2nd time around...problems the first time.

[@llli*koms1016]

I am currently 16 weeks pregnant with our 2nd baby girl and am being proactive about bfeeding this time. I was totally unprepared last time and really struggled. Every nurse gave us different advice and I failed. I was only able to feed her for 6 weeks and my supply was pathetic. I know now that I shouldn't have supplemented with formula in the hospital, but as a FTM, I didn't know better.

My main problem was my nipples, for which I am going to start conditioning them before with cream, and the pain. Towards the end, I started getting sharp pains in my breasts AFTER I fed. We went to the doc and she said it wasn't thrush, but the pain was so intense, I would fall over in tears. I tried to keep doing it but just couldn't.

I know part of my supply issue was due to supplementing and my not eating well due to being so tired, so I plan on fixing that this time, but how can I handle the pain? I read on another post to take the good bacteria pills to ward off yeast infections, but what else can I do. I still feel guilty for quitting so early with my first daughter, but want to really try harder this time and be successful. My wildest dream is to have so much milk that I can give it to my older daughter (2.5 years old) so she can get some benefit now, but I know that's a pipe dream.

Appreciate any help or advice!!!!

[@llli*carm3]

Congrats on the second pregnancy, and for wanting to be proactiveto make sure things go well! I remember reading that you're not supposed to try to toughen up your nipples beforehand, that's outdated advice. I honestly can't remember where I read it though...I'm sure others here will have more on that particular topic.

As for other things you can do though:
1) Line up a good board certified lactation consultant beforehand, and try to attend a few LLL meetings and get to know your local leaders beforehand. You may be more likely to call them with issues if you feel comfortable with them.
2) Cook as many meals as you can and freeze them. Especially if not eating well was an issue the first time.
3) I personally don't have experience dealing with an older sibling while trying to nurse a new baby, but I've watched my SIL do it, and a few things that helped her along the way made a lot of sense to me. Her 2 yo had a baby doll that she took everywhere while SIL was preggo. They got her her own little rocking chair next to her mom's so she could 'nurse' her own baby at the same time once the LO was born. Have some special toys to occupy your older one while you're nursing. In the first six weeks, it's normal to feel like you're nursing the baby constantly, so having ways to keep your older one busy and feeling included is going to be really important.

I know others on here will have some good advice and personal experience to share with you. Good luck, and be sure to post any concerns/questions -someone is bound to be able to offer something

[@llli*mommal]

Welcome to the forum and congratulations on the baby to come! I think you should have every expectation that things will go well and you'll be able to achieve whatever breastfeeding goals you set for yourself. I am with the PP that now is a great time to line up a consult with a good lactation consultant, preferably one with an IBCLC certification. If you run into trouble with this next baby, you'll want a real professional in your corner.

It sounds like your first breastfeeding experience was sabotaged at the outset. The fact that the hospital staff handed you some formula instead of helping you work through your difficulties, and then the fact that you were not assisted with some pretty severe nipple pain... They let you down, mama.

Don't worry about conditioning your nipples with cream. When a baby is properly latched on, she won't hurt you even if you never put a drop of anything on your nipples. If she's not properly latched, it's going to hurt no matter how much cream you use.

Some tips for getting breastfeeding off to a good start:
- Aim for a good birth. Breastfeeding goes best when mom and baby are both healthy and strong.
- Choose your childbirth pain relief options with care. All pain relievers have potential drawbacks- for example, narcotic pain relievers can cause a baby to be born sluggish and unwilling to feed, and epidurals can cause a debilitating spinal headache which makes breastfeeding difficult- so it makes sense to be very familiar with your options and choose carefully among them.
- Assuming you and baby are both healthy and strong after birth, have the baby immediately delivered onto your bare chest to warm up skin- to-skin with you. Babies will often nurse within minutes of birth and not only does that provide them with their first dose of immunity rich, blood sugar stabilizing colostrum, but it also helps speed the delivery of the placenta and reduce a mom's risk of postpartum hemorrhage.
- Delay all routine newborn procedures (weight, measure, footprints, eye ointment, ID bracelet, bath, etc.) for at least an hour, allowing baby a chance to nurse and bond.
- Room in with your baby. Babies nurse more often and moms learn nursing cues faster when babies room in, and there's less chance of a "helpful" nurse slipping baby a bottle or paci.
- If you choose to send your baby to the nursery- and it should be a choice, not something which is dictated by hospital policy- make a sign for your baby's bassinet which says "I am a breastfed baby. No bottles or pacifiers, please. Bring me to my mom every time I cry, or every 2 hours if I don't."
- Do not supplement with formula "just until your milk comes in." Supplementation delays and reduces milk production.
- Avoid bottles and pacifiers until breastfeeding is well-established, typically 4-6 weeks. Babies suck differently on artificial nipples, and that can reduce their ability and willingness to latch onto the breast.
- Surround yourself with helpful people. Make sure your pediatrician is breastfeeding-friendly. Make sure that anyone who comes to visit you expects to do useful things like fixing you a meal, walking the dog, or taking care of your older child. You shouldn't have to do anything but nurse your newborn!

[@llli*lllmeg]

Congratulations!

Excellent suggestions by Mommal. I will add-

Read The Womanly Art of Breastfeeding 8th edition (or just the first four chapters) before baby, if possible, and

Find and connect with any local breastfeeding support prior to baby coming. La Leche League of course, If no LLL, there is usually something. If there are meetings, try to go to at least a couple.

[@llli*vtmtbkr]

I am sucessfully breastfeeding my second after exclusively pumping for my first due to pain, thrush, and a lazy latch. I would add that I had my doctor prescibe Nystatin for thrush this time before I left the hospital just in case and I used that in addition to lanolin creme the first 4-6 weeks just to ward it off. I would also recommend buying Soothies, I had nipple damage to one side this time and the lacation consultant gave me one and it helped a lot to allow that side to heal.

[@llli*koms1016]

Thank you ladies for all the advice. The reason I want to start conditioning my nipples is that my first was like a vacuum, and let me cracked and bleeding. I'd like to avoid this and have been looking up nipple creams. I didn't like how the lanolin was sticky and stuck to my bra etc.

Any advice on what to do about the pain? I'm going to devote the first few weeks to solely breastfeeding, and not worry about anything else unlike last time. Sad that nobody prepares FTMs for nursing and all we hear is about labor and delivery!

Also, my first baby was jaundiced so the nurses and docs pushed for a bit of formula...how do I combat this? Will saying no put her at risk of becoming sick if my milk takes time to come in? With her, it came in on day 4 or 5 so hoping it comes sooner.

I am really determined to get this bfeeding thing to work this time! Thanks!

[@llli*mommal]

The way our maternity care system is set up, there's this huge gap between pregnancy and childbirth preparation and preparation for breastfeeding and mothering. Pregnancy and childbirth can be very guided, information-rich experiences, but when it comes to mothering and nursing, most women are completely on their own!

One of the most important things to know about nursing is that it should not result in unendurable pain. When a baby is properly latched, you might experience a short burst of pinching pain (often called the "30 second sizzle") but it should not be so awful that you are crying in pain or experiencing pain throughout the feeding, or becoming deeply cracked. If you're in so much pain that you are afraid to nurse, then you should get professional help with the baby's latch, and baby should be checked carefully for tongue tie. The experience you had with your first baby sounds outside the norm and I don't think you should live in fear of a repeat. Just be prepared to get the right help if you do get a repeat.

When it comes to jaundice, it's important to nurse as much as possible. That will bring your milk in faster, and the sooner you have milk, the sooner you'll be able to flush the baby's bilirubin. If your baby is jaundiced, make sure you know what your baby's bilirubin level is before you agree to supplementation. Many newborns are somewhat jaundiced at birth, and most of the time that doesn't necessitate formula supplementation. Formula supplementation is only necessary if the baby is feeding poorly, not passing meconium, or is experiencing a climbing bili level which is approaching damaging levels, AND the mom is unable to supplement with her own expressed milk.

[@llli*manitobamommy]

I agree with all the previous advice. You can do it!

I can speak a little to the jaundice issue, since that was part of what caused the formula slippery slope for me with child #1 also. Breastmilk is much more helpful for clearing jaundice than formula, because breastmilk has laxative properties!!! That's how the jaundice is cleared from the system, by being pooped out. Under normal circumstances, there is no reason to supplement with formula, therefore, even if it's still colostrum (so really tiny, rich amounts). Hospital staff like formula, though, because they can monitor the amounts better and feel like they're doing something proactive.

In my case, DS was hospitalized for jaundice, and formula was pushed pretty heavily on us (to the detriment of nursing) until the folks from the NICU came down to assess the situation and told everyone that the best thing for DS was for me to be nursing as much as possible. For me, no-one was listening to me until someone in authority within the system came down to support me. So if you can find an ally, that's your best weapon. But you have to be willing to advocate for yourself and make clear that breastfeeding is a priority for you.

It's also worth point out that just because child #1 had jaundice does not mean child #2 did. But I know the desire to be "ready" - when DD came along, I had all my different strategies planned out for how it was going to work better in this scenario, or that. In the end, she latched on almost immediately after birth and we never had any problems.

[@llli*koms1016]

I should have said this earlier...but our problem was never the latch. We had a consultant come and she checked and said DD had a perfect latch. The pain was on the nipple initially just because I wasn't use to it, but that away after a while. I just felt a slight ting or pinch when she first latched on. Later on, about 4 weeks in, I started having pain AFTER feeding her, deep within. Doc ruled out thrush but looking now it might have be vasoospasm's?

I thought I was doing something wrong because she nursed every hour or 2 hours, and I didn't have enough milk. I started adding formula then which I now know was the exact opposite of what I should have been doing. I thought nursing her on demand was wrong, so I didn't do it. I'm lucky that my DH supports this completely and he'll tell the hospital no formula etc. My mom is also nuts and has no problem telling doctors how to do their job, so I have plenty of people on my side.

I know I am a good Mom for my DD, but the failure at this is something I don't think I will ever get over because I just feel so guilty that I gave up so soon. I'm grateful that she got my milk for some time at least, but want to try as hard as I can now and want to be prepared. If I fail this time, I know I tried my all and it just wasn't meant to be.

[@llli*mommal]

Thanks for adding that detail! The fact that you initially had a good, painless latch should give you lots of hope for the future. It really sounds like the biggest problem you faced was something like thrush or vasospasm- it's hard to say which at this point but it's worth noting that a lot of doctors don't know how to diagnose thrush when it presents without the "classic" white patches in the baby's mouth. It's really common for one member of the nursing pair to be asymptomatic, though both are infected, and it's also really common for thrush to present in such a way that you have one subset of symptoms but not every single symptom.

Pease don't let the mommy-guilt over your first breastfeeding experience niggle at you. You made it to 6 weeks despite some really trying circumstances and you should be really proud of that! And it seems like you took a lot of knowledge away from your first experience. Not all moms are willing to do the hard work of examining their experience, or of forging the determination to do things differently next time!