Surviving breastfeeding hell
What to do when all else fails
This post has nothing to do with minimalism. I haven't done any research, found any sources or included any quotes. It is just my own experience, sent into the ether with the hope that it might help another mother in need (much like these posts helped me at one point).
Before the baby arrived I was 100% certain I was going to breastfeed. I was also sure it would be easy: my mother and all my friends had breastfed their children. Instead I went through six weeks of hell. It was horrible and probably the most painful, torturous experience of my life. I would happily have four more natural births right now then go through the pain again. At times it felt like I was a walking, talking breastfeeding textbook, having suffered from:
* mastitis
* thrush (in the ducts)
* cracks & scabs
* bleeding
* AND vasospasms on both sides
The baby is now 11 weeks old, and one nipple is still cracked and sore. However, although far from perfect, breastfeeding is doable and at times even wonderful.
This is what I've learnt along the way:
1. Sometimes everything goes wrong even though you do everything right
Although I thought breastfeeding would be easy, I did the research. I bought the books, read the websites, spoke to lactation counsellors and prepared myself. My baby was a 3.6 kg, full-term heifer. I had a completely natural birth after nearly 42 weeks of waiting. Due to minor complications I wasn't allowed to breastfeed initially, but after 17 hours, the baby latched on with gusto. His latch felt and looked perfect. I always had more than enough milk. Three days later, the first scabs appeared on my nipples and the descent into hell had begun. The scabs thickened, I developed mastitis, then thrush, then vasospasms. The cracks and fissures just wouldn't heal. I still have no idea what I did wrong or what I could have done to prevent it.
2. Even the best lactation consultant might have no idea what's wrong
Over the course of my ordeal I spoke to a paediatric nurse specialised in lactation, various doctors & nurses from a human milk bank, two gynaecologists and a paediatrician. Every one of them assessed my condition and my latch and all had no idea why my baby was ripping my nipples to shreds. I was given dozens of tips and bogus explanations ranging from "your skin is too white" to "he sucks too much". I learnt that although the experts can help, you have to listen to your intuition - there might not be one right answer or solution so you have to find what works for you.
3. Try everything at least once...
I defied the usual advice and used both formula and nipple shields to get me through this ordeal. For about three weeks I only breastfed my baby occasionally and gave him expressed milk and formula via a finger tube the rest of the time. When after five weeks, and after the mastitis and thrush had been cleared up the cracks still wouldn't heal I used a nipple shield...I can still remember the feeling of bliss the first time I fed my baby without any pain.
I realise that nipple shields and formula can have negative consequences but I wish the breastfeeding community was a bit more open about allowing women in pain to try EVERY possible route available to them. What's better: switching to formula once and for all out of desperation, or using it as an aid for a short period of time under expert guidance?
4. ...but don't do anything that makes you uncomfortable
Brazilians are obsessed with exposing your breasts to sunlight, although La Lecher is against. In any case, every single professional I consulted here told me I had to get sunlight on those nipples. I never followed their advice. I hate walking around without my top on and everyone can stare onto my balcony. Sunlight on nipples was not an option and I'm glad I stuck to my guns. Sometimes you've got to know when to stay in your comfort zone.
5. Make a fuss if you think you know what's wrong
As soon as I was given antibiotics for mastitis I was worried I would develop thrush and I'm pretty certain now that the fungus was the main cause of my pain for weeks, but nobody would believe me. Whenever I mentioned the possibility of thrush, I was brushed aside. It was only after the course of antibiotics was over and I was still in excruciating pain that my gynaecologist prescribed me an antifungal, probably only to shut me up. It worked. Whatever you think the problem is, get your partner and friends to help hound the healthcare professionals to look into the option. I knew I was susceptible to thrush and should have requested the medication earlier.
Finally, a list of all the things that worked for me:
* Antibiotics for mastitis (although I'm not 100% sure they were necessary)
* Ketoconazole and fluconazole for thrush
* 56 hours of feeding formula and expressed breast milk exclusively to allow nipples to heal and recover emotionally from the pain
* Gradually reintroducing breastfeeding after alongside expressed milk and formula via tube
* Using an app to monitor consumption of formula, expressed milk and time spent nursing on each side
* Reducing formula by around 30 ml every two days, once breastfeeding became bearable (with occasional setbacks due to pain)
* Not using one breast for a week to allow the nipples to heal (limited success)
* Using one breast for only 5 minutes each sessions to limit damage (limited success)
* Using a nipple shield every second feeding or so to protect nipples (worked like a charm on the right, did nothing on the left)
The only thing I tried that I wouldn't recommend is laser therapy - after a week of treatment my nipples just opened up again.