Please Help Me- 11 day old baby- Mastitis and Issues (1/8 UPDATE IN FIRST POST) - Page 2

[eternamariposa]

I have to say that I agree with pumpkinhead about verifying your LCs credentials because it is really important when you are relying on someone for something so important that they be a safe and reliable source of information. Also, I don't know how to stress enough and agree more about NEVER letting your nipples dry out and using the lanolin to help them to heal because of the difference that it makes. And right on about supply and demand. I know it is scarey to push the envelope but I think that if you are in fact under the care of an IBCLC and working with your ped you should learn about dehydration red flags and monitor babies activity and weight, but go for exclusive breastfeeding. I would even say focus on the baby nursing with you, eating and hydrating yourself well, and resting and let the pumping go for a while. Pumping with cracked nipples is extremely painful for a lot of mothers and variably effective. But babies are very efficient supply stimulators and it may just be that the two of you need some time and space to balance out your supply and his demand. If supplementing is necessary I don't by any means think it screws the whole thing over, I just think it is best to try to let your body and the baby work it out first. I say get rid of potential interference before adding in supplementation, like pacifiers, bottles, and schedules.

BUT I have to say from research, personal experience, and the experience of other mama's I know that I disagree about nipple shield usage. I think that hands down, all natural straight from the breast is without a doubt the best option, but when things are desperate and there is an indication for them nipple shields can be very helpful. It is really hard to nurse your baby pretty much constantly as is necessary to boost supply and clear out mastitis when every time you latch your baby you are in terrible pain, so if a nipple shield enables the solution it is worth considering. It is important to use flexible, silicone nipple shields so that your breasts are continuing to be well stimulated, but it is rare for them to interfere with supply, especially in an instance where the pain of sore nipples can seriously threaten the nursing relationship. It is a bit of a pain to wean your baby from because they get used to it, but I think if it is something that could save a vulnerable nursing relationship it is well worth it. And like I said after being torn up for four months we weaned from ours at 6 months and my breasts did not revert back to being messed up again, I've never heard of that happening before. A mom I knew who had inverted nipples used hers for three years and had no trouble exclusively nursing her lo in the first year.

[mouso]

I can't read all the replies but wanted to say to get that ointment you were speaking of, the All-Purpose Nipple Ointment that has to be compounded.
I freaking love that stuff and it helped me so so so much with my DD when we had tons of issues.
I had some on hand for my son and used it the minute I got blisters right after he was born. I think it really helped me heal faster.
It blows lanolin out of the water.

I hope your appt goes well and that your supply ups quickly. Do what you need to to keep your LO fed and don't beat yourself up- you are doing everything you can, mama, it's very apparent from your posts.

[pumpkinhead]

I want to add that I agree with you eternamariposa regarding nipple sheilds in that they do have their place in a nursing relationship. That said, I disagree that they are a good solution for sore nipples. Sore nipples are usually the result of a latch issue if they persist longer than 14 days and a nipple sheild isn't going to help that. Most of the LCs I know will actually recommend a "nipple vacation" for nipples that are so sore and cracked that you're dreading that next feeding. My absolute favourite LC who is also a midwife recommends hand expression and fingerfeeding or cup feeding in such instances (or even bottle feeding). You just have to remember that in order to have a successful nursing relationship, everytime your baby eats, your breasts need to be involved. That does not mean that the baby needs to always be nursing directly from the breast.

That said, I do agree that everyone needs to do what they feel is best for them and if it is a tool that is worth using. Nipple sheilds are wonderful tools, especially for a baby that has gotten used to a bottle nipple or for a mother with flat and/or inverted nipples. I just respectfully disagree that they are a good solution for sore nipples and they might prolong the problem or mask a latching issue.

Some women just have prolonged nipple pain regardless of latch and in that instance, I absolutely agree with eternamariposa. If your baby's latch is good and nothing else is helping and a nipple shield is what you need to nurse your baby, then it's what you need to do. I do think that latch and any other issues need to be ruled out first.

[eternamariposa]

Originally Posted by pumpkinhead

Some women just have prolonged nipple pain regardless of latch and in that instance, I absolutely agree with eternamariposa. If your baby's latch is good and nothing else is helping and a nipple shield is what you need to nurse your baby, then it's what you need to do. I do think that latch and any other issues need to be ruled out first.

This was my situation. We were varying nursing positions, checked lo for tongue tie or other oral issues, checking latch and couldn't find a problem. The barrier between my little baracuda and my nipple made a huge difference and really speeded healing for us. I also didn't know at the time, but have serious issues with yeast which was a contributing factor all around and since I couldn't clear up the yeast over night I needed a way to comfortably work on our issues while feeding him still.

[ladyleah]

Thnak you again ladies for the feedback-

To respond to a few questions-- both LC's I have seen are IBCLC's. It turns out that the first one was not good (I didn't know it at the time), as she didn't look in his mouth, or evaluate his suck on her finger or anything. She weighed him, latched him onto one breast with the shield) talked about "soothing techniques", burping, and using pacifiers, took him off the breast and weighed him. Again, never looked in his mouth or watched me try to latch him, or evaluated his suck..... The woman is more interested in selling all her items in her boutique then really helping women. She is also a "celebrity IBCLC" and has been on TV, in magazines, has a video. I understand that she is a business woman and wants to make her money, and shouldn't give away her services for free- but after the $150 I spent for the consult (the gowing rate in northern NJ....not uncommon)- and all the hundreds of $'s I spent in her store ("recommended products") the day of the consult, and a few days later...the woman had the nerve to have her sales associate call me back when I called to ask her questions about the mastitis and milk supply and ask me if I wanted to schedule a "phone consult" with Shari to talk about my issues (for another $50= dollars...). I guess I had called too many times for "free" with other questions since the consult (2 calls). I knew then and there that I was done with this woman.

Come to find out later that she did a completely inaccurate assessment on my son, and myself. I had no idea what she "should" have been doing at that time-- and of course, my husband and I were scared and vulnerable and trusted that she was doing everything right.

Again, I now found out that my hospital, and other IBCLC's in the area do not recommend her due to the same problems that we encountered. Very depressing, but what is done is done. PS- her name is Shari Criso- and while she is a great sales lady, and her videos probably help people...she is all about the $$$. (should have tipped me off that she was a Viacord "rep" as well...lolol)

My second IBCLC was amazing. Saw her today, she did a full eval, and gave me a concrete plan moving forward. Totally awesome. Oh, and PS- she said I can call her anytime for free-- every day if I want...lolol (not interested in doing that though!!!)

I also went to the pediatrician- who told me to follow the IBCLC's plan, which is: Nurse at least 8-10 times a day (both breasts) no shield needed unless severe pain is an issue- then after each nursing pump 15 minutes, then after each nursing supplement 1 or 1.5oz of breastmilk, or formula if there is no breast milk. Take the fenugreek as I have been, eat oatmeal, rest, and hydrate.

She says she has never, ever had a problem getting a baby to only take to the breast even after 6-8 weeks of ONLY bottle feeding (in the case of preemies, or medical illness), and she is solid that as soon as my milk regulates we will get rid of the other stuff. I believe her, as she has been in practice for over 20 years. She also has clients take 24-72 hours off of nursing (pumping only) to heal the breasts and

He seems to latch just fine back and forth between my breast and the bottle so far, so hopefully that continues.

The reason these measures are SO drastic is because my son lost a TON of weight in the last week. He lost 7 oz. according to her scale. He had almost regained his birth weight 6 days post birth, and now he weighs LESS then his discharge weight!!!!

**So, I was nursing 12 times a day, as many said- although I KNEW he wasn't getting much at all....so sometimes the every 2 hour thing does not work. Everyone thinks because my mastitis was so severe that this kicked my body's ass right when my first milk surge was happening (because I was producing a LOT last week!)....and the supply just stopped due to the high fever, no sleep, stress....etc...

PS- His output had decreased, but he was still getting about 6 wet diapers the last few days......in his case, not a great measure.

So, I can't deny that he needs some supplementing, at least for several days...even though I cried for an hour straight after hearing this.

I am also starting the Jack Newman nipple cream as well. The ped (who is also an internist) took one look at my nipples today and said they were the worst she has ever seen, and she was amazed that I had not just given up. (She BF'ed all her kids and is very supportive of BF'ing)
So, just to clarify-- sore nipples was not my issue. Sore would be wonderful, and I can deal with pain. My nipples are broken down, with pieces out of them, cracks, and scabs if I don't have cream on them...my left areola's (the mastitis breast) skin blistered and has since peeled off and looks like raw oozing burn wounds. So, in this case== shields are a-ok according to my IBCLC...however, if things are not painful (and just look it)- then not using the shield is ok as well.

The prescription nipple cream should help me a great deal--as the nips are bound to be infected, even with the oral antibiotics I am taking for the mastitis.

So, that's it for the moment mammas. Keep your advice and inspiration coming, and I will keep everyone updated as well!

I know I can make it back to breast only. I will never give up!!!

[lach]

Oh my gosh, you ARE a trooper. I am so impressed.

I'm sorry the first LC you saw was a scam. Reading your description made me angry. You should totally write to the BBB. LOL, that's the kind of thing I'd do at 2am when I can't sleep and I'd never get around to sending the letter, but it would make me feel better

I'm glad the second LC is much better.

Good luck, and I'm sure you can do it. I'm really impressed by your drive! It's great that you have such wonderful support all around.

Again, please do not take needing to supplement as a sign of failure. It's really not. Sometimes people have problems BFing, just like sometimes people have problems with all sorts of things that "should" be natural and easy and normal. It's not any sort of failure on your part, it's just one of those things that can blindside any of us. Formula exists for a very good reason, and you're using it for that reason. Just imagine how awful it would be for you to have been going through this a hundred years ago, pre-formula: knowing your child wasn't getting enough to eat and not having any way to help (except cow's milk, which everyone knew didn't actually keep human babies alive). Plus, goodness only knows how mastitis was dealt with back then: I got an absolute raging case a few weeks ago that came on over the course of 3 hours, and necessitated not one but TWO trips to urgent care for antibiotic shots because they were afraid the infection had spread into my bloodstream.

Hang in there! It sounds like you're going to be just fine, with all the support you're getting.

[ladyleah]

Eek Lach! That sounds awful!!!!

Thanks for the support. The only thing making the formula thing tolerable in my mind is to keep reminding myself that my son's health is all that matters...and that I am using a high quality, organic formula-- so hopefully that also plays a part....(at least it makes me feel better). Plus, some supplements will be breast milk, so that is also good.

I am thankful for a real plan, and great support to move on. I need to continue to accept "the now" .....(easier said then done! )

Thanks again....

[eternamariposa]

I am so sorry that you had a negative experience with your first LC, especially with the expense to boot. But I am so glad that you are feeling more positive and better supported now, that will take you a long way. s

[pumpkinhead]

I'm so sorry about your experience with that first LC. I'd be tempted to report her .

If the shield is working for you, then I am glad . Also, supplementing does not = failure. Not by a long shot. Formula exists for just this reason and it definitely can be used as a tool to get you to the point where your baby can be EBF.

I would still urge you to try to supplement at the breast if you can bear it. If it's too painful or frustrating, then you need to to what gets you through. If you can cup or syringe feed during the day instead of using a bottle nipple, this can help as well. Sometimes it is very subtle and almost imperceptible, but bottle nipples can change a baby's latch. If cup feeding, using a SNS or syringe feeding simply isn't feasible for you, I'd urge you to try breast flow nipples and stick to a slow flow.

I hope you heal up soon and things improve for you! Sometimes you just have to make this up as you go along and if it's working for you, then go with it! If you're not finding a discernable difference with the fenugreek, you might also ask your ped or LC about a perscription for domperidone. This is possibly the fastest way to chemically build a milk supply (outside of baby sucking, that is)

[PatioGardener]

Just wanted to send you my support. You are amazing I am so glad you found the 2nd LC and have a plan that is moving you forward. You are an incredibly strong woman - I hope that you heal quickly and things get better as fast as they can.

[ladyleah]

I think I updated this post....but I might have screwed it up? lolol Can anyone see the 1/8 update?

[Bokonon]

What a wonderful update! You should be so proud of your perseverance!!!!

[mouso]

That is wonderful!
Yes, that APNO rocks!

[ladyleah]

Thanks ladies! I am so happy that things are back on track and I actually have a decent supply now.....I was so frightened that it wouldn't happen....(as was evident in my frantic posts!!!!)