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Re: Breastfeeding QuestionsFrom: Noelle (anonymous@obgyn.net)Fri, 28 May 1999 11:45:32 -0500 (CDT)
Hi Chelsey, Congrats on the birth of your baby girl and on your committment to breastfeed her! I agree with most of what others have said, but I wanted to chime in with a couple of things. First, there's really no better product than the Lansinoh for the cracked nipples problem and you don't have to wash it off before feeding. It's prefectly safe for baby to consume. Also, I've heard that some of the other brands of "breast creams" are really sub-standard - the Lansinoh is pure lanolin (and apparently the good kind, to boot), so even though it's expensive, it's worth it. Also, instead of buying a whole tube (which cost me around $8 or so), you may be able to get a free sample from your pediatrician/OB-midwife/lactation consultant/LLL. You probably won't end up needing much more than is in the sample tube anyway. Also, while you're trying to cure the cracked nipples, do not use soap or any other cosmetic-type product on your nipples or areola (dark pigmented skin around nipple). To wash them, simply rinse with warm water (not hot) and air dry. Be careful not to rub them too hard with towels or clothing (although you're probably not doing that anyway because it's painful!). I agree with the suggestion to expose your nipples to fresh air whenever possible. (LOL - I used to be a sight sitting around my house topless much of the day and night!) A restrictive bra will probably increase the pain and lengthen healing time - if you can, go topless or at least with just a loose shirt. If you must wear the breast pads, definitely go for good quality pure cotton pads instead of the disposables. Many women are sensitive to the dyes and chemicals in disposables. Also, try the un-dyed, soft flannel cotton cloth pads - I found those to be the best and worth the extra expense. Or, make (or even better, have a friend or relative make for you) your own homemade breastpads out of 100% cotton flannel - just take several layers (try 6 or 7 layers, for best softness) and crudely sew them together. Also, you may find it helps to switch to a laundry detergent without any dyes or perfumes, which could be irritating your already irritated nipples. Now, with all that said, I still think the main culprit of the pain you're feeling is a not-quite-ideal latch. I had this problem in the beginning. I could swear it looked like he was latched right (even with the "help" of a lactation consultant in the hospital) and it still hurt like heck, but then once I went to a different person and she showed me some tricks with positioning, I couldn't believe the world of difference it made! One of the things to be especially vigilant about is that her lips are "flanged." Her bottom lip should be out and not tucked in AT ALL. This was our biggest issue. Also, be sure she's taking in as much of your areola as possible and not holding primarily onto the nipple. Regarding positioning, be sure you're not leaning over her to feed. She may be tugging (ever so subtly) and causing pain that way. Try propping her on lots of pillows (with pillows supporting your back, arms, under your legs, if necessary) with you holding her head and neck firmly. That way you can control her closeness to the breast. Also, have you tried various nursing positions? I'm thinking the "football hold" may be a great one to try, mainly for the benefit of your control over her head and neck at your breast more easily. Plus, it may cause less fatigue in your arms than the cradle hold might be causing. In general, it's always a good idea anyway to be able to nurse in various positions (cradle hold, 'crossover,' sidelying, 'football hold') so baby and you have more flexibility as time goes on. And one more thing about positioning - be sure baby's tummy is against your tummy (especially cradle hold or sidelying) and that she's not twisting her body around at all. Tuck her feet around your body and support your hand supporting her back/neck to help ensure this. I'm sure this is alot of stuff you already know or have tried, but I figured I'd suggest these things just in case. One good book I relied on heavily in the beginning was "The Nursing Mother's Companion" by Kathleen Huggins. It's got short, easy-to-read sections on all kinds of things with "survival tips" and is especially good for the early weeks and months. The tome from La Leche League is also a great resource, although I'm forgetting the name. Avoid any artificial nipple of any kind this early, especially if you have flat or inverted nipples. Baby may well be relying on the way she nurses an artificial nipple, and it may be making the problem of the flat nipples even harder to "overcome." If you're really having a hard time with how much she's eating, hand express or pump with a good electric double pump and then feed her with a small cup, in addition to putting her to breast. (Try one of those little medicine cups.) That way, she'll still get your breastmilk but will not have the "nipple confusion" issue. (However, just because she eats that often and for that long does NOT mean she's not getting enough! Many babies feed that way, especially in the beginning. How is her weight gain? Is she contented after a feeding, even if she's hungry again an hour later? How many wet and soiled diapers is she making per 24 hours? It may be easier to keep track of that by using cloths (at least for awhile) if you have concerns.) Avoid nipple shields or shells - they may give you some very short term relief (although many women find it even more painful), but you may well get into the downward spiral of diminishing milk supply which is common with their use. What you said about her going 2-3 hours after a bottle-feeding but less time after time at the breast makes me think two things: (1) She enjoys her time at the breast so much that she wants to get back to it quickly!, and/or (2) that her latch and positioning may not be the best and she's not taking in quite as much as she may if that was taken care of. Perhaps really focusing on the latch and positioning will not only take care of the pain issue but may also let her feel more full in less time. BUT (and a big but), remember that it's not necessarily strange for her to nurse that long then be hungry again in an hour! (I felt like my son nursed *constantly* in the beginning, even after we fixed the latch problem!!) Other things about the flat nipples - try to stimulate them before nursing by stroking lightly. That way she'll have an easier time right off the bat. Also, if there's a problem with letdown, try hand expressing or pumping for a couple of minutes to encourage letdown prior to putting her to the breast. You may find that helps if some of the pain you're feeling is due to the letdown reflex. (I had shooting pains with letdown for the first few weeks!) Also, this may help satisfy her more quickly - my son would gobble so vigorously to help get the letdown that it hurt! And try to put her to breast before she's frantically hungry and crying -- it can be really frustrating for her then to get a good latch and she may really *gnaw* to get that letdown, both of which will contribute to more pain. Okay, SHEESH - I sat down to jot down a couple of things and I've written a book! I'm sorry if this is all info you know or have tried already, but I empathize so much with you that I wanted to share stuff that may help!!! Breastfeeding is the most natural thing in the world, but it's a LEARNED skill for both mom and baby, and you just need the right support and encouragement to stick it out. It will get better - I PROMISE!! :-) Enjoy that baby girl, and please let us know how it's all going! Noelle
-- Noelle Haland Mama to Ethan (stillborn 12/2/96), Max (born 10/28/97)... ...and Ellie due 4th of July 1999 (a girl!) <noelleh@earthlink.net>
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