Looking back: what went wrong

[LoveCakes]

I'm currently formula feeding but want opinions on what went wrong as it still bothers me and I'd like to try again with future children. Warning it's long!

I breast fed in the hospital and it was ok, the midwives helped and she latched on ok. She wanted to cluster feed a lot which was exhausting and sore but manageable. When I got home the community midwife was better and got me to do it myself but it was always painful. I had cracked nipples and shuddered every time she latched. In the first few days she was only doing one or two wet nappies and no dirty ones since the mecomium ones at the hospital. She was also going 4-6 hours without feeding and if I lifted her would just go back to skeep. When she did wake hungry she latched on but came off pretty quickly. I used to sit and watch the clock until 5 minutes were up and I could 'count' it as a feed. She lost 10oz by day 3 by was gaining on day 5.

The midwife suggested expressing to top up so I got a pump etc... But that night she vomited blood everywhere. We rushed her to a&e at 5 days old. My nipples had healed a bit and weren't bleeding but I was too afraid to feed her. Later that night I used their pump and got 100ml in half an hour but on one breast pure blood pumped out for the first 5 min.

At this point I had a conversation with the nurse crying throughout due to stress, pain, exhaustion and guilt she was in the hospital because of me. I decided then to go ff. I was terrified to bf in case there actually was something wrong with her and they dismissed it and the idea of pumping exclusively was exhausting even though I had so much milk ( it would literally run down me after a shower and I leaked when I ff her for a month after).

I now regret at least trying ff and expressing together until I could calm down and make the decision rationally but I made the decision the day my baby blues hit. She took formula no problem and took 70ml straight away and got into a great 3hr routine after so was obviously hungry. She also started doing the right amount of wet nappies and more dirty ones.

So, why wouldn't she wake to feed? Also was there too much milk, is that why she wouldn't stay on? Also if she was gaining why wasn't she doing wet nappies? Sorry for the essay!

 

[FAB mama]

I'm not sure I understand. Was the vomiting blood because of your cracked nipples or was it blood coming from her?

I probably don't have any answers for you, but I doubt there's any reason why you can't try again with another child. You know now to express if needed if a serious problem comes up. I hope it all works out for you.

 

[LoveCakes]

Thanks, sorry it was a bit rambly. My nipple itself was ok, the blood was from me and coming from the breast through the nipple.

 

[purplecupcake]

What was wrong that was causing you to express blood rather than milk?

 

[AK89]

Did you have diamorphine or anything similar while you were in labour? 'Cause I did and my baby was really drowsy for the first few days and apparently that's why..

 

[lau86]

Did she only gain when you started formula then?
Was she checked for tongue tie? My oldest son had this, feeding him was horrendous he ripped my nipples apart, they were so sore and we also had the problem of him vomiting blood. I got his tongue tie snipped and things improved.
Don't feel guilty, I would've switched to formula too however my son vomited any formula I gave him so I believed it didn't agree with him. In hindsight he was probably just starving and gobbled it down.

 

[luna_19]

I would.suspect a.tongue/lip tie was causing the nipple trauma
Newborns often need to be woken up to feed for the first bit which is normal. Not sure about the blood but if your nipples are bleeding and mixing with the milk it looks alarming but is totally safe. Ties can be genetic so I would have an IBCLC check your next baby right away (many peds/nurses don't know how to spot them.properly)

 

[Maxy1]

I agree with pp if your nipples were so damaged from the BFing you were anxious about feeding then you should have been referred to an IBCLC. It was either a latching problem or a mechanical problem (lip/tongue tie) with the lack of transfer of milk.

BFing is hard work for the baby and if its not going well then she might have just given up. She was probably drowsy from the poor milk transfer.

The milk from the breast can be a few things but I would suggest that you may have had a block in the nipple. I have had a couple of these and they pour out blood when they pop. With DS he forever had my blood in his milk and poop from my nipple damage and blockages.

I fed DD a year after that fine with no problems.

Absolutely don't feel bad about FF, it was exactly the thing you needed at the time and it worked well (I presume). This time round i would see a LC before LO is born so you get a bit of a relationship with them and discuss your history and then when you have baby arrange an appt straight away. Having had a history with my LC already from DS, I was seen with DD immediately.

I also find the advice from a midwife re BFing is serious lacking compared to that of a qualified LC - which is obvious, the LC is the specialist

 

[LoveCakes]

Thanks everyone x

I only had gas and air so no drugs complications. I was pushing for 2 hours though so we were probably both exhausted from the start.

I never found out what caused the blood. When we were back at the hospital we were in the paediatrics ward so quite rightly the focus was on LO. I guess they assumed it was from the nipple but it was ok, I checked when we were in a&e as if I found blood on me I could calm down but it was ok.

The community midwife checked for tongue tie and said she was ok.

I think I'll always feel like I gave up too early but it's easy to look back when you have slept well.

The hospital breast feeding advisor was supposed to see me before I left hospital but was too busy.

Next time (hopefully there will be one!) I'll speak to the midwife before they're born and ask to speak to the advisor or find a local group.

 

[noon_child]

You might have a baby cafe (breastfeeding peer support and often lactation trained HV's too) near you. I'm sure they'd let you talk to them before LO is born so you can chat through your issues last time round. Also find out if there are LLL or NCT volunteers in your area who will do home visits once LO is born.

Up to the point where your LO vomited blood I think your story sound very normal/common. Most babies are sleepy after birth (the contractions keep them awake as much as they keep us awake!) and it can be sooooo hard to get them to feed often enough to get that birth weight back on. Add in a not great latch and LO has to work extra hard to get any milk and within a few minutes they are exhausted, plus the pain it causes you means you don't really "want" them to be awake and chowing down.

It does sound with that amount of damage that maybe a tongue or lip tie was involved.

 

[lauraemily17]

If tongue tie was ruled out it may just have been a bad latch & lazy baby? (I mean lazy in a nice way, both my boys were)

Breastfeeding is just as hard work for babies to start with. They are born with the sucking reflex but not knowing exactly how to latch. Sadly I have found a lot of mws mistake a bad latch for a good one.

I had problems breastfeeding ds1 and turned to ff quite early. I did manage to combine some bf with it for 6 months but in reality he was mostly eating formula & getting pudding & comfort sucking on me! I was told by everyone his latch was ok but it was only as he got older and most importantly larger that I realised it hadn't been at all. He was sucking on the end of the nipple which is bad. As his mouth grew the latch improved as he's get more breast in his mouth.

When I started bf ds2 I had the same latching problems and once again everyone told me it was a good latch but I knew better this time. What he was once again doing was sucking just on the end of the nipple, he didn't have a good chunk of the areola under the nipple with the nipple pointing to the roof of the mouth. I think as I have huge breasts & my babies have particularly small mouths it's hard to really see the latch properly and as the baby is obviously drinking it looks like it's ok.

It meant that for the first few weeks bf ds2 I also had bleeding nipples while I worked on his latch. I watched a lot of you tube videos to learn how best to get him on, the flipple technique worked great for us. His laziness however meant I'd get him on ok then he'd pull back after a few mins. I had to keep unlatching & re latching until he stayed on correctly. I also then and still do have issues with him preferring the fast flow milk so have learnt to swap sides a lot to keep him feeding. If you had an over supply that can also make latching more difficult as the breast is harder.

Re the sleepiness, as has been mentioned, newborns do need to be woken to eat. Ideally every 3 hours until they have regained their birthweight. I also did (and still do at night to get a full 4 hours between feeds) change his nappy mid feed to fully wake him up & ensure he has a full feed.

Oh and on nappies. Ds2 was really slow on getting the "right" amount of nappies and actually had urates in his nappy for the first 6 days! He shouldn't have done & it did worry but at the same time I trusted my body more this time.

 

[BigAl]

My lo was a very sleepy baby, it came as a shock as my son fed beautifully. I think you have to be brutal and wake every 3hrs for a feed. I changed nappy, tickled feet, stripped her naked and rubbed ice cubes on face/neck/feet (though not all those things at once lol). I did find the breastfeeding group invaluable, so you could look that up beforehand. Good advice and support is key to giving best chance of breastfeeding IMO.
There is also an element of luck too, perhaps yours will be better next time.

 

[irish_cob]

Spent ages typing a reply which my phone then lost, arrgh!

Basically community midwives are not experts in bf at all. My eldest couldn't latch on. At all. AT ALL! I spent 3 days (c-section) on the post natal ward, and had loads of midwives, health care assistants etc trying to help me with bfing. None of them thought to get in touch with the infant feeding specialist based at the hospital. After discharge I persisted in syringe feeding and called an IBCLC who I had had some sessions with antenatally and she came and saw us and diagnosed tongue tie. In the hospital they called her a lazy baby etc etc. She wasn't. She was hungry, she wanted to feed, but her tongue was tied to the bottom of her mouth so she couldn't latch on!

The community midwife happened to come out whilst my IBCLC was there and poopooed the whole thing - "she's not tongue tied", and the next day appeared with the NHS infant feeding specialist in tow, to insist that Lucy wasn't tongue tied. Sadly it backfired on her when the infant feeding specialist agreed Lucy WAS tongue tied.

So don't believe the midwives, they're really not trained in this area. I ended up feeding using nipple shields for a couple of weeks, again to the horror of the NHS, they couldn't tell me what to do instead though. The poor baby could not latch on at all, she couldn't cup feed because she couldn't lap with her tongue, syringe feeding isn't any good for anything other than colostrum and very tiny feeds in the first 2 or 3 days. I didn't want to bottle feed. They just couldn't get over the fact that nipple shields are not advised. My IBCLC explained that they were really like a sticking plaster, but that they were perfect for situations such as mine, to get round a problem whilst waiting for a more permanent solution to it (in my case waiting for an appointment to get the tie cut). And it worked, she fed fine with the shields. I was breastfeeding!! Something that the NHS lot just couldn't seem to see past their protocols and whatever else. They just couldn't seem to understand that I'd tried all the attachment and positioning, but the poor baby's tongue was stuck to the bottom of her mouth, I could have hung upside down from the washing line and she still couldn't have latched. They just were so unhelpful and I felt so bullied as I was a new mum and struggling, yet I was breastfeeding, regardless of the shields, couldn't they just have supported me?

Anyway we got an appointment with a paediatric ear nose and throat specialist who confirmed that Lucy had a very meaty posterior tongue tie and she had it divided when she was about 2.5 weeks old. It worked, a few days after that I could feed her without the shields. Sadly I only fed her for 5 weeks in total due to being admitted to hospital at that point, but that's another story.

What I'm trying to say is a community midwife telling you that your baby is not tongue tied is not really worth the paper it is written on. I'm sure some are experts, but sadly from being around these forums and other groups, I've seen it again and again, community midwives are not experienced in breastfeeding and are not competent in diagnosing tongue tie.

For your next baby find an IBCLC in advance. If you're anywhere Yorkshire I totally recommend Charlie at Milk Matters. And I'm sure she'd be able to help you find someone local if you're not nearby. Find out if your trust has an infant feeding specialist - I did, and I rang them up to speak to them about their policies on tongue tie before I had my second. Find your local breastfeeding clinics/cafes/peer supporters and have their numbers ready to ring.

And lastly, I don't subscribe to the idea that breastfeeding should be painful, so many women on here talk about how it hurt in the beginning and it was something that had to be suffered through. I really don't believe that. Yes it's a learning curve, sometimes you might get it wrong and be uncomfortable, but as a species we'd be pretty rubbish if our survival depended on something that was incredibly painful. I've been feeding my second for a year - she is slightly tongue tied - as am I - but nothing like Lucy, and it's never been painful. Yes we've had a few ouch moments, like her catching me with her teeth or yanking her head round to look at something, but the actual process of latching and her sucking is not painful and I absolutely believe that's how it should be. If it is painful something is not right. And seek help. And I mean proper help, not the community midwife.

Hope this helps a bit

 

[LoveCakes]

Thanks again everyone.

I'm in Northern Ireland and have found a site with loads of groups including a weekly one in my home town. I'd consider going to one before I had my baby next time to make contacts.

I read up and went to the class before my LO but it sounded so easy and natural which didn't help when I struggled.

I feel that next time I'll be more prepared so will have to wait and see how it goes. I'll probably be back in here with a big list of questions again!