mutilated nipple, among other things.

[the janet]

I have a 9 day old and this breastfeeding thing is new to both of us. I feel like giving up.

He was doing pretty good for a while once he got latched on, which always takes a while b/c he wildly throws his head back and forth and both hands are in the way. Now there are two pretty big problems.

1. My right nipple has swollen to about 4x the size of my left one. The pain was unbearable for the first day. I couldn't sleep, even after putting on some Lansinoh. Actually, I think the Lansinoh made it worse, it felt like it was on fire. How do I get the swelling to go down?? Should I avoid having him nurse on that side? I don't know if I can b/c I feel like there might be a milk production issue on the left side...

2. He nurses NONSTOP. Once he seems to be satisfied on one side, he falls asleep. I have to wait at least 15-30 minutes for him to be in a deep enough sleep to move to the co-sleeper, or else he wakes up screaming that he's still hungry. From 3-9am, I am constantly switching breasts b/c he won't stay asleep and is inconsolable. I think it might be linked to the possible milk production issue on the left side but I'm not positive.

I realize sleep deprivation is part of the deal with a newborn but I didn't think marathon nursing was. Or nipple mutilation. I have a supply of formula from the hospital that I've had to use about 3 times since I got home. It sits there tempting me. It takes every fiber of my being to not grab a bottle and just have him fall into a formula coma.

[cappuccinosmom]

I'm sorry nobody has replied so far.  My youngest is 3.5, so it's been a while, but all of my newborns never went more than an hour between feedings, and that includes the time of feeding, so if they took half an hour to eat, it would often end up being only 15-20 minutes off the breast before they wanted to start again. 

If you can, I would try to feed him longer at one breast, rather than switching him too often.  What I usually did was start the next feeding with the breast the baby had last been nursing on.  It seemed to help ensure that they were getting a lot of the fatty hindmilk.  With my oldest I did the constant switching thing, and we had a lot of issues.  The younger two were more easily satisfied (thought they still ate very often) and happier over all (and fatter).  It's also helpful to remember that your baby's tummy is rather small, and that small, frequent feedings are the way their bodies are built to take in nourishment.  It's normal for a newborn to want to eat very frequently (even so frequently that mom feels it's "all the time"), but this is probably the most common reason that I hear from mothers when they give up and go to formula.  "He eats all the time"--the assumption is that something is wrong with that.

Re the nipple issue: to me those symptoms would indicate mastitis, as that has been my major issue with nursing.  Is the pain deep in your breast, or just local to the nipple?  Do you have LLL nearby or a hospital based lactation consultant you could call?  It might be worth it to get someone to see the problem.

[KimPM]

I had something similar with my DS -- he chewed on me despite a good latch as confirmed by a lactation consultant.  Everyone was baffled and I had no solutions.   But I was extremely determined to breastfeed.  Turns out he had oral motor issues and sensory processing disorder.  We only found this out after trying solids and seeing his extreme texture aversion to everything I put in front of him.  His automatic response was to chew anything in his mouth that was not food (like my nipple, for instance).  Are you seeing your DS chewing on you?  Have you seen a lactation consultant?

You might need a breast pump to help...

I eventually figured out I needed a breast pump (I refused to buy one before he was born, as I figured I wasn't going to need one...I had planned full-time BF-ing and not returning to work).  But -- as it turns out I needed a pump for medical reasons.  It certainly helped offload the need to get milk out while not being chewed.  It ran in cycles - I would nurse him until I couldn't stand it anymore, then I would pump until it was healed.  Sometimes I only had to pump on one side b/c the other side wasn't so bad.  I started out with a single manual pump (Avent Isis).  It worked fine, but if you find out you need a pump, I recommend the Medela.  When DS was 1 year old and still only nursing (he was avoiding all solid food), I pretty much had to go out and rent a Medela hospital grade pump.  That was really nice.  When that rental was up I just bought a Medela pump-in-style, and that was great.  In hindsight I should have bought that right away.  The other thing is that because he always chewed in one spot, I eventually learned to turn him around on each breast, so that he would chew on fresh areas and give the other ones time to heal.  I did end up getting mastitis a few times, but he never had formula.

As for the inconsolable times, does it seem like he might have gas?  At around 1 year old, I found out (via a lab test) that I was eating foods that I have an intolerance to...and it made my breastmilk bubbly.  DS would eat that and of course he would get gassy.  When I stopped eating those foods, viola, no more bubbly milk.  And I wouldn't have known about the bubbly milk if I didn't have the pump.  I could see the bubbles.

And mastitis is serious - if the pain is more than just topical on your nipple, get it checked quickly.  Also, any injury to that area could lead to mastitis as well, so be aware of that.  If it was me, I would get it checked out and pump exclusively on that side while it is healing.  I also wouldn't put anything else on it until it heals.  Not even Lansinoh.  I also might consider a pacifier if your DS has already been fed and is going to sleep (though I'm not typically a fan of pacifiers - but I even tried them with DS when we were having these issues).  He never took to the pacifier...he tried to chew them, too, and he couldn't keep the suck motion going - he had what they called a "disorganized suck" due to the oral motor issues.  Anyway - I would use a pacifier only sparingly, and only when necessary, such as the nonstop stuff at night - if it truly is constant need of oral stimulation.  Keep in mind thought, that that young of a baby does generally need to nurse every 2-4 hours.

(Please don't anyone flame me for suggesting the pump or paci unless you too have gone through almost three years of nursing hell like I have done with a special needs child.)

[hram]

Im so sorry you are having to go through this right now. I really wish all moms coudl have an easy time nursing their babies. You deserve a calm enjoyable babymoon, and I hope you get some good support  with this.

 First of all, you need to see a LC or midwife who is experienced with nursing problems. The swelling and pain (apart from the expected engorgement at first) is not normal.  If it is mastitis, not nursing will make it worse. Your breast needs to be emptied one way or another. Maybe try olive oil instead of lansinol and make sure your bra is well fitting. Anything tight on your breast can cause mastitis. Also, going braless may help you out. Keep your breast dry and clean so it can heal. I have known many mother's have painful, cracked, bleeding nipples and still continue to nurse, including myself. Its hard and it hurts, but it can get better.

For the nonstop nursing, have you tried bedsharing? Especially in those hard hours early in the morning. It seems your LO just wants to be at your breast with you. They do that, its normal. I havent had a baby that liked to be taken off the breast and put in a bed alone. And for me its not wroth the fight to try and get them to sleep alone when all they want is to be next to me nursing.  I also agree with nursing on one breast at a time, even the same breast for two or three feedings in a row and pumping the other when needed. My infants nursed almost nonstop for the first few weeks. I always thought that was normal, it is for mine so I dont try to do any different. I see that some parents (Im not talking about you, just people I personally know) seem to think babies can go an hour or two without nursing. Their stomachs are the size of their fist, thats small. They need to be fed often. But they also nurse for comfort, its an instinct to survive. They just need to be at your breast. It will slow down, but now istn the right time. Just give it a few weeks and you will see, he wont need the breast so much.

As for the throwing his head back, have you tried other positions? He may feel scared if you are trying to force him to your breast. Have you tried laying on your back and letting him lay on top of your stomach? That way he isnt being forced to your breast, he can find it himself. Or even try side lying. A few pillows behind your back and head can make this a very comfy position for sleeping too. Im not a fan of swaddling, but maybe wrap his arms in a blanket so they cant get out?

As for the formula, thats your call. Your baby is very small to be given both the breast and bottle, it may cause more problems than it solves. I dont know how hard this is for you, and what kind of support you have. And I dont know how important breastfeeding is to you personally. But formula feeding has never sounded like an easy solution. I see getting up all day and night to make a bottle, often with a screaming baby, heating it, washing them, and having to keep buying to be such a huge burden. Not to mention the possible health problems it can cause.

If you have other questions, I know there are a lot of mom's here who would do anythign they can to help you out. I hope things get easier for you.

[hram]

I also wouldnt expect a breastfed baby to go 2-4 hours without nursing. Thats too long IMO, its very normal for them to feed often and to cluster feed. Dont automatically assuem its a supply issue jsut becuase he wants to nurse a lot, even nonstop. Its a supply issue if he isnt wetting or having bm's.

[KimPM]

Originally Posted by hram 

I also wouldnt expect a breastfed baby to go 2-4 hours without nursing. Thats too long IMO, its very normal for them to feed often and to cluster feed. Dont automatically assuem its a supply issue jsut becuase he wants to nurse a lot, even nonstop. Its a supply issue if he isnt wetting or having bm's.

Sorry, I guess I wasn't clear.  2-4 hours at most.  Every hour would be reasonable with that young a baby.  Even cluster feeding...but not for the whole 9 days.  But if it truly is: 24-hours a day-got to be attached to mama's nipple, I don't believe that's normal.  Seeing a lactation consultant should be a priority.

Also - to the OP, just because he wakes crying after 15 minutes of going down to sleep doesn't necessarily mean he needs to be fed again.

[kanga1622]

DS ate all the time for the first several weeks and would only sleep if he was held. It did eventually space out a bit so he started eating every 30 minutes and then every hour. He was a big cluster feeder also, from 5-10pm.

Get some help from an LC for the nipple pain as that seems extreme but the constant nursing sounds normal to me. DS is 10 months and still refuses to sleep unless he's latched on. At least now we can sleep laying down together and my nipples are used to it so I get a lot less pain.

[lindsay t]

all purpose nipple ointment is awesome! you have to get an rx and it's pricey but man oh man it helps a bunch. it has an anti-inflammatory, antibiotic, and something to help with yeast in it. get with a lc too. they might suggest a nipple shield to get you through the pain and asses his latch. hope things are improving for you!

[the janet]

Thank you all for your replies...and sorry it took so long to reply myself. But as you all well know, free time is few and far between with a newborn!

I did finally get an IBCLC to do a home visit last Saturday but only b/c it seemed like I ran into a supply issue. I would have milk pouring into my son's mouth in the morning...then very little the rest of the day, and he started to get incredibly upset. It's improved a bit since he's started sleeping more during the day, giving me time to produce more milk. There are still days where he will only catnap between approx 8am-midnight, so his near hourly sucking would result in a very dissatisfied baby. The IBCLC said it was probably a combination of lower supply and a posterior tongue tie, so he's not effectively getting the smaller amount of milk I'm producing.

Anyway, there are good days and not-so-good days. Yesterday, I started tearing up b/c he made the saddest, poutiest face when he couldn't get any milk during a marathon session. 

As for my deformed nipple, it's still larger than the other but it wasn't a case of mastitis. Hopefully, it will go back down to size when I stop nursing him...whenever that is. I was planning on a year but at this point I'll be ecstatic with 3 months!

I go back to work in 2 weeks so I have to start pumping to build up my supply and store milk. Wish me luck!

[PatioGardener]

Have you had a consultation about the tongue-tie? Are you thinking about getting it clipped? there are great resources about tongue-tie on MDC.