Pain Pain and More Pain

[riuliani]

I have lots of questions and issues with the breastfeeding.  However, my most important concern is the continued pain.  I have seen a lactation nurse and had a public health nurse out to the house to work with me and my son on latching.  From a visual perspective he looks like he is latching well.  His lips are well flanged.  However, he is a snapping turtle.  I believe he is doing more biting than sucking.  I don't think he has the nipple far enough back in his mouth.  I am not worried about his food intake since he is gaining weight nicely.  However, it does take him 30 minutes or more to feed and I usually have to pop him off.  He is 7 weeks old.  I was told after six weeks he should have it all figured out and the pain would stop.  Any suggestions or tricks that may be able to help me?

[nickaucher]

I would ask the doctor/ lactation consultant about the symptoms of a yeast infection in the nipple.  This can cause a lot of pain.  I know some of the symptoms include shooting pains in the breast that continue after the feeding is done.  Or a feeling like glass is cutting you during a feeding.  There are others signs, you should ask just to rule it out.  It can be treated by several methods so this should not stop you from breastfeeding.  Good Luck.

-Nicole

[First Time Mom]

My dd had a great latch according to the nurses in the hospital and home visit but I was in great pain in the beginning and had bleeding. I found the pain took longer to go away because of the constant latching, lansinoh helped in my case. What made the pain much worse for me was that I was not de-latching my lo correctly, I was practically pulling her off so if you are taking you lo off the breast make sure you do it properly by inserting your pinky to break the suction off.

Good luck to you and keep up the great work, once you determine what's causing the pain bfing will be a breeze and you will be glad you made the choice to bf your lo.

[linfran]

Same thing happened to me - son had a great latch, but I think it was too great and my boobs ended up like windsocks (TMI, sorry!).

I found by changing hold depending on which side he was on helped - rugby hold worked good for us.

[Samuel's mum]

I don't think he has the nipple far enough back in his mouth.

A couple of quick questions?

Do you think you might have flattish nipples? There is a little bit of 'preparation' you can do to them before a feed if that's the case.

I'm assuming you've been told he isn't 'tongue-tied'? It comes in degrees. He could have a slightly short frenulum.

Well done for keeping going. You're a star.

However, it does take him 30 minutes or more to feed and I usually have to pop him off.

A 30 minute feed wouldn't be unusual at his age. It depends how much longer it is. Also some babies like to suck for comfort so don't always volunteer to come off!!
I think weight gain and wet nappies are the main reassurance for you.

[riuliani]

Thanks for all the info.  We just had our check up with the doctor, so I don't believe thrush is a problem.  A girlfriend is currently dealing with thrush, so I am pretty confident that I am fine.  We did have him checked for a tongue tie but he is all good.  I am very persistent in delatching properly.  He has a tendency to startle himself and yank away.  As a result, I am very familiar with the pain of an improper delatching.  I don't think I have flat nipples but I definitely find they are not as protruding as they probably could be.  They tend to be quite soft, which doesn't help him.  I try to stimulate them to give him something more to pull into his mouth but I have trouble.  Maybe there is some other way to do this?  I have also watched several videos of babies who open very wide and protrude their neck to get their latch.  He doesn't do this.  Is there some way to force him to open wider?  I think this would help to make sure he is getting more areola and less on top of the nipple.

[Samuel's mum]

in the nipple department, I am also slightly less 'perky' than some. Although there is some controversy with this next suggestion - I had great luck with some advice I was given by a midwife (and a friend with a 2 week old was just given the exact same advice in hospital) to use your finger and thumb to compress the around areola slightly into a flatter shape and more of the breast can be jammed in. Then once latch has been achieved, gradually move your fingers away and hopefully more of the breast will stay in.

It's also described here in this extract from the Sears site (not all BW friendly on that site)
"Make" a nipple. Use the "breast-sandwich" technique to get more breast tissue into baby's mouth. Hold your breast well back on the areola, with your fingers underneath and thumb on top. Press in with thumb and fingers while at the same time pushing back toward your chest wall. This elongates and narrows the areola, which enables baby to latch on more easily.

With flattish nipples many pump for a few moments before moving to latch on the baby or even use a syringe to pull out the nipple (it's useful for everyone from fully inverted nipples to just the less perky): 

Again from the Sears site:
You can also purchase a device specially designed to draw out an inverted nipple before feeding the Evert-It Nipple Enhancer , or ask a nurse or LC to help you make your own with a 10 cc disposable syringe. Remove the plunger, and with a sharp knife cut off a half inch from the nozzle end. Insert the plunger into the cut end of the syringe. Place the uncut open end of the syringe over your nipple so it rests up against your areola. Gently pull on the plunger to draw out your nipple just before putting baby to the breast

Part of the trick of the wide gape is to get the baby on fast. If you ever do see a wide gape (perhaps after you've tickled his nose with your nipple or use your nipple to tickle baby's lower lip ) you put him on fast before it goes.

[jbepko]

I would also try PP suggestion about different nursing positions- football hold, lying down, sitting forward.

[cathbilson]

I'm sure some people will disapprove of what I'm saying, but it worked for me, okay, so please don't have a go at me, I'm jsut trying to pass help along.
I too have flattish nipples, and quite large breasts which early on swelled up like melons. My son had slight tongue tie which all contributed to a major latch-on struggle. As the lactation consulatant put it 'he's trying to suck a pimple off a football!'. She recommended a nipple shield. This goes on over the nipple and has 3 or 4 small holes in it which the milk can pass through. It worked BEAUTIFULLY. After a couple of weeks my engorgement reduced and I was able to feed without the shield, but then a couple of weeks later DS seemed to find his strength and started pinching really hard, hurting a lot when he fed. I went back tot he shields and again the problem went away. We're back without them now.
Some people may tell you this will lead to nipple confusion. Since you say you're already giving EBM (our of a bottle, I presume!) and breastfeeding, I doubt one more nipple shape will matter.
Might be worth a try for you.
Best of luck,
Cath