It’s your first night home from the hospital and your baby who slept and sighed like a tiny wee cherub for the first forty-eight hours is now a furious, red-faced monster and ‘angry screaming’ just doesn’t quite cut it as a description. This piece is just for you.
First, I want you to know that we’ve all been there. You’re absolutely NOT alone. Second, there’s no single right way to go about things and there’s only finding out what works for YOU. Finally, you are doing a fantastic, wonderful job right now even if you feel like you aren’t, you really are, it’s just not always easy.
Now to the practical. This is a kind of middle of the night, trouble shoot guide, a non-extensive list of solutions that could buy you a few hours until you get to a health care provider or work out what’s really going on. Some of this is aimed at breastfeeding families because that’s where I was at with new born babies but for formula advice you can get more information here.
Take a deep breath and remind yourself that you’re a great parent and you are going to get to the bottom of this. Your baby is safe. You are safe and in a few weeks’ time you’re going to share a knowing look with many-a-parent who have been here before. This is the time that you need to learn the ‘mummy mantra’:
This too shall pass.
White noise, loud shushing, rocking, swaddling and if you got a Pilates or birthing ball when you were pregnant blow it back up now because sitting on that and softly bouncing can work wonders, especially if you’re still feeling a bit sore and tired. My babies always loved the feeling of their heads being gently stroked and softly blowing across their foreheads (not talking Dyson the eyeballs or anything, just a soft breeze, you know). Tapping their bottoms while walking with them in a sling, if you’re able, is another option. You will one day find a magical technique that they just love, sometimes that’s even just your voice.
We all know that babies cry so you don’t have to worry endlessly every time it happens. But, if the crying is continuous and baby really isn’t settling after a feed or settling attempts then it’s safer to assume that they are trying to tell you something.
Sometimes even with the very best latch our nipples struggle with the initial onslaught. I’m going to tackle latch issues in the next point down, but here we’ll talk about how to treat nipples. There can be a lot going on that’s causing pain but probably most common is sore and cracked nipples. These need to heal WET and CLEAN. Wash them off with warm, soapy water after a feed, pat dry and then smother them in a nipple cream of your choice. If you have people coming round, or it’s cold, or you just have more dignity than I did, cover them with a breast pad and make sure that anything that comes into contact with them is nice and clean. If possible keep smothering them with nipple cream because they really do heal better when kept moist and clean. Pro tip, if the breast pad sticks to your nipple because you let them dry out, do NOT rip it off (it really, really hurts), dampen it with warm water and a flannel.
Nipple pain can also be a symptom of a thrush infection. Symptoms include shooting pains through the breast and perhaps aching, very painful and sharp stabbing while feeding but that can come and go throughout the feed, not just for the first few seconds. The nipple itself might look pink and shiny. You could also see white patches or spots in baby’s mouth or a thick deposit of white on baby’s tongue (which may also be milk so don’t panic).
Nipple pain is always a good reason to get a professional. It may subside on its own with practise or it may need some treatment, but your comfort while breastfeeding is really, REALLY important. You need to take care of yourself because you’re really important to that little red shouty thing. Also, please, because you are dealing with this now, doesn’t mean that you’ll be dealing with it forever. Get the right help and soon, whatever happens, it’ll be a distant memory, I promise.
I think it really helps here to know what you’re aiming for with nipple/mouth positioning. If you put your own fingertip onto your top teeth, you feel that back of your teeth (duh, but I just want to start this off right), move back slightly and you’ll feel a ridge (alveolar ridge in fact, you’re welcome) after that it gets harder again and that’s your palate and then just back from your palate and towards the throat, it’s soft I’m sure you’re all very excited to find out that that’s called your soft palate or your velum. THAT is what you’re aiming for. That’s why popping your nipple in at the front of your baby’s mouth isn’t very helpful. You’ll note a fantastic diagram to your left featuring the inside of the mouth and throat, complete with hand written notes from first-year university Stephy.
One position that I think was genuinely a revelation was that of biological nurturing, or ‘laid back nursing’. This way you strip down for a bit of skin-to-skin contact, recline or lean back and rest baby gently on your chest allowing them to bob down and get the nipple themselves. This position encourages them to open their mouth nice and wide and they can actually feel what’s what and position themselves, this saves a huge amount of frustrating latching and unlatching. The first few times I tried this with my middle daughter I really, really struggled to trust her enough to do it, the memory of nipple pain makes it hard to believe that they can latch without toe-curling agony, but take a deep breath and know that I’m metaphysically holding your hand. A lovely latch with correctly positioned nipple feels great, it may hurt for the first few seconds but this should quickly subside and if you’re also a bit engorged it’s quite a relief to feel that milk emptying. If my description isn’t very helpful, you can also find videos of this on YouTube and of course ask your midwife.
Formula is an amazing, safe and nutritious milk for babies, it just is. If you think of you and your five best friends, I bet you anything you like a couple of them were formula fed. Using formula to top up a feed if you feel that it’s necessary is always the right thing to do because it’s your baby, your body and your choice. If you offer formula and your baby refuses, that’s fine, they’re obviously not hungry. If you offer formula, your baby drinks it and then settles, you can be sure that you did the right thing.
To put your mind at rest, there’s no such thing as the ‘virgin gut’ and the jury is still out as to whether early supplementation actually affects later feeding. In any case, at the end of the day, the aim of the game is to make sure that your baby grows. I’ve looked and looked and there really is nothing to suggest that supplementation is going to harm your baby, so it can’t hurt.
If you’re not planning to formula feed in the long term it’s best to buy infant formula milk in ready to feed form. We have a great guide to safe formula preparation here, if you have a little more time to plan there’s a fantastic guide to different types of bottle here.
For UK based panicked parents looking at this in the supermarket right now, you’re looking for the number ONE/1 on the label. Other countries have different systems but in the UK higher numbers are for various follow-on milks which have different levels of some nutrients for older babies. Just double check that you have a number 1.
Sometimes babies are crying because they are genuinely hungry and they aren’t quite getting enough to satisfy them. The kind IBCLCs and Doctors at Fed Is Best have made this really helpful meme to help you to spot when hunger becomes dangerous.
With babies, it is never silly or too early to seek medical help, any health care professional worth their salt would rather send a well baby and over cautious parent home than admit one.
To let you in on the biggest parenting secret that there is, we’re all just winging it all the time. No matter how experienced someone seems, babies, children and teenagers are experts at throwing curve balls at us. That’s OK, because that’s what our instincts are for. If you have a feeling that something is not right then just act on it and trust yourself.
You know your baby best and you’re responsible for making decisions based on their needs and with discussion with appropriate care providers.
Disclaimer: The information here is generalised advice, and as such must not be used in place of medical advice. Any concerns that you might have must be taken up with medical professionals in your health care team.