Kickstarting Breastfeeding Questions

[~Sara~]

DD is 3 days old, has pretty much been breastfeed save for the first 12h after birth (I'd had morphine) and maybe 3 other times when I just needed some major sleep.  My milk has now come in with a vengence and I have a couple of questions:

1) the engorgement pain from my milk just coming in is normal, right?  My breasts and nipples (they're cracked, extremely sore, and bleeding some) are so not used to this that I want to make sure it's not mastitis or a plugged duct.  For a timeframe reference, my milk came in early this AM, about 9 or so...so I've only felt this engorgement for ~9h.

2) Since my breasts are so engorged, do I still feed one side only?  DD is lasting a really long time with one-sided feeding already and can easily go 20 minutes on a side now that my milk is in.  She normally pops off when she's done.  I just want to make sure that my body doesn't make TOO much milk (though it's not getting that signal now ) because I'd like to only do one-sided feeding if possible, and offering a top-off from the other side; as opposed to her needing BOTH full sides to be full.

3) At night, should I let her go as long as she wants in between feeds?  Or should I keep waking her to every 3-4h (or sooner if she wakes on her own)?

TIA!

[Love, laughter, & PJs]

Congrats, Sara!

1)  Yep.  Totally normal.    Most likely, anyhow.    Cracked nipples are sooo painful.  Are you putting lanisoh on them?  That helps a ton.  Mastitis you usually see an area of redness and the breast itself is tender.  Are you having that?  Any focal pain or just discomfort when she latches?

2)  It's totally fine to do 1 sided feeding for now.  I did it for months with both.  As long as she's having enough wet/dirty dipes I wouldn't stress and just follow her.

3)  Depends who you ask on this one.    I usually wake by 4h at this age just to really help supply be established, plus if they go too long between feeds they can get so frantic when they do go to eat that they can't latch, poor things.  But some say to let them go longer, even 5 or 6h so I don't think there's a consensus, really.

Hugs!  Did you not BF A?  If not, welcome to the wonderful world of BFing!!

[Erin M]

Congrats sweetie and welcome!

1) I would say that the cracks and bleeding can be normal, but maybe not -- do you know you have a good latch?  Have you see this FAQ: http://babywhispererforums.com/index.php?topic=70305.0  There's some good links in there with videos for latching so you can make sure you've got that latch right.  You can take ibuprofen while BFing and use some ice too, it will make the pain less.

2) ITA with Kate

3) I never woke any of mine, but they woke at the 3/4 hour mark for the first few weeks anyway (or months in the case of ds). 

[~Sara~]

Thanks for the responses, gals.

The engorgement has gone down drastically--thank goodness!!!  There are still some tender spots on both breasts that don't ever get completely drained, but I think that's okay because they're still trying to regulate exactly how much she eats.  I've only been feeding on one side.

Last night and tonight, I've not been able to figure out a cluster feed so she's woken up a lot.  It's been pretty brutal...and I know that she's less than a week old.  But, baby blues have also hit and I'm questioning as to whether or not I even want to breastfeed.  I go back to work in 2 months and won't have anywhere to pump, so she'll have to be formula fed by then.  Plus, I don't know if I'm really one of those moms who enjoys breastfeeding.  I did bf Aaron mostly for the first 3 months of his life, but an antibiotic killed my supply and he was fully on formula since then.  I don't feel guilty about it at all, but I feel like Madeleine deserves at least the same.  I dunno...it's been a rough day today and I'm just trying to think about what works best for us as a family and what we all can cope with (sorry, that ended up being a lot like a Couch post ).

[Erin M]

((((hugs))))) sweetie.  Those first few weeks are really, really tough and the fact that your hormones are all over the place doesn't help one bit.  My guess is at this point, she'd be waking up a lot no matter what you fed her, I would just do whatever you have to in order to get some full feeds into her at night (nursing the baby when he was only wearing a diaper was what I had to resort to often with my ds) so she'll try to stretch out a bit.  I'm convinced that James was also day/night reversed those first few weeks as well, he was so hard to settle at night and just wanted to sleep the day away.  Cluster feeds are tough too - dd1 just naturally cluster fed, I could never get dd2 to do it and ds was just so fussy in the late afternoons I would just feed him to keep him quiet. 

Keep an eye on those baby blues, you know where to find help if you need it!  We're here, holding your hand no matter how things go.   

[nona]

((hugs)) sara

breastfeeding can def put you over the edge! have you had someone check her latch?

i would take one day at a time, then a week at a time.....

with DS, i did better on a schedule than demand feeding bc then i was feeing ATC like a crazy person. I fed DS every 2.5-3 the first week pretty much all day. After he gained all his weight back & some (he barely lost any), i tried to stretch it out longer at night (is his sleepy phase) and did q3 during the day.I clustered at night @ 7, 9 & ?. (its been awhile but i followed a schedule in the BW book).   have you tried giving her a pacifier?

If you dont' want to deal with BF, have you thought about  just pumping (you can rent a pump) and giving her bottles?

it is so hard in the beginning.....

[Love, laughter, & PJs]

Hugs, Sara.  The early days are SO hard, aren't they?  It's also hard to like BFing when your boobs hurt and your nipples are cracked!  Totally get that.

I totally agree that you need to do what you can do, but every day of BM she gets is beneficial to her in the long run so I also agree to take it 1 day at a time if you can.  I don't know how comfortable you would be with this, but have you tried taking her into bed with you?  I find that when they're tiny I can just nurse and sleep and that makes things so much better. 

Major hugs.  We're here for you, hon.

[Mrs Coops]

Firstly Sara many congratulations on your new arrival  

Having experienced cracked and infected pus oozing nipples I can say first hand cracked bleeding nipples is not normal. I would definitely get your latch checked as even a tiny tweak to her latch can make a huge difference.

The engorged feeling does ease, I found it easier second time as I just shoved DS on whenever he so much as blinked! It certainly explains why he gained 1lb in a week

With single side feeding there is a risk that she's only getting the fore milk and not the satisfying hind milk. You can try doing 2-3 feeds from the same side ensuring that each breast gets drained completely at least once. This may also help clear any back up. But there's a risk the other breast will become engorged. I got around this by just letting the other boob drip freely into a cloth or towel during each feed. Obviously something you can't do in public

Wow you return to work early, are you ok with that? Sometimes the added pressure of work adds to already upset emotions and raging hormones.

With work you can wean the day feeds but keep the night breast feeds going, then she gets the best of both!

{{{{big hugs}}}} hope things improve soon. x

[~Sara~]

I'm convinced that James was also day/night reversed those first few weeks as well, he was so hard to settle at night and just wanted to sleep the day away.

Yes, that sounds like M!  She sleeps like a dream during the day, which is great as I can spend lots of one-on-one time with Aaron to help him adjust to this new life and have had ~1h to myself during the middle of the day (yesterday, I got a NAP!!).

have you had someone check her latch?

No, I haven't; but thankfully the bleeding nipples has stopped...that helps me to really focus on her latch.  We've had 100% spot on latches twice: once yesterday afternoon and then again tonight.  I think the problem is that she's still just so little that as her mouth gets bigger, well, things will get easier...let's just say it that way   I'm working on it, slowly but surely   I'll give my BBs some more time to heal and if I'm still having issues, yes, I will talk to someone.

With single side feeding there is a risk that she's only getting the fore milk and not the satisfying hind milk.

Her feeds are about 30 minutes long each, and she's a really good sucker...I'm pretty convinced that she's getting the hindmilk as she seems to last a full 3h in between feeds and is back to her birthweight after only a week.  Those are good signs, right?  I mean, my milk is fully in, so I think I'm good there.

Wow you return to work early, are you ok with that? Sometimes the added pressure of work adds to already upset emotions and raging hormones.

I'm not okay with that, but then again, I didn't want to go back to work in the first place--it was out of necessity.  I'm hoping that I don't have to go back to work after all...we're waiting for some things to come together.  But, yes, having that in the back of my mind definitely affects me.

Overall, I am just taking things one day at a time.  My engorgement has gone down drastically during the day today: I am so, so, so thankful for that!  It's only at night, when she doesn't eat as much, that things really hurt.  That engorgement should go down, too, right?  Like my supply will anticipate not feeding as much at night?

[Love, laughter, & PJs]

I'm pretty convinced that she's getting the hindmilk as she seems to last a full 3h in between feeds and is back to her birthweight after only a week.  Those are good signs, right?

Definitely. 

That engorgement should go down, too, right?  Like my supply will anticipate not feeding as much at night?

Absolutely.  Things will even out over the next couple of weeks. 

Hugs.  Sounds like things are settling out! 

[Erin M]

Sounds like you're doing great! 

One day at a time is a very, very good way to do things in the beginning!

[nona]

yea, great update

[Mrs Coops]

{{{hugs}}} for the pressure about work, I hope you can get longer off.

Yes the nighttime engorgement will ease, it just takes time to settle down into a routine.

3 hours between feeds is great, she's most definitely getting the nice rich stuff.

Things will improve every day as your nipples heal and she gets bigger.

You're doing a great job.