Major wobble post tongue tie release- nearly giving up

[Secondsop]

Hello, I've posted before about my baby's poor weight gain and feeding difficulties. He'll be 6 weeks old tomorrow and has had formula / ebm supplements since about 2 weeks in after initially losing 13% of birth weight. He had a posterior tongue tie diagnosed and this was cut last Tuesday. Since then I've been feeding him as often as possible, but whilst continuing the regime we were put on of a total of 240ml top ups a day. In the week before the TT cut he gained well on this.

But in the 9 days since the TT procedure he has gained virtually no weight - only 10g - and has fallen off the bottom of the percentiles. I could tell that he was struggling to relearn to feed with the new tongue movement and that his mouth was sore, and he's had trouble maintaining his latch and was constantly either slipping off, curling his bottom lip right under, or feeding in a sort of slobbery way without a tight hold.

In the last 24 hours his latch seems to have improved in that he's not slipping off every 5 seconds, and I went to the breastfeeding support group today who showed me the laid back position and said his latch was fine in that position and that after a TT cut things can get worse before they get better. I really hope we're therefore turning a corner. But the health visitor at the weighing clinic wants me to increase the formula amount. I really don't want to do that as if this is a blip and not a downward spiral then it'll spell the end of breastfeeding as that's what happened with my first baby. But he's doing so poorly, am I being selfish in wanting to keep breastfeeding him? My husband and mum are constantly saying that I should just give him more formula. But then I've put him through the TT procedure for nothing. Or should I power on through for another few days and see if he really is cracking the feeding technique?

He's producing 5 very heavy wet nappies a day, but since the TT cut has only pooed every 3 days.

[Misty9]

Oh you poor thing, you've had it really hard :( all I can say is you've done amazingly well to get to this point, whatever happens next.

First, is he actually losing weight, or just gaining slowly? If the latter, then I'd stick to your guns for a bit longer. What did breastfeeding support say about it?

Secondly, re the tongue tie release, my baby had it at 5 weeks and it's only in the last fortnight that she's started moving it about a bit more - 5 weeks later. I'm not suggesting you wait that long, but improvement can definitely take time. Also, whatever happens its a good thing to release the tie as it could affect weaning onto solids and sometimes even speech. Ours was pretty traumatic, but I'm still glad we got it done.

Sounds like you definitely could do with some more real life support and expert advice. Is the breastfeeding support group useful?

Hope things improve for you.

[Secondsop]

Thank you both for your responses. Misty, after the initial weight loss he has been gaining albeit slowly and in fits and starts, but only got back to birthweight last week and is now below the 0.4th centile, so we're not in the territory of a baby dropping (eg) from 95th to 85th. It's interesting to know it took that long for your baby after the TT release. The bf support group were helpful in finding a new latch position which I was able to replicate at home but time will tell whether he'll actually regularly do good feeds like that. I'm going to the bf cafe tomorrow (run by the same people) and will speak to them again. I'm also being visited by my regular HV next tues and will go to the bf drop in in a week. So the support is out there, but I'm not sure whether there is anyone who will actually help me with the decision as to what is best as they all come at it from their own perspective. Although On the other hand I guess whatever decision I want to make, I know I can find support for it somewhere! I do wish though that someone would say to me "you are unlikely realistically to get to exclusively bf this child for a while if at all, so that being the case the first priority is to get the baby sufficiently fed without worrying about the effect on your supply and then the precise balance of bf and ff can be worked out with time". I think that is, actually, what I want to hear.

I'm also wary that there's some really hot weather coming up and my baby could be at risk of dehydration if he's not feeding effectively. I am leaning towards an increase in top ups for the next 4 days and seeing how he is on tues when the HV visits.

sillylass thank you for your honest response. It is really helpful to have that perspective. I tied myself in knots trying to keep up bf with my first baby who hated trying to latch on, and it really affected my bonding with him, along with the overlay of guilt that I wasn't doing my best for him as I wasn't exclusively bf. I'm trying really hard not to have that feeling creep in again.

[Secondsop]

misty thanks also for the info about it being helpful having the TT cut in any event. My boy was also hopeless at drinking from a bottle before it so there is still that benefit there for us too. My elder boy has, I am sure, a TT that the hospital we went to then didn't treat as they "didn't believe in" posterior tongue ties and he is slow to talk so I wouldn't be surprised if his speech will turn out to need extra help because of it.

[Misty9]

Happy to help, albeit only virtually. I too had awful problems breastfeeding my first and, despite my stubbornness getting us through 11 weeks of agony, it seriously affected my bonding to him for about a year. I did go on to feed him for 15 months, but swore I wouldn't do it again. Unfortunately we've had similar problems with our second, but thankfully not the pain.

I think you know what you want to do then, the sentence you wrote regarding top ups and breastfeeding sounds fine to me - and get support whatever your decision. Was it definitely just tongue tie affecting his feeding though? Sounds like quite extreme latching issues for posterior tongue tie. But I'm no expert.

[Secondsop]

I think I probably have supply issues as well as the tongue tie affecting feeding, which had made things doubly hard. The infant feeding midwife said my blood pressure medication can affect supply although that seems to be an anecdotal side effect rather than an official one. But with both babies I've struggled to get enough breastmilk into them so low supply has been suspected.

Last night i was breastfeeding him and he just kept being frantic for more and not settling. So I gave him some formula and (bearing in mind this is a baby who thus far would only ever sleep cuddled up to one of us and hated being put down even for a minute) he was so calm and satisfied after the formula that he let me put him in the bassinet where he just lay happily, awake, making little noises, and then dropped off to sleep by himself.

[beanbearer]

Hi Secondsop,

Can totally relate (my 3rd is now 3 weeks old, TT, lost weight, supply seriously reduced because he was taking so little despite being "well latched on"). So horrible, frustrating, hard work and not how it should be.

Pumping to top up feels like the worst of both worlds - all the hassle of sterilising, the stress of "will that be enough" and continued attempts to breastfeed which tend to be pretty unsatisfying for mother and baby. But if we can get over this mighty hurdle, secure our supply, wait for our babies to learn to use their tongues effectively then it should be possible to revert to full breastfeeding. Pretty bleak though in the meanwhile.

I don't know if this will resonate with you but a BFC said to me we should stop using the phrase "giving up" because it reduces what is an incredibly tough decision where you are absolutely focused on what will be best for your baby and family to some kind of cop out - which it absolutely isn't.

Can only wish you all the very best with it, and whatever happens, keep fighting those guilty feelings because they ruin what should really be pride in doing everything possible for your baby in a really difficult situation.

[beanbearer]

Also after long discussion with others who've had latching issues of various kinds at BF support group yesterday, have sent my husband on a mission to buy nipple shields because some people find their babies like the way they stimulate their palate. Seems to be worth a shot as the cut-away silicone ones don't have quite the same supply-reducing effects that were reported in much of the literature that the "don't use nipple shields" advice is based on.

[Secondsop]

Hi beanbearer thank you for your positive words - sorry that you are also going through this. I unfortunately don't have much success with pumps (I can hand express, getting a maximum of an ounce a session with half an ounce being more common so it's slow work) so I am not holding out much hope of maintaining full supply (which I don't think I ever had to begin with as neither this or my previous baby gained weight when ebf). I've instead been trying to keep putting the baby to the breast as often as I can to keep up as much breastfeeding as I can.

Today I've been giving him more formula because, on dwelling on it for most of the night, I'm not sure that minimising formula to try to maintain maximum breastfeeding is in his best interests. Surely breast is only best when other things are largely equal, which in this case they are not - at six weeks old he weighs the same as when he was born, which can't be good in anyone's book. The breastfeeding counsellor told me that it took "patience" after a tongue tie cut, but I'm not lacking in patience - it's not that I'm getting fed up wanting instant results. Rather, I'm very worried that I'm jeopardising his health if I don't make sure he's properly fed now. So priority one for me is feed the baby. Priority 2 is for that to be breastfeeding.

He is latching and feeding even better today and is still happy to go to the breast, so I'm hopeful that he's going to give us as good a chance as we can for him to be as breastfed as possible.

I loved what you said about the phrase "giving up". You're right, it's a positive choice about what is right for our babies.