Sore nipples, and only a few wet nappies

[Jicky]

Hi all,

Im a first time mum with a 7 day old bub.
In hospital the midwives were trying to help with some BF issues and in the end they all said she was attaching fine.
But now at home my nipples are sore, cracked and bleeding. When she feeds she squashes the nipple. I was told my nipples are quite large. Each time I attach her I put her chin on my breast first then push her head down so the nipple goes to the roof of her mouth and still Im in agony. One breast is so sore I express it and feed her that as well.
In one day she only does about 3 wet nappies and lots of dirty ones which makes me wonder if she is getting enough. My mum had a breast milk issue with me as a bub and Im beginning to wonder if I do too. Im seriously considering formula now but am worried I will be depriving my baby. I feel like a failure and for the first time in my life I really have no clue on what to do.
Please help.

[helle]

It's normal for it to hurt and to have sore nipples for the first few weeks, however not thru the entire feed... usually it's only the first few sucks that make your toes curl. Mine lasted around 6 weeks. People forget that our nipples aren't used to being sucked on constantly and they need to time adjust. However, I was told that the nipple (the part that sticks out... ) should come out of bubs mouth the same shape as it goes in, so perhaps somehow she isn't quite getting enough of your nipple in? Have you made sure that before you put it in her mouth she has her mouth open, really wide? This was trouble that I was having...

The best advice I can probably give to you is seek out a Lactatian Consultant and listen ONLY to their advice. There is so much information, and middies have so many different "styles" of how to breastfeed (as do mothers) that sometimes you can get so much thrown at you, you don't know what to do!

I can remember the first few days of having jackson he didn't do many wee's, but lots of poos. I would imagine that because your LO is having lots of dirty nappies that she is getting enough... but perhaps go and see your CHN and see. Maybe she mights even have a LC she can recommend!

GL! The first few weeks are hard, but you can do it! xx

p.s. get your hands on some marcallen cream. best invention ever for cracked nipples

[Yeddi]

Yep, sore nipples to begin with is normally one of those things people forget to tell you until you're going through it. If baby is passing stools (especially more than once a day) then you've got no worries with bub getting enough. Having large nipples though, could certainly be adding to your pain factor as it means bub is only latching onto the nipple and not the surrounding areola. I don't know what to suggest in order to get baby to take more of you areola into her mouth if it is about size, as it would be relative to the size of her mouth and the size of your nipple. On the up side... she'll grow into it.

You could try massaging your nipples with olive oil in between feeds to help with dryness and cracking. Most commercial creams should be washed off before a feeding, and it's easy to forget, so I prefer to go for something that doesn't matter if I forget.

[onthefly]

It is not normal to have cracked or bleeding nipples - this is a pretty good sign that the baby's attachment is not correct. You poor thing! It's so, so painful I know.
First, find a lactations consultant. The hospital your birthed at may have LCs on staff you can consult with. There are also private LCs around that you can pay to come to your house - absolutely worth the expense. Believe me when I say that very often these sorts of problems can be overcome quite simply IF you have the right support and advice.
You can also call the ABA helpline 1800-mum-2-mum, which is availlable 24/7 for advice and support.

Hhow many feeds is she having in 24 hours? Any issues with the birth or after?
Generally once your milk comes in we'd expect 4-5 heavy wet disposable nappies and at least a few poos. 3 wet nappies might be a little light, but it's not far off and lots of poos is a very good sign so don't panic. It's very likely that once you get the attachment sorted this will come right on its own (and it's early days anyway).

Anyway, you need in real-life support for this from someone with expertise in breastfeeding who can sit with you, talk with you, watch you and help you out. Barb Glare, our breastfeeding expert on BB, may be able to recommend an LC in your area if you try PMing her.

All the best

[helle]

It is not normal to have cracked or bleeding nipples

oh yeah... i was meant to add that in.

[MantaRay]

Hun, this is something that you would be best to get some help with straight way. Lots of pooey nappies is a good sign, but she should be having more than 3 wet nappies. Also, your attachment isn't right if you are feeling pain and have damaged nipples. You are doing a really great job - lots of mums have troubles like this in the early days and go on to breastfeed just fine. It is all a learning curve for you and bub - it's not like you've ever done this before and none of us are good at it at first. It is fantastic that you are trying so hard and I am sure you will get through this.

One thing that stands out from your post is the pushing her head - the baby's chin should be on your breast, but your hand should be supporting her neck, not pushing her head. Try drinking a half-full cup of water - you will notice that your head is tilted back - that is the same angle your DD's head should be on when she's feeding. Without the head tilted back she won't be able to attach properly.

There is some information on Baby Led Attachment on the ABA website - Australian Breastfeeding Association - Baby-led attachment. You might find that helpful - many mums find that Baby Led Attachment helps them to feed more easily when attachment is working well using the mother led methods.

Your DD will probably need at least 8 feeds in 24 hours and you can tell if she's getting milk during the milk if she is getting into the suck-swallow, suck-swallow rhythm for a while. Knowing how many times she is feeding and how long can be helpful to figuring out if she is getting enough. Also is she waking for feeds by herself?

You can call the ABA helpline anytime, it's toll free 24 hours a day on 1800 mum 2 mum (1800 686 2 686, drop the last 6 for VOIP). They can talk you through attachment and help you to figure out if your little one is getting enough milk and give you a list of Lactation Consultants in your area if you would like. They are very understanding and very helpful - well worth a call!

All the best with it hun. It gets easier but getting help sooner rather than later makes a big difference

[Barb Glare]

Hi,

You've got some great advice. Breastfeeding shouldn't be really painful. Many mothers worry about their milk supply, but it sounds to me that, despite the painful attachment (which isn't normal) your baby is getting plenty of milk. the real key to working out how how much milk your baby is getting is the number of *dirty* nappies, so if your baby is having several pooey nappies then you are getting plenty of milk. Remember, when a nappy is dirty, there is probably a wee in there as well. How many times is your baby feeding in 24hrs? Have a look at the links Manta sent, but also follow Marcellus's advice and get an LC

[Jicky]

Thanks for all your suggestions girls.

Im feeding her about every 2-3 hrs, but today I just couldnt stand it and gave her a comp feed just so I knew she had something.
I have a community nurse coming out tomorrow to see if they can help. But judging by her last feed which ended in me in tears I am seriously considering the formula, but will wait and see what tomorrow brings.

[Barb Glare]

Hi,

If you have always thought of yourself as a breastfeeding mother, it can be distresing to find yourself in such pain that you want to stop breastfeeding. Right now your problems seem to be insurmountable - but this is something you can work through. Have you considered hiring a breastpump and expressing for a day or two to allow your nipples to heal? It won't always be like this

[Swoop]

Hi Jicky,

You've been given some fantastic advice here already, which I can't really add to.

I just wanted to add in my own little bit of moral support, as I know exactly what you are feeling now, I have large nipples, and as a newborn my bub had a very tiny mouth and additionally i went through what felt like every breastfeeding drama in the book and spent a lot of feeds at the beginning in agonising tears too. I hired a fantastic lactation consultant who helped me immediately over the phone until she could get to my house and really see what was going on, and when she did that was the turning point which allowed me to start healing my poor damaged nipples and carry on to breastfeed painfree. My DD is almost 11 months now, and still going strong on the breastfeeding - apart from a blip a few weeks ago when my LO got a bit snap happy with her new teeth, that pain is a distant memory.

A lot of people don't like it and usually I'm for the all-natural route, so this went against my instincts, but I did find a tube of lansinoh was the ultimate relief and healed the cracks in my nipples much faster than they healed without it. If you want to give it a try it's in purple packaging in the baby section at the chemist.

You're doing a great job hun, it is so hard at the beginning and you are doing so well to hang in there. If you can get the right help at the beginning it does get a lot easier, i promise! You're in the right place for some great advice on BB too :-) Good luck with getting this sorted and let us know how you get on.

[onthefly]

Please call the ABA or get a lactation consultant Jicky. A few formula feeds doesn't have to mean it's all over. I know right now it may feel like there's no way forward, but it is possible if you can get the right help.
You health nurse may be able to offer some advice, but it's just as likely she will not. Expressing for a bit may also be a good idea.

[MummaSue]

I can't add to what the others have said either but just want to offer some support.

I was exactly where you are now, 4 months ago. I have large nipples, bubby has a small mouth, we got some dodgy advice from various health professionals, I had holes in my nipples and mastitis a couple of times. My GP told me to stop breastfeeding. I didn't. And it was a friend who offered me a simple little trick to latching on (which it turned out we were doing wrong). She showed me to put nipple to babies nose and with your thumb, flick the nipple into bubbies mouth. After doing that there was no pain despite the holes still there - we could feed through it and they healed and the pain went away. Expressing a few times a day helped too to give me a break from feeding from the damaged nipple.
We are still going strong with the b/f over 4 months later but I had a few moments where I had the formula ready.

You're doing a fantastic job!
I hope that you can get some adequate help.
Much love
Sue xx

[Miss E]

Big hon, I know how difficult the position you're in now is. I was there just over a year ago with horribly cracked nipples and bf problems that just seemed like I would never be able to solve. There are 4 things that made it easier for me to get through it:

1. A nipple shield – I'd get one asap (I found the Medella ones the best). It will make it much easier for you to get her to attach right and protect your nipples so they can heal. In my case I used this up until he was 8 weeks when we started to gradually wean. By this time his mouth was bigger and it was easier for him to attach correctly, but it wasn't until 12 weeks that we were doing all feeds without it.

2. Call a LC – the MCHN can be helpful, but nowhere near as good as a LC. It really is worth the investment. That and calling the ABA whenever you have a problem.

3. Bathe your nipples in a salt water solution after feeds to prevent infection while they are cracked – I found it worked best if I put a bit in a medicince cup and then put that over my nipple so that it got a good bath iykwim?

4. Avoid expressing if you can - I also expressed so that I could avoid feeding cos I was too sore, but in hindsight I think expressing is much rougher on your nipples cos the suction is so strong, which can make it harder for your nipples to heal.

I hope this helps. Try not to get too disheartened cos you are doing a fabulous job I'm no expert, but the tips I've given made it easier for me to get through this really difficult period and let my nipples heal while we worked on getting the attachment right. Now, 13 months on we're still breast feeding. I have to be honest and say that if it wasn't for the nipple shields we wouldn't have been able to continue breastfeeding past 2 weeks. DS was having weight gain issues and it all seemed too hard, but they really were a lifesaver for us.

GL, you're doing a great job x