Help Has Arrived!

Yesterday someone from the Bump referred me to the boards at Kellymom, where a couple of people suggested I look for a board certified lactation consultant (IBCLC), telling me that they have a lot more training and experience than your run of the mill LC. I had no idea there was such a thing or a difference between the two - sure enough, the LCs at my hospital are not board certified. It would probably be more accurate to call them lactation nurses. So I googled and found someone locally and gave her a call - she said she would do a two hour consultation, with full reports given to my OB and Miles's pedi, and a one hour followup in a week or two, for a fee of $100 - and she could see me that day (yesterday).

I checked with Mr. I and he agreed it was worth the money even though we're on such a fixed income right now. As he pointed out, if I could continue breastfeeding, $100 is a lot less than formula would cost.

So I made it over there yesterday afternoon and I FINALLY GOT SOME ANSWERS.

*Huge sigh of relief.* My mood is a thousand times better today and I think even if she hadn't been able to fix our breastfeeding issues, just having someone sit down with me for two hours, totally devote her attention to this, listen to me, and validate my feelings and thoughts about it was incredibly uplifting. I can't tell you how good it felt to have someone look at me and say, yes, you are dealing with significant pain, and no, it doesn't have to be this way.

Miles does not have tongue tie (have to cancel that ENT appointment today) but we are dealing with a number of issues.

1. My biggest problem is that my nipples were badly damaged by the nipple shield on DAY TWO and have never recovered or fully healed. I've just been putting the baby on cracked, bleeding, traumatized nipples for four weeks and this is why I have such severe pain. She looked at the cracks on my nipples and visibly winced. And she said, "lanolin isn't helping, is it?" THANK YOU! She's getting me a prescription for "quad cream," which is a combination of antibacterial, antifungal, and steroidal ointment to speed healing and provide pain relief. The healing will take a while but the pain relief should come quickly, thank Baby Jesus.

She was completely horrified when I told her that, one, the hospital LCs gave me a nipple shield the day after delivery, and two, they gave me a size small. She said she never, ever gives people a size small because every time she's seen it used she sees bleeding nipples. It's tiny, and basically it draws the tip of your nipple into the baby's mouth, which is insanely painful and damaging.

And there was no reason to give me a shield in the first place. She said she only uses them for women with flat nipples, and mine are perfectly good for breastfeeding, not "short shanked" like the hospital LCs told me. They gave it to me pretty much just to cover up the latch issues rather than try to correct them, which is exactly what it felt like to me at the time - here, take this nipple shield and go home. I KNEW that damn thing wasn't right! It felt awesome to have her back me up on that.

2. My latch is okay - at the initial latch-on. But as the feeding goes on, Miles get tired or lazy and wants to pull away or slip down and suck on the end of the nipple, which would be painful even if I weren't already sore. He also likes to "hang out" on the boob, which might be okay for women who aren't all messed up like me, but hurts too much for me. She showed me how to keep his head in place, and stimulate him to keep drinking without letting him loiter at Boobytown.

3. Miles can move his tongue properly, but sometimes he doesn't, and holds it back in his mouth and gums the nipple - she felt this with a finger in his mouth. So we have some exercises we can do with him (with a finger not a boob) to help train him to use his tongue properly.

4. I do have a little bit of an oversupply and fast letdown, which may be causing some of the head-yanking and nipple-pulling he does at the breast. I can try to keep his head higher than his body to help with that.

5. He stimulates letdown a little too aggressively, so I can start a feeding by massaging the breast and hand expressing a little milk to get things started and prevent him from attacking me.

6. I may have a mild cause of Raynaud's Phenomenon of the nipple. I don't have the classic outward sign of blanching or color changing, but to her it sounded like a possibility because I described having severe pain when I step out of the shower or go outside in the cold weather. She said I should discuss this when I see Dr. J for my post partum visit in a couple of weeks. I can probably address this just by keeping warm and treating the underlying cracking/soreness, but there is a prescription medication for it if I need that too.

She also said (unlike the LLL leader) it's perfectly fine to pump and bottle feed when I'm in too much pain and to let my nipples heal a little. Already I see a difference in the cracks from the breaks I've been taking from nursing. And she said it's fine to use a pacifier too, since my milk supply is perfectly adequate - she mostly avoids it when the mother's milk supply is not established and baby needs to suck at the breast to keep it going. She did say that the Nuks we have are fine but avoid Soothies (which Miles dislikes anyway) because the shape of them is not compatible with breastfeeding.

While I was there I bought a 6 pack of Bravura washable breast pads for $12. I do tend to leak and have been smoking through my box of 100 Avent disposable pads, so these should be more economical in the long run, and they're very comfy. They have a moisture-wicking side and a terrycloth side. They're pretty thick and might look a little lumpy in a tight tshirt, but luckily for me it's winter and I'm always layered up.

All in all, that was one of the best $100 bills I've ever spent. I was on a total high when I left. Mr. Ibis was really happy that I finally got some help and he understood how good it felt for me to get some validation for what I've been dealing with. And just to get some answers finally! I felt like I was going a little insane as everyone around me just said, "oh, your nipples will toughen up, try some lanolin."

I'm going to feel a little funny going back to Mom & Baby, since it's led by one of the hospital LCs and I now regard them collectively as the devil for essentially sabotaging my entire breastfeeding experience, at least the first four weeks of it... not intentionally, but certainly that was the net result of their "help" in the hospital. I kind of want to tell them about it, and maybe help the next woman they foist that horrid small shield upon, but it's a bit awkward, isn't it.