I would love to be able to breastfeed, but don't feel very optimistic. Help me!

[DJs mummy]

I'm nearly 20 weeks pregnant so obviously still have a while to go but feeding is playing on my mind a lot already so I thought I'd post sooner rather than later.

So this is my situation in a nutshell:

- I produce a LOT of milk (all have been c sections but milk has come in by day 3 each time I think)

- First time, I managed to feed for 3 weeks.  First week was kind of ok, then it just got worse and worse (pain).  Kept being told latch was fine.  Tried different positions.  Tried nipple shields.  Got to the point where my nipples were literally falling off me   My left nipple has never quite healed properly.  Had to stop as I just COULD NOT bare to have ds get even close to latching anymore.  As soon as he started waking and wanting a feed I'd be crying and dreading it.  I stopped all at once.  Milk took a while to stop - had to wear about 6 breast pads in each cup as I literally just poured milk! 

- Second time, tried again and by day 2 I was in horrendous pain again.  Kept being told latch was fine etc, but I just don't know.  I can't say I ever felt like the midwives really knew what a correct latch was    Kept asking to see lactation specialist in hospital, but kept being fobbed off   Then it was the weekend and they don't work at weekends (in the hospital)!  In the end had a day or two rest and then switched to expressing.  I managed to keep this up for 6 weeks, expressing all Dd's feeds.

-Third time, tried again.  Dd latched on about 45 mins after birth.  Fed for about 20 mins and when she came off I was bleeding   Tried for about 24 hours but it just got worse.  Tried pumping (so painful I was beside myself crying etc...)  In the end one of the lactation specialists advised me to stop.  She concluded I'm just highly sensitive

-So here I am again thinking about what my forth experience may be like.  I am prepared for it to possibly not 'work out' again, but I just want to do all I can to try and make it successful this time.

I'm not even particularly worried about feeding for months.  Even just a few weeks would be considered success.  My third baby (who I only really managed to feed for about 2 days) ended up getting meningitis at 5 weeks old and obviously I've blamed myself for that   I know she prob would have still got it even if I'd been breastfeeding but I just felt responsible etc... (She was fine by the way - no long term affects at all )

One thought I had was - would it be worth trying using nipple shields from the very outset?  How much will this affect my milk coming in?
Is there anything I can do to 'toughen myself up'  before baby arrives?

Any advice would be brilliant.

Thanks x

[Erin M]

would it be worth trying using nipple shields from the very outset? 

This is actually what I was thinking as I read your post.  I can't be sure, but since you say you produce a lot of milk, it probably wouldn't hurt.  After all, people are able to establish their supply by exclusively pumping in some cases, why not with just nipple shields.  My best advice to you, would be to use the next few months to find a LC now, one that is sympathetic to your situation and knowledgeable -- and will be able to support you in the early days and perhaps before starting.  Not sure where you are, but I would think you could contact your local LLL group to see if you could find a recommendation, or some sort of bfing support group. 

[C&B&E]

I wonder if it might be worth contacting a breastfeeding specialist to chat to in advance?  I notice you're in the UK - do you have any breastfeeding groups near to you? 
Both of my lo's had tongue ties - extremely painful to feed, chunks of nipple falling off after 24 hours, etc etc, and both had to have their tongue ties snipped when they were 1-2 weeks old (which I had to arrange myself as the midwives at the hospital assured me that their latches were fine and there were no problems...which was *completely* wrong, later confirmed by a breastfeeding counselor).  Were your lo's checked for tongue tie? 

Another thought might be whether it is worth expressing the week before your baby is due?  I know there are different thought about this, but my sister is a neo-natal nurse and she suggested it to me with my second lo as then there is less pressure to formula feed if things aren't going well for the first 48 hours.  Might be worth exploring 

[SILLYFACE]

Oh bless you! It can be so tough at the start and you are so brave to consider bf for the forth time with such hard experiences.
I would find all the contacts possible now. The hospital will have an infant feeding advisor and if you are in the UK that is who you need to locate. The 'big boss' of the midwifes. I found this out 4 months into a very difficult start, so the more research you do now, the better start you can have.
Nipple shields are used by loads of ladies, and if your nipples are damaged, they many be the answer.
I'd definitely get the midwifes to do a check for tongue tie straight away.
I wont go into the obvious with lansinoh, compress etc, but a breastfeeding pillow does wonders for positioning. Not to name drop but 'My Breast Friend' is so comfortable and I found it made a huge difference when I was trying to increase my supply.
Good luck hun xxxxxxxx

[~inbalance~]

I wonder if it might be worth contacting a breastfeeding specialist to chat to in advance?

I was going to suggest this as well.  See if you can have the support in place before the baby is born.  After I had my DS1 and BFing was so hard that first week, we finally got a proper LC to visit when he was a week old and she was FAR better than any of the midwives, doctors or nurses I had seen previously, and I was kicking myself for not speaking to an LC BEFORE he was born (but I naively thought BFing would be easy! )

Hugs.  I remember going through horrendous pain and even some bleeding the first few weeks with all my LOs.  This past time it was so bad that I was certain her latch was wrong, but it wasn't.  It just took a few weeks to get established, but once we did things were fine. 

[DJs mummy]

My last section I particularly planned for it to be on a monday so that I'd have the chance to see the LC whilst in hospital (baby number 2 was born on a thurs and then, as I said, the LCs didn't work weekends so by the time I'd been fobbed off for 2 days I was kind of already too late!)

With my second I was in tears by day 2 and I remember going to the nurses station and asking to speak with a midwife.  A midwife came to my bed to chat with me.  When I exlained the pain I was in she asked if I'd had the same problems last time.  When I said yes, believe it or not, her response was 'well why are you trying again then?'!!!  Nice one!

With this being my forth section I'm kind of considered high risk and I'm very hesitant to start expressing before baby's delivered in case it starts me off in labour and I end up with an emergency section which would not be good.  I had been thinking about that though.  Kind of makes sense if it weren't for the fact I really really DO NOT want to start labour off!  (Am I right in thinking it would possibly induce labour or have I got that wrong?)

[becj86]

(Am I right in thinking it would possibly induce labour or have I got that wrong?)

It can, but I'd do a little more research, as I think there has to be a certain amount of stimulation for that to happen. I read about it as I was going to express colostrum for any future baby from about wk 37 of pregnancy so if it did induce, it wouldn't be so bad but in case I got sick again that LO wouldn't have to have medicine-laced milk. Do you leak at all during pregnancy? I know I did - could you collect a little bit of leaked colostrum in a shell and store it?

Having lost chunks of nipple early on and gotten the help I needed to continue long term (props to you for sticking with it and going again!), it does get easier once you find a way to get LO to latch properly. DS latched painlessly for the first time when I tried baby-led attachment - I let him latch, just lay in the bath with him on my chest and let him nuzzle around til he found the nipple and latched in his own time. It hurt where the tears were initially but after 2 sucks, it didn't hurt and for the first time I could BF him without excruciating pain. 

With your history, I'd suggest considering expressing and bottle feeding or using nipple shields from the beginning (I lost the largest chunk of nipple through a shield though... so they're not the be all and end all of nipple protection) and slowly adding breast feeds in at times when your supply is lowest so LO learns to latch and feed without a large stream of milk squirting down his throat, as happens with oversupply/overactive letdown. DS had a shallow latch to cope with the flow of milk.

[C&B&E]

With this being my forth section I'm kind of considered high risk and I'm very hesitant to start expressing before baby's delivered in case it starts me off in labour and I end up with an emergency section which would not be good.  I had been thinking about that though.  Kind of makes sense if it weren't for the fact I really really DO NOT want to start labour off!  (Am I right in thinking it would possibly induce labour or have I got that wrong?)

Yeah, I didn't do it either as I was having a planned section and was worried too.  But in hindsight, I wish I'd've done more research and done it  !  I found it hard to find out information about it - but you have lots of time to research and you could ask a couple of midwives to get their opinions. 

[*Ali*]

Huge hugs and kudos to you for trying again.
I was also thinking about suggesting you use nipple shields from the outset whilst reading your post.
I think getting specialist help before and immediately after the birth will also be key.
Good luck.

[Fiver]

As I was reading, tongue tie was also screaming out at me (possibly posterior ones that are harder to spot).

Definitely try to find your local BF support group, whether that be a LLL, ABM or NCT group.  If they don't have one onsite, they should be able to point you in the direction of a BF counsellor or LC.  Also, don't forget the phone helplines run by these groups, too.  If you phone from a normal landline and don't have your number blocked, the idea is that you are put through to a BFC in your area who, if they can't help over the phone, may be willing to come out and see you.  All the phone numbers are in the IRL help FAQ.  A good BFC/LC should also be able to identify a TT and arrange to have it divided for you.  If you can get along to a group while you're still pg, they should have a supply of Lansinoh samples that they can give out as well (bonus!)

As for expressing antenatally, there are a good number of diabetic mums now who harvest colostrum in the later weeks of pg and freeze it in case their LOs have problems with low blood sugar and also LOTS of mums now who tandem feed.  As I understand it, the suggestion for inducing labour is connected with nipple stimulation.  If you're hand expressing colostrum into a closed cap syringe (you wouldn't use a pump due to the small quantities involved) you're unlikely to be twiddling your nipples (also, I've been told it takes many hours of this to make that much difference!!)

If it helps with the decision, I expressed some colostrum for the reasons above.  I had a planned C/S for DS and a VBAC for DD.  I went into labour at 38+2, the day before DS had been delivered by section.  Obviously I can't say for sure that the expressing didn't make a difference, but my suspicion is that my uterus knew when it had expelled previously!!

You can do this!  Don't let the MWs fob you off with "the latch looks ok".  If it hurts, the latch can be as ok as you like, but there's obviously an underlying issue.  A good BFC will help you investigate what that is and how it can be fixed.  That may be nipple shields for a while, checking/rectifying a tied tongue or just tweaking positioning and attachment.

*hugs*