Raw painful nipple (expressing)

[SoupDragon]

Hi, I hope it's ok to post in here given that I am not actually 'breastfeeding' in the proper sense?

I've been expressing since coming home from hospital with my LO, who is now 8 weeks old, as she cannot latch to nurse from me directly. I spend about 2 hours a day expressing, which I try and space out through the day but usually end up doing a block in the morning and another before bed. I don't get enough to exclusively feed her breastmilk, but since I'm producing it, some is better than none, right?

I've never had a problem with pain before but the last couple of days one nipple has been quite sore and itchy, not just while pumping but all the time. I noticed blood on my breast pad this morning annd there is a small raw area on the nipple.

I use lansinoh, change my pads regularly as I do leak even though not really bf, keep nipples clean (wipe with a water-wipe after pumping and let air-dry), and my pumping equipment is kept spotless.

Anything else I can do to try and heal this raw spot? I can't stop pumping on that side, as that's my best side by far (produces double what the other boob does!) and I can't risk my supply dropping. Should I be putting antiseptic on it or anything?

ETA: forgot to mention the flanges etc are the correct size and the nipples aren't rubbing on the sides, and I haven't altered the suction, it's on a medium setting.

 

[SoupDragon]

Nobody? It's not getting any better, I could really use some advice :/

 

[RaspberryK]

I'd rub breastmilk onto your nipple and I'd also express in shorter more frequent sessions as an hour in the morning and an hour at night is probably causing the issue.
Xx

 

[pineapple91]

i would also suggest pumping 20 mins every 2 hours this will mimic babies nursing needs increase your supply and not hurt the nipples as much. GL

 

[SoupDragon]

Thank you...I know shorter more frequent sessions are better, I do try but it's so hard sometimes as DD will usually only nap on me and I can't pump while she's on me! I will do my very best to do this though, as I know it is bad to do what I'm currently doing (though it is satisfying to see that 6oz in the bottles at the end of the hour!) and won't be helping the nipples at all!

I will try rubbing milk into the sore bits, too...I assumed it was bad to leave it on, but perhaps not? I know it has antibacterial properties, so that can't be a bad thing!

I'd love to be able to increase my supply...at the moment I get a total of 12oz per day, which is 2 feeds, and the other 3 feeds are formula. I don't know if I'll ever be able to exclusively feed her ebm as we're already almost 2 months in, but even an extra feed of breastmilk a day would make me so so happy...is it possible to increase supply significantly this far in while pumping?

I eat loads of porridge as I have read oatmeal helps, and have looked into fenugreek and brewer's yeast...does anyone have experience of using these, and how much to use/where to buy (UK) that won't cost an arm and a leg?

It so frustrates me, as I really wish I could just breastfeed, but we are trying so hard and have seen so many breastfeeding experts, midwives, etc, and are getting absolutely nowhere, DD just can't do it for no apparent reason. But that's a whole different thread :/

Thank you again for the advice, I will do my best!

 

[RaspberryK]

Yes you can absolutely increase your supply, some women have relactated from complete ff to ebf.
You may find helpful advice in the exclusive expressing thread.
Xx

 

[SoupDragon]

Thank you, I will go look at that...I would so love to be able to feed her just breastmilk. Even the GP looked horrified when I told her I was still pumping, and everyone says it's so much work, why am I doing that, but as I am producing it I would never forgive myself for not doing my best to give it to DD. I never look badly at anyone else for ff, ever, but for me personally, I was devastated that breastfeeding hasn't worked for us as it was always how I had planned to feed her, and pumping makes me feel better about it!

Now we are in less of a state of chaos in the day, hopefully I can organise myself to be able to pump more often, and maybe my poor nips will protest less!

 

[RaspberryK]

You might even learn to pump one handed while baby naps on you?
I've heard pumping at night/early hours is best for supply.
Xx

 

[SoupDragon]

I can just about do one side while she naps on me if I keep her to one side of my lap or on my shoulder (only if she's properly conked out rather than her usual catnaps!), but I usually double pump and the bottles get in the way so I can't have her in my lap at the same time :/ But doing one side has to be better than doing no side at all, so I will see if it enables me to do more overall

 

[RaspberryK]

Good idea as long as you alternate:-D
Xx

 

[SoupDragon]

I'm doing my night-time pump now but I'm only going to do half an hour...my boobs have felt like they're going to explode this evening, and I've got nearly 7oz already after only 25 minutes

I'm going to be out tomorrow over lunchtime but I am going to do half an hour first thing (if DD wakes up I'll do a pump in the night, if not I won't tonight as we had a pretty broken night last night and I could do with an uninterrupted night if I can get one), then every couple of hours thereafter for 20 mins, and will try to do a pump right before I go out.

I assume that even though I'll be cutting down pumping length, if I'm increasing the number of pumps in the day it won't matter if I stop when my milk is still freely flowing?

Hoping the pain won't be as bad from tonight/tomorrow...will leave some milk rubbed in to my nips overnight

 

[RaspberryK]

If you stop when your milk is flowing freely i'd say your supply will reduce at that pumping session, however if you add extra sessions in you should make up for it then so it's up to you.
I'd pump til your "empty" or flow has slowed considerably.
Xx

 

[Kiwiberry]

The reason you don't produce enough to exclusively feed your baby BM is because you don't pump enough during the day. I know it has been said, but you really should pump at least every 2-3 hours around the clock. Once you hit 800ml a day they say you can go from 8 times a day to 6 times a day on pumping. Not really sure how true that is since I am too scared to try. BM is produced based on your babies needs. Since she is not exclusively BF and you only pump around 2 times a day then its because your body thinks she only needs to eat twice a day so that vastly reduces the amount of milk you produce.

Also, like the PP said you can put your baby on one side and pump 1 breast at a time. You should really only be pumping for 10-15 minutes each breast or 10-15 minutes if you do both at once. Your milk will never completely dry up since your body is constantly producing it. However, you should stop when you see big gaps between each drip. At least this is what I was told anyway since I have to use the pump since my baby is in the NICU.

As for the nipples being raw, I have that same issue. I have not found a fix for it yet. My flanges are the right size as well. I tried lanolin to sooth the nipples and it works great but its also recommended that you don't use that past a week. So other than that I have not found any other method that works.

 

[SoupDragon]

The reason you don't produce enough to exclusively feed your baby BM is because you don't pump enough during the day. I know it has been said, but you really should pump at least every 2-3 hours around the clock. Once you hit 800ml a day they say you can go from 8 times a day to 6 times a day on pumping. Not really sure how true that is since I am too scared to try. BM is produced based on your babies needs. Since she is not exclusively BF and you only pump around 2 times a day then its because your body thinks she only needs to eat twice a day so that vastly reduces the amount of milk you produce.

I do know this, and I feel terrible about it. We had family visiting until DD was 5 weeks, which, contrary to what you'd expect, vastly decreased the opportunities I had to pump, as we had no chance of finding our feet with a routine, plus DD needed (and still does) to be on me to sleep. I only had a single pump for a lot of that time, too. It's only since it's been just us at home that I've been able to do 2x per day on both sides - the morning when DD is still asleep and the night when DH is in bed and DD is in the crib so he watches her while I pump. Occasionally I get to do another short pump in the day, which I plan to increase from now if I can. My supply has doubled since 5 weeks so I hope it will increase further.

I have had literally no pumping support from any healthcare professional...it's been a case of 'pumping is so much hard work, just use formula if you can't breastfeed' from everyone, so I didn't know how I was supposed to do it until I started reading online.

 

[Kiwiberry]

The reason you don't produce enough to exclusively feed your baby BM is because you don't pump enough during the day. I know it has been said, but you really should pump at least every 2-3 hours around the clock. Once you hit 800ml a day they say you can go from 8 times a day to 6 times a day on pumping. Not really sure how true that is since I am too scared to try. BM is produced based on your babies needs. Since she is not exclusively BF and you only pump around 2 times a day then its because your body thinks she only needs to eat twice a day so that vastly reduces the amount of milk you produce.

I do know this, and I feel terrible about it. We had family visiting until DD was 5 weeks, which, contrary to what you'd expect, vastly decreased the opportunities I had to pump, as we had no chance of finding our feet with a routine, plus DD needed (and still does) to be on me to sleep. I only had a single pump for a lot of that time, too. It's only since it's been just us at home that I've been able to do 2x per day on both sides - the morning when DD is still asleep and the night when DH is in bed and DD is in the crib so he watches her while I pump. Occasionally I get to do another short pump in the day, which I plan to increase from now if I can. My supply has doubled since 5 weeks so I hope it will increase further.

I have had literally no pumping support from any healthcare professional...it's been a case of 'pumping is so much hard work, just use formula if you can't breastfeed' from everyone, so I didn't know how I was supposed to do it until I started reading online.

Awww, I am so sorry you have not had any support. Did you not have any lactation consultants where you gave birth?

Do not fret too much about your milk supply. I know it will only get better and better if you keep at it. Pumping is hard work, very hard work. I have been doing exclusive pumping for over 2 months now and I know there are probably other moms out there who have done it longer. Just keep going though! I know you can do it and your baby loves you for it (not only that but you know what I mean hehe).

Formula probably tastes like crap to them compared to the sweet BM us mommies can produce.

 

[SoupDragon]

No, I gave birth in an NHS hospital so beyond basic positioning help (which was different from everyone we saw) for bf, there was no help, and the hospital would not let us leave unless we promised to ff. They didn't have a pump available while I was there so I was hand expressing colostrum to spoon feed her, and my milk didn't come in until about 6 days pp (2 day labour ending in emcs probably had something to do with that) so we had a really rocky start and I had it drummed into me that I'd never be able to exclusively pump.

Formula does indeed taste like crap compared to breast milk...(is it weird that I've tasted both?!) DD seems not to have a preference for either, but I know which I'd rather drink given the choice.

I spent quite a lot of time beating myself up, crying, and feeling like a terrible mother for not being able to breastfeed, especially as there is no physical reason for it - DD just can't seem to learn the way to latch, and ends up getting frantic and frustrated, no matter what we try to help her. I have calmed down about it now, and though I desperately wish I could put her to the breast to feed, when we try it nothing changes, and it upsets us both a lot. I know I'm doing the best I can so I just have to get on with it and try to make sure I'm doing as efficient a job as possible of getting milk for her.

 

[Kiwiberry]

Wow the hospital really did not have a lactation consultant???? They honestly made you promise to FF???? What in the heck. Is that how it normally is in hospitals where you are?? At the hospital I went to here in the US they pretty much drilled breast feeding into my head.

I have heard stories of babies learning to breast feed later on (if they don't latch properly in the beginning). I know for my baby we had to breast feed a lot before she even got the hang of where milk comes from (she is a preemie in the NICU though so have no full term baby to compare my experiences with).

Is there any way you can see a lactation consultant outside of the hospital hun? I am really sorry you have felt depressed and upset about it. I have been there too especially when first starting out. There are lots of moms that I know of that exclusively pump their breast milk because they don't have time to take care of their baby all day since they have to work. So whoever told you that is crazy.

What position are you putting your LO in to try and get her to latch? Can you go into detail a bit more on what goes on when you do try to breast feed her?

 

[SoupDragon]

If they did have one I was never offered to see them. It was just the midwife assistants who used to come and try to help us latch...they'd manage it occasionally but we could never do it on our own. DD just roots endlessly and can never find the nipple even when she's got her mouth in the right position. She tucks her chin when she looks like she's about to latch, making it impossible for her to do so. Then she cries, thrashes about, and won't be calmed to try again for ages. If you try to guide her she screams and thrashes more. She does it with the bottle teat too, but because that's so much bigger she seems to have an easier time getting hold of that, and of course the milk flows easier from it.

We have tried nipple shields, no nipple shields, rugby ball, cradle, cross cradle, lying down...I don't know any others! I've tried using a nipple everter (nipples are flat-ish but will go erect) to make the nipple more obvious to her, and that hasn't worked either.

And yes, they really did make us use formula...they said I wasn't producing enough, only tiny bits of colostrum (which I thought was normal in the early days) and that she needed 70ml of milk at each feed so had to have formula. This was at 3 days old. She was born at 40+1 and was huge, and they made a massive fuss about her blood sugar, even though it corrected itself within a day of her birth.

I keep trying her because I'm hoping she'll somehow magically click with it, but after 2 months I'm not sure she will.

There's no LLL around here, I don't know if there are other private lactation consultants though, I could google that...I'm just conscious of the fact that it will probably be extremely expensive :/

 

[Kiwiberry]

Wow hun, I am so sorry you are having such an issue with it. That hospital should have offered donor milk to you at least instead of using formula. The good thing is you can work on your supply so you can start exclusively feeding her BM. I know that doe snot ease any of your pain though on not being able to breast feed yet.

You could do a quick google search and see if you do have any LC's you could go to. Instead of going you can give them a call and just ask if its possible to teach your LO to latch if they are a month old. See what they say, maybe they will be kind enough to give some advice over the phone?

 

[RaspberryK]

I'm sorry you received such bad "advice" in hospital. I think unfortunately it's pretty standard in the uk.
Xx