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Thread: Frenectomy was done at the hospital but still in great pain

  1. #1

    Unhappy Frenectomy was done at the hospital but still in great pain

    Hello,

    I'm new to this forum and desperate because of all the pain while breastfeeding.
    My first baby had a frenectomy performed at 3 weeks old but I could never breastfeed and had to pump exclusively for 9 months.
    I've just had my 2nd baby and this time, the frenectomy was done on his 2nd day of life. He latches and draws milk but I scream in agony each time and the pain only gets worse during the feeding. The nipple comes out all squashed and bruised and flattened.
    Please help, will it ever get better? What else can be done? At the hospital, the nurse said the latch was OK.

  2. #2
    Join Date
    Jun 2009
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    Default Re: Frenectomy was done at the hospital but still in great p

    Hi I just have a moment but I will try to give you some quick ideas. First off yes it should get better. But that does not mean you should wait for it to get better will probably need to take some steps to figure out what is going on.
    If there is any way you can get a visit with a professional board certified lactation consultant I would very much suggest doing that.
    Just because a latch looks okay does not mean it is okay. There is much a mother can do with positioning and latch techniques to help the latch feel better.
    To that I recommend very often is laid back breast-feeding, and the breast sandwich technique. One is positioning the other is latch. They can be used individually or together. I can't describe it more here right now but if you search those terms on this website and on the web you should find more information.

    Do you know what thrush is? That can also cause great pain when nursing. You just want to rule that out as well.
    Do you have a visible nipple injury? Sometimes when a nipple is injured the area can actually become infected and that will also cause more pain.

  3. #3
    Join Date
    May 2006
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    Default Re: Frenectomy was done at the hospital but still in great p

    with LLLMeg. I really hope you can get a visit with an IBCLC- latch problems respond best to hands-on help from a professional! And don't let anyone tell you that the latch must be fine because it "looks okay". What the latch looks like means next to nothing. What it feels like is what really matters!
    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!"

  4. #4

    Default Re: Frenectomy was done at the hospital but still in great p

    Thank you for quick replies, I have consulted an IBCLC in the past (3 years ago), but at the time, although I got some helpful advice, it did not make my breastfeeding successful. I will try to find somebody else in my area to give it another try and in the meantime, I've been researching the breast sandwich technique and also the Reverse Pressure softening because at night, the engorgement make the latching almost impossible. Any helpful links or resources would be appreciated. My last feeding was much better for some unknown reason (maybe a deeper latch or softer areolas) but the nipple still came out flattened.

  5. #5
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    Default Re: Frenectomy was done at the hospital but still in great p

    Great! If latch is sometimes not painful that would indicate the issue is not thrush, which is good news just because thrush is a pain (although it is treatable)

    I am so glad you found the RPS technique. Smart! Yes engorgement makes latching very difficult for baby and can cause pain. I know it sounds counterintuitive when nursing hurts, but often the best thing a mom can do is nurse frequently even when nursing hurts. Because 1) frequent nursing helps lessen engorgement and 2) a calm, not to hungry baby often latches better and 3) baby learns to nurse by nursing.

    Sometimes nursing continues to hurt after latch is ok due to nipple injury (either open wounds or deep bruising can make even a good latch hurt) So, If the pain is still present but is lessening, that is a good sign.

    If you have local LLL certainly you can call and speak to a Leader (actually you can call and speak to any Leader anywhere) for help, and this would of course be free as we are volunteers. If you find a local Leader there may be a meeting coming up or they may do home visits. However, if nursing is so painful you are ready to stop, I do suggest to see an IBCLC if you can. They typically have training beyond what an LLL Leader can offer.

    basics of laid back nursing. Remember you do not have to be actually lying down as in this illustration. Mom can be at any amount of recline, even almost sitting up, and baby can be in any position. Play around with it and find what works best for you: https://www.llli.org/docs/0000000000...astfeeding.pdf

    nice simple pictorial on latching baby. This IBCLC also has a nice article on her site on what to expect at an IBCLC apt. http://cwgenna.com/quickhelp.html

    latch on pictorial with breast sandwich: http://www.mother-2-mother.com/NippleSandwich.htm

    healing tips for nipple injury http://kellymom.com/bf/concerns/mother/nipplehealing/

  6. #6

    Default Re: Frenectomy was done at the hospital but still in great p

    Since the last night, I've noticed that even though the latch seems better and it hurts less when breastfeeding, the nipples are still coming out bruised (new injuries) and flattened. So I'm wondering if the nipple still does not go deep enough or/and at the right angle, giving it the "lipstick" shape.

    The consultant I've seen in the past told me that the nipple should be pointing upwards when entering the baby's mouth and in order to achieve that, she would squeeze and pinch the areola. This technique seems to be the opposite of what I've seen on other sites (do not hold your fingers close to areola).

    Also, I have a question about laid back nursing: a friend told me that it's important not to be reclining backwards otherwise there will be no gravity effect to help the milk come forward. So this seems to be wrong advice from my friend?

    My other difficulty when trying to improve the latch on was to make baby open wide enough. When he is hungry, he starts crying and gets angry and fussy but if I don't wait until he cries, he is too sleepy (he's only 1 week old).

    Thanks again for all the advice.

  7. #7
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    Default Re: Frenectomy was done at the hospital but still in great p

    Basically I would say if your nipples continue to get new injury, that indicates a problem. If your nipples are coming out lipstick shaped but nursing is comfortable and you're not getting new injury and baby is clearly getting plenty of milk, I would not think that is necessarily a problem.
    Sometimes tongue-tied needs to be treated more than once. I don't know what sort of aftercare instructions you were given, but their various sucking exercises etc. that are sometimes needed. However since your baby was treated so young I am not sure they would be needed in this case. Even when there is no physical barrier, latch can be painful or shallow.

    I would not say that either your lactation consultant nor your friend were "wrong".
    The thinking on latch and positioning has gone through quite a revolution in the last few years. If I had to sum up what the thinking is now, I would say it is "try many different things, and do what works for you."
    I have not heard of reclined breast-feeding causing an issue because gravity is not helping the milk come out. Milk actually ejects from the breast (it may not look like a spray and that's fine but it is coming out without the assistance of gravity) and a baby who is latching and nursing probably should have no trouble getting milk out even if they are on top of mom. In fact this is why this position is often very helpful if the problem is fast milk flow because gravity can be helpful in slowing the flow down a bit. I have heard the concern that it can cause plug ducts, However if the baby is nursing with good frequency and removing milk from the breast efficiently, this should not be a major concern, especially as this position allows you to move baby around the breast more freely, which would actually facilitate removing milk from all the ducts. The research on laid-back breast-feeding is very clear that in many cases but of course not all, it facilitates a more comfortable latch and greater comfort overall for both mother and baby.
    It is true that you want to keep your fingers back from the areola when doing the breast sandwich technique. Basically you don't want to block the baby from being able to get a good latch with your fingers. But of course every mother's nipple and areola is shaped and sized differently so how breast sandwich will look in an individual case varies.
    There is also a technique for latching that is called the drop in technique I believe, which does include taking a pinch of the upper areola and basically "dropping" the nipple into the babies mouth. Perhaps this is what your former IBC LC showed you.

    As far as trying to achieve and asymmetric latch, this is again something that some mothers may need to be careful about, and others do not.
    I know this all seems as clear as mud, but in actuality this is very freeing. Basically the fast and hard rules about positioning and latch have been found to be generally not as necessary nor as overall helpful as they once were thought to be. Mothers are free to experiment more. Basically if latch does not hurt, and baby is getting enough milk, you are good.
    Last edited by @llli*lllmeg; April 30th, 2014 at 01:36 PM.

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