Do nipples "toughen up"?

[@llli*dylan.james]

Having suffered with cracks and bleeding from week 1 of BF and having forced myself to drop the nipple shields, we now appear to be turning a corner. My LO is nealy 5 weeks old and had a TT diagnosed and treated at 2.5 weeks. Although our latch is now much better it is rarely pain-free. At best it's "scratchy" and the first latch of the day literally brings me out in a sweat, but I keep telling myself it will get better and that I CAN do this for my son.

This past week I'm making good progress to get him fully back to the breast, so he's been BF a LOT. With him fussing, unlatching and relatching frequently during hours of seemingly endless feeds, I am experiencing some pain but I try not to unlatch him unless I think he's breaking the skin, because he gets quite upset at being taken off and I want him to settle and enjoy it. To my surprise, even when it's hurt the most, my skin seems to been intact. Fairly often the nipple comes out creased/with a white line or lipstick-shaped but the pain subsides pretty quickly. Have I just been lucky to date or do your nipples adapt? I've been treating with Lansinoh a couple of times a day and letting the air get to them because I can't afford to get them damaged like before.

[@llli*krysbe]

First, if the nipple is coming out looking like lipstick, that's the cause of the problem. Your LO is still having a bad latch. Your nipple should still come out of the mouth fairly normal looking (just long). DD did this for awhile, too. Make sure that the tongue is still over the lower gums (after DD had her TT released she still didn't do it right for awhile). In my experience, this is the most common cause of that. That said, the nipples do eventually desensitize and you can shower normally again (instead of protecting the nipples from the falling water!). When you do have a sharp/uncomfortable pain while he's nursing, unlatch and try again. The more you get it right now, the less painful it will be later (especially after teeth come in!). Good luck!

[@llli*joe.s.mom]

I think your latch still leaves something to be desired. I'll just say this from experience as I'm breastfeeding my 9 week old ex-TT'd baby right now - it can be very hard to get a perfect latch with a TT'd baby, even after the clipping. It takes a lot of work and practice to get them to open their mouths wide enough and take enough breast into their mouths. You're trying to retrain the way they use their mouths, but not sticking out their tongue much is an ingrained habit even at birth. Also, I'm learning that most TT clips are incomplete. ENTs will just clip as much as they can without putting the baby under general anesthesia, which makes a lot of sense. But most of the time, there is still some tightness left even after the clip. Finally, many TT'd babies have other issues like high palate or lip tie that can make a perfect latch hard even if the TT was completely clipped. Basically, yes, it's challenging!!

For me, positioning has really helped. Are you using lots of pillows and keeping the baby nice and high up on your body? Also, start sessions with your nipple at your baby's nose level and make baby reach for it. This feels very counterintuitive, but it really helps! Lean back a bit while you feed so that the baby is more on top and is latching himself on. Keep him on his side with his belly pressed to you - don't let him breastfeed on his back with his head turned, KWIM? It can be really helpful to get some hands on assistance from an IBCLC on this stuff - I know I struggled with it (even after breastfeeding my son for 2.5 years!) at first, until I saw a lactation consultant.

All of this has made a big difference for me, but the second I get lazy, my nipples are back to being creased like what you describe.

To answer your question, I don't know that nipples really toughen up all that much, but I do know that babies get bigger, their mouths get bigger, and they tend to naturally latch better as they get older. I'm definitely still waiting for Maggie's latch to improve, because it's a lot of work getting her in the right position every time (and I have a 3 year old so I don't always have time to latch her on perfectly).

[@llli*mommal]

To answer your question, I don't know that nipples really toughen up all that much, but I do know that babies get bigger, their mouths get bigger, and they tend to naturally latch better as they get older.

I don't think nipples really "toughen up" at all. I think the's a really good reason why nipples are sensitive and delicate: a latch that feels bad is often a latch that doesn't transfer milk well. If your nipples were as tough as shoe leather, you'd miss the painful evidence that the latch wasn't right, and that would be bad for the baby. But as JoMo said, as time goes on a baby's latch almost always improves. A bigger baby = a bigger mouth = a deeper, more comfortable latch.

As long as baby is growing normally and having the right number of wet/poopy diapers, I wouldn't worry. What you describe sounds like the sort of latch problem the baby will grow right out of.

[@llli*dylan.james]

We have experimented with positions and semi-reclined works best or the cradle hold. He hates the football hold although that's all I could manage after my c-section. We have limited success with side-lying as he tends to tuck his chin when rooting or after latching. He is generally such a wriggler though that getting into any position, if I haven't caught the hunger signs early, is a challenge. Allowing him to self-latch has worked in the past but he does tend to grab at my nipples...we've all experienced that I'm sure!

Tonight we had a setback. Unbelievable pain in my right nipple, a new sort of pain. That side was starting to feel full as I hadn't offered it at the last feed (there was no hardness though). When he latched i got a shooting pain right INSIDE the nipple, like it was bruised and was being crushed. I guess realistically that could be exactly what's happened? Or could it be a blockage or something behind the areola? I'm just feeling it now as I thought I should express, and the pain is all around the areola and nipple, but inside the breast rather than at skin level. The tip of the nipple is slightly redder than the left one, but otherwise there are no exterior signs. Any ideas what ths could be?

[@llli*joe.s.mom]

Two ideas:

Clogged duct: Any hard knots or lumps on the painful side? Does it still feel a little full even after a feeding? http://kellymom.com/bf/concerns/mother/mastitis/

Thrush: Or is there is a burning scratchy pain? (Usually you'd see bright red/pink nipples too, although this can be subtle in women with darker skin.) http://kellymom.com/bf/concerns/child/thrush-resources/

[@llli*dylan.james]

I'd had clogged ducts a few weeks back on the other side, but not with this pain. They disappeared quickly with heat, massage and even quicker when I put LO to feed on that side (we were just starting with back to the breast then)

I guess this time the clog is just closer to the nipple...I'll have to see how the next few hours go with heat, massage and expressing. I'll report back!

[@llli*joe.s.mom]

Could it be a bleb? Those REALLY hurt.

[@llli*amysmom]

I actually think it's the opposite. Nipples are stretched beyond what they've ever had done to them before. That stretching and suppleness is what makes our breasts able to get to the back of their mouths in order to transfer the milk. So no, they don't get tougher.

I would also agree with the PP that said it helps when the baby grows, they learn what the best latch is, Mom insists on the best latch.... It all just comes together.

Do NOT let them nurse if it hurts. You're doing them a disservice by teaching them that a less than perfect latch is okay and you're only hurting yourself.

[@llli*zackndelaneysmama]

bleb is AWEFUL!!!