Weak sucker?(8 Posts)
My little boy is just over 5 weeks old and breastfeeding is continuing to be a struggle and quite keen for some advice!
A bit of history - he was slow to latch on and resulted in >10% weight loss and then slow to gain. Birth weight 6lb10oz was only 7lb1oz at 4 weeks. Until 3.5 weeks, he was EBF with syringe/ finger feed top ups with expressed milk. Each feed taking ages and eventually began to struggle with the amount of time expressing was taking on top of everything. He was either very sleepy or unsettled at this point. At 3.5weeks, HV suggested formula top ups to aid weight gain.
For the last week and a half we have been doing a larger top up before bed (to allow me to get a decent few hours) and then topping up around 60ml a couple of times a day from a bottle. Despite my upset at having to introduce formula (it was clear he was struggling with just my efforts), I can see the difference in him - much more settled and brighter and last week had gained 13oz in 6 days!
I had introduced the formula with the hope that eventually he would be able to come off it but over the past few days I've found that he's been really bad at feeding. I don't know if this is new or whether I've just become more aware of the problem. Particularly at night he appears to have a pretty weak suck and nibbles away on my breast for only 5-10 minutes at best (sometimes less). He comes off without much break in suction and really doesn't seem to open his mouth wide enough to get a god mouthful of breast. He is also really bad at falling asleep at the breast. I've tried everything to keep him awake including stripping him off, rubbing feet, stroking head/ears/hands, even tried a cold spoon on his tummy (didn't keep him awake!). I've also tried opening his little mouth in a vain attempt to get breast in his mouth. Have been to bf clinic a few weeks ago and they didn't have concerns with his latch then. Despite the weak sucking, he does often have milk in his mouth or running out of his mouth. I know I have a decent milk supply as I expressed this morning and got 2 oz out one side in about 5 mins! I'm amazed I still gave such a good milk supply as I'm finding I'm giving him more and more top ups (always after I offer him me) when he has a rubbish breast feed.
I have also found that he's not the best at sucking from the bottle (using nuby natural touch bottles and just changed to medium flow teats as using amptamil comfort feed which is thicker than most and he was struggling to get it out of the bottle). Even when we give him just formula, he very rarely struggles to take more than 90ml in one go and can take a long time (he even falls asleep with bottle in mouth at times. Had previously tried dummy to settle him but not keen to suck this either and just spits out.
He feeds every 3 hours day and night.
I'm really keen to keep going with bf but it's becoming more and more frustrating to keep him sucking/interested. Really beginning to wonder if it's all worth it and whether we'd just be better off on formula. Really feel like I've failed but at least he's now gaining weight etc.
Does anyone have any experience with weak suck? Have I made him worse by giving bottle? Will we ever get back to EBF? HELP!
my initial thoughts would be to consider having him checked for tongue tie. He ticks a lot of boxes - mouth not opening, struggling with bottles too, low weight gain, frsutration at the breast, apparent weak suck. Take a look at this page:
www.ann-dobson.co.uk/tongue-tie_symptoms.html - does it sound anything like?
I always suggest contacing Ann Dobson (she travels all over the country) if you can afford a private consultation (cheaper than formula...) or Milk Matters who do a TT consultation by email: milkmatters.org.uk/international-service-tongue-tie-talk/
Firstly, I agree with OCC, it does sound like it's worth checking for Tongue tie. You may be able to see it yourself if you google tt images.
Secondly, your ds sounds very like my 6 wk old dd. She had tongue tie but snipped on day 4, very sleepy feeder, infact sleepy full stop til about 3.5 wks old. She took ages to feed and then still didn't gain much weight. She had only gained 1lb by 5 weeks. I have had lots of mw's, 1 HV and 2 bf counsellors check the latch and all fine though she does have a small mouth so it's a bit inconsistent with her. But what I think it boils down to is that she has a weak suck and is basically a lazy feeder!!
It is totally up to you if you want to continue or not. Many here would persevere and there is something called a supplementary nursing system (Medela make it) which can help a baby take it's top ups through a tube while staying at the breast. I find it quite fiddly though. I really want my dd to get breast milk too and am exploring the possibility of exclusive expressing. I am pretty much doing that at the moment and it's actually a lot quicker than trying to bf, topping up and expressing! Dd is now gaining weight well. I have concerns about my supply though and expressing milk is never such a good stimulant as a GOOD feeder at your breast. Good luck with it all and enjoy your new DS .
needssomewine good to hear you're battling on. If it gives you any hope, my DS's TT wasn't diagnosed until 6 months despite me being convinced he had one, and we're still nursing at 15 months so it can be done
Truthsweet has some great links on exclusive expressing if you ask her.
Although the signs and symptoms of tongue tie sounds quite similar to his feeding issues, I don't think that he has a tongue tie as he sticks out his tongue past his gumline when mouthing etc. I have also tried putting little finger in his mouth and he appears to suck on this quite well. I do believe that the mw at bf clinic checked his mouth for this also but guess she could've miss it.
TTd babies can sometimes stick their tongue out - it's not a confirmation of there being no tie.
Equally, he may not have of course, but I'd rule it out with someone qualified (not a MW unless they're specially trained in TT, but an IBCLC with a specialism in TT. There are others apart from Ann but I don't have any more names I'm afraid).
weeal I should add that it's just as likely that your ds doesn't have tt. As I said, my dd who now doesn't have a tt has a weak or lazy suck so it could be just the way things are. She took enough milk from me to keep her going (and was well in herself etc) but not enough to grow at a more normal rate and also to keep milk supply up.
Posterior tongue ties are often missed, and as OCC says don't mean they can't stick their tongues out (my daughter could). If you express while he's feeding it won't take longer and you'll get more milk (as he's causing letdowns for you and vice versa).
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