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?