Breastfeeding help for two month old
August 25, 2013 4:35 PM   Subscribe

I've looked at the archives but couldn't find much specific to my situation. I have been breastfeeding my nine week old since he was born, but recently things have gotten more painful. It's never been easy or pain free, but lately nursing has resulted in so much bleeding that my poor little guy is spitting up pink/red after a feeding. I have four days left of maternity leave and an appointment with my OB in two Thursdays, but is there anything I can do in the meantime to make feedings a little less upsetting for both of us?

What I'm doing now:

Lanolin before and after each feeding.
Soothing gel pads.
Hand expressing briefly before feeding to avoid super heavy letdown.
Occasional crying and swearing.

There are no visible cracks in my nipples and I don't see any signs of thrush. Please, tell me there's something else I can do or that we'll turn a corner soon. I keep thinking things are getting better and then they get so much worse. I have a decent freezer stash if I need to dip into it. I love nursing aside from the pain and my boy's upset tummy from the blood - I just want to enjoy the rest of my leave!
posted by House of Leaves of Grass to Health & Fitness (26 answers total)
 
have you tried using nipple shields while nursing?
posted by bq at 4:38 PM on August 25, 2013 [3 favorites]


Have you spoken with a lactation consultant? I'd call the hospital where you gave birth or just your local one and ask for help.
posted by cestmoi15 at 4:39 PM on August 25, 2013 [3 favorites]


Get thee to a la leche league post haste. Or maybe your doc has a lactation consultant. Demand to be seen by someone on Monday. This can be fixed whatever it is and remember you are doing a great job no matter the outcome. Good luck.
posted by TheLibrarian at 4:40 PM on August 25, 2013 [3 favorites]


Yes cestmoi is right about the hospital. They want to help you!
posted by TheLibrarian at 4:41 PM on August 25, 2013


also, if you just can't stand it any more, instead of giving up altogether, you can switch to exclusively pumping for a while to give your nipples a chance to recover and maintain your supply.
posted by bq at 4:42 PM on August 25, 2013 [1 favorite]


TYRR is right - if there's not visible bleeding from your nipples for that blood, then it's possible that there is something else going on. Call your ped ASAP.
posted by bq at 4:44 PM on August 25, 2013


When my son was born, my milk took 5 days to come in and in the meantime he chewed me to bits in hunger and frustration. The midwives told me to just persevere amongst the blood and tears until finally an angel of a lactation consultant told me to just take a break. Stop BFing for two days (still express to keep up your milk) but bottle feed and give your poor breasts a chance to heal.

While this is happening, wear loose or no shirt at all, apply breast milk or lanolin to your nipples and be kind to yourself. Your poor breasts (and everyone involved!) are going through trauma and need a chance to recover. Then try again. For me, it made all the difference.

But I chime in with everyone else when I say look deeper for the cause - blood generally comes from cracked nipples. If it's coming from inside the breast, and enough to make him ill, I would want to find out more. (A ped may not be the right doctor to ask but they'll point you to who you should.)
posted by Jubey at 4:48 PM on August 25, 2013


Response by poster: Weight gain is fine, and his latch is good - we saw a bunch of very helpful LCs in the hospital. I am reasonably sure the blood is coming from me since I can see the bleeding when he pops off the boob. I have not tried nipple shields recently but had trouble with them a few weeks back.
posted by House of Leaves of Grass at 4:49 PM on August 25, 2013


There are a variety of things that could be causing what you describe. The OB likely won't be able to help very much with breastfeeding, unfortunately; they don't have a lot of training there (seriously, even many midwives are crap at breastfeeding help after the first few hours). You want to go see an International Board Certified Lactation Consultant. The ILCA can help you find someone. Kellymom.com is a good resource in the mean time, particularly their page on nipple healing. I'll try to post more ideas later; have to pay attention to my 7-week-old.
posted by linettasky at 5:08 PM on August 25, 2013 [2 favorites]


Also carefully check the baby for upper lip tie and tongue tie.
posted by waterisfinite at 5:10 PM on August 25, 2013 [2 favorites]


If you pump, is your milk tinged with blood? Or do you just see it after nursing?
posted by barnone at 6:31 PM on August 25, 2013 [2 favorites]


You could also check the Oh Baby Mine page on Facebook; she is a certified lactation consultant and can answer posts, though it sounds like you have a relationship with an IBCLC already.
posted by coldhotel at 7:18 PM on August 25, 2013


one of my close friends had this problem w/both of her kids (one's 2.5, the other is 4mos), and it turned out they both had tongue tie (and i think the baby had upper lip tie). they were both identified at the same time, so she only had a frenotomy done on the baby, and she said that nursing is no longer painful or causing cracked nipples. i watched the frenotomy and it was incredibly quick and apparently mostly painless for the baby. i have heard from my own pediatrician that it was pretty common for tongue/lip ties to be identified and corrected at birth by midwives but this has since fallen out of favor.

anyway, just something to consider!
posted by oh really at 7:44 PM on August 25, 2013 [2 favorites]


oh, and nthing the idea of pumping exclusively for a bit so you can heal. my friend said that saved her sanity!
posted by oh really at 7:46 PM on August 25, 2013


Lots of people are hideously allergic to lanolin and don't know it. Try switching to a lanolin & petroleum-free preparation.
posted by batmonkey at 7:47 PM on August 25, 2013 [1 favorite]


My son had a painful latch, and it turned out he was also tongue-tied. The doctor took care of it super quick and with minimal fuss.

I also agree that a lactation consultant/La Leche League are your friends here and should know how to help you continue breastfeeding, if that's your priority.

I also also agree that it's a great idea to be kind to yourself and let your body heal.
posted by woodvine at 8:23 PM on August 25, 2013


First of all, I'm so sorry you're going through this. I had similar issues with my son. His weight gain was fine but nursing was painful. Finally at 10 weeks he was diagnosed with a tongue tie. I think it was mild enough that his latch wasn't terrible, but still painful. I never had cracking or even much bleeding, just teeth-gritting pain. I saw maybe 3 different lactation consultants before someone noticed it. Even if tongue tie isn't the issue, I'd have the latch checked again, just in case something has changed.
posted by Empidonax at 8:25 PM on August 25, 2013


This sounds a lot like a tongue tie as people above mentioned. Have his tongue and upper lip checked too.
posted by saradarlin at 10:02 PM on August 25, 2013 [1 favorite]


Response by poster: Thank you all so much for your help. To answer a few questions:

No, no fever or lumps. No blood when I hand express or pump. No noticeable redness aside from the irritated nipples. He was evaluated for tongue tie in the hospital - is a mild tongue tie or upper lip tie something that might be more obvious as he grows?

I have a suspicion that the LC I've called will not be able to suggest anything other than a nipple shield - any anecdotal evidence of nursing getting better at this late stage?
posted by House of Leaves of Grass at 5:51 AM on August 26, 2013


Okay, I'll say it.

As much as you want to 100% breastfeed, sometimes it's not possible. See your doctor, get the best advice you can, and if you have to feed formula, it's okay. Tons of us turned out fine anyway.

Enduring pain and frustration, is no way to live.
posted by Ruthless Bunny at 6:14 AM on August 26, 2013 [2 favorites]


My little guy spit up blood from breastmilk when he was a few days old. The thing that helped me most was trying to give each breast a little break to heal - can you try breatfeeding on only one side for a day or two and pump the other side? Then switch? It might help heal things up. I went on to EBF for 13 months, so don't give up!
posted by jrichards at 7:15 AM on August 26, 2013


My experience was that it can definitely get better after 2 months (I went on to nurse for 2ish years). Part of it was the tongue tie, but I think some of was just that his mouth grew. I used a nipple shield for a bit and that helped a lot as well. I just remembered that I went to 2 different pediatricians in addition to the 3 LCs before anyone noticed the tongue tie, so it might be worth to push for a re-evaluation. My impression (as of 4 years ago) was that frenectomies were becoming less common, and some mild tongue ties resolve themselves so the pediatricians were reluctant to recommend snipping right away...but after 10 weeks of painful nursing they were willing to go ahead with the procedure (which was simple and easy). We still had to work on his latch some, but things improved fairly quickly after that. Another thing I just remembered is that a sign of a bad latch is a "lipstick-shaped nipple" (don't worry, that doesn't link to a picture, just a discussion!) and I definitely had that--have you noticed anything like that in addition to the bleeding? Best of luck to you.
posted by Empidonax at 7:39 AM on August 26, 2013


I've got anecdotal evidence of it getting better. With my first, I gave up breast feeding at about 10 weeks because it was painful and horrible and ick. With my second, it was still painful, but I fought through it, and by 12 weeks, it was like a switch went off, and now at 21 weeks I can breastfeed upside down and backwards with no pain or difficulty. The thing that helped us the most seemed to be learning to nurse lying down - it changed something about her latch enough that it stopped hurting, and once we did that for a while, it just...stopped hurting. We never had any blood, though, and I find that really strange. But, yes, gets better!

(But, no judgment if you want to stop, either. I did with my first, like I said, and she is a perfect and brilliant four year old now, so, do what works for you.)
posted by dpx.mfx at 8:35 AM on August 26, 2013 [1 favorite]


I'm one of those for whom it got entirely better after the first 8 weeks (actually, we were closer to 12wks when it suddenly zoomed into "we can do this" territory).

We also had transformation with me reclining to nurse. That was a game changer.

The other thing that helped me was warm compresses. Loved those so much. Alternating warm and cool will help most things like this heal faster.

Alternating direct feedings with pumping (I got a really good one - the Hygeia EnJoye) seemed to help us turn the corner, too.

But, yeah, if it doesn't get better and you're bleeding and your little one isn't getting what they need, it's okay to supplement. You can always slack off the supplementing if you heal and get more comfortable.
posted by batmonkey at 2:50 PM on August 26, 2013


Short-term, my suggestion is a nipple shield to help protect you while you heal. I used one (and by one I mean a zillion, stashed all over the house) and it saved my nursing relationship on multiple occasions. (My son's latch issues never resolved so I used the shield for the entire two years I nursed him. This is unusual and/or not recommended, but like I said, it saved our nursing relationship, which was something that was important to me.)

If you are able, try to make an appointment with a lactation consultant as soon as you can. A tongue/lip tie is a definite possible root cause for your problem, and a good LC should be trained how to recognize them. If that is the case, clipping the tie should end up resolving your problem.

Also, since you do have a bit of a freezer stash, I'd definitely start there versus formula if you need a longer break than the nipple shields can provide. Your baby will still be getting your milk, and you'll get a chance to heal up. Plus, there are some moms who exclusively pump - their babies still get entirely breastmilk, just not from the breast. (I hope it doesn't come to that, but if you respond well to the pump and aren't able to resolve whatever is ultimately causing the damage to your nipples... it's an option.)

You're doing a great job. I hope you're able to get the help you need to get your bfing issues resolved!
posted by meggan at 6:09 PM on August 26, 2013


He was evaluated for tongue tie in the hospital - is a mild tongue tie or upper lip tie something that might be more obvious as he grows?

Some ties are difficult to diagnose. If you don't find relief elsewhere, I would ABSOLUTELY suggest getting a second opinion on the tongue/lip tie!
posted by waterisfinite at 1:48 PM on August 27, 2013


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