Chomping

iVillage Member
Registered: 01-27-2012
Chomping
9
Fri, 10-12-2012 - 1:27am
LO will be 3 weeks old on Monday. I had bloody nipples with open sores, so the hospital had me trying everything: Primargan supplement, pumping and bottle feeding (and using oxytocin nasal spray), nipple shields, and feeding through the pain that was comparable with labor at times.

The wounds have mostly healed but there is still pain and each time we nurse, her top gum seems to saw into my nipple - I now have a groove and gaps of nipple missing on both sides. I'm guessing we had a latch issue all along and the hospital simply medicated the ill effects. Nevertheless, we get in around 12 feedings - using pumped milk or formula for the two evening feedings as she seems totally unsatisfied with my milk at that point.

How can I fix her latch so she feeds effectively and less painfully? There appears to be a shortage of lactation consultants in my area - I haven't even been able to get one on the phone. The nearest La Leche Liga is over 1.5 hrs away. :-/

LO will try to use her hands to grab the breast and latch on how she pleases, so the first struggle is getting her arms out of the way while she fusses and throws her head in all directions.(She is already able to lift and turn her head both on her back or tummy.) The next struggle is getting her to open her mouth wide enough. She never keeps it open for more than a split second, and in her rush, she ends up with my finger (located about 2 inches away from areola), breast but no nipple, just nipple or latches but then slips immediately. All of these end with a chomp to hold my nipple in her mouth most likely. Eventually she latches but she continues to use her gums as she sucks - this is my biggest concern because the longer I nurse, the more my nipples suffer. I'm also getting clogged (I massage them out nearly all day) as well as what feels like severe chafing.

Thank you in advance. It's such a relief to have found a board like this!

PS - Current schedule is 20-30 min one side every 1-2 hrs during the day with a couple 3 hr gaps mostly mornings and sometimes a 4-5 hr gap at night after a bottle feed. Lately she has been spitting up a few spoonfulls after most meals. She's also on saline nasal spray for congestion that has her breathing through her mouth at times. :-(

- JM

Community Leader
Registered: 06-10-2008
In reply to: txdela
Fri, 10-12-2012 - 8:22am
Welcome to the board!! I'm just curious where you live (general area)?
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iVillage Member
Registered: 12-21-2009
In reply to: txdela
Fri, 10-12-2012 - 11:06am

Oh my goodness, I’m so sorry you are in such pain. It’s very challenging to help with a latch online but we’ll give you all we have. Would it be possible for you to travel to a larger city to see an LC? Call the La Leche League that is 1.5 hours away and ask them if they know someone closer to you or even someone experienced who could help if you can travel. Maybe there is a middle point where you and the LC can meet. When I did home visits it wasn’t uncommon for me to travel an hour to see moms.

First I want to reassure you that the kind of pain you describe is not considered ‘normal’. I don’t want you to think you should just feed through the pain.

If you are already using bottles some mothers will take what we call a ‘breastfeeding vacation’ to allow the nipples to heal. If you are going to do this you need to pump with a very high quality double pump. Ideally you need to pump at least 9-10 times per day.

Can you tell me what type/brand of pump you are using and if pumping is comfortable?

How much are you breastfeeding at this point vs using bottles? How many oz of expressed breast milk to you give each day and how much formula?

Here’s some information for you to get you started:

How do I know my baby is latched correctly:

http://www.ivillage.com/breast-feeding-latch-information-ivillagecom/6-a-127400

Description of latch:

http://forums.ivillage.com/t5/Newborn-to-6-mo-Questions/Description-of-latch/m-p/116388185/highlight/true#M129660

I think it’s important to take the baby off the breast when there is pain. When you leave the baby on the breast when there is pain the baby learns to keep doing whatever it is that is painful. I agree with you that it may be mostly or completely related to latch. Babies often clamp down on the nipple if the latch is shallow.

Of course now that your nipples are so damaged it’s unlikely you will be immediately comfortable even with the best latch. Usually I describe it like this. If your current latch pain is 8 out of 10 (10 being the worst pain you can imagine) and the feeding pain is 5 out of 10 you should notice a distinct difference if you improve the latch but not perfection. So you may notice that with a better latch you might notice a 6 with latch and 4 with the feeding.  Every day it should be a bit better so the first day might be a 6 and a 4 but the next day or in 2 days possibly a 5 and 3. The pain level should gradually reduce every day or so eventually going totally away. If the pain level stays the same or increases either the latch is still off or something else is going on.

In addition to what I linked you to above you might also try the ‘laid back’ position. Sometimes this really helps the baby to help you with latch and it also helps keep the baby’s hands out of the way.  To do laid back, just recline, like you would in a reclining chair. Hold the baby tummy down on your body, head near your breasts, and feet going down toward your feet. Position him with his nose near your nipple. Often the baby will push up with his hands and open very wide and almost latch himself. This position actually fosters the wide open mouth and helps the baby keep the hands out of the way. If the latch is very painful/pinching remove the baby quickly and try again.

Does you nipple come out of the baby’s mouth shaped like a new tube of lipstick/pointy?

Nipple soreness:

http://parenting.ivillage.com/newborn/0,,8znxl4pf,00.html

I also want you to look at this information to clarify that it’s really important not to judge if the baby is getting enough milk by his behavior. Babies are commonly fussy in the evening and want frequent breastfeeding sessions. Here’s more

Is my baby getting enough milk?

http://parenting.ivillage.com/baby/bbreastfeed/0,,8rr83zjm,00.html

Why is my baby fussy, and what can I do?

http://parenting.ivillage.com/newborn/nbreastfeed/0,,8znwfldp,00.html

 What's a normal breastfeeding routine?

http://parenting.ivillage.com/baby/bbreastfeed/0,,8n69dpmw,00.html

After, you read through the links please get back and let me know what you think and answer the questions if possible.

Kathy Kuhn IBCLC

iVillage lactation consultant

and Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas and Charlotte    

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 01-27-2012
In reply to: txdela
Sat, 10-13-2012 - 6:19am
Thank you so much!! I have lots of links to read! The closest large city is Muenster, but it appears their group is no longer active. I'll try to contact someone in Essen for a referral.

The pain has improved drastically, but it appears I am now producing too much milk possibly - I always try to get my nipples out best I can but letting Valerie try to find a latch that works for us both seems to be the best temp solution - yes, I always get lipstick shaped (or even 'flat') nipples. We're doing 10-12 breast feedings a day, and I've pumped around 100 ml (3 oz?) for her "midnight snack" at fussy time. Today I'm going to try not pumping and see how it goes. She seems muuuuch easier going so far today - I really put in the hours yesterday, though. ;-)

At the hospital, I used the Medela Symphony II and did a "vacation". LO came at 38w, so pumping hurt then too. It still is uncomfortable, but the Philips Avent hand pump actually feels better to me! I've just been using it to relieve pain when my breasts get hard spots.

Thanks again - I've been reading your other posts too and they've been very helpful. In fact, that was the whole reason I even suspected a latch problem as the nurses and midwife had said my latch was great!

- JM

iVillage Member
Registered: 01-27-2012
In reply to: txdela
Sat, 10-13-2012 - 6:34am
PS - How do I wait for a yawn if she jumps at the nipple herself? It looks like a shark attack.

- JM

iVillage Member
Registered: 01-27-2012
In reply to: txdela
Sat, 10-13-2012 - 4:34pm
She definitely prefers to latch on in the laid back position! That pretty much solved the shark attack latch. ;-) We had no issues the first time but after that, we started having issues with the nose being buried and not being able to breath as well as the likely related issue of tucking her chin into her chest. Is there a common cause for this?

The scale shows she's gained 100g, so that tells me she's getting at least the same amount as before but in half the time - most of her sessions are now 15-20 min instead of 25-35.

I noticed the tops of my nipples turning white - is that blistering? Is there a way to avoid them?

Thanks again!

- JM

iVillage Member
Registered: 12-21-2009
Sat, 10-13-2012 - 8:18pm

How wonderful you’ve been able to improve the pain. Whatever your pain level is at this point try to remove the baby quickly if she gets on and it’s more painful. You should notice some improvement each day if you have ‘fixed’ the latch. If the baby latches herself and it is painful, remove the baby quickly by putting your finger between the baby’s gums. Read and re-read the posts on latch. A key aspect is aiming the lower lip at the edge of your areola, or at about one inch from the base of the nipple. Then wait for the baby to open wide she should reach up for the other side of the nipple with her upper lip. If a baby is latched well the lower lip is further away from the nipple and the upper lip is closer.

The pump should not hurt. Is the flange size correct? Your nipple should not be squished inside the flange. It should fit in the way my wedding ring would fit if I moved it to my littlest finger. There should be some air space around all sides of the nipple. The symphony…….all the Medela pumps have different size flanges available.

Also be sure you don’t have the suction too high. There is no advantage of turning the suction up high. Keep it at a level that is comfortable.

Kathy Kuhn IBCLC

iVillage lactation consultant

and Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas and Charlotte    

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 01-27-2012
In reply to: txdela
Sat, 10-13-2012 - 9:12pm
Oh wow - all of the pump flanges I've used so far fit more like a glove and rubbed on all sides!

The chafing was a bit much, so we gave her the 100 ml I pumped this morning. Earlier today an unfortunate chomp also set me back pain-wise - I'm at the point where I'm scared of the latch pain even though we had a few good sessions.

Thanks so much for your help and the such quick responses!

- JM

iVillage Member
Registered: 01-27-2012
In reply to: txdela
Mon, 10-15-2012 - 12:08pm
The sucking pain seemed like less but my nipples are turning white with blisters and the left one broke open at the tip and is bleeding. :-(

- JM

Community Leader
Registered: 06-10-2008
In reply to: txdela
Thu, 10-18-2012 - 10:08pm
Ouch!! That sounds really painful! Blisters and bleeding nipples are definitely NOT normal. Can I assume you're having a lot of pain while nursing? Are you still having pain while pumping?
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