Well, this sucks. Tips, support on bf for a FTM

[TCK_Runner]

I had my baby last Wednesday... I've decided that even though I had a natural childbirth as a FTM (was lucky to get that and surprised even myself), the worst part so far has been the postpartum period breastfeeding issue. The nurses and midwives at the hospital were a bit militant about it and despite breast shields, compresses, etc I ended up bloody and in need of formula by end of day 2. Once I healed a bit they gave me a pump, a really nice medela dual electronic one. I have used it since then because my nipples are still too sore from the first few days.

My current MW (not hospital MW) looked at my nipples and says I need to pump another day or two before they heal better and I can try using the shield again and seeing if it hurts less with the baby. In the meantime, I must continue to pump. Sometimes, I have a good pump and I can get out a lot in 20 minutes, relatively speaking of course (like 100 ml from the two boobs combined). Especially if I massage a bit in advance and during the pumping. But that's like 1 in 3 or 4 pumps. Most of the time, however, it's less than 40-50 mL combined. Yesterday I pumped in the evening and only got 15mL total. I was pretty upset and started crying - my husband got worried about my mental state. I feel so guilty about having to give her formula, but my MW has reassured me this can be normal for the first week after birth and that as long as she is getting some breast milk it shouldn't be a problem once my milk comes in better...

Any tips/advice or support online for these kinds of issues? My MW also said I can't put her back on the breast til healed (I agree with that) because it could get bloody again, and I could end up with mastitis (sp?) and then I wouldn't be able to pump even and would have ONLY formula. I don't want that at all! I am already rubbing in oils and massaging the boobs, I am drinking special teas, taking my vitamins, etc. There seems to be little support online for this... I had a very very bad experience at a LLL meeting two months ago so please don't suggest that. They would just make me feel like a bad mother right now and I'm already feeling that way.

 

[NoodleSnack]

I think you got a lot of bad information. If you can pump 100ml, your milk has come in. You need to either feed on demand or pump every 2-3 hours day and night at least to maintain your milk supply.

If you can bear it, you can feed from the breast, bleeding doesn't affect your milk, and mastitis usually occurs due to blocked duct, letting baby feed is one of the way to get rid of it faster. Since you bled, the problem is probably due to latch or LO has tongue or lip tie, you need someone qualified to look at that for you. If you really want to continue bf, I think you need to see a lactation consultant.

 

[sheldonsmommy]

Oh the nipple cracks. I feel your pain there. I used Lansinoh religiously to help them heal but I continued breastfeeding. The pain was excruciating for about 10-15 seconds, then it subsided significantly. I presume that one of the midwives checked your latch and you know how to release the latch if she's not on properly? If not, maybe you can look up a video so you can see what it should look like?

The baby at the breast is what will give your body the best signal to produce and let down your milk, and baby will be the most effective at emptying your breast, which is the most important factor at preventing mastitis. But I can understand if it's too painful at this point. As soon as you can, put baby to the breast with the shield whenever she shows hunger cues or is fussy and ditch the formula. This could be every 1 to 3 hours at this age, and feeds can last around 30 minutes. This is so tiring and you'll feel like a cow, but so important to boost your supply to get it to what baby needs. For me, this meant forgetting about housework, going out (for now), and parking on the couch or bed with everything I need at hand. Being relaxed will really help.

Until you decide to start nursing again, there are a few things that help me pump. Don't be in a rush, and try to relax. Stress will inhibit your let down reflex. Take deep breaths. Be close to your baby when you pump, and cuddle her if possible. Your body will react physiologically to having her close. Massage can help get the ducts further away from your nipple, I start massaging under my armpit and move inward. Also leaning forward slightly to let your breast dangle more can let gravity help get all the milk out. Pump for 10 minutes more per side after milk stops spraying out, or more if you can tolerate it. Pumping is hard work and for me it starts with a good state of mind.

Keep in mind that once you are able to nurse, your baby might be frustrated that it doesn't flow as quickly as from a bottle, so be prepared for some fussing. Also, formula acts differently on her stomach and will keep her full for longer, so supplementing while trying to boost your supply by breastfeeding sends a confusing message to your body about how much to produce. It's a delicate balance.

Are there any other resources near you besides LLL? It may be worth looking into

Eta- wow sorry for the novel, but I found these first days so incredibly hard, so I hope I helped a little

 

[irish_cob]

You need to get baby checked, you need a good lactation consultant, midwives don't have enough training on breastfeeding, if baby is damaging your nipples there is something wrong with the latch - could be positioning and attachment issues, could be tongue or lip tie, could be something else, but something isn't right - your nipples shouldn't have to "toughen up", that's a myth!

 

[Rachel_C]

I agree that the advice you've received so far is pretty bad. Unless your nipples were pretty much hanging off, you can still breastfeed when they're sore and cracked. For some people, your nips really do just need to go through it to toughen up. I personally feel that all the messing around with pumping and shields and formula just prolongs the agony for you - skirting around the issue rather than going through it in one short sharp burst. That's just my experience though!

Your baby's tummy is TINY at the moment. 50 ml sounds like a good amount to me so don't feel bad - you're doing great. Remember that if you can put LO to the breast, no matter how well you feel you're doing with the pump LO will be able to get more milk if the latch is right.

I'd say you're more at risk from mastitis when NOT feeding directly from the breast, as LO will get so much more milk out.

 

[leigh5tom]

Double post sorry x

 

[leigh5tom]

I agree about feeding through. I know the agony it is though. My nipples looked like they had been rubbed against a cheese grater. I found that when they were sore and painful it was much easier to know when babys latch was right because you will feel that it is much more comfortable, rather than let them heal up to then get sore again because of a bad latch. I fed through the toe curling pain whilst crying and dreading every feed, and my little ones latch is great now. He had tongue tie so you can imagine how my nips were. Good luck honey, it does get easier. Lansinoh is a life saver and wearing breast shells to stop nipples rubbing against clothes works well aswell x x x

 

[TCK_Runner]

Thanks everyone.

Just to be clear - I have only been able to pump 100mL once or twice. Normally it is 50mL or less. I have to feed her something because she's starving and eating her hands otherwise, like all day everyday. She is doing much better now with a bit of formula to top her off after she's drunk my milk. I won't let her starve, I don't care if it makes her latch better or whatever to not give formula.

I will try the shield on the left one later today or tomorrow - the right is still far too sore. I am using massage, warm compresses, and multi-mam patches to get them to heal faster.

 

[patch2006uk]

My eldest didn't latch at all for 8 days and I expressed for him and got about 20mls combined. Their tummies are only around 15mls in capacity by the end of week 1, so your supply sounds like more than enough for now. If LO will latch, I very much agree with the advice to let them. Is there someone who can come sit with you and help with position and attachment? I had the number for BFing supporters at the hospital on the front of my purple notes this time around, and I called them just to come and observe a feed, and they came the next day. Does your hospital offer anything similar?

Once established, breastfeeding is fab. These early weeks are hard-I've been up most of the night for the last couple of nights with a cluster feeding baby. He also just wants to be latched all day. I know this doesn't last forever, but it's still draining!

Hugs for you all x

 

[patch2006uk]

Oh, and we did give my eldest formula top ups, as he was hungry for more than I could express. Once he started latching, he cluster fed for about a week to build my supply. It was exhausting. But I did feed him until just after his third birthday, so a rough start doesn't have to mean the end

 

[AC1987]

awww!! its really hard as a ftm I know!! It was agony the first 2 weeks for me with dd1. but it got better later, and I ended up combi feeding her with formula.


however 2nd time around is soooo much easier... only pain is initial latch.

I hope it gets better for you!

 

[halullat]

When my LO was born we had to top up with formula due to jaundice, I now exclusively breastfeed so don't worry that you can't get there. I would advise to pump and offer the breast if you can bear to, have you tried holding your LO just before pumping (skin to skin)? as that could possibly help.

If you do get mastitis the best thing to do is to breastfeed, in fact most often it is recommended so don't worry about that apart from discomfort for yourself. I got mastitis as my LO wouldn't feed off my left breast, but after getting his latch right on that side my mastitis cleared up quickly.

I am also a ftm and found it very painful to begin with, eventually it does improve. We just phased out the formula pretty quickly and the only issues we have with his latch are down to his lip tie it seems, he really struggles being fed by bottle as he expects to have to get a mouthful and doesn't.

Don't beat yourself up at all either, you are doing a great job. If you LO has some formula that is fine! It has stopped your LO going hungry and getting ill (the reluctance of the hospital staff to let my LO be topped up is what caused him to develop jaundice as he was getting barely anything from me), I am sure you will be able to phase it out. The initial stages are really hard work so believe me you are not doing anything wrong x

 

[Foxyloxy]

You poor thing. I was in a similar situation with bleeding cracked nipples, it was agony, every time I fed I cried. Some pain at first is normal but bleeding is not and is a sure sign of a bad latch. Check out videos online of how to latch properly or get a lactation consultant to observe you and check for tongue tie. My baby was just lazy and didn't open her mouth wide enough to get a good mouthful! But it does get better as your baby learns to latch properly and your nipples toughen up. I used to tell myself every day I would keep it up for one more day and stop tomorrow which got me through mentally. Then one day a few weeks later I was feeding and suddenly realised it wasn't hurting and was actually quite enjoyable. I'm still going 11 months later!

The best analogy I heard from a midwife was BF was like breaking in a pair of new shoes, you are probably not walking wrong but may get blisters at first. But someday those shoes may be the most comfortable thing you can wear.

 

[hardd2011]

Try food to help encourage milk supply too. I ate oatmeal twice a day after having my son and my supply came in in 2 days. And drink lots of water. Also when you are able to feed again an hour after you feed pump (5-7 minutes each side)(3-5 minutes each side)(2-3 minutes each side). Also like everyone else said, see an breast feeding consultant. They have intensive training to help with things like that.

 

[Marythefairy]

I don't have any advice as the pps have said e everything I would but take it a day at a time. If u feel you can come back and update us with how your doing. It might be there's further advice to be had or just writing it down helps you focus. Take care.

 

[TCK_Runner]

Hey everyone. I've had some more time to "work" on this as well as talk to other mothers in similar situations to mine. I think I've had more problems than others for a variety of reasons. I didn't mention it in the original post, but I'm a vegetarian distance runner who, in addition to not eating meat, doesn't consume much or any lactose and I drink/eat soy and have a low body fat/BMI. Apparently these kinds of things matter when trying to build up milk supply because 1) I don't have a lot of extra adipose tissue and 2) soy protein can apparently interfere with hormones involved in breastfeeding. I'm not a doctor, but these are the kinds of things my friends who are doctors and nurses have told me.

With that said, I have started adding in a few minutes on each breast a few times per day with the nipple shield. Sometimes it hurts a lot, sometimes not so much after the initial pull -- which I hear is normal and is the kind of pain I have no issue tolerating. I don't even notice it, it's like getting blood taken or something. The main problem now is that my nipples are inverted a bit, so I need the shield or the pump to get them out so she can latch on. If I don't, she struggles to find the nipple. I'm 100% OK with continuing to use shields and expressing milk if that's what will keep her going and my nipples not bloody. Also, she's still working on an efficient latch, and I want to continue to work on that with her.... she's only 10 days old, we've got some time to work on this now that my milk seems to be coming in a bit better. I'm able to express 100 mL most of the time because I started pumping regularly, drinking lots of bf'ing tea, tons and tons of water, warm compresses, massaging them, etc. I'm really happy to see this work paying off, even if I am tired and a bit sore still. Again, my concern is less about her perfecting the nipple latch and more about me getting her breast milk. In the meantime I continue to top off her feeds with formula. Luckily, since I am pumping often, I am building up so we don't have to keep adding formula like the first few days. This seems to be working quite well.

As for breastfeeding exclusively, I don't aim to do this, it would be nice but is not going to kill me if I can't. I guess I should have been forthright about that to begin with. I am OK with some formula in her diet. I like that my husband feeds her once during the night and lets me sleep and that she's able to take the bottle. Getting more sleep seems to also be helping my supply (and sanity). Also, we noticed that when we give her a bit of formula (30-40 mL) she sleeps a longer stretch of time (2-4 hours) than if we give her breast milk (she only sleeps an hour or two max when she has that).

Some people have mentioned "nipple confusion" as a huge problem. I have spoken to several of my friends, all of whom have said that they have found this to depend heavily on the child and most of the time it hasn't been an issue for them... in any case, many of these friends did the formula top-offs for the first month with a bottle and had no problems switching their babies over to the breast, as long as they also introduced the breast slowly and early on (which I am also doing). So I've decided not to worry about it for now, keep doing it a few minutes on each breast every few hours, and pumping out the rest in the meantime.

Oh, and I do know that if I exclusively pump it's likely I'll get tired of it and/or my milk supply will remain low or dry up by 12 weeks. I am well aware of this and if that happens then so be it.

So that's where I'm at. I can report back in 3 weeks or so to let you know how it's going!

 

[sheldonsmommy]

Really glad to hear it's getting better for you!

 

[Marythefairy]

Great to see your determination to succeed. Well done and thanks for letting us know how your doing. It sounds like it's slowly heading in the right direction and can hopefully only get easier.