I'm here to tell you that whenever the experts (doctors, lactation consultants, La Leche League literature) say "it shouldn't hurt," that's really a half-truth at best. What they should tell you is that it will very likely involve some soreness, possibly some real pain in the beginning, but that the soreness won't last forever and there are remedies to get you through it. And it's worth it to get through it.
Because for me, the first week ALWAYS hurts. It always involves soreness, no matter how fantastically baby latches on for the first time or the first ten times. Yes, it's important to pay attention to positioning and make sure your baby latches on as well as possible. But that's NOT going to prevent you from having any pain whatsoever. Here's how I know this: even pumping hurts for me in the first week. A pump really can't have a bad latch unless you've fallen asleep and let the thing slide off your nipple and onto bare skin (this happened to a friend--ouch!) But a pump will suck on you, and if your hormones make you engorged and extra sensitive in the nipple region, this sucking is going to hurt, at least mildly and temporarily.
Pumping aside, my babies have ferociously strong sucking instincts, especially in those early colostrum-only days. You know, approximately days 1-3, when your easy-flowing milk isn't there yet. Rob was complaining that his pinky hurt after newborn Rachel and Ian sucked on it. Think about the nerve endings in your pinky, and multiply that by about 20, then again by the 12-16x a day they want to nurse. Ouch.
Then add engorgement to the mix. Day 2 or 3 for me. Those soft breasts turn hot, hard and angry. In my case, they don't seem to want to give up all that milk right away, either. The bumpy, hard nipple/areola is harder for baby to get and keep a good latch on. Fortunately there are some remedies for this, too.
By Day 5 or so, things can soften and calm down to the point where it feels like the worst damage is over, the healing is beginning, and I don't need to marshal so many remedies and preventive measures to get through each feeding. By next month, Ian might be able to latch himself on properly in the dark, as Rachel did by that age. Until then, if I diligently position him well and do just a few things to make for a better latch, we'll keep on trucking and I can be reasonably confident that the worst is well over.
The good news is that after the first month or so, you and baby will have learned each other and the process so well, that you hit payoff mode, where things get good and start to get better and better.
Payoff:
- Baby's digestive system will be happier with breastmilk than formula, resulting in fewer blowouts, less gas and stomach/GI pain. (We switched to formula at 8 months with Natalie and holy moly, the blowouts!) Less need to burp.
- Breastmilk is a natural sedative for baby at night, and the hormones are a natural sedative for you. Result: You both get back to sleep faster than you would otherwise.
- Breastmilk is free (after the initial month's investment, getting over the pain), and always available at the right temperature. No storage/contamination concerns.
- You will lose weight effortlessly, or be able to eat whatever you want without gaining weight.
- Nursing is the best tantrum tamer, if you make it into the toddler years. This is the single biggest reason why I nursed Rachel until age 2-1/2.
- Those cluster feedings that drive you crazy and keep you and baby tethered to each other during the first month? They go away shortly after that, unless baby is sick or something. The feedings gradually space themselves further and further apart.
- Baby gets more efficient at nursing. What used to take 20 minutes will soon take 5. Yeah!
- Nursing babies rarely, if ever, get constipated. Having gone through constipation with Natalie--believe me, it's best avoided if possible.
- Built-in bonding.
- Possibly fewer ear infections and illnesses. Knocking on wood here, but so far none of my kids has had an ear infection. Ever.
Here's an overview of what I've learned or remembered this time:
Engorgement:
- Dry heat really is your friend. Heat up a rice sock or heating pad and hold it against the engorged flesh of your breast. Not your nipple--I bet that would hurt. Do this for a minute or two prior to starting the feeding, and massage the breast tissue (gently) to help open up those milk ducts.
- Pumping is your enemy when you're engorged. Use it only as a last resort to relieve engorgement, because it tends to backfire--you'll be just as engorged or worse in an hour or two.
- This came from a lactation consultant, and I wish I knew about it earlier! Prior to latching the baby on, surround your nipple with your fingertips, push back against the areola toward the chest wall, then gently pull the nipple out to extend it. This momentarily softens the areola and lengthens the nipple, which makes it easier for the baby to correctly latch on (and stay on).
- Don't be afraid to nurse frequently, but do feel free to cut your baby off it's just dragging on too long and you're hurting. Switch sides, if nothing else. This will give you and your baby and chance to practice that pinky-unlock thing you have to do to get them unlatched if they're not letting go.
- Ibuprofen might be your friend, too. It's anti-inflammatory, which might help somewhat with the engorgement. It helped me.
Nipple soreness:
- Have your baby nurse on the less sore side first, because he/she is going to suck harder at the beginning of the feeding. When you switch sides, the suck should be less intense, giving your more damaged nipple more of a chance to heal.
- Use lanolin--apply after each feeding and before covering up your nipples, so that they don't scab and get stuck to the inside of your bra.
- Those soothing gel pads are only helpful for maybe 24 hours. I used mine too long, found that they started adding to the pain, then promptly threw them in the trash, and have felt better ever since.
Getting a good latch:
- Feed in a quiet, reasonably well-lit room in the beginning. Kids barging in or a too-dark room can make for accidental bad latches.
- Don't re-latch your baby 5-10 times trying to get the perfect latch. It will hurt worst in the first 15-30 seconds of the feed, then ease up (to hurting less or not at all) after that. If it's really a bad latch, it will hurt too much for you to continue beyond 15-30 seconds.
- Those little baby arms and hands are going to get in the way at first. Experiment with swaddling to wrap the arms down, but if that results in more frustration for your baby (and ultimately, you), unwrap the arms and do your best to patiently work with your baby until he/she understands that the hands have to be out of the way in order to nurse. I find myself saying, "arms down" to remind Ian of this, though that's probably more for my memory than his.
- The asymmetrical latch works well--just don't forget to line up baby's belly against yours and cradle the base of his/her neck with your hand properly before attempting to latch on. This positioning really helps.
- Cross-cradle hold is the easiest one to get right at first. It puts you more in control of your baby. It's not so friendly on your back, in my experience, but you can work on easing things up on our back after your nipples are okay. Take your time working up to side-lying or cradle hold. Football hold works best in armless chairs (or in the middle of a couch.) But it's not my forte, so I'll just list it as another option.
