Help :'( - BFing with implants - discouraged

[@llli*shawna.bray]

Hi, I'm new here (and very new to motherhood) and haven't lurked at all, so I apologize if this is something I would have picked up with better diligence.

I have saline breast implants that were placed in the ideal way for breastfeeding: under-the-fold incision, sub-muscular placement. My baby is 3 days old and my milk hasn't let down, but I'm only producing colostrum on one side. It's excruciatingly painful to let her latch. I am confident we're latching well: everyone at the hospital said so, including the 4 nurses and LC I talked to about it. She was a total natural; grabbing tons of areola, flaring her lips, etc. We worked a bit on holds but it was consistently painful the whole time. It's very frustrating to keep reading and hearing that it shouldn't be painful: nothing was wrong with latch and nothing ever was. I think my nipples are oversensitive from my surgery but who knows. No one in the hospital had any implant-specific comments or advice.

Now we're home, and I realize that only one of my breasts is producing colostrum. They're both pretty battered and painful, though some holds are more tolerable than others. In the hospital we did two bottles to give my nipples a rest in between attempts; I called the pedi nurse and she said due to my "history" and the fact my LO hasn't had a dirty diaper in over 24 hours, we should supplement but still put her to my breast every 2 hours. At this point though, my nipples can't take it. the productive one is bleeding and the unproductive one is no longer interesting to her. She gets on, starts sucking and then starts shrieking. They're throbbing with pain off and on, and I'm keeping them under Hydrogel thingies.

I feel like a failure and can't stop crying. Is it going to get better when my milk lets down? Is it possible it never will? Will my unproductive breast ever become productive? Is it just way too early to be freaking out? Are there any resources tailored to implant-related concerns? Is there any way to know for sure that you are or aren't one of those women just inherently limited by her implants?

[@llli*manitobamommy]

First, take a few breaths...

These are all problems that moms who never had implants have, so it may well have nothing to do with the implants. Second, it is likely that these things will all resolve themselves in time. Chances are very good that you ARE producing colostrum in the other breast, it's just not producing as much, or the pumping isn't getting as much out on that side. Colostrum comes out normally in REALLY tiny amounts.

Regarding pain, it is VERY common to experience pain at first. I know people say it "shouldn't hurt". But what they really should be saying is "don't settle for having pain - keep trying to make things better". That said, sometimes you never figure out what was wrong, if anything, or your baby just needs to "grow into" it. I know I experienced pain for many weeks with my first (not to the extent you're describing through), and no-one ever found a problem. Eventually it just resolved itself. Nursing is something both mom and baby have to learn over time - it's natural, but doesn't come naturally, if you know what I mean. I really encourage you to find a Board Certified Lacation Consultant (make sure they are board certified) that you can have a one-on-one meeting with and see if anything can be found to make things less painful for you.

It is possible that your implants are contributing to the problem, but it's also really likely that this is just normal "learning to nurse" difficulties that will be easily resolved with the right support.

[@llli*maddieb]

please don't feel like a failure. many moms experience what you are experiencing in the early days, moms with no history of breast surgeries! It is way too early to assume all is lost or even that your issues are due to your implants or surgery. That may be part of it, it may not.

I am not sure how you can tell that only one breast is producing colustrum. Colustrum is very scant and many mothers never see it at all. It is clear or a little honeyish in color. Many moms who for whatever reason are not nursing and have to express their milk find that it is difficult to effectively express colustrum with a pump, and that hand expression works better. But in any case, colustrum comes in tiny amounts by nature's design. So when expressing, expect droplets, not streams, of colustrum. Typically, for the first few days this scant colustrum is all a healthy newborn needs.

At about day three the milk starts typically starts to become more abundant and milky looking. it is very important that milk is regularly removed at this point, to encourage normal production and reduce the chance of engorgement. baby should be nursing a minimum of 10 times a day. If that is not possible, mom needs to pump and/or hand express about that frequently.

Your baby is three days old. At this point before milk becomes more abundant, one poop a day could be entirely normal. How many times has baby pooped total, in her life? How are pees? Also, fyi, the act of sucking itself, and colustrum, help make a baby poop.

As far as painful latch-it does not really matter what the latch looks like. How it feels tells us what is going on. Some discomfort esp. just after baby latches can be normal as you both learn breastfeeding. But it should not hurt so badly that you need to 'rest' your nipples or damage is being done. That does indicate either a latcj issue or something else being not quite right. It does not, howeve, mean you shoukld not nurse. Many moms who experince painful latch continue to nurse while seeking help with the pain. How to approach this is an individual choice but there are many benefits to keeping baby nursing at the breast at least some of the time if you can.

Unfortunately you can not assume nurses and doctors know a thing about helping a mother with breastfeeding issues. Can you see a board certified lactation consultant (IBCLC) for an outpatient appt? This would be sitting down with a trained person for at least an hour and working on the problem, and may be much more productive than a few minutes visit with the lc in the hospital.

[@llli*djs.mom]

And really your may not come in for another day or two and that is still fine. Here is a good video from Dr. Jack newman about what a good latch actually looks like. And the other two are right there for you to watch too. http://www.youtube.com/watch?v=Ox8ht-EVnQA

[@llli*maddieb]

btw, implants themselves or even implant surgery may not cause any problem with milk production. but some women have pre-existing conditions that cause a lack of breast tissue that may have been why she was a candidate for implants in the first place, and that may be what causes lower milk production. This is the kind of thing you can discuss with an IBCLC. Again, nothing you have described in you op suggests you will have any physiologic issue producing enough milk.

[@llli*shawna.bray]

First, take a few breaths...

These are all problems that moms who never had implants have, so it may well have nothing to do with the implants. Second, it is likely that these things will all resolve themselves in time. Chances are very good that you ARE producing colostrum in the other breast, it's just not producing as much, or the pumping isn't getting as much out on that side. Colostrum comes out normally in REALLY tiny amounts.

Regarding pain, it is VERY common to experience pain at first. I know people say it "shouldn't hurt". But what they really should be saying is "don't settle for having pain - keep trying to make things better". That said, sometimes you never figure out what was wrong, if anything, or your baby just needs to "grow into" it. I know I experienced pain for many weeks with my first (not to the extent you're describing through), and no-one ever found a problem. Eventually it just resolved itself. Nursing is something both mom and baby have to learn over time - it's natural, but doesn't come naturally, if you know what I mean. I really encourage you to find a Board Certified Lacation Consultant (make sure they are board certified) that you can have a one-on-one meeting with and see if anything can be found to make things less painful for you.

It is possible that your implants are contributing to the problem, but it's also really likely that this is just normal "learning to nurse" difficulties that will be easily resolved with the right support.

I feel so dumb, as much as I read up on pregnancy, I never studied up on nursing much, just holds and how to get a good latch, so I had no idea that this was normal. Thank you.

One side produced colostrum in pregnancy and the other didn't. One side will let me hand express it and the other won't. I suppose the other might be producing it and I just don't notice it, but I see she gives up on that side, which makes me think it's not doing much for her.

I already worked with an LC at the hospital, and she wasn't helpful in terms of resolving my problems. She said that the latch looked good from the outside and the way my nipple looked after also looked right (in terms of how she was sucking my nipple into shape). She recommended trying different holds, and I have found ones that were less painful, but all still very painful (like, am having to breathe through the pain when she first latches and then they become a tolerable ache, not a sharp pain anymore). I'll definitely meet with one again but I was so disappointed the first time! She just didn't say anything substantive.

[@llli*shawna.bray]

please don't feel like a failure. many moms experience what you are experiencing in the early days, moms with no history of breast surgeries! It is way too early to assume all is lost or even that your issues are due to your implants or surgery. That may be part of it, it may not.

I am not sure how you can tell that only one breast is producing colustrum. Colustrum is very scant and many mothers never see it at all. It is clear or a little honeyish in color. Many moms who for whatever reason are not nursing and have to express their milk find that it is difficult to effectively express colustrum with a pump, and that hand expression works better. But in any case, colustrum comes in tiny amounts by nature's design. So when expressing, expect droplets, not streams, of colustrum. Typically, for the first few days this scant colustrum is all a healthy newborn needs.

At about day three the milk starts typically starts to become more abundant and milky looking. it is very important that milk is regularly removed at this point, to encourage normal production and reduce the chance of engorgement. baby should be nursing a minimum of 10 times a day. If that is not possible, mom needs to pump and/or hand express about that frequently.

Your baby is three days old. At this point before milk becomes more abundant, one poop a day could be entirely normal. How many times has baby pooped total, in her life? How are pees? Also, fyi, the act of sucking itself, and colustrum, help make a baby poop.

As far as painful latch-it does not really matter what the latch looks like. How it feels tells us what is going on. Some discomfort esp. just after baby latches can be normal as you both learn breastfeeding. But it should not hurt so badly that you need to 'rest' your nipples or damage is being done. That does indicate either a latcj issue or something else being not quite right. It does not, howeve, mean you shoukld not nurse. Many moms who experince painful latch continue to nurse while seeking help with the pain. How to approach this is an individual choice but there are many benefits to keeping baby nursing at the breast at least some of the time if you can.

Unfortunately you can not assume nurses and doctors know a thing about helping a mother with breastfeeding issues. Can you see a board certified lactation consultant (IBCLC) for an outpatient appt? This would be sitting down with a trained person for at least an hour and working on the problem, and may be much more productive than a few minutes visit with the lc in the hospital.

I'll try to set up time with another LC. I will admit, I felt very criticized by the first. She seemed skeptical about my pain level and what my early latches were like. I just felt like I was getting stock answers from her, you know?

[@llli*shawna.bray]

And really your may not come in for another day or two and that is still fine. Here is a good video from Dr. Jack newman about what a good latch actually looks like. And the other two are right there for you to watch too. http://www.youtube.com/watch?v=Ox8ht-EVnQA

The only thing different here than I was told by the LC and nurses at the hospital was that they had me "burying" her nose more but I will see if that helps.

[@llli*shawna.bray]

btw, implants themselves or even implant surgery may not cause any problem with milk production. but some women have pre-existing conditions that cause a lack of breast tissue that may have been why she was a candidate for implants in the first place, and that may be what causes lower milk production. This is the kind of thing you can discuss with an IBCLC. Again, nothing you have described in you op suggests you will have any physiologic issue producing enough milk.

Yeah, I've read that, that it might have more to do with the state of my pre-surgery breasts than anything else. I would be surprised because all my aunts and mother BFed though. I guess implants can also put pressure on things in such a way to reduce production but it sounds like that wouldn't be evident at this stage either way.

[@llli*manitobamommy]

No need to feel "dumb" - you came to the right place! We all come to these forums because there is so little knowledge and so much misinformation out there in the real world about breastfeeding. Even health professionals can have very old-fashioned or just plain queer ideas about breastfeeding. I am so sorry you had a bad experience with the LC in the hospital. There are a lot of good LC's out there doing good work, but there are also a lot of under-trained or misinformed ones. That's why we've been stressing that you find one that's Board Certified, so you know that you're getting one with the right training.