Breastfeeding - not feeding efficiently

[CaseyE]

My DS is 9 weeks old and I am still struggling to breastfeed. I have resorted to expressing after each feed and then bottle feeding him the EBM and topping him up with formula if required. He is currently getting in addition to the breast 2/3 EBM and 1/3 formula) This has been going on since he was 4 weeks as he was not gaining weight. (At 6 weeks only gained 300g from birth weight) I am able to express between 400 and 600ml per day so I don't think I have milk supply issues, I feel his latch is poor as his sucking is very weak. His lower lip is curled in and it appears his tongue is not reaching past his gums. He had a slight tongue tie which was snipped at 8 weeks but this has not improved things. I have also been told he has a high palate. Has anyone else had these issues? I am trying to persevere but there seems to be so many obstacles and I'm beginning to wonder if it's worth it. I have been to bf clinics and tried various different bf positions with no improvement. Any advice on how to improve things or is it too late for us?

[tiktok]

Casey this sounds really difficult - and breastfeeding, expressing and using formula is the hardest way to feed :(

You must have been in touch with some sort of breastfeeding specialist to get the tt and the high palate diagnosed. Is it worth returning to them and asking for more info?

You have probably googled high palate (sometimes known as 'bubble palate') and if not, you can do so. There is some speculation that tongue tie and high palate are linked.

Sometimes, babies with some oral anomalies respond well to self-attachment positions. Google 'mother and baby dance' and 'biological nurturing' for ideas on this.

It's certainly possible for babies as 'old' as this and with these issues to learn to bf more comfortably and effectively. Hope you find good help.

[McBaby]

Has the tongue tie been rechecked. First time ours was not cut enough as it was more extensive than the surgeon thought. Ours reformed from scar tissue a further two times so we had to have four cuts in total - this is more than normal.

[Imeg]

Mine was a really inefficient feeder, would feed for hours on end but not gain much weight. I found breast compressions as described on the link below made a big difference, made the feeds much more efficient. There was a bit of a time lag before his weight started going up (I think a combination of my supply building up and him getting better at feeding as his head got bigger) but it made the feeds a lot more efficient within a few days.
I didn't have access to a specialist so not sure about tongue/palate though now he's a toddler and I can see better I think probably he has a mild tongue tie.

www.nbci.ca/index.php?option=com_content&view=article&id=8:breast-compression&catid=5:information&Itemid=17

[CaseyE]

Thank you for all your suggestions. Things have slightly improved over the last couple of days so I am trying to stick with it. His suck still doesn't feel very strong but I can see him swallowing more. I find the breast compressions really help. I guess now is knowing when not to top him up with the EBM as I read somewhere that babies can still take the bottle even after a full feed. I am not confident enough yet to stop them all together as I still don't think he is getting enough on the breast alone. I am also hoping that as he gets bigger, reaching the 3 month mark, it will get easier for him. Anyone else find this?

[chloechloe]

I really feel for you as I went through a similar thing with DD and was expressing and topping up with formula. It really is the hardest way - I got myself into such an exhausted and stressed mess as it was so time- consuming. I think it was also super confusing and stressful for DD as she had no routine at all with so many feeding variations.

All I can say is take it one day at a time and it WILL get easier. You have done an amazing job to get this far. For me the only way I could get DD to stay latched on for more than a minute or so was with a shield. When that was working the MW told me to stop expressing which I did. At first I was quite reluctant as I thought I would end up having to give her more formula. As it turned out I was then able to EBF within a few days - it made everything less chaotic and I think both me and DD were less stressed which made a world of difference.

I have found that DD has got much stronger as the weeks go by as well (now 11 weeks), so hopefully it will be the same for your DS.

I wish you lots of luck, you're doing an amazing job!

[CaseyE]

Thanks Chloe, you are right it is so time consuming! Luckily DH has been amazing and helping out so much! I have tried breast shields once and it didn't really work, but you have inspired me to give it another go. Well done for sticking it out too, it is really tough! x

[chloechloe]

Maybe give the shields another go? I tried them in hospital and DD just spat it out so I was convinced she would never latch on with them. I tried again a few weeks later when I was at the point of giving up and all of a sudden she drank for a solid 20min for the first time ever! I expect the first time she was just too small and weak, whereas a few weeks made all the difference.

I had lots of warnings that they can cause a lower milk transfer but have fortunately not had any problems. For me they have made the difference between breastfeeding and not, so I have made my peace with them! Also it ges much easier to use them as time goes on. The big issue is making sure you never forget them when out and about!

[CaseyE]

I'm pleased to report that Lo has taken to the breast shields ?? They have made a vast improvement, I suspect it must help with his high palate. I've been keeping my supply up artificially (by pumping) anyway so hopefully my milk supply won't be affected by them either. I am only expressing after every second feed now and hopefully I can reduce this further as he gets better and better. Thanks again everyone for your suggestions. One happy mommy x