How to fix a Bad latch and blistered nipple?

[@llli*gabygabs]

My baby is now 5 month and I've been breast feeding from day 1. Although I suffered a lot the first few months because of sore nipples, then realized it was because she had a bad latch. It got better around the 3rd month, and by the 4th month the doctor told me to start supplementing with formula because she was not gaining enough weight. For the past month my right breast nipple (which is her favorite, because it appears to always have more milk) it's been sore on and off. I'm pretty sure is due to her latch, but I have been trying to fix it and apparently I can't. It looks like she is doing a good job, but it gets all blistered and it hurts. Sometimes more than others. It's a pain I can handle but it's annoying. Specially now because I think she is teething and I use my breast to comfort her often. So how can I fix this? And also is it ok to comfort her with my breast? Is it also possible for her to have a bad latch only in one breast. Because the left one it's perfect!
Also, she is been feeding for shorter periods of time. She used to take about 15-20min on each breast and now it takes her 5-10min. And she doesn't seem to get hungry more often. She is peeing and pooping good 6 to 8 times a day, and her mood is great. So I guess she is good. But still seems weird to feed for that short amount of time, and sometimes she doesn't even want the supplement of formula, so I guess she is satisfied with the breast...

[@llli*mommal]

Can you give us a complete weight history on the baby and describe the pain you're experiencing a bit more fully- e.g. when does it happen, what exactly does it feel like?

It is 100% normal and desirable for the breast to serve as a source of comfort. Nursing for comfort is a great parenting tool for soothing a cranky, tired, or hurting baby, and it is also good for milk supply. Comfort nursing will not make your baby fat, demanding, hard to wean, or an axe murderer- though there are plenty of nutty people who will swear that it will do some or all of those things. Well, maybe not the axe murderer part. That's a little hyperbolic.

Short feedings in an older baby are textbook normal. Most older babies can get their food needs met in just 5-10 minutes, and then they wants to get back to playing!

[@llli*gabygabs]

Well, to begin, she was 3 weeks early and she weighted 5.2lbs.For the first months she was a small baby, but according to the doctors on the verge of normal. She always seemed happy and alert. And peeing and pooping ok. By the time she was 4months she weighted 9.6lbs and then is when the doctor said to start supplementing. She told me to offer her 2oz of formula after each feed, and I was sure she'd rejected because she never seemed hungry after feeds. But she did! She ate it all. So I started doing that and in a month she gained 2lbs 11oz. She would eat the 2oz of formula after each feed but the first one, and on the last one she would eat 4oz after the breast. But then towards the beggining of the 5th month she quit a meal and started eating 5 times a day (6am. 9am, 11:30 or 12pm, 2 or 3pm and 6pm). But now she is barely eating on the one around 9am and no formula and just taking 2oz of formula in the 3 last meals. And her feeds are between 5-10min each breast. Does this seems like to little food? Honestly I offer to her the breast or the bottle and she just rejects it. She is been eating then about 5 times a day, sometimes 6, but mostly 5. And every feed is both breast for 5 to 10 min plus the 2oz of formula after 12pm. And she seems happy pretty much all the time. She is been sleeping through the night since 2.5months. Although lately she is been waking up around 12am.
About the pain in my nipple. I think it's the latch (even when it looks fine on the outside) because it hurts when she eats, specially the first grab and then it mellows down through the feed, and sometimes I see blisters after she is done. Like like bubbles. It is not a milk blister because I know how they look, because I used to get them through the first 3 months on and off.

[@llli*mommal]

Thanks for providing the additional detail. I wish your child's doctor had talked you through the mechanics of supplementing with your own milk at the 4 month appointment- if you'd been able to pump enough for the supplements there would have been no need for the formula.

It's odd that your child is now eating so infrequently. Most babies nurse a minimum of 8 times a day, and many nurse more frequently than that. What would happen if you offered a lot more often than baby seems to want? And since your baby is sleeping so long at night, I am curious: what are you doing during the night- is baby sleeping in a swaddle or with a pacifier? If so, it may help to unswaddle her and take the paci away, since those 2 things can prolong the baby's sleep and when you have a baby who may not be nursing enough, prolonged sleep stretches are not what you want.

Regarding the potential latch problem, I think I would want to go and see an IBCLC about it. I'm sort of wondering about a tongue tie, since that could explain slow gain and the pain as well.

[@llli*gabygabs]

I used to pump before more often but since I was always with her and I would feed her directly I stopped doing it. And next time I needed to pump (for a work meeting) it took me a while to accumulate the milk because for some reason I was not getting enough milk. Could it be because the pump is not that great? (I Borrowed from a friend so it's been used) or could it be because I was just producing enough for her feeds? I wouldn't think she is got tongue tie because the other nipple seems perfect and doctor has never told me anything. Wouldn't the doctors notice a tongue tie by now, though? She never really ate 8 times a day, maybe the second month like 7-8 times a day, then 6-7 during the 3rd and 4th month, and when I started the supplement after the 4th month she started with 6 times a day and now about 5 times, its pretty much every 3 hours the feedings. The thing is that almost never she cries for food, I give her the breast. I offer it to her by 2 hours after the 2nd feeding because that's when she doesn't want to eat that much.
About the sleep, she started to sleep through the night around 2.5months, she'd only wake up around 4am and then by 3 months she would sleep straight till maybe 5:30-6am. When she started to sleep though the night my breast would filled up so much, and I was pumping that milk, but slowly they started to dry. When she wakes up at 5:30-6am they are pretty big and she drinks all that. She used to be swaddle and used the pacifier to sleep (which I removed as soon as she felt asleep) until the 3-4th month. Now she doesn't use a swaddle and hates the pacifier. Though isn't sleep part of the development process? They always say never wake a sleeping baby. To be honest I've been glad she is a good a sleeper, even though she hates falling asleep, but once she does, she sleeps. Also her naps aren't long at all, she is what they call a cat napper. But of course I worry about her nutrition. I worry about everything!

[@llli*mommal]

Hey mama, sorry it took me so long to get back to you! Maybe you've figured everything out by now. If not...

Could it be because the pump is not that great? (I Borrowed from a friend so it's been used) or could it be because I was just producing enough for her feeds

Using a used pump or a not that great to begin with machine can definitely impact output. Low production can also impact output at the pump. So this is sort of a "chicken or egg" problem. The best way to fix it is to nurse on demand, nurse more often, and use a better pump.

I wouldn't think she is got tongue tie because the other nipple seems perfect and doctor has never told me anything. Wouldn't the doctors notice a tongue tie by now, though?

Doctors often aren't good at diagnosing tongue ties, or ignore them because they are of the mindset that tongue ties will stretch out and fix themselves with time, ignoring the fact that breastfeeding often derails while a mom is waiting for a tongue tie to loosen. I would discuss the possibility with your pediatrician, maybe also with a pediatric dentist or pediatric otolaryngologist, and check out pics of tongue ties online. Really obvious ones can be spotted by a non-professional.

She never really ate 8 times a day, maybe the second month like 7-8 times a day, then 6-7 during the 3rd and 4th month, and when I started the supplement after the 4th month she started with 6 times a day and now about 5 times, its pretty much every 3 hours the feedings. The thing is that almost never she cries for food, I give her the breast. I offer it to her by 2 hours after the 2nd feeding because that's when she doesn't want to eat that much.

This is probably the root of a lot of your difficulties. With non-demanding babies, you want to proactively offer the breast at least 8 times a day, and more than that if the baby is having issues with weight gain. When your baby was having issues with weight gain, your pediatrician should have recommended that you increase feeding frequency first rather than adding in supplemental formula.

About the sleep, she started to sleep through the night around 2.5months, she'd only wake up around 4am and then by 3 months she would sleep straight till maybe 5:30-6am. When she started to sleep though the night my breast would filled up so much, and I was pumping that milk, but slowly they started to dry. When she wakes up at 5:30-6am they are pretty big and she drinks all that. She used to be swaddle and used the pacifier to sleep (which I removed as soon as she felt asleep) until the 3-4th month. Now she doesn't use a swaddle and hates the pacifier. Though isn't sleep part of the development process? They always say never wake a sleeping baby.

What they should say is "Sleeping babies who are nursing well and gaining weight appropriately may be woken, or not, as the mother chooses. Babies who are having trouble with weight gain should be woken and nursed at night."

Sleep is part of the normal developmental process, but "sleeping like a baby" is very different from sleeping like an adult. Infant sleep cycles are shorter than adult sleep cycles, they rouse from sleep more easily than adults do, and most babies continue to need to wake to eat until at least a year of age.