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Thread: Help with latch

  1. #1
    Join Date
    Jun 2011
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    178

    Default Help with latch

    My third baby is 4 days old today. My nipples HURT!

    It appears he's only getting the tip and not the bigger part of the nipple. He eats well, and as my milk is already in, diaper output has switched to the mustardy-seedy format, and I was excited to see that!!

    So, since I know it's not really affecting HIM, I need help for me. I clench my entire body and curl my toes for every nursing session.

    Help? He is moderately tongue-tied but lacation consultant felt it wouldn't be an issue considering he was able to put his tongue around her gloved pinky when she checked.

    Thanks!
    Miss Sassy Pants 1/9/05 BF 13 months
    The Animal 5/25/11 . . . BF 15 months
    Just welcomed Flash 4/24/13 . . . getting to know each other
    Married to the man of my dreams.

    I'm a blogging mama too: www.clutteredgenius.com

  2. #2
    Join Date
    May 2006
    Posts
    21,117

    Default Re: Help with latch

    Sorry you're in such pain, mama!

    The first thing I would do is to seek a second opinion about the tongue tie, preferably from an IBCLC who can watch you nurse and can help you figure out if this is something that will respond to time and positioning, or if you and baby would both benefit from have the TT released. Whether or not a TT needs to be dealt with depends not on how the tongue feels to the LC's finger, but rather on how much it impacts breastfeeding.

    Are you seeing breakdown of the nipple? Scabs, cracks, blisters?
    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
    Join Date
    Jun 2011
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    178

    Default Re: Help with latch

    We will see the pediatrician tomorrow, and I'll be asking her about the tongue tie for sure. The nurse who saw me in the hospital is IBCLC.

    Nipples are a little dry, but i'm putting lasinoh on them and giving them air. That seems to be helping. The pain only happens with the latch on - it dissipates as he nurses. I think we fixed it this afternoon as when he came off, the nipple was LONG - otherwise, it was looking a bit like the end of lipstick - that's NOT what it should look like, right?
    Miss Sassy Pants 1/9/05 BF 13 months
    The Animal 5/25/11 . . . BF 15 months
    Just welcomed Flash 4/24/13 . . . getting to know each other
    Married to the man of my dreams.

    I'm a blogging mama too: www.clutteredgenius.com

  4. #4
    Join Date
    Jun 2009
    Posts
    5,595

    Default Re: Help with latch

    Have you tried different positions, latch techniques, etc? Also I know it sounds weird but letting baby nurse very very often can help with latch pain, for a few reasons.

    Here are a few latch and positioning ideas to try. Yes it is not uncommon for there to be latch pain in the first several days or even weeks. But it definitely is a read flag, and especially because you are an experienced mom, (did you experience any latch pain with your older children?) this kind of pain suggests to me that something out of the ordinary is up. You may need to consider if you can arrange to see an IBCLC for a private consultation outside of the hospital if this does not improve quickly.
    Many doctors are still not trained in recognizing and treating tongue tie in breastfed infants. But most lactation professionals agree it should be treated asap when it is negatively affecting breastfeeding (and if it makes nursing painful for mom then it is affecting breastfeeding.)

    Tips with pictures on latch and different positioning ideas (includes side lying) http://www.llli.org/faq/positioning.html

    Laid back position http://www.llli.org/docs/00000000000...astfeeding.pdf

    Laid back video http://www.biologicalnurturing.com/video/bn3clip.html

    Here are two simple pictorials, one on tongue tie and one on latch. Notice in the altch one that the mother is in a “slightly” laid back position, looks like on a couch? This is a very “adjustable” position, play around to find how you and your baby are most comfortable. http://cwgenna.com/quickhelp.html

    latch and 'Breast sandwich' article http://www.llli.org/llleaderweb/lv/lvfebmar04p3.html (probably only needed if baby cannot latch or latch is hurting mom)

  5. #5
    Join Date
    Jun 2011
    Posts
    178

    Default Re: Help with latch

    I saw that about the sandwich - thank you for these links.
    I can't make a sandwich with my breast - it's so full or big right now. I know this will calm down eventually - so am I just needing to wait?
    He'll open his mouth really big, and I go to help him with the nipple - then he almost looks like he's just trying to kiss the tip - he purses his lips as one of the articles above explains.

    Yes, I know it hurt with my first - she actually broke my skin and that was brutal. My 2nd had a lot of trouble with latching and there was much air gulping. That's why I'm trying to catch this as soon as I can...
    Miss Sassy Pants 1/9/05 BF 13 months
    The Animal 5/25/11 . . . BF 15 months
    Just welcomed Flash 4/24/13 . . . getting to know each other
    Married to the man of my dreams.

    I'm a blogging mama too: www.clutteredgenius.com

  6. #6
    Join Date
    Jun 2009
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    5,595

    Default Re: Help with latch

    I can't make a sandwich with my breast - it's so full or big right now. I know this will calm down eventually - so am I just needing to wait?
    When a mother is very full in the early days, two things are usually going on. 1) her milk is becoming abundant and 2) she is experiencing post partum edema. This can happen to any mother but is most pronounced if mom had any intravenous fluids before, during or after labor. The engorgement creates breast “congestion.”

    So yes, it will calm down, most immediately as your body rids itself of the excess fluid and later as your milk production ‘levels off.” but you can certainly be proactive in the meantime. Here are some things to try, no need to do everything, just what makes sense/fels right to you.

    1) Nurse very often. It is normal for a newborn to nurse a minimum of 10 times a day and more-much more often, is fine. The more often milk is removed, the softer the breast will be.
    2) Try reverse pressure softening to move any edema out of the areola and soften the breast (see below linked article)
    3) Nurse "laid back" as shown in above links, and/or, just lay on you back when you can to allow fluid to move from breasts back into body. Don't nurse while entirely flat on your back, however. It's not considered entirely safe in some situations and most mothers do not find it comfortable.
    4) hand express a little milk out prior to baby latching to soften the areola
    5) If very frequent nursing alone does not soften the breast enough, you might need to hand express or 'massage' milk out (in the shower, for example, works well for some moms.) Pumping will very likely cause additional issues than not at this point, however, if you are becoming engorged and you cannot remove the milk any other way, then you may also want to try pumping, just enough to soften the breast.
    6) Try ideas to reduce swelling-cold packs, otc anti-inflammatory.
    7) Some mothers find warmth helps to bring on milk letdown but heat will also increase swelling. You might want to avoid placing heat directly on the breasts.

    Engorgement FAQ also has reverse pressure softening info http://www.llli.org/faq/engorgement.html

    Hand expression http://www.llli.org/docs/00000000000...expression.pdf

  7. #7
    Join Date
    Jun 2011
    Posts
    178

    Default Re: Help with latch

    Oh wow. Thank you so much. That makes so much sense as I had 3 bags of fluid before/during labor. Wow. Didn't even realize that could cause an issue. I've been quite impressed with the size of my girls, but they're really frustrating me, too. Ok, gonna stock up on water and try the cool compresses. Thank you so much!
    Miss Sassy Pants 1/9/05 BF 13 months
    The Animal 5/25/11 . . . BF 15 months
    Just welcomed Flash 4/24/13 . . . getting to know each other
    Married to the man of my dreams.

    I'm a blogging mama too: www.clutteredgenius.com

  8. #8
    Join Date
    Jun 2009
    Posts
    5,595

    Default Re: Help with latch

    yes there really is a time they can be 'too big!"

  9. #9
    Join Date
    Jun 2011
    Posts
    178

    Default Re: Help with latch

    Now the nipples are cracking. I'm "lubing" them up - what else can I do? Won't it just exacerbate the issue to have baby nursing on it? I about came off my chair today when he latched...
    Miss Sassy Pants 1/9/05 BF 13 months
    The Animal 5/25/11 . . . BF 15 months
    Just welcomed Flash 4/24/13 . . . getting to know each other
    Married to the man of my dreams.

    I'm a blogging mama too: www.clutteredgenius.com

  10. #10
    Join Date
    Jun 2009
    Posts
    5,595

    Default Re: Help with latch

    What will exacerbate the issue is a continued poor latch. Many mothers choose to nurse during nipple trauma (cracking, bleeding, scabbing) while working on fixing the latch, and once the latch is better the nipples heal right up, even while baby nurses the entire time. Others decide to 'rest' the nipples and 'give them a chance to heal' by pumping. And some nurse some and pump some.

    How to approach this is up to you-there is no 'wrong' way. However, it is important to be aware of the various issues that may be caused by early introduction of pumping and bottles. If you decide to pump and not nurse for now, at some point, latch has to be 'fixed,' which always to some extent involves mom and baby figuring out what is going to work for them as far as latch and positioning goes. In other words, pumping may allow your nipples to heal, but if latch is not corrected, you are back to square one. On the other hand, if you are risking extreme nipple injury, pumping for now may make the most sense.

    If the latch ideas I have posted have been tried with no improvement, it may be time to consider getting hands on help asap. At best that means a private consultation with an IBCLC (Board Certified Lactation Consultant.) Below I am posting an article about what to expect at such a consult and also two articles on injured nipple care. OPlease let us know if you are having difficulty getting an appt. with an IBCLC.

    What did the doctor say about the tt?

    what is involved in a lactation appt http://cwgenna.com/lconsult.html

    healing sore/injured nipples http://kellymom.com/bf/concerns/mother/nipplehealing/

    nipple hygiene http://cwgenna.com/nhygiene.html

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