A question for those exclusively feeding EBM urgent please!

Redrec.... hope it's getting better for you and DD. Just to let you know there is a La Leche League Breastfeeding meeting tomorrow at Dubai Mall Organic Cafe, between 12-30 - 14.30, I think it would do you the world of good if you can get along there and speak to the LLL advisers and other Mums for lots of BF advice, support and encouragement.. sometimes even just seeing other Mums feeding their DC can give you a boost. LLL Dubai are on facebook

I do believe you, because it was the same for me, all my friends either had an easier time or else gave up so hearing others stories on a forum gave me the hope I needed. 10 months from now you will be paying it forward and helping another new mum. :) Start on the breast the baby last finished on, so if she had all of breast A and half of breast B, the next feed she will finish breast B and have half of Breast A, and so on. If she only has one breast per feed you can just start on the other one next time, always offer the other after she has finished with the first (or in my case I kicked him off the first after around 30 minutes and gave the second). Keeping a hair tie on your wrist that you switch to the side last fed on will help you remember for next time. Disposable nappies are very absorbent, tip 100mL of water onto a dry one and it will give you an idea of how a wet one might feel. Lanisoh or the medela one;purelan are the same thing, both good and don't need to be washed off before feeding. The medela one should be available wherever Medela products are sold. (at Toy'sr'us in Doha) Put a small amount on each morning and a big dollop before a shower to protect your nipples from the water. When my nipples were at their worst I also used Mebo which works better, but you have to wash it of before a feed. How long a nap are we talking?, one 5 hour stretch (preferably at night) should be fine. Try to get 8-10 feeds in a day at this point. You're doing well, keep it up!

Basically the idea of "nipple" confusion is not necc that they will resist the breast but more that they will suck on your nipple the way they suck on the bottle ie a shallow latch rather than taking in a big mouthful as they should. I think the dummy and the bottle do make it worse but at the same time, what to do with a really "sucky" baby, you need to play that one by ear. A poor latch doesn't necc mean the baby isn't getting enough milk, RT what makes you think you were "starving" your baby? A baby can cry and want to suck for other reasons, sucking will soothe them to sleep regardless of hunger level. Are you swaddling, I can't recommend it enough and try feeding her when she wakes, then laying her down awake right after the feed so that she is not overtired by the time she needs to drift off to sleep. Awake time vs sleep time for a 2 week old is very short. I know you have probably read,googled, youtubed everything you can and you already know that your nipple needs to be further back in baby's mouth but how to get there? Best you can do is sit comfortably and let your breast hang where it naturally falls, then hold baby very close to you (tummy to mummy) so that she has to tip her head right back on order to take in your nipple. Make sure you do not move your breast towards her (its easy to do without realizing, get someone else to watch). You can also try pulling down on her jaw once she has latched and trying to get a deeper latch that way. I know you hear that you should always delatch when it hurts but there is another school of thought that says most of the damage is done on the latching and delatching and you are better to tough it out and try to get a better latch next time. A very cold sip of water right on the point of latching helped me somewhat. Oh I so wish I could somehow fix this for you, I hate to think of someone else going through this :(. I promise you you are at the worst point and it will get better soon even though you might not initially realise it is, DH had to point out to me when I was able to have a conversation while feeding that it obviously wasn't as bad as it had been. Take it week by week, each week I would pat myself on the back for having got through it and tell DH I wanted to stop, but then another week would go by and there I was. Set yourself a goal to get through the next 2 weeks and a reward once you get there. I promise this is not how it will always be!

My boy also has a really strong suck reflex and I resisted the pacifier for so long thinking it would confuse him etc. But I was feeding him all day as I thought he was hungry all the time when in fact alot of the time he was tired. He took the dummy straight away and it just soothes him especially between feeds. I don't give it to him at night as for some reason he is brilliant at going to sleep in the evening so we don't need it then. My LC said that all the talk of nipple confusion is not always correct, it totally depends on the baby. I knew he was putting on weight as he was getting heavier and weighing him confirmed that although he was massive to begin with. So somehow despite his poor latch he was getting enough (prob cos I was feeding sooo often but also as I would still persist as I couldn't bear to take him off and then hear him cry in hunger). Also he has a slightly short tongue which doesn't help but the LC said it will only improve as it grows. I still get slightly flattened looking nips after feeding but it is definitely less painful now. the LC also said that sometimes that will still happen and as long as you're not in pain it might just have to stay that way. You have to find what works for you. If topping up with some EBM after a feed helps her go to sleep than go for it, if you're still giving the breast and pumping it shouldn't affect your supply. The one thing the LC taught me was not to feel bad about expressing at times and using the bottle to help recuperate and heal. She also had me using Fucidin cream to help my nipples heal quicker which definitely helped. I really hope it starts getting easier for you soon! kiwi - I can so sympathise with that, I too would just let the tears roll silently :( BF-ing is definitely hard going and I wish I'd been more aware of that going into it....but with lots of perserverance and support we'll all get there!!

I would literally flinch when I heard him wake and I knew it was time to feed, and yes feeling like a failure :( I remember once DH brought him to me and when he latched on I cried out in pain and DH said "don't yell at him" and tears just rolled down my face for the rest of the feed. I think it was at that point that DH "got" how much I was struggling.

we're getting there thanks kiwi - it's been much better this week! For me when I was down it was more a case of feeling useless and a failure. It really helped having my hubby support me telling me I was doing a great job and reminding me of his weight gain etc. But I know what you mean re: hating it, and having people say "do you think he's hungry again" would just do my head in!

yep sydnygal, mine was also a strong suck with a bad latch, you're nearly into the pain- free stretch I promise! PS its ok to say the words "I hate breastfeeding" despite the social taboo, my mum flinched every time I said it but venting to my more sympathetic friends helped a lot and eventually it became that pleasant bonding experience we are all promised.

I just wanted to add my words of support Redrec - you will get there! I totally sympathise with kiwis post...my baby is almost 6 weeks now and we are only just getting there - I agree the pain was way worse than anything to do with my c-sec and there were many times I was feeding and crying at the same time! You never imagine something so natural can hurt so much! In my case my baby wasn't latching properly yet at the same time with really strong suction so my poor nipples we just compressed and shredded to the max! vasospasm, blisters/blebs, cracks you name it. He was doing fine though, putting on loads of weight luckily, it was only Mum suffering! I got through it with the help of a fab LC who at times had me expressing the more traumatised side as it healed and bottle feeding and breastfeeding with the other side which thankfully posed no confusion for DS. It is still not entirely pain free but it's getting better every day, so perserverance and support is the key. If you are in Dubai I strongly recommend Paula Miller at Cooper Clinic - she was such great help. best of luck! x

great post kiwispiers second everything you've written... I waited for this tiny creature to open her mouth wide like the books promised and it didn't happen, I had lipstick shaped nipples, tears in my eyes, sore jaw from gnashing my teeth and scratches on the floor from curling my toes into it!! BUT.... as she got bigger it got easier, every feed was another lesson and I kept at it. when it's difficult to get BF establised (ie; stop being so blummin painful) then you need to be determined, stubborn and have some support.. I had DH on side and regular text msgs from friends telling me how great I was doing and to keep going, I never once considered giving formula and hadn't even bought any bottles (so I wouldn't give up in the middle of the night) don't let anyone tell you that your milk isn't enough for the baby or that you don't produce enough.. absolute rubbish, the problem lies in getting the milk to the baby because of poor latch and this improves with time and practise so keep going!!

oh and in retrospect, later on I probably should have had a course of antibiotics incase of mastitis despite not having had a fever. I also found I needed to turn off the AC when feeding as my poor traumatised nipples would vasospasm with the cold.

I feel your toe curling pain :( it does mean the latch is too shallow, and her tongue is not covering her lower gum ridge or she is compressing your nipple against her hard pallete (if your nipple looks like the end of a lipstick when she is finished, thats what is happening) I tried EVERYTHING but just couldn't convince him to open wider. I think I might have brought it on myself a bit by giving him EBM in a bottle and a dummy so early but his latch was so painful I couldn't handle it :(. I didn't supplement with formula, instead I bought a set a baby scales, and after around 2-3 weeks I just toughed it out without expressing. There were times I was feeding and crying at the same time, and taking more pain relief than I did for my c-section :( I almost wished he wouldn't gain weight but he did. If your doesn't you'll need to keep going with the EBM for a bit longer. I fed him 2-3 hourly by day and on demand at night. You need DH to be heavily on board, helping you in any/every way possible so that you can focus on this. I was lucky my mum came for a month and did all the cooking and cleaning etc. He also fed for around 45 minutes the first month or so, and pretty much never de-latched by himself until he was much older. Falling asleep at the breast is very common and quite normal, I always fed him as soon as he woke rather than when he was due for a sleep. They are pretty sleepy in general at the start and more so if they are a bit jaundiced, try to give her her baths and nappy off time outside if you can so she gets the daylight. (also helps her body clock to learn day from night). If the latch is really inneffective it can mean they are getting bored without enough milk flow. Stripping her down to a nappy tickling her toes, wiping her face with a wet washcloth are all tried and true "wake up the baby" tips. The thing that probably kept me going was my LC telling me that even a bad latch will get less painful, as your nipples will toughen, by the third week my nipples looked much better but it still hurt until around week 6, (progressively less so each day) and was uncomfortable for another few weeks. Then one day, around week 10, I was so sick of trying so hard and him still not latching correctly, I just sort of left him to it, forgot about shaping the nipple, cross cradle etc and he latched beautifully by himself :) and continued to do so. In the beginning you have too much milk, so they never really "empty the breast", the only way you can know if she is getting enough is by her weight gain, but you need to weigh weekly not daily a you can't see a trend day by day. Keep an eye on wet nappies too, what goes in , must come out. You are in Dubai?, I gave birth in Doha last August and there wasn't a lot of help available here (and most was on vacation). I think you have a lot more there, I recommend trying more than one LC, 10 if you need they all have different tips and tricks and 10 weeks is worst case scenario, most people get through the worst much sooner. I found from a motivation point of view, I told myself I would get to 3 months, and then re-evalutate. I honestly thought I would stop then, but by 3 months everything was perfect :), so I extended to 6, then 9 and am now heading heading towards 12. There have been some hiccups along the way but I'm glad I toughed it out, although I wish I hadn't had to. and we all thought birth was the tough part :( edited by kiwispiers on 16/06/2011 <em>edited by kiwispiers on 16/06/2011</em>

Sorry my last message was a bit abrupt (my baby woke). If you can get her to latch without the shields then great but maybe try a latch without the shields then a latch with before the bottle. The shields feel more or less like a bottle to them and if you express a little milk into the end of the shields it might help. I was dealing with a very experienced LC with DS and she said she only really recommended the shields for that purpose and not to prevent nipple pain. With the shields at least her sucking mechanism is correct unlike the bottle where they suck differently to get milk. DS took about a week to latch on one side (despite both my nipples looking identical) and 10 weeks before his figured out to open his mouth wide enough to take a deep latch, days feel like years at the start so I feel for you :(. Was she a forceps or ventouse birth? apparently sometimes that can cause a little facial bruising that makes latching painful/difficult. Or a little jaundice can make them too sleepy to try hard enough. The big thing they all recommend is basically staying topless all day with the baby (in only a nappy) in bed with you and letting her latch on whenever she feels inclined until she is latching well. You would need some help with your oldest of course. I'm guessing your LC has already been through the steps but I think the deal is to start the baby on your chest and let her wiggle down sideways herself and self latch without you intervening much,

RT not using the shields to avoid nipple confusion and then bottle feeding makes no sense IMHO, if they help at all use them as long as you need to. I would try to latch at every feed, do it a little early so she is not starving hungry. Hang in there, the first 2 weeks are the worst.

Have you tried using nipple shields? Sometimes in the early stages a baby needs more of a feeling that there is "something" in their mouth (especially if you have flattish nipples) before they will start to suck and the shields give them that feedback. Buy them in a variety of brands and sizes. Try not to give a dummy too so he saves his energy for your boob. The other thing is your intital letdown could be a bit slow so pumping for a few minutes first then trying to BF could help with both giving faster feedback and also drawing your nipples out a bit so there is more to "grab on to". As the ladies below have said, you can EBM feed exclusively but it is more difficult than EBF in the long run so you should keep trying getting LO to latch, even if it is painful, my DS took 10 weeks to perfect his latch although in our case he had a super suck and didn't pop off, but completely shredded my nipples in the process. :( I'm sure since you have seen an LC you already have an idea of skin to skin and keeping your baby against your chest all day for a few days so that his instinctive behaviours get a chance to kick in.

Redrec, I have been exclusively pumping since day 1, DD has never breastfed directly from me, and I have always been able to maintain fantastic supply. I have had a few occasions of low supply, but they were mainly stress related. There are many things you can do to stimulate supply. Power pumping is one; which is basically to pump on and off for ten minutes at a time for an hour. You only need to do this for a few nights, and you should see an improvement in supply. It's supposed to mimic how our LO's would feed when going through a growth spurt. You can do this in the evening once your LO is in bed, and have an hour to spare ;) As you've already tried Fenugreek, you can also use Motilium to help your supply. It's a motility drug with the side effect of promoting lactation. Basically take 3x 10 mg tablets 3x a day; you can even up the dose to 4x tablets 4x a day. Once your supply is established though make sure to wean yourself slowly off the drug, i.e. cut out one tablet than wait a few days before cutting out another one and so forth. If you see your supply go down, then go back to the previous dose and try again a week later or so. If you are going to go through the exclusive pumping route and I'd only recommend this only if BF doesn't work, then you will need to invest in an excellent double pump. Also to make it as comfortable as possible try and go hands free. Basically what I did is that I got a nursing bra and cut two slits where the funnels are located and just slid the funnels in. I wear another nursing bra and when it's time to pump I unhook the bra, put on the pumping bra and away I go! I can even surf the internet while I pump and browse on my favourite site EW :) It doesn't look particularly sexy, but hey whatever I can do to make my life just a tad easier ;) HTH

Agree what all the others have said. Seek the assistance of a lactation consultant to help with latching. Also run on a search on this site for "breastfeeding premature baby" and you'll get loads of advice/tips. As for exclusively pumping. Yes it is more than possible. DD2 is currently 6 1/2 months old and I am still exclusively pumping. I also only pump 2/3 times a day now and still make over 1 litre of milk per day, so once your supply is established you won't have to keep pumping every two/three hours forever. If you do end up with supply issues, there are techniques, herbal remedies and medication that can help reestablish supply. There's a great site/forum for Exclusively pumping mums that you can post questions to. Plus they've created a 101 manual for exclusively pumping that is really useful. Here are the links: http://forums.ivillage.com/t5/Exclusively-Pumping/ct-p/iv-ppexcluspump Beginners Guide for exclusively pumping http://forums.ivillage.com/t5/Roll-Calls-Introductions/Updated-Beginner-s-Guide-looking-for-input-and-any-additions/m-p/116687945/message-uid/116687945#U116687945

at that age, make sure you swaddle her tight , very handy when u BM as then you can just hold on one hand. Yes, that nursing pillow helps as well... your milk won't go.. do a regular body to body contact... It will be easier as the day goes by.. come to mumcierge this wed if you can, Cecile will be there :)

Aww this sounds like me with my baby she's now 16 weeks old. My first 4 weeks of ebf were so hard and I felt crazy reading everything and anything to figure it out. But before I continue - keep at it, bf is now a dream, just 12 weeks on and it gets easy as pie. Hang in there. Ok so my baby was born 4 weeks early and just could not latch on in the positions you see/are told about. So what I did (after trial and error) was bought a nursing pillow from Mothercare in Mirdiff CC. I chose a comfy chair and brought her in tight to me. Then I 'very literally' held her head in position with one hand and with the other (same side to the breast she was feeding from) held the boob in position. Hard? yes, tiering? Most definatly, but worth it. And you won't be doing it for long....3 weeks maybe 4 because they get stronger and stronger so quickly. She also didn't feed long at all, seriously her feeding sessions were like 10 mins every 2 hours and I was going mad with worry. So after I fed her I would pump.....yep, every two hours after every feed. I have a great electrical pump and it worked wonders. I had a nice supply building up in the fridge and they were a life saver when going out. I used the milk in tomee tippe closer to nature 5oz bottles. Roll on a few weeks later and my feeding sessions are 40 mins long, she's putting on weight nicely and all that worry and stress of milk supply, feeding and latching on are distant memory. So in summery - relax a little, pump regularly and with time your little one is going to surprise you :) Good luck x