I would give him the second side directly on the nipple once a day. I always did the second breast because it meant he wasn't starving and wouldn't get so frustrated and upset as we tried to work it out. Then I gradually built up to doing a feed on each side once a day, then twice a day until we were doing every second feed without it. By the time we got to 12 weeks we were able to drop the shield for good.

I can't recommend using a shield highly enough or starting expressing from day 1. It helps to draw out the nipple so that overtime you can overcome the flat nipples and it also means that breastfeeding can be a pleasant experience for you and your LO without you being in pain and your LO getting terribly frustrated. At least that's what I found. HTH

[Barb Glare]

Hi,
Nearly all nipples can work just fine. Your baby imprints YOUR nipples - it's all he knows, so your baby makes your nipples work.
I wonder how your first birth went? Babies born normally are primed to suck within the first hour after birth. When they are born their eyes are wide, and they fix their gaze on the nipple and move towards it! (even without your help) But sometimes the circumstances surrounding birth blunt their normal instincts. It can take a little extra time to get the hang of breastfeeding. Birth DOES matter to breastfeeding. Have your baby skin to skin and avoid being disturbed during the first hour. Ask that weighing your baby be delayed and that any checks be done whilst your baby is on your body. Delay having shower until after your baby's first feed. And when you do have a shower, only wash below the chest and don't use soap. Babies have a strong sense smell and this guides them to the breast. It's important that you don't wash off the scent. Ask friends and relatives to wait a couple of days for their cuddle - they will have plenty of time. At the beginning your baby needs to learn to bond with you and work those breasts.
It is well worth seeing a skilled Lactation Consultant before the birth to both to debrief your first breastfeeding experience and make a plan for your next. She will give you an assessment of your nipples. Strangely, I have seen women with completely normal nipples who have been told they have flat nipples. I sometimes fee we should all sit in a circle with our tops off and have a good hard look at each other's nipples.
Babies feed often - probably 7 or more times in the first day. Then *all the time* the second night. After your milk comes in your breasts may become very engorged and hard - you may find your nipples are really flattened out. Icepacks will help reduce the swelling (It's not just milk, but blood and lymph fluids as well) Expressing a little before feeds will help soften the breast. Frequent feeding will help avoid your breasts becoming too engorged.
Take an ABA breastfeeding class - they are great for second time mums. You are sure to have many "aha" moments - by and large we don't know how breastfeeding works - it can seem so hit and miss with your first baby. But when you understand the process it all makes a lot more sense.
If you have problems get help - quick. Get things such as tongue tie checked out. Even though you had a really tough beginning it sounds like you had an ultimately successful breastfeeding experience - well done with sticking with it over the tough times.

[kyliealysha]

Thanks for the reply Barb. Gives me a lot of food for thought.

I had an emergency c section with my daughter and did not get to hold her until at least an hour later, I did not realise this could have been one of our problems.

How would I find a good lactation consultant in my area?