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Thread: 8 WO - Shallow Latch, can it improve?(LONG!)

  1. #1

    Default 8 WO - Shallow Latch, can it improve?(LONG!)

    Hello ladies,

    After weeks of browsing these forums (and finding them extremely helpful, I might add!) I decided to post my individual story, both as an encouragement to others and because I'm hoping for a bit of encouragement myself!

    My DD is eight weeks old as of yesterday. I've breastfed her almost exclusively from day one except for a brief stint with pumping/bottle feeding (more on that later). To put it mildly, she has never latched well. While I didn't have any drugs or interventions in labor, I did have a very long delivery and ended up pushing for almost four hours. Ouch. She was very lethargic during our stay in the hospital. The lactation consultant tried to stop in once or twice but she was just one person and there were tons of other births that week so she never really got a chance to show me how to get a good latch.

    DD's jaundice levels were very high when we left the hospital, which made her even more sleepy. I fed her every one-two hours around the clock for her first two weeks of life. Thankfully, she gained well and the jaundice cleared up. However, about two days home from the hospital, my nipples started hurting. They've hurt ever since then! Everyone I talked to said that some transitional soreness was normal, so I tried just sticking it out. A week after her birth, I was going crazy with pain every time I latched her on. I had bad cracks that bled all the time. I used lanolin but it was pretty much useless. I finally realized that this was more than "transitional soreness" and went back to the hospital LC. Almost right away, she noticed that DD had a minor posterior tongue tie and recommended that we get it clipped. She also wrote me out a prescription for APNO and gave me some hospital grade gel pads, both of which I started using right away.

    I couldn't get in to the ENT Dr. for another week, during which my milk came in full force, I developed two lumps in my right breast, and spent most of the weekend in bed with a fever. Not fun. The fever cleared up, as did the lumps, but my breasts stayed extremely full despite feeding my daughter around the clock. Engorgement + cracked nipples = agony. I kept thinking that if I could just make it to her ENT appointment then everything would get better.

    Well, the TT was clipped with little fuss. The only problem was that it didn't make any difference whatsoever in my comfort level with nursing. DD still wouldn't open her mouth wide and when she nursed, it pinched and hurt the whole time. I stuck it out for a few days to see if the improvement would be gradual and then broke down and called the lactation office at the hospital again. This time, I talked to the weekend LC who suggested that I rest my nipples by pumping and bottle feeding for a couple of days. I was in so much pain and so upset about the whole thing that I took her advice right away. Unfortunately, even after two full days of resting my breasts, things weren't looking much better. I hated how much time it took to pump, feed, and clean all of the parts and bottles and I really missed the bonding with my baby. What's worse is that it took me a good week to get my baby comfortable with nursing from my breast again. She totally developed an aversion to it after having the bottles. For the record, we used the Advent Slow Flow ones.

    Somewhere around my DD's 3rd week, I called the hospital. Again. I'm sure they were sick of hearing from me by then. Anyway, the original LC that I had been working with suggested trying a nipple shield. Somewhere around this time I also had an appointment at the midwives clinic I had worked with throughout my pregnancy. Their lactation specialist took a look at me, suggested I try lanolin (again) and wrote me out a prescription for antibiotics in case I was infected. She didn't even have me latch the baby on. I was too tired and wigged out to notice how silly that was...I just took myself over to Target and bought a nipple shield.

    Things worked out alright for about a week. I HATED using the shield but it did allow me to have DD on my breast and nursing somewhat pain-free. The only problem was that after a few days I noticed that she never, ever seemed satisfied after nursing. Her poops also went from the seedy yellow to frothy green, she was gassy constantly, and just seemed to be having a tough time getting enough. I think that because her latch/suck was never good to start with, she couldn't figure out how to get the fatty hindmilk out with the shield on.

    I should also mention that, four weeks postpartum, I was still engorged. I had SO MUCH MILK. Seriously, I was going through two or three bras a day, changing the sheets all the time, etc. DD would choke and sputter every time she fed. After doing lots of research, I self-diagnosed myself with an over-active letdown and started block feeding. It took about a week and a half, but the engorgement finally subsided to a normal amount and the crazy leaking slowed down.

    After a very frustrating morning of trying to nurse and feeling like DD was just terribly frustrated and hungry, I called the hospital again. It was right before Christmas and no one called me back. I also called my baby's pedi and asked for a recommendation for a lactation consultant so that I could get a second opinion. Thankfully, I was able to get in to see a different woman at another hospital who was so, so validating and helpful. She showed me a maneuver that I could do to sort of help correct the shallow latch while the baby was already on. Basically, it was a matter of adjusting the baby's position so that her head had to be tilted back and pressing on the small of her back with my hand to keep her close to me and force her to open her mouth wider while feeding.

    While it improved things slightly, my nipples still hadn't healed. By this point, the cracks were deep. One side was more an open wound than a crack (still is, for that matter...). I gave it another couple of weeks before I started reaching out to people again. Oh, and in the meantime, I went back in to the midwives clinic for a follow-up appointment, during which they decided to treat me for thrush by giving me a prescription for diflucan, which did nothing at all to heal things up.

    A friend of a friend suggested that perhaps I look into CranioSacral therapy, which I did. I was able to get an appointment with a pediatric DO who knew how to do CST. Right away, he told me that my daughter had quite a bit of tightness in her neck. He also felt her suck and said that she was "gumming" the nipple and tongue-thrusting. One adjustment made such a huge difference! I'd never seen DD suck like that before.

    Unfortunately, it's been difficult to get her to "hold" the adjustment. I've taken her back in once more. It helps a little bit every time but it's still not entirely what it should be. She no longer uses her gums but sometimes she seems to get confused and sucks the old way. Also, although she CAN now open her mouth wide, she will sometimes still pull herself off a bit into a more shallow latch. So, I'm trying to be diligent about taking her off when she does this and re-latching her properly. The sucking I can't really do too much about, just keep hoping that she gets the idea that if she sucks properly, she gets more milk.

    It's been about a week since her last cranial adjustment. I would say that about 60% of our feeds are ideal. I am seeing what I think is new tissue growth but it's coming very, very slowly. Feeds no longer hurt the whole time (unless if she's not latched on well) but they do still hurt for the first 30 seconds or so, especially the right side with the big open wound.

    My current care regime is swabbing the nipple with a saline rinse after every feeding and then applying liberal amounts of coconut oil. I was using the APNO but then stopped because I didn't want to keep exposing DD to the steroids in it. I feel that the coconut oil is just as effective at keeping the pain down and fighting infection and I don't feel bad at all if DD gets a mouthful of it when she feeds. I'm also using soft cloth breast pads to keep my nipples from rubbing against my bra. They're not plastic lined and they breathe well. They are way gentler than the disposable ones I've tried.

    So, my issue is this: I'm past the point of no return. Even though the first month or so was horrific, I'm now utterly determined to stick this out. Even though it hurts, even though the sight of the damage still freaks me out a bit, I LOVE bonding with my baby in this way. It feels so amazing to know that I've nourished her despite everything and that she's grown and gained good weight all along. I truly think that, even if it hurt like this for another two or three months, I would be willing to stay with it. The pain no longer feels overwhelming to me. I don't know if it's because it's actually not as painful or if my tolerance has just gone through the roof, ha.

    The only problem is...should I just keep doing what I'm doing? I mean, can or will things continue to improve as she gets older? Is there any weight to the whole "baby's mouth is small" idea? Will my nipples eventually heal and am I at risk for getting a really bad infection in the meantime? I also worry about my milk supply; it's totally fine now but if she's not always sucking/latching correctly, do I stand a chance of it decreasing too much?

    So, that's my saga. Whew. Any suggestions that I haven't tried yet? Also, anyone else been in a similar situation with an older newborn and seen it improve with time?

  2. #2

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    Also, as if I haven't said enough already, I'm going to list all of the things I have tried and how effective they've been to save you all some effort:

    Lanolin: useless
    Expressed breastmilk: equally useless
    APNO: Seemed to help but I didn't want to use it long term
    Coconut oil: This has been my best bet so far. The little healing that I've seen has been a result of using CO.
    Saline rinses after every feeding: Again, have been the most effective at keeping things clean.
    Vinegar rinses: Didn't do much
    Exposing breasts to air: I have a touch of Reynards and so this isn't a great option for me. It seems to make my nipples throb if they get even slightly cold.
    CST: Seems to improve things slightly.
    Nursing in football hold: I hated it, and so does DD. It just never felt natural to either of us and so now I just use cross cradle.
    Reclined nursing: This actually does help quite a bit, especially if I'm a little full. I lay her tummy-to-tummy and support her neck with one hand and my breast with the other.
    Nursing in the tub: This helps too. It's amazing how much it seems to make her "rooting" instinct kick in. I try to do this once or twice a week.
    Skin-to-skin: Also very helpful. We do it once or twice a day and those are usually some of our best feeds. It's tough right now because it's winter and no matter how high I crank the space heater it still feels drafty.
    Side-lying nursing: Not really helpful. I don't feel I have enough control with my forearm to get her latched on. I need to have my hand on her neck/back to get it right.
    "Flipple" latch: I wish I could get this to work. It makes so much sense. Unfortunately, DD's jaw starts moving the second she's anywhere near my nipple and I have to rush to get her on when her mouth is open wide.
    Asymmetrical latch: This is what I usually have the most success with - sandwich the breast, plant her chin below the areola and then scoop her head up and over, aiming my nipple towards the roof of her mouth. I have to be really, really quick because like I mentioned above, she chomps down immediately.

  3. #3
    Join Date
    May 2006
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    24,794

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    Welcome to the forum and congratulations on the new baby and on making it through 8 excruciating weeks! I know it was excruciating because I went through many of the same things with my firstborn. It does get better, I promise! It took me until 4.5 months for healing to begin, but once the gaping cracks closed up nursing was more or less smooth sailing. I never got mastitis or any other kid of infection. I do think I had more nipple blebs and more plugged ducts than average, but they were minor nuisances in comparison to the cracks and were mostly gone by 8-10 months. So I would say that yes, there certainly is something to the "small mouth" thing.

    Was your baby ever checked for a lip tie? They are frequently overlooked, even by people who are knowledgeable about tongue tie.

    ETA: One thing you may not have tried yet is a shot glass full of warm water. Before latching your baby on, lean down and immerse the nipple in the shot glass, bring the shot glass up to your skin to form a seal, and then stand up again. Hold the shot glass on the nipple for 30-60 seconds. This will hydrate the cracks and soften any scabs on them, and that will mean less pain when the baby latches on.

  4. #4

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    She does have a very minor lip tie. The main LC that I've worked with said it probably wouldn't make enough of a difference at this point to pursue it. From what I've researched on lip ties, I'm sort of inclined to believe her.

    It's good to hear that there's hope on the horizon . I keep thinking that one of these days I'm going to have that moment where I'm like, "oh, wait. It doesn't hurt at all anymore!" I just hope I still have some nipple left by then, if you know what I mean!

  5. #5
    Join Date
    Apr 2014
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    688

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    I just wanted to say you have come a long long way and you are doing great!

    My daughter's latch wasn't sorted until she was around 4 months old when we finally saw an IBCLC and an osteopath. We had 5 sessions of CST in the end.

    I will say keep trying with the flipple, it's a big learning curve, and yeah it can be a rush but it is worth it

    My Raynauds affected my nipples but only really when my DD'S latch wasn't great. Try those little hand warmer things after feeds if you need to keep them warm

  6. #6
    Join Date
    May 2006
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    24,794

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    It may be true that the lip tie is not worth pursuing, but I personally think it's a good idea to seek a second opinion on that. Lip ties can not only impact breastfeeding, but can also impact dental development, resulting in the development of a gap between the front teeth.

    If you think you're seeing healing of the nipple at 8 weeks, odds are very good that you'll be completely healed in not too long. Once ai noticed healing going on in my cracks, it was about a month before the cracks were completely gone. No scars, even!

  7. #7

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    Sorry to steal your thread, but what is cranial...? I am wondering if it might help us. My nipples are so sore, creams including APNC are useless. Based on what you said about your experience, when you unlatch did you have to wedge your finger between gums? Maybe my lo can't open his mouth wide enough! Thanks! Again sorry to steal your tread, but a light just went off, and I'm ready to pack it in over here.

  8. #8
    Join Date
    Jun 2009
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    10,754

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    Here is some info about cranial sacral therapy, or rather, this article links to other articles : http://kellymom.com/bf/concerns/child/cst/

  9. #9
    Join Date
    Jan 2015
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    101

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    Wow, you've been through a lot and so much of it sounds very similar to my story with DD. My daughter's tongue tie was clipped when she was about 8 weeks and that combined with about 5 CST appointments and, yes, time finally brought me some relief. So it was probably 3.5 months until we were nursing pain free. Until then, I was taking Motrin around the clock to help manage the pain.

    In terms of healing cracks/open wounds in your nipple...a very well-respected breastfeeding doc gave me the following advice. After you put coconut oil on your nipples, cover them with saran wrap. I know it sounds crazy, but the idea is to keep the wound moist so that it doesn't scab over. Then, when you latch baby again she won't "suck off" the scab which, as you know, is excruciating. It's called moist wound healing.

  10. #10
    Join Date
    Nov 2011
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    85

    Default Re: 8 WO - Shallow Latch, can it improve?(LONG!)

    First of all, you get a standing applause from me! You are one determined lady, it is obvious that your journey so far has not been easy. Your child is very, very lucky to have you, as many before you have thrown in the towel much earlier. I am not an expert on the issue, as I only had bad nipple pain for about 2 weeks. However, like you, leaving my breasts "out and about" and out of a bra was not an option. I used the Medela breast shells, which helped immensely: http://www.medela.com/IW/en/breastfe...-problems.html

    They basically allow your nipples to air out and not be in contact with anything while still wearing a bra.

    Mind you these are a temporizing measure, and the ultimate fix will be 1) to perfect latch as you have been doing and 2) as your baby ages, her mouth will grow, which should help. Sounds like you either need to work more with that second hospital LC or just use someone other than the first LC.

    Soldier on mama! Please trust, it will get so much better. As amazing as your nursing experience is now, you have no idea what sweet, heart-melting things await you as the months go on and your baby becomes more interactive while nursing! You owe this treat to yourself for everything you have been through!
    Last edited by @llli*greatestjoy; January 26th, 2015 at 04:09 AM.

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