Bad jaundice, tongue tie, difficult latch and awkward boobs!

[Shantotto]

I have an 8 day old and desperately want to breastfeed. We seemed to start well, everyone in hospital saying how great the latch was. It got very very sore and I knew he wasn't getting much, he wasn't swallowing anything. A lactation consultant helped and diagnosed tongue tie. Got this snipped and first feed after was amazing - I could tell he was swallowing. This then went afterwards and we were back to the start with struggling to latch. His jaundice is still really bad and I have to top up with formula to make sure he is getting enough to try and shift it.

I know his tie is still healing but I find it so hard to latch him on well. My boobs are really far apart and the nipples point off to the side so the 'easy' cradle nose to nose thing doesn't work for me. On the right I can do rugby hold, baby is very long so is wrapped all the way around me and I still find latching hard as his mouth doesn't open very wide.
This postion on the left feels impossible to get it all lined up and his mouth to open wide enough. I really hate this position. I've tried laidback feeding and the poor thing just can't get attached and it upsets me to see him rooting so hard.

Also when he is on he barely swallows. I don't think I am letting milk down.

However with a lot of support at s bf drop in he latched well and obviously drank for 30 mins. I think at home I am to anxious to do it properly. Which doesn't help let down! All advice I've seen is to pump and try expressed milk while we learn but I can't pump more than a few drops. Again to anxious to let down?

I just don't know where to turn now. I think I can do this but seemingly not without help! I'm so upset about giving him formula but I am deseparate for him to feed well. If his jaundice doesn't improve by next week I'll be back in hopsital with him. He is doing wet nappies but has only done two poos since all his meconium came out in hospital.

One positive is midwives are ok with his weight loss so far. Any advice would be so appreciated!

[JiltedJohnsJulie]

Firstly, how much you can express is absolutely no indication of how much baby is getting. So please put that worry aside.

Next, not everyone gets "letdown". Did you know that? . So if you are stressing that it's not happening please just relax, you may be one of the ones that don't feel it.

The tongue tie isn't going to help. Has the Lactation Consulant given you any follow ups? Feeding a baby with tt can be tough and a little support can help

Offering formula is not a crime. What would the alternative be? Please relax and look at this as a longer term project. You are doing everything you can for a successful outcome right now.

Do you have a partner? Can I suggest that you and loo go to bed for the next 24 hours? Take you phone, remote, kindle, whatever you need to help you to relax. Forget about letdown and don't worry about top ups. A good Babymoon might help you both to relax. Get your partner to do any top ups and to bring you food and drink. You should feel much better after a day tucked up.

I'm not trained though so it might be worth talking to a bfc on one of the bring helplines. Do you have the numbers?

[JiltedJohnsJulie]

Congratulations on your new arrival too

[Shantotto]

I've spoken to lots of people who are telling me to try positiona injust can't get to work - like lyibg down on my side or laidback breastfeeding. Just keep telling me to try. Lactation consultant just left ME with advice to top up and to just keep trying. I find it so uncomfortable in rugby hold and I just can't get latch right most of the time. Had some good feeds this morning. Then some terrible ones with a screaming baby. Have topped up with formula. I know I might not feel let down but baby very rarely seems to swallow so I think he is getting anything. He doesn't open very wide and its so hard.

I feel useless as I don't know how to do it consistently and like I am failing. I just want him to be happy and full. He looks so skinny and I am so worried about his jaundice.

[Shantotto]

Oh and I've spent all day just with him and me skin to skin and its felt wonderful but doesn't seem to help him feed better.

[captainproton]

My first was like your ds and when I look back it was hell. If you think you've had some good feeds today then take heart from that. It takes around 6 weeks for babies and mums to crack breastfeeding, and then you factor in all that your son has been through in the last 8 days, he's a champ!

There is absolutely nothing wrong in giving him formula when he is too tired to feed, breastfeeding makes a baby work for their milk and bottle feeding is just easier.

dont panic too much about him crying for frequent feeds, this is how all babies increase your milk supply. Just go with it, it can be very frustrating, take ages but it's all practice.

I was told to not let my dd go for more than 3 hours without feeding and if she was just too tired i would give a bottle. Sometimes I managed to express enough, some times I topped what meagre amount I got out of my boobs with formula.

We did finally wean off formula after a few weeks but be prepared that you will need to build up your supply, which will probably mean lots of baby on the boob fussing until he's got enough to make him happy.

It's hard and you are doing so well.

Btw my second also had jaundice he hardly pooed at all for he first few weeks and although this can be dangerous we did end up back in hospital for tests and they said he was fine.

He did the mother of All explosions when we got back home that he practically halved his body weight.

So try not to worry, babies who get bad jaundice nearly always do so because they have immature livers, especially if born a bit early, it's not anything to do with your breast milk or boobs.

[Shantotto]

Thank you. I wish he would be crying for food! In glad you could wean off formula. I'd happily sit for hours with him on there!

Things seem to be getting worse though - Id been having some successful feeds, but just tried and he's now lifting his tongue really high so I can only get nipple under his tongue, there's no room between tongue and roof of mouth. He's so fighty, his arms go crazy and I struggle with him so I can't poke his tongue down. Have given two formula top ups in a row now. :(

[GoooRooo]

OP I had almost exactly the same situation with DS. Posterior tongue tie that wasn't diagnosed, trouble latching, jaundice - I felt he wasn't getting enough milk and he was losing weight, midwife said don't be silly. I was a first time mum and thought she knew best.

Two days later he was dehydrated and in hospital under lamps for the jaundice. I don't want to worry you, but I do want to tell you our story because I wish I had listened to my instincts more and just given him formula. If you feel he isn't getting enough there is NOTHING WRONG with giving him formula and you should not feel bad about it.

[captainproton]

Are you waiting for him to cry before feeding him? Early cues are them moving head side to side, smacking their lips and hands to the mouth. Try latching him on when he does this and he might be a bit calmer. Sometimes babies can get themselves worked up they forget why they were screaming in the first place (yes I'm thinking of you DS even though you are nearly 2 and still do it!)

[captainproton]

Wine is probably not that good for a baby who might be sleepy from jaundice, as it could make them sleepier and miss out on a feed.

[Guyropes]

Are you wearing a nursing bra? If it's not helping, try without?
Congrats btw!

[DunderMiffed]

Did he have a difficult birth? My baby really fought at the boob like you describe and what really helped us turn a corner was seeing a cranial osteopath. You want a good recommendation as it's pricey and not super regulated (if you are in the sw pm me!) but it was like night and day for my ds. We were pretty skeptical when we left the appointment as she hadn't seemed to do much but the next feed was calm and feeding became really easy really quickly after that. We saw a very experienced Nhs lactation consultant the next day and she was so positive about cranial osteopathy.

Good luck and congrats! X

[captainproton]

GoooRooo, jaundice which requires phototherapy is not caused by lack of milk. I know they give babies formula to shift it from their system but that doesn't mean it's because you didn't give your baby enough milk in the first place. The main cause of that kind of jaundice is the baby's immature liver.

I have met mothers as a peer supporter, so consumed with guilt for failing to provide enough milk for their baby, and I struggle to make them see it is not their fault.

I think the problem is hospitals discharging breast feeding mums of babies born slightly early 36-39 weeks as they are more at risk of re-admission due to to jaundice. If they just waited a few days longer it would prevent so much suffering.

As you know these babies become very sleepy and it's hard for them to maintain a good latch for long and they are difficult to wake. Add in tongue tie and it's a real battle.

Every baby being BF before discharge ought to be checked IMO by a proper qualified tongue tie specialist before they go home it would save a lot of problems and failure rates.

[GoooRooo]

Captain that's true, but the dehydration definitely was caused by lack of milk and I should have listened to myself and given him a bottle of formula and he wouldn't have got so stick

[GoooRooo]

*sick, not stick

[GoooRooo]

Every baby being BF before discharge ought to be checked IMO by a proper qualified tongue tie specialist before they go home it would save a lot of problems and failure rates.

Yes yes to this! DS was 37 +3 when he was born, I had no idea that being born earlier was a precursor to jaundice so that's interesting to know.

I am now pregnant again and in bold on my birth plan I have that I will not leave the hospital until this baby is checked for tongue tie.

[Greenstone]

Personally I think a formula top up or two for persistent jaundice is an excellent idea. You haven't ruined anything at all. Latch him however is comfy for you, sometimes I think all of this frantic positioning is an extra stress. I had a nice sensible HV who said You put Her on the boob however works for you while she's still so tiny - she can find the boob herself later once the need to gain weight fast has passed. Try a bath together if that feels feasible?
Breast compressions and switch nursing, plus a bit of formula, got dd on track.

Sunlight really does help with jaundice too, even sitting for half an hour by a sunny window in November helped dd a lot.

[captainproton]

Don't beat yourself up about it, if it helps we did give our dd formula top ups but it didn't prevent her needing phototherapy. And I know what you mean about dehydration, I always like to make clear on threads like these when a mum is going through jaundice with their newborn that it's not their fault. BF is still the best for your child.

In America they have decided that a baby is not quite term if born before 39 weeks, this is one of the reasons why. Babies born between 37-39 are called early term and they recognise that these babies need more help than those born later.

We don't have that classification in this country but I think it would help if we did.

[Corabell]

Have you tried a firm breastfeeding pillow to help balance baby so you have two hands to help you?

I have also heard that a rolled up muslin under a boob can help keep it in position ( and can help with feeding lying down).

If it helps at all I always struggled with my left boob as it was so hard to latch and after a few weeks my baby fed mainly from the good side. I had no problem with supply or mastitis but did have a very massive right boob!

[captainproton]

goooRooo a baby with a sibling who had jaundice is also more likely to develop it as well. Both mine did and I did too apparently, I am pregnant with my 3rd and I am pretty sure I will be going back to hospital a few days after he/she is born for some light treatment. Or perhaps I could somehow persuade this one to stay inside me a bit longer than my other 2....

[Greenstone]

captain really interesting, dd2 was born only a week early but was markedly more sleepy and jaundiced than dd1 who was bang on 40 weeks, no jaundice.

[VeryPunny]

Have you been checked for breast hypoplasia? You mention your breasts being far apart. Hypoplasia does generally mean supply issues. Formula at this age is like medicine if needed, please don't feel guilty.

[captainproton]

I hope the information I have given has helped you feel a bit less to blame for things not going so well. As a BF peer supporter I am pro BF, but even I know that when faced with a myriad of problems formula can be a god send and it's not an instant nail in the coffin of long term BF.

[Hellochicken]

My first had tongue tie and lots of nipple damage before it was cut at 9 days. Then milk came in, then mastitis, then was admitted with this. It took a while before he was able to latch properly (sorry if this is disappointing to read but it probably took 2-3 weeks before we were getting it right every time). He did start formula when in hospital and for a couple of days I was only breastfeeding ?3 times in 24 hours, over the next weeks we went back to breastfeeding only. But really you could combine feeding, I just really wanted to not have to make bottles up at night (exhausted by this stage) and found the formula affected my supply. I could only express max 1/2 oz in first few weeks so didn't bother except to 'stimulate' supply on a few occasions when long gaps between feeds.

Anyway what i wanted to say was that during the bad latch/white hot nipple pain days I tried different positions and wanted to suggest trying to get head under left breast with baby's face looking up. So kind of modified cradle hold. Your back will be kind of hunched forward and need to move your right leg a bit for babies body to get tucked in close to you but lower down. Right hand under babies shoulders/neck. Not sure how I can explain this better without a photo.
Also I fed each time from best boob first, then offered other boob, until improved.
I was massively anxious and in pain with each feed and this affected let down. As time went on this improved, I did get DH to talk to me during the feed to try and distract me. There were attempts at calm deep breathing and lots of tears.

I am not sure why I am telling you this, maybe because at the time some people said I was a little crazy to keep trying, and that it was a really hard few weeks, I never realised it could be that hard. Having said that I fed him for a year so the hard weeks were outweighed in the end by the easy ones. Also 3 subsequent children were a breeze in comparison.

[Shantotto]

Thanks so much for all your replies! Just lost a huge post so will try and be brief.

I've been sat on the sofa in just my pants for two days and I don't think it is helping much. I have a breastfeeding pillow and various others. I was advised to get good latch and then use pillows. to support afterwards. I did try rolled up muslin under my boob but it didn't really keep it upright.

Birth not too bad - waters broke and labour didn't progress so was induced by tablet 30 hours later. They kept telling me I'd need a drip too so epidural was a good idea. It was topped up once, and I was one push away from instruments but got him out i the end. After though I was very unwell and needed an epidural blood patch for a headache that was really awful. They spotted the bad jaundice too and DS was under a heat lamp for 15 hours. It improved lot but now seems the same. He was 8 days early.

I have also seen a cranial osteopath, forgot to mention that. It's really heartening to hear that I can hopefully keep going with the bf, I really feel like if I can just get him well then I can focus on the feeding.

I was struggling to rouse him to try and feed every two or three hours, but for the last few hours he's gone from slightly stirring and hunger signs to full on screaming incredibly fast. Which I'm taking as a good sign to indicate his sleepiness is wearing off!

Haven't been checked for hypoplasia - would my gp be able to do that?