Q&A: breastfeeding the second time around

Vanessa writes:

"I had a terrible time starting breastfeeding with my daughter. I had flat nipples and sensitive skin and my daughter had a high palate. I never cracked or bled, but my nipples were constantly in pain (bruised and abraded) for the first two months. I saw a lactation consultant several times, and the latch looked good to her. From everything I read, it seemed fine to me too. She had some suggestions for correcting the problems I was having, but nothing seemed to work for us. I was determined to breastfeed, so I just kept going through the pain. Eventually I was able to heal and we went on to breastfeed comfortably for over a year. 

Now I am pregnant with my second child, and I am getting nervous about the same thing happening again. It's been a while, and I know my nipples are not as tough as they were. Do people usually find it easier the second time, or do I just have to get through the bad part with the knowledge that it will (eventually) get better?"

I think almost everyone finds breastfeeding the second time at least a little bit easier, if only because you know there's light at the end of the tunnel one way or another. Plus, the first time around neither you nor your baby knows what you're doing. The second time, even if your baby has a hard time latching at the beginning, at least you know how to nurse. Since breastfeeding is a two-person job, that makes an enormous difference.

I think it's possible that you'll be in pain again if the new baby also has a high palate, since it sounds like that may have been the big issue you and your daughter had. But it shouldn't be as painful for as long as it was, because you're not starting from the same point physically or emotionally. With your daughter, you had no idea what to expect, and the pain probably seemed endless. The next time, you'll know that the brand-newborn phase is really only a short time (even when it seems like an eternity), so it'll be easier to trust that you'll make it to your goals. (I"m assuming you're like a lot of us and set progressive goals of making it to 3 weeks, then 6 weeks, then 12 weeks, etc.)

Plus, even though your nipples seem exactly the same as they were before you had your daughter, they're going to be ready to swing back into active duty much more quickly than they did the first time. The flatness might not be such as issue, and they won't need as long a period of toughening up.

I really think a major factor in what makes the second time around easier for most women is that the second time you know what's normal and what's not. You know how to latch a baby and how to check and correct your own latch. You know that if you get lazy about enforcing correct latch during the middle of the night you'll be paying for it the next day, but it's more a calculated risk than a miserable betrayal (the way it felt the first time around when you discovered that equation). You know that one bad feed isn't going to kill your baby or make your milk dry up.

And none of the other stuff will be a shock, either. Nursing by itself can be difficult, but that first time around it's just sensory overload when you add it to all the other aspects of caring for a newborn. The poop, the odd marks on the skin, the spitting up, the crazy only-sleeping-during-the-daylight schedule, the mood swings, the loss of identity you feel, the fights with your partner, etc. The second time through, even if you don't remember and anticipate all this stuff ahead of time, when you're in it you can remind yourself that none of that lasts forever and you're doing a great job of treading water until things change.

Another often-overlooked factor is that statistically women have more success with nursing after easier births than after harder ones. And second births tend to be much easier than first births, whether they're repeat vaginal births or repeat c-sections, and recovery is almost always easier the second time. (The women I know personally who've attempted VBACs mostly seemed to be happy they'd tried them, whether they ended up delivering vaginally or by c-section. So I don't know that the attempted VBACs can be considered "easier," but the mothers had increased self-esteem after them.)

If you really had problems nursing the first time, and ended up supplementing with or switching to formula, you probably felt rotten and inadequate. The second time around a) you'll probably have an easier time and a better supply anyway, and b) you'll know that any milk you can give your child is great, so using formula doesn't make you a lesser mother. It doesn't seem like the horrible tightrope act is was the first time, since formula doesn't equal failure anymore. (I'd urge anyone who had a crappy nursing experience with a first child to try it with a second. It could be far easier, just because the second child is a different person. To increase your odds of success, see an IBCLC lactation consultant before you deliver. She'll help you pinpoint what the major problems were the first time and come up with a plan to increase your odds of success the next time. You'll never know if you don't try.)

So I think you're going to have a far easier time with the second baby, Vanessa. I can give you my data point: I'm white and have pale skin and blue eyes (which seem to correlate to having nursing pain for a longer time at the beginning). With my first son I had nipple pain for 5 weeks. Some of that was a bad latch caused by the Boppy (it didn't hug up to me and my son was so big that he'd fall into the crack between the Boppy and me and twist around, hurting my nipples) but some of it was my paleness. With my second son I started to feel a little pain, but by day 3 it was resolved.

Anyone else want to give data points on the differences between nursing a first and second child?

Comments

[Kate]

I did not really have problems with either one, but the confidence I had with my second baby allowed me to relax (thereby helping everyone). As Moxie noted, when 50% of the people know what they are doing, it makes the job easier.

I wasn't paranoid about weight gain or "elimination"; I *never* woke up my second baby to feed him. And I wasn't constantly on the phone to my doula (also an LLL leader), so I could sleep when he did--IF my toddler was sleeping too.

[hedra]

Moxie, you've done a brilliant job of highlighting the issues. MWAH! (That's blowing you a big kiss, in case it didn't sound like one.)

My experience is different, but still fits the same general outline.

First child, horrible clamping latch (likely from an oral aversion), crying pain on my part for 5 1/2 weeks, magically went away.

Second child, totally different issues with both him and me, and many *more* of them - milk/soy protien intolerance, oversupply, lazy latch, breast inflammation (I'm one of the lucky ones whose breast tissue goes haywire postpartum - like letting down molten lava, thank heavens for Ibuprophin!). But despite so many more problems the second time, MUCH better experience.

The difference? Just as you said. I knew that I could find an answer. I knew that things weren't 'right' and that they could be made right, and even if they could not be made right, I could tough things out for quite a while knowing that things would change with time. And if I couldn't tough it out, I could bridge the gap in another way. I got help, I had resources, and I knew where to find information.

Honestly, I did think that some of my specific technical skills would come in handy. I'd learned a dozen ways to position and burp Gabe in 3 1/4 years. I was a MASTER. Um, not. I couldn't apply a single one without modifications with Brendan. GAH! Dang! Whole new baby, whole new ball game. Maybe 20% of my technical baby skills were applicable as-is. BUT, that attitude and understanding under it all was the real issue. What made having a second a breeze wasn't 'I know all about babies now' but 'I know how to LEARN a baby, now!'

By the time the twins were born, I knew that we could roll with anything. That I could learn what I needed, that I could find the resources I needed, that I could ask for help without fear, that my best skill was not 'burping by doing x' but 'reading my child' and 'trusting my instincts' and 'finding solutions' and 'making it even when we can't find the right solution'. That makes the second time around (and the third and fourth at once, for us), much easier than the first.

[Kelly]

Psychologically, everything was easier the second time around. You're just not as antsy and paranoid and worried that you're somehow going to harm the tiny being you've been entrusted to care for and help grow.

As someone who had a horrible nursing experience with #1 (she refused to latch from day 2 in the hospital), I was plenty scared about what would happen with #2. When she did arrive, I found that I was much more relaxed and confident than I ever felt was possible. It's amazing how much your body knows better too. With #1, my milk took 8 days to come in, and the second time around, barely 2 days. That was such a relief. No trotting out the pump, no supplementing with formula, no beating myself over the head for being such a goddam failure at birth and then breastfeeding.

And I also made myself a deal. If breastfeeding was as much a problem the second time around, I'd simply give her as much of my own milk as I could, and I'd supplement. I'd let myself off the hook.

And even though #2 was easier in terms of her actually wanting to nurse, I had a host of problems plague us until about 5 months partpartum: oversupply, yeast, mastitis, nipple vasospasms (felt like my breasts were on fire), cracked nipples, yada yada yada. She wanted to nurse every 45 minutes and of course, would not take a bottle.

(Something I'd like to recommend, despite the hefty price, is Dr. Jack Newman's APNO (all-purpose nipple ointment). Lily's pediatrician prescribed it for me (you have to get it from a compounding pharmacy, and it's like $70, goddam it!), but a little goes A LONG WAY, and it was a lifesaver as far as nipple pain was concerned. It just about eradicated any trace of pain, much better than any thing OTC.)

Ah...breastfeeding.

[HollyRhea]

I only have one baby, so I can't say much. But I do want to let Vanessa know that a high palate is conducive to a great singing voice.

[Menita]

My experience with my first was just awful - I never got her to latch and I pumped round the clock for three months until I just gave up.
Psychologically I was much better prepared for my second - I knew that I needed to wait some things out a little longer, I went to a breastfeeding support group every week for the first six weeks, asked for help often, and followed my gut about what felt right to try (I still use a nipple shield at nine weeks - I know Moxie, I know, but it has been a lifesaver for me and the boy is doing well on it).
Good luck, Vanessa!

[Carla Hinkle]

Ooh, I am so glad you put up this post ... I am having my 2nd in January and love to see the tips! Not that my 1st was so tough but more tips from BTDT are always helpful ...

[Moxie]

Hey, my problem with nipple shields is that you have to keep track of them, and wash them, and keep track of them. And you always have to have them when you nurse, so if you're in one room and they're in the other...

I think some LCs see them as a one-size-fits-all solution to latch problems, and then people who don't really need them end up stuck with them or having to wean off them.

But I have no problems with the shields themselves and know they've saved many a breastfeeding relationship.

[Vanessa]

Thanks for the advice and reassurance! I had to laugh at HollyRhea's comment - my daughter loves to sing, but let's just say that her renditions of Twinkle, Twinkle Little Star do not inspire thoughts of a vocal career.

[Michelle]

I was sore with my first son for three months. Cracked and bleeding sore. Attributed it to a short frenulum and slightly high palate. Figured when #2 came along it would be a breeze b/c a) I knew what I was doing, b) if he had a short frenulum I knew what to do and c) my body would already be "toughened up." Wrong. Granted it only took until ~6 weeks of age this time for me to not wince with every latch, but the reason I was able to get through was purely because of the light at the end of the tunnel -- I had BTDT and survived and knew that this too shall pass. Good luck!!

[Missy]

I read this and had to comment. I just had my third baby this summer and I've nursed all three kids. With my first, I had alot of problems when she was a newborn. I felt like I needed 3 hands (and often did use 3 when DH, my mom or best friend were around). Latching was an issue. I had alot of pain. It got better and we went on to nurse successfully for a year, although I had supply issues when I returned to work and had to supplement.

The second baby came along and nursed like a pro. No latching problems, no pain, I only needed one hand. And of course, I thought that it was me, the experienced breastfeeder, look how great I was at doing this. We nursed for 16 months, no supplements.

The third baby came along and we were back to square one. He nursed exactly like my first. Again I needed another set of hands! He was a bit of a lazy latcher, caused mommy a lot of pain. When my milk came in he refused to latch at all. All was resolved with the help of an LC. He is 9 weeks old now and we are doing great. But it made me realize that for me, it is VERY dependent on the baby. But again, having been through it before and knowing it gets better helped tremendously.

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Hey, my problem with nipple shields is that you have to keep track of them, and wash them, and keep track of them. And you always have to have them when you nurse, so if you're in one room and they're in the other...

I think some LCs see them as a one-size-fits-all solution to latch problems, and then people who don't really need them end up stuck with them or having to wean off them.

But I have no problems with the shields themselves and know they've saved many a breastfeeding relationship.

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