4 wk old not latching properly - too late now?

[Lucy1977]

Hi

I'm BF DD who is 4 wks old but we've had a bumpy ride, I haven't ever had a pain free feed and then we got Thrush. Midwives and Health visitors looked at her latching and gave me some help but other times said she was latching on fine but then I watched an NHS breastfeeding video last night and it appears she's not latching right at all? By that I mean she does take some aeorola into her mouth but it definately doesn't go as far back as their diagrams? My DD also fusses a lot and moves her head around and comes off the breast and then re-latches again and there's often a Clicking sound and milk does pour down the side of her mouth sometimes so I know all these indicate she's not latching properly.

Any tips how I do get her to latch properly? My boobs and nipples were tiny in comparison to those in the video I watch and where their aerola appeared soft and easy for the baby to take it in their mouth mine are really hard and wide (their was more mouth shaped). My boobs aren't engorge so it's not like expressing some will help? I tried to get more of the aerola in DD mouth when she was feeding earlier but she kind of gagged and then cried.

DD is putting on weight, she was 7bs 4.5 oz at birth then 5 days later was 6lbs 12 oz and on Tues (so 3 wks since being 6lb 12) she was 8lbs.

Thanks for any advice,

Lucy
Olivia 27 days old

[NotQuiteCockney]

Does she seem generally well?

You say the feeds hurt, when do they hurt, when she latches on? When your milk lets down? Or throughout the feed? Are your nipples sore the rest of the time?

It sounds like her weight gain is good. (Was she always weighed on electronic scales, naked?)

I think the best way to get some help is to see a BFC - midwives and health visitors are often crap on breast feeding support. Do you have local BF support? Where are you?

[Lucy1977]

Thanks for your quick response

Yes DD does seem generally well, she's been smiling for a few days now and recognises my voice and does 2-3 dirty nappies a day and about 4 wet ones.

She's always weighed naked on electronic scales.

My boobs do seem less sore today, that might sound a bit vague but we've only just finished our Thrush treatment and prior to that they were so cracked and full of splits that I wasn't sure what and where the pain was.
When I feed DD I get a pain when the other boob starts leaking - is that the let down? Also, my left nipple has a sore sensation when DD uses her tongue to call more milk (that's what I understand that bit to be?).
It's nowhere near as sore and painful as what it has been and I don't have to air dry them constantly (before it was to sore to put a top on).

You're right I do need to see a BF councellor - I thought I had good support in my area and was given a BF buddy but they are trained by the HV and I haven't heard from my BF buddy yet (I called her for advice when DD was 1 wk old and she said she'd call me the next wk but haven't heard from her - I appreciate it's a volunteer system so I didn't want to hassle her).

Does anyone know if there is a BF councellor I can pay to see? I really am keen to carry on BF.

Thanks

Lucy

[CattyB]

Well done for sticking with it! Your dd does sound like she's thriving so she's obviously getting well fed.

I've bf all 3 of my boys until they have self weaned in bith cases around 20m. Ds 3 is now almost 9 m and things have been fine this time round as my boobs seem know what they are doing!!

1st time round I was lucky never to have any real probs but did have a quite painful let down which I never knew was normal but apparently it is - and is an idication of how well you are feeding.

My babies have never let too much milk dribble but a friend always had to tuck a muslin in to catch the overflow and did so all the time she feed. She never had sore nipples so it obviously wasn't cause by poor positioning just the way her babe fed.

BFC wise La Leche Leaque (www.laleche.org.uk) may have someone close to you and may the NCT (www.nctpregnancyandbabycare.com).

Wishing you and your all the best x

[koolkat]

Lucy - well done for getting this far and lots of sympathies for the thrush. It is really hard bf a baby this young without having to deal with thrush as well.

DS and I got thrush when he was around 4 - 5 months old. EVERYTHING you have said, sounds like she still has thrush. The fussing, going on and off the breast, clicking. These are classic thrush signs.

If you have always had pain while feeding that would indicate a bad latch. It is very good that she is putting on weight, but your latch needs to be monitored.

In the mean time if you answer the questions below, I may be able to help further with how to treat thrush.

I became rather an expert as DS and I suffered from it for about 5 weeks. It is a bugger to clear and even if you think it has gone, it may not have.

1. When did you start the thrush treatment ?
   

1. What creams are you using ?
   

1. Are your nipples being treated as well as baby's mouth ?
   

1. Do you have shooting like pains right down the breast and chest area (not just nipples) ?
   

1. Do you ever express milk ?
   

1. Would you consider expressing a couple of times a day and feeding baby by syringe or spoon ? (an excllent way to get more milk into a fussy baby). If she has thrush her mouth and throat may be sore and it will be painful for her to feed.
   

1. Where do you live ? I am a member of my local LLL and can try to find you an NCT or LLL adviser if you let me know which town you live in.

[NotQuiteCockney]

The pain does sound like let-down pain, which is annoying, but not a problem ... or at least not fixable, and not the sign of anything being wrong with you or the baby. It normally gets worse in the first few weeks, and clears up after a few months.

There aren't a lot of BFCs you pay, and those are sometimes not good. You should be able to get support from the LLL/NCT/ABM/BFN, depending on the area you live in. If you told us vaguely where you are, one of us might be able to find you something?

[Lucy1977]

Wow thanks ladies for your rplies, I really appreciate your help.

Koolcat - replies r below:

1. When did you start the thrush treatment ?
   

2 wks ago tomorrow

1. What creams are you using ?
   

I had diaflucan ( or known as fluconzol?) and DD had Daktarin gel

1. Are your nipples being treated as well as baby's mouth ?
   

yes

1. Do you have shooting like pains right down the breast and chest area (not just nipples) ?
   

thats what I did have, this pain has gone now

1. Do you ever express milk ?
   

I can't seem to get more than a dribble out and made my nipples more sore

1. Would you consider expressing a couple of times a day and feeding baby by syringe or spoon ? (an excllent way to get more milk into a fussy baby). If she has thrush her mouth and throat may be sore and it will be painful for her to feed.
   

Certainly if that what I need to do but just prob of not being able to express?

1. Where do you live ? I am a member of my local LLL and can try to find you an NCT or LLL adviser if you let me know which town you live in.
   

I live in Strathaven, near Hamilton in South Lanarksire

DD has just had a feed now, it was only short but she wasn't as fussy but the clicking noise still here :(

Also, after her cluster feeding from 9-11 she usually sleeps until 3am but then wakes every hour - any tips on keeping her awake enough to get a belly full of food to make her sleep for 2 hours at a time or is this normal? (she's always done this so don't think its a gs)

Thanks again

Lucy
Olivis 27 days old

[NotQuiteCockney]

There's a breastfeeding support group in Strathaven, but it is HV run:

Strathaven Breastfeeding Support Group,
Strathaven Health Centre
The Ward
Strathaven
ML10 6AS
Shona Brownlie
Health Visitor
01357 529911

According to \link{http://www.lanarkshirebreastfeeding.org.uk/support.htm\this} page, their group is on a Wednesday from 10:30 to 11:30. You probably already know about these folks? There are some Hamilton groups on that page, too.

Alternatively, you can try phoning the LLL/NCT/ABM/BFN folks - I don't know which group has better coverage in your area, I'm afraid. (Those are the La Leche League, National Childbirth Trust, Association of Breastfeeding Mothers, and the Breastfeeding Network.)

Re: the sleepy baby. I'd just sleep with her, so she can snack, and you can nap, and everyone's happy. \link{http://www.leron-line.com/handouts/sleepy_baby.htm\This} page has some interesting ideas. But the problem is, you don't want your baby to think 3am is a good time to wake up and party, iyswim. Easier to sleep with the baby and not worry about it, in my experience.

[Lucy1977]

Thanks NQC - I go to that BF clinic every week (they say the latch is fine).

I'll call the LLL league - I hadn't heard of them before

Thanks

Lucy
Olivia 27 days old

[NotQuiteCockney]

You know, it may be that your DD's latch is mostly ok. And as her mouth gets bigger (along with the rest of her) it may well get even better, iyswim. The problem is generally that the baby is taking too little of the breast into their mouth, from what I know ...

If your nipples and breasts aren't much like the nipples and breasts of the woman in the video, then of course they would look different during breastfeeding!

[Lucy1977]

NQC - yep you're right my latch etc will be different as I've got different boobies! I hadn't seen any videos of BF before so it was good to see how others do it, they had a good method of pushing the skin above the nipple to turn the nipple up so that ensured the nipple was at the top of the baby's mouth.

It was just when I was hearing them say "indications that the latch is not correct are: milk coming out of the baby's mouth, clicking noises, pain" etc etc made me realise we have all of those!

Hausfrau - that's interesting to hear about your friend having a clicking sound as well - perhaps all is ok with us?

Thanks

Lucy
Olivia 27 days old

[NotQuiteCockney]

But the problem is, Hausfrau, she has had it checked out, repeatedly.

It might be worth trying one of the other BF clinics, listed on that page I linked to? In case one of them can see something, or suggest something, that your local clinic can't?

Or, yeah, LLL/NCT/ABM/BFN. Hmm, not BFN, they've got no support centres in your bit of Scotland (I \link{http://www.breastfeedingnetwork.org.uk/breastfeeding/support_locator.php?areaId=14\think}?) \link{http://www.laleche.org.uk/pages/groups/scotland.htm\Here's} the LLL details for Scotland. I can't find out what's up with NCT up there. Hmm, and the ABM link to the Lanarkshire breastfeeding support website that I linked to before. So maybe the NCT have something else going on up there, but I'm dubious about the LLL, ABM or BFN. (They might have supporters who aren't running any drop-in groups, I guess, just taking calls on the supporterline and visiting people ...)

[Lucy1977]

NQC - thanks for the LLL info, I called the helpline and spoke to a lady - up here there is only 1 LLL group in the West of Scotland and since they have their monthly meeting on Tuesday at her house I'm going to go along then to get checked out. Thanks again for suggesting this.

Hausfrau - to be honest I think when the midwives/HV was checking out my latch was when DD wasn't due a feed and so she was just taking some food but just going through the motions as it were. ouch - I don't want to lose my nips!

Thanks again

Lucy
Olivia
27 days old

[koolkat]

Lucy - please make sure the thrush has completely cleared.

Sometimes you need the treatment to go on for another week or so AFTER the symptoms have gone to make sure the damn thing isn't still there. It is such a persistent bugger !!

Dakatrin gel is excellent and the best treatment for thrush on the market. Keep using it if you need to.

As a LLL member (of course I am totally biased) I can confirm they are excellent !

Do make sure their Leader sees your latch and discuss the thrush with her as well. If they have monthly meetings in your area, fantastic.

Eventually once your baby is old enough to be on solids at 6 months, they will help you with that too. One of the BIG discussions at LLL meetings is sleep The mothers there may have some helpful tips for you plus LLL has a library (well it's a box full of books !) on most topics of interest including sleep and behaviour.

Come back and tell us how you are getting on !

Best of luck, and ENJOY YOUR BABY !

[99redballoons]

Hi Lucy, well done for persevering with bf! It's sooo hard to get established, but so easy and rewarding once you get going. I haven't had thrush, but have had mastitis with both of my two (ds & dd) around the 2 wk mark, so sort of know the pain you've had to go through.

Something that hasn't been mentioned yet, could your dd possibly have a tongue-tie? My ds did (has), and being my first baby I didn't realise there was a problem, except that he was finding it do difficult to feed properly, was fidgety, made clicking sounds, and squashed my nipple. Finally the HV mentioned that he could be tongue-tied (4 wks in!!). It was only after lots of research myself that I realised this definitely was the problem. Here are a couple of links to see if you can relate to any of this.

\link{http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Tongue-tie?open\Link 1}
\link{http://breastfeed.com/resources/articles/tonguetied.htm\Here is a good picture of a tonguetie}

I managed to bf ds for 10mo so it wasn't a problem in the end. He finally got the hang of things in week 5-6.

Thankfully dd (4mo) doesn't have a tt, but still makes the odd clicking sound on my right breast, which funnily enough has a slightly smaller nipple than my left so perhaps she finds it different to latch on to when I swap sides.

Also, to help with pain (not sure if it's compatible with your thrush creams) is LANSINOH. It's about £10 from Boots, but is the best cream ever!! It soothed my cracked nipples no end. I had tried lots of cheaper products but nothing worked as well as Lansinoh.

One last thing that comes to mind. My HV said to look at your breast, the shape of it (pertness) and where the nipple is. Now imagine a straw coming out from the centre of your breast and out of you nipple. That is the angle the baby should be held to latch on to you breast. So if your breast is [ahem] pert then maybe you need to sit up straighter and more forward so that you go in at the correct angle. She said if the angle is wrong it will be like drinking out of a bent straw and nothing will come out, or not easily. Made sense to me and did the job. I always think of this if I feel the latch wasn't quite right, I just take dd off, readjust myself and try again. I find that lots of women starting off on bf don't realise how important sitting upright is and having plenty of support under your arms and back. Maybe change bf chairs? Also get a "V" pillow to rest dd on?

HTH and you start feeling better soon.

[koolkat]

Yes, Lansinoh is completely compatible with thrush creams. No need to wash off Lansinoh before or after a feed. Also if you use the thrush creams AFTER each feed, no need to wash off.

[Lucy1977]

Thanks for your help ladies. Today has been a nightmare feeding DD - she's so frantic at the breast that in the end I think she gives up and falls asleep! When the click occurs she stops feeding and breaks the latch, I've also noticed a kind of dull click as well - I think her gums hit each other when my nipple isn't far enough back.

KK - i haven't had the breast pain and I can't see any symptoms in DD so I hope the Thrush has gone now but I'll keep my eye on it, my treamtent was a 7 day course of tablets so they have finished but i could still use the gell on DD just on case?

99RB - thanks for the links, the signs are very similar aren't they but I've checked DD's mouth and her tongue is oval shaped and she does poke it out just past her lips (she did this alot after putting the thrush treatment gel on that wa orange flavoured!!)

I do think I need a v pillow as my breasts are small and pert at the moment (ha ha they are at the moment but sure they will droop after feeding!)
Your tip about visualising a straw is excellent as my nipples are more on the "corner" of my boobs rather than out the front ( sorry if TMI but looking down at my boobs they look like irregular triangles not roung and the top of the triangle, my nipple, is like being at point North East if it were on a compass- does that make sense?) So when I position DD her body can't be tucked up to my belly as otherwise she can't get latched at all as the nipple is round the other corner!

DH is going to give her a bottle of formula now as I'm just not happy that she's had enough milk today - she's been really sleepy and only nursed for 5 or ten mins at each feed. :-(

Thanks again, I'll let you know how I get on Tuesday.

Lucy
Olivia 28 days old

[busybaby]

Your experience sounds v.v. similar to mine - my dd now 5 months old and been on bottles for just over 1 month .
My dd is slightly tongue-tied and so couldn't latch on properly - the clicking noise and sliding off the nipple sounds especially familiar.
We also had thrush - in my milk ducts as well - I sympathise greatly with you.
I diagnosed my dd's tongue-tie myself when trying desperately to find out if there was any link between thrush and colic - she was awful with it ... obviously because she wasn't latching on properly.
Could your dd have a similar problem? I'll find one of the websites I looked at for you - it has lists of symptoms for baby, mum and feeding ...

[busybaby]

I've just read your last post in more detail - I got excited, sorry! My dd can also poke her tongue out well and has only a slight 'heart' at the end of her tongue. More noticeable is a dimple further back on her tongue when she pokes it out, and when she puts her tongue up to the roof of her mouth or top lip the frenulum looks tight and white. It is only a mild tongue-tie but enough to be a problem for her when latching on.
It took me nearly 4 months to figure out why dd was struggling with feeding so much - she was frantic at the breast too - and was not thriving. We saw a number of health care professionals and none of them spotted it! It was only my desperate research that led me to the diagnosis - the HV then agreed with me.

[busybaby]

The link that 99RB has given says basically the same as the ones I found.

[Lucy1977]

Thanks for your replies busybaby. I've had a look at her mouh and her tongue does have an ever so slight indent in the tip of her tongue - not really noticeable apart from when she's screaming. The bit of skin underneath also is white when her tongue is mid scream. I'll mention this to my HV tomorrow.
Can I ask - did yor DD ever feed peacefully or was each feed a struggle?

99RB - if DD is tt it's encouraging to read that your DS bf for 10 mths.

Thanks

Lucy
Olivia 29 days old

[koolkat]

Lucy - I still think she may have thrush. Don't know anything about tt.

I would go to see bf adviser asap.

[Lucy1977]

KK - I'll try using the Daktarin gel today to see if it helps.

Roll on Tuesday when hopefully the bf councellor can help.

Do you think a baby would go to sleep hungry? I'm getting myself upset as DD is asleep on my lap after she seemed to give up trying to fight with my boob :-(

Thanks

Lucy
Olivia 29 days old