It’s normal for us to work with mums taking a little while to get the hang of latching and positioning. It’s normal for us to work with mums who are a bit sore.
While it may feel normal for us - when you are in the middle of that experience, it feels like the end of the world.
You dread each feed.
You fear that things are going to get worse.
And you don’t really understand what’s happening.
Is this normal? Is breastfeeding meant to feel like this? How much pain is meant to be tolerated? When should I get support? Why can’t I work out what’s going on? Is my baby getting enough milk? When can I take him off? Is it now? Please?
The mum who I was working with had been online and tried to find the stories of other people struggling with latching. And surprisingly she found very few. There are breastfeeding stories out there but it appears many people who have struggled with latching don’t think their story is worth sharing.
However it can very extremely valuable for mums to learn that struggling with latching is normal and people come out of the other side of the experience with support and with time.
So what IS normal?
Here’s an easy rule: if you are in any discomfort, why not get someone with training and experience in breastfeeding to check your latching and positioning?
Who cares what’s normal! If it hurts, let’s check.
Better to be over-cautious and get help just in case. Far better to go to a group and be reassured in a couple of days you will feel more comfortable than continue to struggle at home and wonder if this will improve all on its own.
In the vast majority of places in the UK, mothers can access trained support – from midwives, breastfeeding counsellors, IBCLCs (lactation consultants), La Leche League leaders, and peer supporters. Even if you are unable to leave your home, people may be able to come to you.
And in a worst case scenario, if you really can’t see someone face-to-face, volunteers on the national helplines are trained to talk about latching over the phone. That often sounds bizarre but when counsellors ask you about the placement of your cracks or damage, the shape of your nipple or how feeds feel – we are able to build up a remarkably useful picture.
Even if your tenderness is within ‘normal range’ and your latch is fine, no harm will come from getting support sooner rather than later. Don’t wait.
Before you give birth, find out what resources are local to you and make sure you know where to go in the early days.
The truth is that some tenderness in the first few days may be normal (and that’s first few days, not weeks). Our nipples are being stretched to 2 to 3 times their natural length to place correctly beyond the junction of the baby’s hard and soft palate on the roof of their mouth. That stretching may take a little bit of getting used to. There may be some discomfort in the first 10-20 seconds as that stretch occurs. For the FIRST FEW DAYS.
But pain throughout a feed? This shouldn’t be tolerated at any point.
What’s also NOT normal is a nipple that comes out of a baby’s mouth misshapen. If a nipple is placed correctly it comes out at the end of a feed (in the first few seconds it leaves the baby’s mouth) longer than normal but rounded at the end like a jelly tot. If it’s sitting in the soft tissue beyond that hard and soft palate junction, the end of the nipple can’t get squashed and flattened.
But if the nipple is pressed against the hard palate (perhaps because the baby’s bottom lip is too close to the base of the nipple, or the chin isn’t close into the breast, or the baby’s gape isn’t wide enough), that nipple may come out wedge-shaped, flattened, tapered like a lipstick just out of the tube or with a white stripe across it. It might also get distorted if a baby isn’t using their tongue effectively.
If a nipple comes out of a baby’s mouth like that. Or a nipple starts to get cracked and visibly damaged, then you really shouldn’t delay in getting some help.
A huge amount of people struggle initially with latching. Many of us have never seen breastfeeding up close until we come to do it ourselves. When we’re pregnant and we’re imagining breastfeeding (if we can psychologically get past thinking about the birth for a moment), we often picture breastfeeding as about ‘popping the baby on’. It’s more than that. And if we lived in a society where we had grown up around breastfeeding and seen it every day, we’d know so much instinctively.
Breastfeeding a newborn doesn’t always feel as natural as we might expect. It’s OK to admit it’s difficult and you need some help. As Rosie, one of the mums sharing her story below, says, “It was about as natural as trying to put a sock on a snake.”
However, changing a nappy can feel a bit like that too. And giving a bath can feel like trying to wash a snake with a baby sponge. We are learning new skills and that can take time.
This is one of the reasons that good antenatal breastfeeding information can be so important. And certainly why seeking out face-to-face support from a breastfeeding specialist once problems start to develop can be so crucial.
Here are some stories of mums I met on Twitter who were kindly prepared to share their experiences.
Thank you ladies, I hope your stories inspire others:
Helen Ledger: I wish people talked about it more, I really think it’s the last taboo but it’s the most natural thing ever!
I really struggled to latch my first baby to my right breast. It started in the hospital, the chair in the delivery room just wasn't right for feeding & I couldn't seem to get the baby on properly. Then a few days in she would bring up little bits of blood & I just knew it was from me!
I have large areola but small nipples, especially the right one (hope that's not too much info) & I think the end of the nipple was just rubbing somewhere in baby's mouth.
It got to the point where I had a wound on my right nipple that was excruciating to latch the baby on to. I was told to keep trying but to be honest, the pain was so severe I would be in tears every time. Plus, the wound would open every time & I would be back to square one in terms of it healing! I was told to try to avoid expressing but I decided if I wanted to continue breast feeding, it was my only option. I expressed as often as I could from my right breast & fed from my left when baby was hungry.
Soon the wound healed enough for me to latch the baby on again & because I was at home & comfortable & could adjust my position/pillows etc., I got the latch correct, aiming the flat of the nipple up slightly when the baby went to latch on.
I went on to feed my daughter from both breasts until she was 2 years old. My husband was a great support & encouraged me to give it a month before I gave in. Fortunately, by the end of the month it was much more comfortable.
I have also been feeding my second child, who is now 9 months old, successfully.
I think we just don't have a culture of breastfeeding now. I think it should be on TV more. Women don't need to sit with their top off & their boobs out to breastfeed; it should be shown discretely on programmes of influence like Coronation Street etc.
Kate Stinchcombe: I don't know if you need any more stories about overcoming latch problems to successfully breastfeed.
The short version is that I was trying to prescriptively put my son on to the breast without considering the position of my nipples which, kind of point out to the side! I became very sore with blisters and bits of nipple dropping off etc!
The longer version is that I had a 10lb5oz baby and a 3rd degree tear. After initial skin to skin we were transferred to a main hospital and I had surgery after which I was exhausted and we just didn't get off to a great start. The young midwife told me that the audible clicking noise was a good sign because it meant the baby was getting milk. I regret not complaining once I knew better.
I had mixed experience of support from the midwives possibly because initially I was unsure if this was the way it was meant to be. My mother failed to feed me after two weeks with the same problem so could offer no advice. I had no breastfeeding peers to call on. It was Christmas so all the support groups were shut and the NCT BF counsellor had gastric flu and was too ill to even answer the phone.
On day 8 my own midwife (who had been on holiday) advised me to express for a couple of feeds to allow myself some time to heal. It broke the cycle a bit but I was still dreading every feed.
Eventually when my little boy was 3 weeks old we saw the bf counsellor who advised me on positioning. I slowly gained confidence. Rowan started gaining weight and at about 21 days he was back at birth weight and we were discharged by the midwife. It took about 3 months for us to establish a good breastfeeding relationship. He was always a big boy and hungry but never needed formula and was breastfed until 13 months.
2 years later, I didn't really have any problems with my daughter once I remembered to position her correctly. She has a tongue tie but it never seemed to cause any problems. She's 17 months now and breast milk is still her main food.
That was quite cathartic!
Lucy McGill: Oscar was born at 39 weeks by emergency section for foetal distress. I think he needed a little bit of oxygen, but he wasn't too poorly. We were in hospital for 48 hours after the section, & during this time he appeared to feed - trying to suck at the breast, but for only 30secs or so each time. I was asked by lots of midwives why I kept taking him off- I wasn't, he kept coming off. He was screaming for most of the 48 hours we were in hospital, & neither of us slept much. I was given the 'breast is best' talk lots of times (which was frustrating as I was desperate to breast feed) and I was helped to express & Oscar was syringe fed. The general opinion seemed to be he was feeding, he was just really hungry. I couldn't wait to get home as the advice seemed to be different with every shift.
On day 3 at home the community midwife spotted that Oscar had an elevated tongue tip and every time I tried to feed him my nipple was going under his tongue. The poor thing couldn't latch at all, and other than the little bit of syringed milk, he'd pretty much had nothing at all for those first 72 hours.
Interestingly, my hospital discharge notes say Oscar was 'breastfeeding well'.
The midwife asked what I wanted to do, I said I wanted to breast feed, & for the rest of the afternoon she helped me try to latch him on. I had to hold him in a sitting position next to me, with his head level with my nipple (midwife thought gravity would help the tongue tip), and I would stroke his tongue down, and then quickly try to latch him on with his tongue down. I send hours & hours 'practising' this.
I bought a manual pump & was expressing & cup feeding. So each feed would consist of me practising the latch, then expressing & cup feeding. We'd start a feed, the process would take about an hour and a half, and then we'd have an hour or so 'off', and then start over! By about the 5th or 6th day, we'd achieve 1 good latch or so a day; by 7th or 8th day, 1 good latch per feed; and by day 10 or so he was feeding just from me. The midwife spent at least another whole afternoon with me (during which she was ringing colleagues to pass on other home visits) possibly longer. Oscar hardly lost any weight at all - I can still hardly believe this!
We went on to battle reflux, cow’s milk allergy, blocked ducts & thrush, but I fed him for 11 months, & owe it all to that midwife (I've told her this). I'm now in my 11th month of feeding no 2 (just mastitis, thrush & blocked ducts & a bit of biting this time!), I still feel so grateful to that midwife (& my husband who worked just as hard as me during those early feeds).
I really feel so strongly that the right support at the right time is key to successful breastfeeding. The support has to be accessible during that desperate moment - a breastfeeding group next Wednesday is no good!
Rosie Don: I come from a large family of breastfed kids, so there was no doubt in my mind that I was going to breastfeed my baby. I assumed it would be easy, second nature. I had made sure to attend a brief but informative lesson on breastfeeding at the local health centre, which focussed on good position, good attachment. I felt all prepared.
I was determined to have a very natural birth, and, due to missing my first scan, I had a slightly contested due date. Days over my due date, then weeks, then into the hospital for induction followed and my ideal birth seemed a distant dream. Well, at term plus 21days, it felt better to be surrounded by doctors than water! To cut a long story short, we ended up having an emergency C-section, and were exhausted for ages after. I think a midwife must have got Small to latch the first time, while we were still very much post-op. Then we slept.
On waking I was asked if the baby had fed yet, and when I said no, that we'd been sleeping, I was met with a concerned "she really should have had a feed by now", and of course I felt ever so guilty. So I tried to feed her, but I seemed to have too many, or not enough, arms to support her. It was about as natural as trying to put a sock on a snake. I felt a bit of a failure for a moment. She was just too exhausted to latch on, and I was too exhausted to help. The very young midwife said "I'm sorry, but... you just look so uncomfortable" to which I replied - panic very evident in my voice - "yes PLEASE help me, I don't know what I'm doing!”. I have heard some say they felt embarrassed if they had to let a midwife milk them, but I just felt grateful and relieved. Small had her first feed from a syringe.
For the 48 hours we were in the hospital, we spent much of the time skin-on-skin, bonding like crazy. We began to get the knack of this latching-on business. I remember the doctor who examined her saying there was a 'slight' tongue tie, but that it shouldn't cause much problem. Wrong! The week after we came out of hospital was torture. I had read about on-demand feeding and felt it was the best idea, but every second was such phenomenal anguish. I had had some 'advice' (??) from my partner's sister, who said breastfeeding Small's cousin was "the most painful 3weeks of [her] life". I realise now that genetics may have been a factor with this tongue-tie business.
Very soon, within a week, I had nipples cracked, scabbed, bleeding, the shape of small's palate suctioned onto the teat after a feed. I knew the nipple should be further into the mouth than that. I didn't even have any cream, had decided against shields and dummies - I was at my wit's end! Luckily a call to my health worker resulted in her dropping round free sachets of lansinoh (on a bank holiday!) and booking us in for a tongue-tie op in 3days time. The end of our trial was in sight. I couldn't wait to get us to that clinic.
The difference was incredible, after the procedure to cut small's tongue-tie. I wish that first doctor in the hospital had been able just to sort it out there and then. It's only because I was well informed that I didn't give up, and even with all the reading in the world, we all still at some point must be thinking, "Is it supposed to hurt this much?".
It's been exhausting, but so SO worth it, and we're still nursing now at two and a half years. How does it feel? WONDERFUL.
Emma Cantrell: I had latch problems with both my children. With my first I struggled in hospital with no proper help to feed, within 12 hours my nipples were cracked and bleeding. This carried on for 3 or 4 days, I was told by midwives that pain was normal. It wasn't until I told my Mum (a midwife herself) about it and showed her the deep, raw cracks and blisters that she said that it definitely wasn't normal and was a latch problem. She taught me the rugby ball hold, which helped straight away. It took three weeks of painful feeding and a lot of lanolin cream before my nipples healed and feeding was easy and enjoyable.
With my son I felt a lot more confident. However, I started feeding him holding him traditionally across my body and again, there were blisters and cracks. As soon as I saw this was happening again (whilst still in hospital) I asked to see the infant feeding specialist midwife at my hospital. She was brilliant. She helped me with lots of different postures and told me I had 'perfect nipples for breastfeeding’!! Feeding was quickly pain free and has been plain sailing ever since.
Jeanne Russell: I had extreme pain for 6 weeks. Looking back, I can't believe I stuck with it and continued to breastfeed. I would wince in pain and cry with each feeding. My poor nipples were raw, scabbed and in terrible shape. I finally attended local LLL meeting where the group leader was so kind. She help me and another first time mom after the meeting for over an hour and a half. She talked to us about skin-to-skin, understanding how to identify a proper latch - or break a poor latch, and in my case my daughter needed some help getting a deeper latch. This leader gave us confidence and support in addition to the technical help. There was no pressure at that meeting and I walked away feeling a little stronger. From that point on, my breastfeeding experience was very enjoyable and something I became very passionate about. My daughter nursed for a year and I cherish that time.
At some point during the following year I decided I wanted to pursue this as a potential career change and I completed a Certified Lactation Counselor program and I'm beginning to build a supportive local business. I see this path leading towards meeting wonderful women who just need what I needed in order to continue breastfeeding and enjoy it. I'm 31 weeks pregnant now and I look forward to my next breastfeeding experience.
Louise King: Before pregnancy I had never really given breastfeeding any deep and meaningful thought and therefore had little opinion on it. ‘Bitty’ jokes and ideas of older children being breastfed made me laugh along with most other people. When I became pregnant, my understanding of the importance of breastfeeding for health benefits deepened.
During our breastfeeding session as part of our antenatal NCT classes. The question: why are you keen to breastfeed?
Out of the group of five couples we all had similar responses – ‘it’s good for the baby’, ‘it helps prevent diseases throughout life for mother and child’, ‘it’s cheaper and easier’. My own reasons were the same; I knew I wanted to breastfeed for all the right reasons, and some perhaps more self-centred – the promised weight loss and laziness essentially!
I knew of course that breastfeeding is so good for the baby, and I knew I would want to give it a good shot, but In all honesty, I wasn’t sure if I would be able to manage it, and rather than thinking I would succeed no matter what, decided to try my best and see how it went – I could always switch to bottle feeding couldn’t I?
However, I had already begun to worry about whether or not I would be able to having heard stories of difficulties from my reading up on the subject and anecdotes from friends. Especially as I have (the dreaded!) flat/inverted nipples! How would the baby latch on was the question in my head above all else, driving me to research how I could assist my unborn child so I could get breastfeeding established, and thus began the journey and the first (of many) purchases to make it all so much easier for me and baby.
#1 Nipple shells to draw out the nipple prior to birth.
I was so caught up in reading up on how to draw out the nipple I barely had time before Elliott was born (2 and a half weeks early) to entertain other common problems with breastfeeding that I had received literature about. Little did I know I would experience quite a few first hand!
Not long after giving birth I managed, with excellent midwife assistance to give E his first feed from the R side. However, getting him onto the L proved tricky. Because I’d had a c-section (Elliott was breech), I stayed in hospital for three days and had plenty of help from midwives. I was also allowed someone to stay overnight – my sister stayed the first night and without her help I don’t know what I’d have done. I remember being quite shocked at the time about the almost barbaric way some of the midwives were putting E onto my breast to help him latch but I now understand it wasn’t barbaric at all. Like us mothers, babies need to learn their own techniques too, and they do not in fact pop out and know where their mouths go.
When I got home the feeding on the R was going well but the L felt all wrong. I have a very clear memory of my Mum hand expressing my L boob in my living room to encourage the milk flow for E in front of my husband, sister, brother-in-law, niece, step-Dad and cat! My brother-in-law later asked my sister ‘was your Mum just milking Lou?” I can laugh now but at the time it really wasn’t funny for me! It was also around this time that my boobs stopped being hidden demurely but looked at and pulled around by all and sundry, something I quickly got used to.
And so the journey continued. The next stage; my milk came in. Nothing can quite prepare a woman for this biological development. Everyone talks about the Pamela Anderson effect but when it happens it’s a real shock. Having huge, hot, tender, swollen boobs doesn’t do the feeling justice. On top of this, I was still finding feeding on the L difficult, so had expressed the L boob, predominantly feeding on the R and feeling (and looking) very lopsided. When E was weighed at eight days old he had (of course) lost weight. I remember feeling so angst ridden. My hormones were going crazy, I had extreme baby blues, crying and laughing (craughing we called it) and I had lopsided tits. Plus my baby was looking scrawny. Did I grab the nearest bottle in order to push aside my fears? No, in fact I didn’t actually ever consider it. I think part of the reason is the amazing help I had from visiting midwives, my NCT breastfeeding counsellor and my family. I persisted and persisted. I bought yet more products to assist. Next on the shopping list were:
#2) Niplette to draw out the nipple,
#3) the My Breast Friend feeding cushion (with a handy pocket for storing said contraptions as well as chocolate).
And I pumped my L boob every time prior to feeding to encourage the nipple and milk.
But in my naivety I hadn’t realised was how long the whole process took. I felt like a human cow, glued to the sofa, constantly feeding. Everyone kept telling me it got quicker and easier and to make the most of it. I remember resenting being stuck to the sofa watching TV and catching up with Mad Men Season Five (yes, I take this all back now!). Plus, all the feeding on the R had taken its toll. Somewhere along the line I’d acquired an open sore on my R nipple (cue purchase #4 Lansinoh). I went to the doctor who prescribed an antibiotic cream and to return after one week if it hadn’t healed. It didn’t heal. Still I persevered with my breastfeeding, seeing how well my son was doing, gaining weight, pooing and weeing and all the other things they tell you are good signs. I went back and had my first course of antibiotics and was also advised to use nipple shields #5 nipple shields. These helped with what was now I can only describe as going between discomfort and sheer teeth grinding pain. But I still continued breastfeeding. Although hazy now (selective memory obviously), I cried about this nearly every day, my husband frequently tried to persuade me to stop breastfeeding and even my mum (a pro-breast feeder) did suggest once or twice it might not be worth it.
But I refused to give in. I have no idea where I got this belligerence to continue from but I did. Something inside me just had to carry on.
The infection and sore gradually decreased after a second dose of antibiotics but there was still a nagging soreness in my nipple, and I still couldn’t breastfeed without the shield. In desperation I made another doctors appointment and saw a different (female!) doctor who suggested it might be thrush. She took a swab and prescribed me an anti-fungal ointment, with instructions to come back five days afterwards. The cream helped but it still wasn’t right. At this point I really was at my wits end. I was in a quandary. In many ways breastfeeding had become easy, ironically feeding on the L was a cinch and Elliott was thriving. I went back to the same doctor. Although the swab had come back clear she prescribed me the one off tablet for thrush. Within twenty-four hours I had no pain, no pulling sensation, no gut-wrenching trauma and within forty-eight hours I was nipple shield-less! I have not looked back since, and everything everyone said about breastfeeding came true. It is so so easy. No sterilising, no warming, no getting up in the night to get things ready. A piece of piss if you will. On top of this, my son had doubled (yes, doubled!) his birth weight in three months. I did that – me and my boobs.
When I started breastfeeding, even before all the issues, I didn’t know how long I’d carry on for. When things were though I thought maybe six weeks. Then it got easier and I thought, ok, how about three months. Then it got easier still and seven months along we are still breastfeeding, with four teeth in his mouth too.
I don’t now question when I’ll stop. I don’t really think about that I just go with the flow. From someone who laughed at breastfeeding beyond babyhood I do wonder if that might be me. Breastfeeding is so much more than just food; it’s a huge comfort and an incredible bond between baby and mother. I also now understand why the long feeds when the baby is first born really should be cherished; if nothing else nowadays E is so quick the chance of me watching a programme would be a fine thing!
I know breastfeeding is really hard, and without doubt the fact that I have a family full of breast feeders plus positive midwives on hand made my journey easier in many ways, in other ways it was bloody gruelling but I got there and I’m really chuffed that I did.
"You may be worried about breastfeeding and worried that it might ‘not work’. This is a common feeling when you live in a society where breastfeeding is often sabotaged by incorrect information, patchy support from a stretched health service and powerful messages from formula companies. But it’s not a feeling that is entirely logical. We are mammals. We get our name from the dangly milk-producing bits. It defines us.
This book aims to make you as well-prepared as possible. I would like you to breastfeed for as long as you want to and as happily as possible. I want you to feel supported.
Some of this new life with baby will be about flexibility, responsiveness and acceptance. If you are used to a world of schedules and decisions and goals, it may be a bit of a shock. Learn about human biology before you think it sounds a bit too scary! Babies are the products of millions of years of evolution, and we are too; if we can just tap into our instincts and trust them a little bit.
Success comes when we tap into those instincts and when we know when to get help when our instincts aren’t answering all of our questions.
Can everyone who wants to breastfeed make it work? No. Not everyone may be able to exclusively breastfeed due to medical issues. Most of these people can give their baby breastmilk, though, which the book also covers. (And let’s not start this journey by imagining you’ll be someone who won’t make it...!)"