Please Help Me- 11 day old baby- Mastitis and Issues (1/8 UPDATE IN FIRST POST)

[ladyleah]

Hi ladies....please help me out here, I am desperate!!

My baby is 11 days old. My nips were bloody and raw before I left the hospital-- probably from letting him over-nurse and use my nips as a pacifier, but that is neither here nor there-- I just thought it was best for him to stay on when he actually latched...

He had a docs appt at day 6, and was gaining weight quite well...the doc was pleased and told me not to return with him until 4 weeks.

Saw a LC at day 7. She told me I needed nipple shields until my nips healed....I was not liking that at all, but agreed. Two days later I stopped using them for fear of "nipple confusion"-- although the nips were really not healed....but he was eating well (much better on the side I wasn't using the shield on-- I was still trying to protect the left side---this also screwed me up I am sure)

Also- he never has wanted to cluster feed, or anything like that. He only wanted to nurse every 3 or so hours....when I tried to do it more, he would fall asleep right away.

Day 10- came down with a horrible case of mastitis in my left breast. Fever of 102....chills, the works....awful. Still tried to nurse him every 2 hours--but I don't think he was getting much. Started antibiotics last night, and finally my fever broke this afternoon and I am feeling better....

BUT, my milk supply has disappeared in both breasts. I am trying to feed him, and then pump off to increase supply. But I can't get more then a quarter ounce each time (from either breast!!!). He is NOT getting what he needs today, and I am freaking out. I can tell he is not swallowing as much, and I know from pumping that not much is coming out (I was easily able to pump 1 oz from each breast before)

Please ladies- help me. I am fearing that I will need to supplement with a bottle of formula. I would be fine with supplementing a bottle of breast milk-- but I have only collected 1.5 oz. today!!!!

I feel so alone and ashamed that I can't feed my son properly. My DH is awesome in supporting me, but I am really getting depressed now.

I will make an appt. to go and see another LC next week (hopefully Monday)-- because I didn't care for the other one I saw....but I don't know what to do until then!!


***UPDATE on 1/8****
I want to thank you all for the amazing amount of support I received from this board after posting this message. Thanks to a ton of hard work....we are now on day 8 of ONLY BF'ing with no supplementation, and a pretty good milk supply (I have frozen about 20 oz so far, and have about 20oz in the fridge!). He is getting on average 3oz per feeding (I have had a feeding scale, so I know the amount...although I am giving that up soon) No nipple confusion occured after the almost 2 weeks of having to supplement, thank God.

He is gaining about 7-8oz per week right now-- so that is great news as well.

Although I ordered the Dom (got it 2 days ago)- my LC said not to take it yet because my supply is looking really good and we don't want to end up with an oversupply (thanks to More Milk Plus, Goats Rue, Oatmeal, Brewers Yeast, Pumping, etc....). I feel good that I have the Dom though, should I need it in the future!

And the nips are almost fully healed thanks to the Jack Newman's APNO...that stuff is awesome.

Again, I appreciate the support that everyone has offered. It really helped me during a dark and frightening time....

Baby to all!

[Bokonon]

Mastitis sucks, no pun intended! It can decrease your supply, but the very best way for you to bring it back up is to nurse, nurse, nurse, and then nurse some more.

Don't stress out about what you are pumping. A baby is MUCH more efficient than a pump.

Watch wet and poopy diapers. http://www.kellymom.com/store/freeha...oughmilk01.pdf

You are doing great, just keeping nursing! You are not a failure, and giving a bottle of formula could introduce problems where none exist to begin with.

[ladyleah]

Today his output has been poor. Only 3 wet diapers, when he used to have around 8 per day. He had a few poops as well-- but not too much.

[Bokonon]

Originally Posted by ladyleah

Today his output has been poor. Only 3 wet diapers, when he used to have around 8 per day. He had a few poops as well-- but not too much.

Is that 3 in 24 hours, or 3 since this morning? Poops are good! How often are you feeding him? I would try feeding at least 12x a day until you feel like your supply is back on track.

[lach]

I just recently came out of a really awful case of mastitis and it sucks! It totally dries up your supply, too. I don't know if it's because your body doesn't produce milk because of the clogged duct, or because you're so sick it's devoting energy elsewhere, but I definitely had to work overtime to get my supply back up. And I have an older baby, so that's a lot of milk!

I definitely recommend Fenugreek. My milk all but dried up with an awful cold combined with a few other issues when my daughter was a baby, and the Fenugreek got me back in the game.

Also, are you using Lansinoh? Unfortunately, the cracked and bloody nipples are pretty common with a newborn. But it does get better. I swear. Use the Lansinoh religiously and you'll feel much better after a few days.

[ladyleah]

The total for 24 hours was 4 wet diapers, and poop as well. Significantly less then in days past.

I have been nursing every 2 hours (in pain from the cracked nipples of course), but as I said before-- and as lach mentioned about the "dry up"....he is hardly getting a thing because I don't have anything in there!

I started Fenugreek today (3 capsules 3X daily), and am very hopeful that this will help the situation.

I have been using Lansinoh and Earth Mama Angel Baby cream on my nipples- so I will keep that.

If my supply doesn't return ASAP, I am not going to kill myself if my DH has to feed him one bottle of formula. I have read that many have had to do that on this board, and things were still ok. I am not giving up on breastfeeding. Ever. So that isn't an issue...and I am sure that once my body goes 24 hours without a 102 fever that things will start to regroup.

I am not willing to risk letting my son get dehydrated.....no matter how guilty the options make me feel.

[Bokonon]

Originally Posted by ladyleah

If my supply doesn't return ASAP, I am not going to kill myself if my DH has to feed him one bottle of formula. I have read that many have had to do that on this board, and things were still ok. I am not giving up on breastfeeding. Ever. So that isn't an issue...and I am sure that once my body goes 24 hours without a 102 fever that things will start to regroup.

I am not willing to risk letting my son get dehydrated.....no matter how guilty the options make me feel.

I would never have suggested such a thing, and I apologize if I made it sound that way. You should certainly not feel guilty at all for feeding your child.

[ladyleah]

I am sorry-- I didn't mean for that to come off as rude at all. I apologize!

I am just so upset over this- as I was one of those women who thought that I would have no issues with breastfeeding at all. I am shocked, depressed, and anxious about everything that has happened in regards to the bf in the last 11 days and I am doing my best to quit crying and move forward-- but at least once an hour I dissolve into tears....

The thought that I can't feed my son, and that I would have to resort to formula, even once, makes me ill. But I recognize (at least in intellect) that the world won't end.

I mean, it doesn't seem like he has too much nipple confusion going...as he has nursed for a few days with shields, and has had 3 breast milk bottles...and he latches back on the breast just fine.

Makes me nervous that I am setting myself up for a nasty bout of PPD as well....hopefully, I am wrong about that.

<<<<<<<<<<sigh>>>>>>>>>>>>>

Again, sorry. I didn't mean to sound like a b$tch.....I appreciate everyones feedback.

[Claire and Boys]

Any time you are sick your supply is likely to take a hit. Just keep nursing and drinking plenty of water and it will rebound. Feel better mama

[lach]

PP is a rollercoaster ride of hormones and emotions even if you don't have PPD.

I know you're probably in a lot of pain right now and very frustrated, and that's totally normal. Despite the official line, the cracked and bleeding nipples is, unfortunately, totally normal. The only people I've ever heard of who didn't have some pretty severe pain at the beginning of breastfeeding are people on the internet: both this community and various other online forums. I live in a fairly progressive area, and every single mother I know breastfed, and I don't know a single person in real life who didn't have a little bit of bleeding, a whole lot of pain, or both. And our local hospital has excellent BF support, so I know that I had excellent LC support the whole way, and that most of my friends did too.

So don't beat yourself up because you're having a tough time. It's normal, but it's possible to work through it. And no, mastitis isn't normal, but it is common, and you can definitely move beyond it.

This may not be exactly what you want to hear, but forewarned is forarmed, and the pain lasts about 4-6 weeks. And please, please don't feel guilty if you have to resort to a little bit of formula. We all do what we have to, and what's best for our baby doesn't always live up to our pre-baby ideals. (That's a lesson all mothers learn at some point!). The most important thing is that you're both healthy.

[Katie T]

I didnt read all the responses so sorry if this has been said. I found when I had a fever/been ill that I have to really eat and drink alot to help my supply rebound, I think fever really tanks me. So eat and drink enought and nurse nurse nurse, and with in a day or 2 your supply should be back up.

[ladyleah]

Thank you all so much for the support. I certainly appreciate it. I can hang in with the pain....after an unmedicated 21 hour birth with 2 hours of pushing (eek)...my DH reminds me that I can certainly handle my share of pain!

It's getting the supply back that is frightening me now, but I am just going to keep hydrating, taking the Fenugreek 3 times a day (my pee smells like maple syrup now...so I must be starting to process it), nursing him every 2 hours- even if he isn't getting much.

Also, will see another LC this week to keep me on the right track. Hopefully they can get me in sooner rather then later....

Thanks again mammas....

[annekevdbroek]

Hiya Mama - Congratulations on your new baby! I was popping in to say that I found putting the Lansinoh on *before* nursing was hugely helpful. It took me a while to figure that out because I had the mindset that it was for after nursing for some reason. You may have already figured that one out, but I wanted to pass that information along in case you hadn't.

I had to supplement a few times with my frist baby due to problems with latch and my supply not coming in. He's fine. He is 6 1/2 and happy and bright! Formula is for feeding babies and there are certainly very good reasons to use it when needed. No reason at all to feel guilty!

[ladyleah]

Thanks Anne- I will definitely try that! And I also appreciate the support. He got one oz of formula and one oz of breast milk at 530am this morning, and he latched back on to the breast at 8am, so that was good. Hopefully my supply gets pumped back up soon so that we don't have to do that again...but it feels good to know that it is a possibility!

I also spoke with his pediatrician today for a while about this issue-- (i love that she will call and chat with you on a Sunday!)-- she is very supportive of BF (and BF all her kids)-- so she is a good support, and also reassuring about supplementing, should we have to do that on occasion. We are going to go in tomorrow though just to be safe-- she also wants to take a look at my breast and nipples and possibly prescribe Jack Newman Nipple ointment? (i think that has to be compounded....)

Again, thank you very much for the support. I can't tell you how much it means right now!

[eternamariposa]

I think it is awesome that you are so committed to breastfeeding your baby and NEVER underestimate the value of any amount of breastmilk that your baby gets. I totally understand that there can be times when supplementing becomes necessary even if slightly unwelcomed.

I can COMPLETELY relate to what you are going through. Following my son's 26 hour long birth, complete with two hours of pushing and a fierce labial tear I was not prepared for breastfeeding to be an issue. We had serious weight gain issues, awful nipple trauma that didn't heal until ds was four months old, and mastitis. I don't say this to scare you on the contrary I made a lot of mistakes and there was so much that I didn't know and ended up learning and I wanted to share it with you in case any of it may be helpful to you.

-Always favor moist wound healing over dry. Lanolin will help your breasts heal. Nipples heal from the inside out, they DO NOT need or benefit from scabs.
-Along with checking your latch and positioning, checking baby for tongue tie may be a good idea, and it is very likely that if you don't have thrush causing the nipple trauma to become severe that the vulnerable tissue will likely contract it. SO, I disagree with the practice of trying to use breastmilk as a healing agent for sore nipples as this can exaserbate thrush terribly, instead pat your nipples dry after a feeding and apply your lanolin.
-For the yeast possibility and the mastitis a good probiotic vitamin would be a very good idea.
-I had a nipple sheild with ds for over six months and it was a life saver for my ravaged nipples and it did not interfere with supply at all. The flexible silicone ones conform very well to the shape of the mother's nipple. We also were able to wean from the shield at the six month mark with very little trouble.
-Pumping is a terrible indicator of a mother's true supply. Great example: I had to nurse my sister's baby due to an emergency and within a day and a half I was nursing my son and her daughter on demand and both were getting plenty, and I have never successfully pumped more than two ounces at a time even when severly engorged.
-Supplementing should be done with care to avoid future complications. If you have to you have to. I could be wrong, but it sounds like it could be the stress of the situation compromising your supply. Taking the time to relax before feedings, keeping the baby with you skin to skin as much as possible, and nursing very frequently help A LOT.

Despite all of my rambling I could really go on and on about this but I will only do that if you want me to so I will shut up for now, lol.

[ladyleah]

Eterna-
Thank you so much for your pointers-- I really appreciate the info, and yes-- I totally agree that stress just worsened a bad situation. I mean, my MW, pediatrician, and the new LC that I am going to see tomorrow said that a high fever can knock down supply-- so I know that is part of it....but stress only makes everything worse. And I have been stressed. I am a lot better today, and am trying to relax and meditate and all the stuff that I used to do before I had this special little boy. I don't do well with no sleep.

I had a similar labor....21 hours (unmedicated by choice)- 2 hours of pushing- and an episiotomy cut in the last 10 minutes of pushing due to the babys heart rate dropping (my MW said she has only cut a few in all her years- but it was necessary, so it had to happen....although I requested to tear instead, but hey--what the hell can you do at that point ) The nice private birthing experience with just my MW and husband was totally blown after the first hour of pushing--then other people started in, and at the end a NICU team was standing at the door. (when he came out his Apgars were 9's and an 8--so they took off-- but it was so stressful to have a team there when you can't push your baby out and things are "not going well") The birthing process that I was totally zen and unafraid about, actually became traumatic and distressing to me about an hour into pushing due to the circumstances.

So, I didn't sleep for two days AFTER the birth...(and the two before since one night I was in labor all night at home)...then I continued to have sleep issues because I would start dreaming about the pushing stage...and so on and so forth.

All of these factors contributed to my nipples not healing, and my getting mastitis, as my immune system was probably in the toilet, even with all the supplements I take.

Today I am more hopeful, and going to trust that he gets what he needs from the breast. My supply appears to be better today-- judging from his swallowing sounds-- although his output is still much lower (but he did get to 6 wet diapers) then normal. Tomorrow he has a doc check up, and I have an appt. w/a LC...so I am hopeful.

I won't give up on BF.....so that makes me happy. I am certain that I can get to a place where this can work....so I need to just RELAX......

Thanks again for the feedback everyone...feel free to keep it coming!!

[eternamariposa]

I am so glad to hear that you feel like your supply is on the rebound, improvements are improvements you know? On the other hand, I am so sorry that things turned the way that they did during labor. I can only imagine how incredibly intense that would be in the state of birthing hormones, stress, and exhaustion. And I am really glad that you got what I was saying about the relaxing because I remember having a really hard time with that when my lo was brand new. It was like, are you serious, relax?!!!! My sister cleared up her mastitis right away with frequent nursing and by-brace yourself-chopping up garlic cloves and taking them like pills with a tall glass of orange juice. Freaky but effective, lol. For me, nursing and rest were the answer with lots of warm compresses and hot showers right before nursing so that I could relax better. I remember feeling like I was in labor for a week or something because of the after pains and how badly it hurt to latch my son that I was still doing my very deep, controlled breathing.

Do you have a La Leche League group that is accessible to you? Being around other mothers, in a room with a very natural, pro nursing and compassionate energy was really nice for me and I waited way too long to pursue it. It is good to get it out, to tell your story, to cry if you have to, to lean a little, especially when you are in a phase of your life when you are trying so desperately to be strong for someone else.

[LorenaAZ]

I, like eternamariposa, had nipple trauma until about 4 months. My DD is almost 11 months now and we are nursing strong. I was diagnosed with PCOS and low glandular tissue by LCs and was told I would never be able to exclusively breast feed. They told me I was starving my baby during her first 2 weeks outside the womb. I supplemented because I felt like the worst mother on the face of the earth for not making enough milk for my baby. But I had had enough after 6 days of supplementing with formula. I started pumping after every single feeding even through the night, although I never got more than 0.5oz, it was still stimulation. I never supplemented again and we are doing wonderful. DD is thriving.
We also had a very traumatic birth and I was not ready for what hit us regarding breast feeding. If you can find Lactate Support by Gaia, take it. It's the only thing that worked to increase my supply, and I tried everything. Also, if you need to supplement, try to find donor milk (from milkshare.com or from a friend). I still don't respond to pumps, and have my DD's caretakers feed her donor's milk when I'm away.

Good luck Mama!!! You'll get through this!!! You are so set on making it work that it WILL! Congratulations on the new addition to the family!!

[ladyleah]

Thank you for that....yes, there is a group. The next meeting isn't until January 8th, but I am planning on attending. I found the 1-877 # they offer to be VERY wonderful and the people quite helpful (I called twice this past week!). I am looking forward to sharing and listening with other like minded mammas in person.....

[pumpkinhead]

First off, take a deep breath. You can do this .

There are a few things in your OP that set off warning bells for me, but these aren't things that can't be corrected. The LCs that you have been seeing, are they board certified? That is do the have the title IBCLC? If not, I would recommend trying to find one that is board certified if you can (I know this isn't always possible).

Is your baby getting any bottles at this point in time?

Newborn babies don't use us as pacifiers. They are programmed to need to suck and are comforted by sucking, but initially, before your mature milk is in, they're getting colostrum. Colostrum is jam packed with good things, but it's hard for a baby to extract and they don't get very much which is why they want to nurse almost constantly in the beginning. This is normal. This isn't you "spoiling" them. The more you let them just nurse, the faster your mature milk will come in. Once that happens, most babies will space out their feedings, if only slightly.

If at this point your nipples are still getting worse instead of better, there might be a latch issue. Look here for some great info and links on how to latch your baby:

http://www.kellymom.com/newman/03a-sore_nipples.html

Also check out the videos at www.breastfeeding.com

Using nipple shields for sore nipples can be counterproductive. Your nipples really do need to get used to a child sucking vigorously on them every few hours and most people will have some soreness and maybe even some blistering while this happens. The sheilds only delay this. When you stop using them, this will have to happen all over again. I recommend using Lansinoh after every single feeding. Don't ever let them dry out. Apply every hour or so if you need to.

If you have to supplement, don't use a bottle. Get a SNS (supplemental nursing sysetem like a Lact-Aid) or finger feed or cup feed: http://www.kellymom.com/bf/pumping/a...e-feeding.html

If you think your supply has taken a dip (note, pump yield is not an accurate measure of this. Your baby's behaviour and out put is the only proper measure of what you are producing) I would suggest just taking your baby to bed with you for the day. Skin to skin is pretty important for wee ones. Have your breasts naked and available for nursing at all times. Strip your baby to his diaper and hold him skin to skin with you. Not only is this good for your milk production, it will help him latch better. Most good LCs employ this technique when helping new mothers latch their babies on.

Nipple sheilds can also cause supply issues. They dont' always but they can, so it is good that you're not using them anymore. Until your feel like your milk is back up, stop using any artificial nipples if you can (no pacifiers etc). Fenugreek tincture can help (the capsules work, but aren't as effective as the tincture) as well as oatmeal (the kind you have to make yourself, not the instant packages). No bake oatmeal cookies are a great way to get some if you don't like porridge.

Pumping after feeds and between feeds until you feel like your milk is back up is a good way to help as well.

When you are nursing your baby, when are you in pain? Is it while you are initially latching him on for the first few seconds or does the pain get worse as long as he is nursing? If it's getting worse and not subsiding, you might have a latch issue. When he's sucking, does he tuck his lip in or is it flanged out? If it's not, you either need to relatch him or try to flick it out while he's sucking. You might try using the football hold for a while as this lets you see everything that is going on and gives you a free hand to adjust his latch if need be.

Good luck!