Finally a latch, now vicious pain

[jlanda]

Having trouble getting breastfeeding going after a rough start after birth. To make the long story short, the nicu started him on formula without telling me, didn't alert me to lactation consulting services until they started him on formula, etc. etc. We had almost an impossible time getting him latched, he would get frustrated, cry, and just went nowhere. I kept pumping what miniscule amounts came out and gave it to him, but it was pathetic.

I got some nipple shields and it helped, but I started getting sore. Saw a lactation consultant (not hospital) who told me I had the wrong nipple shield size. Then she showed me a video about self attachment. We gave it a whirl, and though DS still needed help with pinching of the areola, he was able to latch.

Now with some minimal pinching, I can get him latched 100% of the time. The problem now is that it hurts something godawful. At first, it does hurt/pinch like heck, then that subsides and everything's fine. After about 5-10 minutes, it starts burning/raw/tugging, like I'm breastfeeding a shark. Then DS suddenly starts actually pulling and tugging and cocking his head back to make everything worse. Often, a line of sting trails up the breast and I keep wanting to scratch as if a pine needle was poking me.

With the shield, except if DS is being rough again (pulling, tugging, which I try to gently keep him from doing) it never hurts. It's driving me mad because I'm having trouble getting my supply up and hate having to supplement, and I know I can't get it up without the full latch. On top of that, he hangs onto the nipple (shield or not) for almost 45 minutes on each breast. Feeding times, (I breastfeed on both breasts first, then give formula because he's begging for more after hanging onto me for almost an hour and a half) can take 2 or more hours, and it's draining. I want him off the formula and shield, but I can't figure out why it's burning so much.

My LC said to keep on the shield until he gets a little bigger and gave me a prescription for Reglan to increase supply and get him off the formula, but I have a history of depression and don't trust the potential for that side effect, so I wont' take it. I'm taking a nursing tea as much as possible during the day, trying to eat well and drink a lot, and sleep is pointless. It's just hard to eat well when feeding times take hours, and well, sleep with a 3 week old is just a moot point anyway.

I'm going to call someone from my local LLL, but has anyone else experienced similar before? I just don't understand that eventual burning pain that arises but isn't there from the beginning.

[7libramama]

You know I had such INCREDIBLE pain when my now 7 week old dd would latch and it pretty much lasted the entire feeding. My nipples were bruised and I was miserable. Then I took her for her first visit to our chiropractor(she was about 3 weeks). He checked her and found she had a subluxation of the atlas. He explained that subluxation caused a "short gag" so she was constantly pushing my nipple back out a ways as to not gag on it. He adjusted her and now we are doing fabulously! He taught us how to hang her upside down by her holding her by the ankles and she has held her adjustment and is doing wonderfully. I suggest having your baby see a chiro that LOVES babies as ours does.

[BakerALM]

Is your baby actually feeding for those 45mins that he is latched per side? It should be active sucking with chin pauses when he swallows. If he starts to fluter suck or just hold the nipple in his mouth for more than a few seconds you should switch sides. Even if you are switching sides every few minuites. That will build supply. I suppect that he is pulling and tugging because he is no longer getting milk and has not gotten frustrated. You can keep switching back and fourth until he no longer is swallowing, then supplement. That sholud help your pain. I guess he is doing funny things with his mouth to mess up the latch once the milk flow slows.
check out dr jack newmans website for videos that teach you how to reconize when your baby is actually swallowing milk.
Good luck!!

[jlanda]

That flutter sucking... he does that a LOT. Kind of feels like a soft vibration? I will definitely give the side switching a try when he does that. No wonder the supply is taking forever to grow. It was suggested I keep him latched on for up to an hour to help build supply, but I will give the switching a shot since I'm not getting too far as it is!

[mrforbes]

Another thing to check could be the depth of his latch. A shallow latch can cause continous trauma to the breast from nursing. It sounds as if your breast is getting irritated from a latch related situation. I used a nipple shield for a while and then had shallow latch problems after switching back to the breast, the irritation of the breast that I felt sounds a lot like yours.

[SleepyMamaBear]

when you suppliment it would help tremendously to use an at the breast supplimenter like the Lact-Aid system.
sounds like you need some supply help, domperidone could give you the extra boost you need, without the depression Reglan gives.
he also has a poor latch if it hurts like that, watch the Jack Newman videos to learn the assymetrical latch. a poor latch leads to poor milk transfer which can lead to a smaller supply.
he could also greatly benefit from cst.

[borislava]

Sounds like you already got some great ideas, I wanted to add that even though DS had a great latch, in the early weeks I still had problems with nipple cracks, bleeding and pain. I had my OB give me a prescription for the all purpose nipple ointment - it is a Jack Newman's medication - a combination of antibiotics, lanolin, anti-fungal drugs, it is usually compounded in a compounding pharmacy. It helped tremendously with the healing of my nipples.
I also second the domperidone - get some ordered - no side effects like Reglan. If you need more info on it there is a thread in this sub-forum just for domperidone.
Also - try babywearing (bare is possible) and co-sleeping as much as possible. This is what personally helped me with DD when we had similar problems.
HTH and keep us posted!!!

[BakerALM]

Originally Posted by jlanda

That flutter sucking... he does that a LOT. Kind of feels like a soft vibration? I will definitely give the side switching a try when he does that. No wonder the supply is taking forever to grow. It was suggested I keep him latched on for up to an hour to help build supply, but I will give the switching a shot since I'm not getting too far as it is!

Yes flutter sucking just feel like a vibration not active mouth motion and swallowing.

It is true to keep him latched for as long as he wants IF he is still actively sucking and eventually getting milk, that will build supply since it will further drain the breast reaching the hind milk and telling your body to make more milk. BUT if he is just flutter sucking that will not drain the breast no matter how long you leave him there (some milk may drip in but nothing of quantity if you already have a low supply) that is why switching sides in that situation is the best course of action. I bet your LC meant that but did not explain the fine details. This plan should work better and also free up some time in your life

[jlanda]

So I went to see another LC that's closer to my area than the other. We went over things and developed a strategy to get my supply up. However, I know the latch is still off.

After going over the Dr. Newman site with a fine toothed comb, I gave the latch another whirl and FINALLY it didn't hurt. On next feeding I tried again and still pain. Then I looked at the nipple and saw ridges as if he's clamping down and holding tight somewhere. Kind of like if you were to bite the skin on your arm and hold it for a while, you'd see ridges left where the spaces between your teeth are. It traces from the nipple down to the areola, so it's definitely a shallow latch at best. I'm just not sure how to correct that. I pull him on when his mouth is wide open, but then he just starts suckling hard until it latches but hurts.

It often feels like the lubrication bumps on the areola get raw too, usually where the clamp is and also where the bottom of his mouth is, like it's being abraded.

About the gag reflex, I took a suggestion from one of my books to use my pinky as a pacifier. However, barely past the spot behind the gums, if my finger gets past there, he starts gagging. Is it perhaps the shallow gag reflex that's causing a shallow latch that's causing this pinching thing? I'm going to see the LC again soon, but I wanted to get other opinions on top of it.

[Family4Christ]

About the gag reflex, I took a suggestion from one of my books to use my pinky as a pacifier. However, barely past the spot behind the gums, if my finger gets past there, he starts gagging. Is it perhaps the shallow gag reflex that's causing a shallow latch that's causing this pinching thing? I'm going to see the LC again soon, but I wanted to get other opinions on top of it.

A chiro that treats babies is invaluable! My LO had the same problem and was "biting" me with her gums and gagging. She was adjusted and improved greatly immediately. They adjustments are very gentle - not at all like regular chiropractic for adults.

Also, fast milk flow or a sensitive gag reflex can cause a babe to clamp down or push the nipple forward and have a shallow latch.

[paulamc]

Originally Posted by jlanda

On next feeding I tried again and still pain. Then I looked at the nipple and saw ridges as if he's clamping down and holding tight somewhere. Kind of like if you were to bite the skin on your arm and hold it for a while, you'd see ridges left where the spaces between your teeth are. It traces from the nipple down to the areola, so it's definitely a shallow latch at best. I'm just not sure how to correct that. I pull him on when his mouth is wide open, but then he just starts suckling hard until it latches but hurts.
.

I am having the exact same problem with my 5 1/2 week old baby, on my right breast. Things are going great on the left side, but on the right I'm usually in pain (a sharp pinching feeling) throughout the session, and when he comes off the nipple looks pinched. I'm afraid there might be a crack but I'm not sure since I don't really know what it looks like. I try to do the same thing on the right side to latch on - cross cradle hold, like on Jack Newman's website - but he constantly bobs his head all around and I never seem to be able to get a deep latch. I don't seem to have the gag reflex issue, but my right breast is a bit bigger. I hope you resolve your situation - if you do, please let me know how you did it!

[paulamc]

Oh, I meant to add one thing I've done that is helping me a lot, and maybe it would help you. My nipples have been so sore between feedings - I can't stand for a shirt to rub against them, and nursing pads/ bra don't feel good either. The soreness makes it uncomfortable to carry or wear the baby as well. So I got some of those hard shells (Madela Soft Shells for Sore Nipples - the part against your breast is soft, the part against your shirt is hard) that go over the nipple, allow air inside, and prevent rubbing against clothes. It's been such a help! I still have the latch problem most of the time, but at least I feel better between feedings. I tried Soothies before that, but didn't like having to wash my breast before feedings to get the residue off - the washing itself was painful, as well as an inconvenience.