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Thread: Very Difficult Time Breastfeeding

  1. #1
    Join Date
    Mar 2012
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    Default Very Difficult Time Breastfeeding

    Hi everyone, this is my first post. I've been trying to breastfeed my 4 week old since birth and can't seem to get the hang of it. This is going to be a little on the long side as my frustrating breastfeeding journey is lengthy. I'm just looking for more advice on what to do. I breastfed her within an hour after birth, even though I had a c-section the nurses were wonderful about meeting my request to breastfeed as soon as possible. Right away she had trouble latching on because I have flat nipples. Eventually we got her on there, but she kept slipping off. The LC at the hospital gave me a nipple shield to use, which worked well for a few days, but then it started to get in the way. I couldn't get it to stick properly and the baby was collapsing the tip of it because she wasn't on there far enough despite my many attempts to get her on there properly.
    After discharge from the hospital the baby went for her first check up 3 days later and lost 10% of her birth weight and her doctor was concerned so told me to supplement with formula. Which we did and still do during the night when she's exceptionally hungry. She is a big baby, over 9 pounds at birth so it's not like she was getting too skinny, the doctor just didn't want her to lose anymore weight. Four days later when we went back she gained 2 ounces a day, which was great. Meanwhile, I continued to have issues with her latching so I called the LC at the and asked if I could come in for help. During the visit we were able to get her to latch, but she was upset that the milk wasn't flowing fast enough and would pull away crying. The LC set me up with a tube device (the name of it is escaping me), I clipped the tube filled with formula to my shirt and the other end was taped to my breast so baby got a faster milk flow. It worked wonderfully while there, but once I got home with it I couldn't get it stay in place and it became another object of frustration so I stopped using it.
    The next day I said to myself that I will get the baby to latch without any contraptions and to my surprise it worked! She latched on and for the rest of the day I had no problems getting her to latch. Then by the next day I was so incredibly sore, obviously she wasn't on there correctly and I didn't know it. The pain became so bad when she would latch that I literally would scream. One time my husband came running in the room thinking I was seriously hurt. I couldn't tolerate the pain any longer and decided to pump and feed her by bottle. I was aware of the risks of doing this because of nipple confusion, but I was in so much pain... not to mention sleep deprived and incredibly frustrated because breastfeeding wasn't working out. I literally dreaded feeding time... which brought me to tears because I wanted and still want so badly to enjoy breastfeeding my baby.
    I went back to the hospital and saw a different LC and she showed me how to get the baby to latch by making a "nipple sandwich" and pushing the baby on. It worked well there, but once again when I got home I couldn't get her to latch properly. The latch looked good, lips were flanged out and open wide... yet it still hurt. It pinched every time she would swallow and I would hear a clicking noise at times. I had blisters and extremely tender nipples. I went back to pumping and feeding her by bottle so I could heal again. In the meantime while pumping I developed a cluster of clogged ducts on the top of my left breast. I kept trying to relieve this by putting a warm compress on my breast before and during pumping. It wasn't working and they were only getting harder and more painful. So I went out and bought a larger flange and thankfully had immediate relief. The larger flanges are technically too large though as my whole areola is sucked into it. I continued to use it though since it was what got the milk flowing from those ducts. After a week or so of straight pumping I wanted to attempt to breastfeed again, but I told myself not to get so frustrated if it doesn't work out because at least she's getting the breast milk by bottle. These occasional breastfeeding sessions were going well, even though again she still wasn't latched properly, but since it was only a couple times a day the pain never got to the point where it was unbearable. This past week I've been attempting to breastfeed her more often... several times a day. Now she doesn't want to open her mouth wide enough, I guess because she's gotten use to the bottles. Eventually she will open wide, but it takes a lot of coaxing and me gently pulling on her chin. However, no matter what I do I can never get the nipple far enough in her mouth. Yesterday I did manage to get her on there far enough and for the first time I didn't feel anything... just a gentle tugging. No pinching, no noises and I was so excited. Two seconds later she slipped down to her usual spot and the tenderness returned. To top it all off that same cluster of clogged ducts has returned and pumping/breastfeeding isn't relieving it this time. I tried to put the baby on that breast again and after a half hour of attempting to get a correct latch I decided to give up. I'm really close to just giving up entirely on breastfeeding and giving her formula. It hurts me so much to say that, but I don't know what else to do. I've tried so hard to make this work and we can't seem to get the hang of it. I've read tons of information on how to get baby to latch correctly, I've watched videos and looked at pictures and I just can't seem to get it. Any suggestions on how to get her to latch properly would be greatly appreciated. Also, any idea on how to relieve this cluster of clogged ducts? The pump is an Ameda Purely Yours, so I'm surprised it's not draining the milk better. Thanks in advance for reading this and offering your suggestions. Even if it doesn't work out, it feels nice to vent!

  2. #2
    Join Date
    May 2006
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    20,643

    Default Re: Very Difficult Time Breastfeeding

    Welcome to the forum and congratulations on the new baby! I am sorry you've had such a rough time nursing her so far, and I can completely understand why you're close to giving up. I had very badly damaged nipples when nursing my firstborn, and nearly threw in the towel. Every day I swore up and down that I was going to switch entirely to formula tomorrow. But tomorrow never quite came, and eventually we were able to get breastfeeding sorted out and nurse until she was 3.

    The first thing I encourage you to do is to get a better pump. An Ameda Purely Yours is probably not what you want to use- I know because I used one. It's a good pump for a mom with an established supply who is pumping at work and nursing the rest of the time. It's not a good pump for a mama whose baby is not nursing well, who is having trouble with plugs, or who is contemplating exclusive pumping (EP). I recommend getting a hospital-grade rental with properly sized shields. You will get much better milk removal that way.

    Second, I suggest seeing the LC again, or preferably a different LC, one who is also an IBCLC. They all have different tricks and one may notice something which another missed. I am thinking that there is a possibility of an undiagnosed tongue tie, perhaps a posterior tie, and you definitely want someone to take a look.

    Tips on latching:
    - experiment with different positions. I personally had the most success nursing in the side-lying position, other mamas have reported success with the football hold (use lot of pillows).
    - prevent the breast from slipping out of baby's mouth by supporting it throughout the feeding. Use your hand or a washcloth rolled up and tucked beneath the breast.
    - even very small babies will sometimes mimic you if you open your mouth wide when attempting to get them to latch
    - when supplementing, use a bottle with a slow-flow nipple, pause the feeding frequently, and don't let baby learn sloppy latch habits by slipping the bottle into a half-open mouth. Tickle baby's upper lip with the bottle nipple until she opens wide, and then put the bottle in.
    - keep using the nipple sandwich technique- it really is a great way to get a better latch.
    - be patient! Time fixes most latch problems, because as baby grows her mouth grows and it becomes easy for her to achieve a deep latch every time. As long as you continue to nurse at least part-time, and maintain your supply using the pump, you should eventually be able to transition to exclusive nursing.

    Hang in there, and let us know how we can help.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Very Difficult Time Breastfeeding

    Yesterday I did manage to get her on there far enough and for the first time I didn't feel anything... just a gentle tugging. No pinching, no noises and I was so excited. Two seconds later she slipped down to her usual spot and the tenderness returned.
    Slipping off the breast could be caused by the positioning. Many of the positions moms are taught can actually create this issue. You could try a laid back position so gravity helps keeps baby on the nipple instead of pulling baby off. And always remember that you are free to experiment with positioning! Every mother and baby are different and fit together in their own unique way. See: http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/#

    Forceful letdown would also cause a baby to pull back into a more shallow latch. Again, laid back positioning helps with this, and other things. see: http://kellymom.com/bf/got-milk/supp.../fast-letdown/


    I agree with mommal, if you continue to need to pump alot, you may need a better pump. You could also try hand expression after pumping and many other things to battle the plugs. See: http://www.llli.org/docs/00000000000...plugsblebs.pdf and http://www.llli.org/docs/00000000000...expression.pdf

    Most most important right now is that you must be removing milk from your breasts frequently-a minimum of 10-12 times a day. If baby can nurse, great. that is the best way to remove milk. But if baby cannot nurse, or it hurts you too much, pump and/or hand express. But keep the milk flowing out of the breasts regularly. This is VITAL, not only for milk supply but for many other issues like plugs.

    Breastfeeding issues, even extreme ones, are almost always solvable. Unfortunately it is so hard to have to deal with this stuff while also dealing with the exhaustion and "world turned upside down" feeling of life with a newborn. But the exhaustion and the feeling overwhelmed would be there anyway, that is how it is for most moms in the early days no matter how baby is fed. If you want to keep trying, there is every reason to expect you will be able to nurse just fine, probably pretty soon. For more help, you could contact you local LLL, go to a breastfeeding support meeting, see the IBCLC again or see a different one, (if the folks you are seeing at the hospital are not IBCLCs you might want to find one in your area, they should take time with you, a typical initial consultation takes about 90 minutes) you could have your baby assessed for tongue tie just to rule that out.
    Last edited by @llli*lllmeg; March 31st, 2012 at 07:11 PM.

  4. #4
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    Mar 2012
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    Default Re: Very Difficult Time Breastfeeding

    Thank you very much for your responses. I must say I find it very disappointing to hear that the Ameda Purely Yours is not good enough. The LC highly recommended this one, when I went back to her and told her about the issues I was having she said "Well it's a good thing we got you a good pump." I'll look into renting a hospital grade one until things improve. They did check for tongue tie while we were still in the hospital and that's not an issue here.
    I'm already doing a lot of the things mentioned, so hopefully it will get better. I tend to use the cross-cradle hold because I have better control over where her head is going. I did try the laid back position and it was very comfortable, much better than sitting in a chair. She still didn't have a great latch, but I think we both were more comfortable in general. I usually pump every 2 to 3 hours and during the day when she nurses I pump after she's done. She's my alarm clock at night, when she wakes up I take care of her and then pump again... which is typically every 3 hours. On a good note, the cluster of plugs has resolved itself. That was quite painful, I hope it doesn't return anytime soon! Thanks again, I'm going to keep at it. I was having a really bad day when I wrote my first post, which is why I was talking about giving up.
    mommal - When did things get better for you and your daughter?

  5. #5
    Join Date
    Mar 2006
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    10,440

    Default Re: Very Difficult Time Breastfeeding

    I like the Purely Yours myself and have good results...and I am an EPing mom. I think it is Ok for a pumping mom in many situations, so I agree with the LC.

    However, if baby is not nursing at all, a hospital grade pump will be more efficient and smoother to use and thus usually better for your supply.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  6. #6
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    May 2006
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    Default Re: Very Difficult Time Breastfeeding

    The PP and I have a long-standing disagreement on the efficacy of the APY. (Don't hate me, Susan!) I think it's a decent pump for most women, but underpowered for moms with difficult supply problems or moms who are EPing. At the very least, getting a hospital-grade rental can't hurt, and may help.

    You asked when things turned around for me, and the answer is that it took me about 1 month of pumping in addition to nursing, taking Reglan, blessed thistle, and fenugreek, and supplementing at the breast, to get my supply up to where it needed to be. Getting nursing turned around took about 4.5 months- but I don't think that's at all representative of the average woman's experience. I think most moms see positive change in a timespan that can be measured in weeks. Often people say "Oh, it all gets better at 6 weeks!", and that is true for many moms. But in case you're not one of them (fingers crossed that you're not!), then you haven't done anything wrong. Sometimes it just takes a little more time.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #7
    Join Date
    Mar 2012
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    Default Re: Very Difficult Time Breastfeeding

    mommal - It's great that you had the patience to get past the issues you were having! I'm really hoping my issues resolve soon.
    Just a little update: I went to a meeting and one of the leaders checked the baby's latch. She said it looked perfect, yet when baby came off the nipple was pulled out slightly more on the top. The leader thinks it's either tongue tie or the baby just needs to grow a little more as I have large nipples. I'm going with the baby needs to grow more since she was already checked for tongue tie. I've been nursing more frequently over the past few days, despite the tenderness. Sometimes when she's done the nipple is shaped perfectly, other times one part is pulled out more than the rest. I'm just hoping that this stuff will work itself out and I'm trying to not focus so much on the negative aspects of it. I'm also taking a more hands-off approach. Instead of holding her head and pushing her onto the breast, I'm just lying back and letting her find the nipple. She'll latch herself and if it's a really bad latch I take her off and let her try again. Today I hardly had any pain while she nursed, yet the top was still pulled out more. Weird... I do have to say though that it has gotten better and continues too. I guess I was hoping all would be resolved by now. I'm still pumping too at night and my supply is great. I was getting over 25oz daily when I was mainly pumping, now that she's breastfeeding more often I get more like 18 to 20oz. I stash what I pump away in the fridge for when her feeding frenzy starts in the evening, haha. Oh, and we haven't had to supplement with formula at all for several days now!!

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