Can This Breastfeeding Relationship Be Saved?

Amalah,

I just had my first child, a baby girl, two weeks ago, and we are having some problems breastfeeding.  She tore me up in record time, to the point that the well-regarded lactation specialist at the hospital took one look and said “STOP!”  She said to only pump for four days (until my follow up appointment), at which point she said to allow my daughter to latch and nurse until the point of discomfort, and then pump.  Of course, during that time, my sweet girl got formula from a bottle (and colostrum from a syringe, and milk from a bottle once it came in).  Now that we are trying to nurse a little several times a day, she isn’t too psyched about the stationary non-rubbery nipple I keep trying to cram in her mouth.  So, at this point, I’m pumping enough that she is now getting exclusively breast milk, but… she’s getting 95% of it from bottles.  I have a very hard time getting her to latch, I think because of nipple confusion AND a tiny mouth/giant nipple combination.  We both get pretty frustrated when I try to nurse her, especially in the evening/at night.  It still hurts to nurse her – some of this I attribute to the poor latch, but even when I get her on pretty well it still hurts quite a bit more than pumping.

So, my question is…  should I keep trying to nurse her?  I have limited maternity leave – only three more weeks, and then I am back at work full time, so I will be pumping anyways during the day.  I am currently pumping every three hours for 15 to 30 minutes per session, so it’s a big time commitment (I don’t know how this compares to how much time one would spend nursing, nor if I would at some point get to cut down on the frequency of sessions).  My husband gets up with the baby at night to feed and change her, while I get up to pump.  Obviously if I could just nurse her, at least one of us would get more sleep… but I just can’t decide if it is worth the frustration?  I definitely feel sad that I am missing out on the bonding experience, that I am hooked up to my electric pump instead of gazing lovingly at my squishy newborn – but when we try to nurse, it’s more of a toe-curling, wincing experience than anything warm and fuzzy.  So I am just starting to wonder if pumping exclusively and then bottle feeding isn’t the most practical / least frustrating option.  I am wondering if I am leaving anything out of the equation?  Any guidance or words of wisdom would be much appreciated!

Best,
S

Ay yi yi, this is a tough one. Part of me wants to default to the ALL THAT MATTERS IS BABY IS FED AND MAMA IS HAPPY stance, but another part of me wants to smack your well-regarded lactation consultant sideways for telling the mother of a days-old infant to STOP NURSING ENTIRELY FOR FOUR DAYS. That’s a huge interruption, and yes, is probably directly to blame for your daughter’s reluctance to get back on the breast.

The first post-hospital LC I saw after Noah’s birth gave me similarly bad advice for my torn-up nipples/low supply problems (don’t nurse, pump instead) but that was for all of 24 HOURS until I came back in the next day. At which point I saw the other LC in the practice and sobbed in front of her because oh, I hated pumping and not nursing. And SHE was all, “oh, the other LC probably just thought you wanted a little break, but if you don’t want to do that, by all means nurse first, then pump.” So I did, but like you, I think the damage was done in even just that short window. Noah was never again going to be a patient, happy nurser. It wasn’t nipple confusion, exactly, but more like he’d figured out that there was an easier option out there, so we struggled on and off with nursing strikes and low supply (from both my boob anatomy and his poor suck) until I called it quits between five and six months. If I’d gone four days with that plan, good lord, yeah. It would have been even more of an uphill battle to get him back on the boob. I’m sorry that happened to you.

I have breastfed three newborns now, and let me tell you: My nipples bled and scabbed and hurt with every. Single. One. I don’t mean to scare any first-time not-yet-nursing pregnant women out there, but there it is. It took about two solid weeks of nursing before I could do it completely pain free. And the thing is, I always attributed the pain/bleeding to something being Majorly Wrong — obviously Noah and I had a barrage of difficulties, and Ezra had a tongue tie that wasn’t corrected until he was seven days old.

But then: Baby Ike. Who was not tongue tied or premature or high birth weight, who latches perfectly now, and gains weight just fine and is just an all-around enthusiastic, happy nurser. GUESS WHAT. It hurt at first. It hurt a lot. Those first clumsy newborn small-mouthed latches in the hospital tore me UP, and it took a full two weeks or so before I healed completely AND was at a point where we had the latching thing down enough that I wasn’t essentially re-injuring myself with his mouth. There was blood, then scabbing, and solid days where I had to brace myself and curl my toes and bite down on something every time he latched on. I even think I may have burst into involuntary tears once because it hurt so bad.

And that was all happening when everything was considered NORMAL. And FINE.

I can’t tell you whether or not you should continue trying to nurse or just pump exclusively. I can’t tell you for sure that your daughter will forget her bottle preference and move between boob and bottle with ease as long as you stick with it, because babies are wild cards like that. I can’t tell you which option will make you happier or saner because it’s different for everybody. Me? I hate pumping. HATE IT. I also hated those early painful days of nursing because yeah, who could possibly enjoy something that feels like you’re sticking a delicate part of your body into the gaping maws of a pencil sharpener?

I can tell you that for just two weeks in, you still sound pretty normal to me. Especially since you have been pumping so much more than nursing — your nipples have not had adequate opportunity to toughen up. Which they DO, eventually, as hard as it can be to believe when you’re in the worst of it. The one-and-a-half to two-week mark was very much the lowest point for me, each time, because it hurt. But then…it didn’t hurt quite as much. And then…even less. And then…not at all.

Again, this is all independent of your daughter’s latch and other extraneous bottle confusion circumstances, but still. It’s possible that her latch has in fact improved but you aren’t yet feeling it because you’re still healing from the old wounds. If you aren’t noticing those ugly dark marks on your nipples immediately after a feeding anymore, chances are her latch/mouth size problems are getting better. But it’s still normal for everything to be slowly clicking into place and for nursing to STILL HURT, this early on.

I know. Nobody told me, either. All I’d ever heard was that if it hurt, something was “wrong.” Which…yeah, maybe. Later on. But not right at first. And two weeks in is still “right at first,” in my book.

Obviously, plenty of women pump exclusively — and yeah, with your short maternity leave it’s GREAT that you have a good pumping routine established and are secure in the fact that your daughter will accept a bottle during the day. But if there’s even a twinge in your heart that worries you’ll regret giving up actual nursing entirely…it seems to me that two weeks postpartum is a little premature to make that call. I mean, it would be FOR ME, personally, because now I know my own breastfeeding learning curve and have come out the other side successfully with both Ezra and Ike. And it’s great. It really, really is a wonderful thing and I am totally that cheesy dolt who will talk about how much I genuinely treasure the experience blah blah SHUT UP.

With Noah and Ezra, since I was working from a bad first experience, I set very small goals. Nursing for three weeks was the first, since that gave me time to get past the torn-up toast-point nipples and toe-curling pain. Then I aimed for six weeks. Then 12, and so on. Since things weren’t ideal with Noah, I told myself I was allowed to reevaluate whether I wanted to continue at each mental goal point. And then I was pleasantly surprised when I’d hit that marker and realized how much better it was consistently getting (even if we weren’t “exclusively” nursing like I’d hoped). With Ezra, once I hit six weeks, I realized I didn’t even need to set another goal, because we were fine. We were NOT fine at two weeks (pain-wise, anyway; my supply was fine), we were better at three weeks, we were golden by six. With Ike I didn’t bother with the goalposts at all, but that’s the luxury of experience — I know it would suck at first, then suck less, and then be worth it in the end.

So I don’t know…I’m worried I sound like I’m trying to twist your arm here and pressure you to keep going, but I swear that’s not my intention. And I also realize that MY experiences are not like, some kind of universal one-size-fits-all experience. But I do know that if I thought breastfeeding was always going to be like it was at two weeks in, I would have drop-kicked the whole concept out the door and grabbed the Similac. But it wasn’t. It isn’t. Do with this information what you will, and what you feel is right for YOU.

In the meantime, if you DO decide to keep trying, I found a few things that really, really helped with the boob pain:

1) Soothies Gel Pads by Lansinoh: Lanolin cream is great, but when you’re really torn up or chafed, these pads protect you from bra friction and the comforting “feeling” last longer than the lanolin. (You can also store them in the fridge or freezer for even more relief.)

2) All-Purpose Nipple Ointment (APNO): This requires a prescription and a compounding pharmacy, but it’s worth hassling a pediatrician, OB or a nurse practitioner (my LC was one) for it. SOOOOOOO much more healing power whallop in this stuff than plain lanolin, plus there’s an anti-fungal AND an anti-inflammatory in it. If your health care provider stares at you blankly, print out the linked article and/or ask for the following prescription: Mupirocin ointment 2%: 15 grams, Betamethasone ointment 0.1%: 15 grams, add to miconazole powder to a concentration of 2% miconazole.

Fabric/reusable nursing pads: I’m actually not prone to too much leaking, but when it happens, it’s ALWAYS been in the first few weeks after my milk initially comes in. I always thought washing nursing pads sounded like a ginormous pain, so I used the disposable kind for both Noah and Ezra. Now that I’m all weird and cloth-diaper-y and stuff, I bought some cotton ones in preparation for Ike. Duh. Sooooooo much more comfortable on sore nipples than the scratchy paper kind, and just as easy to wash as like, anything. Wash ’em with your bras, or whatever.

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