nipple damage

[@llli*sluu09]

Hello, I have a 4 week old baby and am just getting back to nursing. I initially had nipple damage and had to pump for a couple of weeks while I healed. I have tried using a nipple shield to help with pain, but baby has no problem latching and I find difficulty using the shield sometimes (doesn't stay on and I don't feel like my breasts drain as well). She tends to slip while dozing and now I am finding that maybe due to my small breasts, she is not getting enough breast tissue into her mouth. I am starting to notice my nipples starting to crack again and am wondering if anyone has suggestions on what I could do to improve nursing my little one. I would rather not use the shield, if I could find a better way to nurse. I have tried using the sandwich method too. Is the pain just something that I will get used to?

[@llli*lllmeg]

Hi sluu09, and welcome.

Have you found a local breastfeeding helper? An IBCLC, (professional lactation consultant) or a LLL Leader or other breastfeeding volunteer, or a friend or relative with breastfeeding experience? Or all of the above?

Of all the breastfeeding issues, a painful latch is the one where in person help is the most important. So if that can be arranged, I strongly urge you to do that. If you have already seen someone, I suggest, talk to us about that and/or find someone else. Also, it is important that a physical issue such as tongue or lip tie be ruled out.

Yes some moms find there is some latch pain in the first week or so that goes away as they and baby figure out what works and what does not. But that means the pain goes away because latch has been corrected, not that mom 'gets used to the pain." The idea that mom has to ‘toughen up her nipples” or get used to the pain of nursing is a myth. Nursing should not hurt and when it does, that indicates there is a problem that needs addressing-usually latch, sometimes thrush or a bacterial infection, and sometimes more than one thing is going on. Also, your pain and injury was to the point that you felt you had to stop nursing and pump, use a nipple shield, and at 4 weeks there is still a problem. This is ample evidence there is a real issue that needs to be identified and corrected. You have been working so hard. You deserve to nurse comfortably!

While some mothers find the shields help with painful latch, that is not really what shields are for. They are best used when a baby cannot latch without them. Basically, if they are helping, it is ok to keep using them, but if they are making little difference, I would suggest not using them. Also some moms find they need one for one side and not the other, or some feedings and not others, etc. If you do keep using them but feel baby is not able to extract milk well, you want to watch baby’s weight gain and output closely and may need to pump as well to make sure your milk production is not negatively affected.

Getting a good latch often requires that mom and baby find what position(s) work best for them. This will vary from mother to mother, but there are some basic tips to follow. There is much research to suggest that a laid back nursing posture is very helpful for a shallow latch and for baby pulling off the nipple. So if you have not tried that yet, I suggest doing so, if you have tried it and it is not helping, keep trying wiht whatever adjustments you think may help, it is a very versatile position and you can adjust your position and baby's position in many ways.

I am going to link some info that I hope you will find helpful.

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. In the one on latch, Notice 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

This video is not in English but it does not matter. Shows the versatility of laid back nursing: http://www.youtube.com/watch?v=7SZ3zb5OYMA

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)

What is normal in the early weeks with a breastfed baby http://kellymom.com/bf/normal/newborn-nursing/

[@llli*auderey]

Yes to all that LLLMeg says on latch.

I just had my second and got cracked nipples and my IBCLC gave me a crazy treatment that worked incredibly well. Take 1 drop of Dreft laundry detergent and put it in a cup of warm water and soak the nipple for 4-5 minutes. You can use like a shot glass and hold it on to your nipple. Then air dry VERY well. Then apply a very small amount of bacitracin ointment (bacitracin only, no other antibiotics like neosporin). You'll want to wait an hour before nursing again. Do 1-2 times a day. I only had to do this 3 times before my (minor) cracks healed enough to tolerate.