Expert: ruth kraft - 8/11/2009

Question
Hello. I recently had my second child. And like my first, I am solely breastfeeding from the start. However, around a week ago, I noticed that every time I go to feed my baby, it hurts my nipples and breasts on both sides. Like someone is stabbing me with needles. I noticed they were cracked so I started using Lanolin cream on them and pumping the milk for him. But he acted like he wasn't getting enough milk being pumped. I was pumping around 2oz every 2 hours. So I started supplementing with similac formula for fussiness, gas, and colic. He would eat 4oz every 3 to 4 hours. After 3 days of pumping, I tried breastfeeding him again. After one day the pain came back. I know he is getting enough to eat when he nurses because I hear him swallowing and he has plenty of wet and dirty diapers. But he still acted like he was hungry. So I had to supplement a bottle of 2oz of formula twice during that day. My question is why is it hurting me to nurse him? Is he not latched on correctly? Everything I have researched shows that he is. IS it ok to just pump the milk out for him? Will it diminish my milk supply that way? That way he still gets the benefit of breastfeeding. Is it ok to supplement with formula and if so which kind do you recommend? I never had any problems with my first child. She was born premature and I nursed her from day one till she was one year old. SO With me having problems with him and having to supplement with formula, I feel like I am felling him, letting him down. I hope that makes since. I just want to do what is right for my son. One more thing, how do you know if the baby is eating to much if I have to supplement with formula. Please help. I know breastfeeding is best, but I don't want my baby to be hungry. One more thing, my son just turned 1 month old.

Answer
Hello :) It certinaly sounds to me as though he is not latched correctly. Too much right on the nipple not on breast tissue. It does tend to be much more work to pump to feed of breastmilk, bowever it is possible to exclusivly pump. I cannot reccomend formula that would be something that has to come from your doctor. However, I would strongly suggest you get the latch/position corrected and you wont have to worry about supplimenting at all. that is thebest for you and the baby.

You an tell the baby is getting enough by if he is having at least 6-8 wet diapers a day and 1-2 dirty diapers. ( after 6 weeks only the wet diapers are most important )  you can also tell he is alert and wanting to learn and interact with you and is gaining weight. If you are only supplimenting 2-4 ounces of formula a day, chances are, you don't really need it. You just need to get the latch fixed so he nurses better, for less time and less painfully to you. Sometimes a latch issue might be so small it looks correct but theres something that still needs to be tweaked... SO don't feel badly that you are missing it...

SO, first, go to www.drjacknewman.com and watch the videos on effective nursing. Then, call the hospital where you delivered and ask to speak to the lactation consultant and set up a meeting with her. If that isnt possible then go to www.LLLI.org and contact them by phone or email to get a local free breastfeeding councelor . Have them evaluate in person, what is going on. If that doesnt work or you want to do over the phone counceling, or via internet, I know someone who does breatfeeding couceling by SKYPE over the net.

I hope that helps!