Can a baby get worse at BFing? Is there something else going on?

[BertieBotts]

DS2 is 4, nearly 5 weeks old. We had a rough start as we were separated for about a day and a half when he was in special care and was tube fed. Then on days 2-3 we were together, but hospital wanted me to top up 50ml after every feed, he was very sleepy and needed to be woken and kept awake to breastfeed, they kept telling me not to let him feed for more than 10 minutes, which I ignored, but I kept to their top up request (min 30ml) because he obviously was expending all his energy trying to feed. I did paced feeding and kept it at his pace.

Milk came in on day 6 but was slow - I've never really leaked though I get drops coming out of my areola (!) when I have a letdown.

We came home on day 7 and top ups were reduced at this point to about 10-20ml and not every feed, probably about 3-4 in 24 hours. I was topping up at this point in response to him feeding for a long time and starting to get frustrated at the breast/seeming unsatisfied, which didn't happen every time. While I was waiting for the bottle I'd let him suckle to stimulate more production.

We continued this on coming home and about halfway through week 2, stopped the top ups completely as he seemed happy without them. However by the end of this week after two days of mysterious crying we decided to try a bottle in case he was hungry and yep - he was. So started up again although he'd tend to only have one a day at this point.

By about 3 weeks I was getting multiple letdowns per feed and I could see this wasn't happening before so I guess my milk supply has just been REALLY slow to come in. My boobs are also noticeably bigger now, but I haven't had that hard-as-a-football thing at all and still no leaking.

Anyway, what's happening now is that he's still on roughly one top up a day, although he tends to skip a day about one in every 5. He had been taking about 40ml but this has increased to a whole one of the small 90ml bottles and then lately he finishes the 90ml and looks for more.

I've noticed when I get a letdown - whether he's feeding or it's a spontaneous one - I get this feeling like needles into my breasts, it's weird, and I don't remember it happening with DS1. But the main issue right now is the latching. It's weird because at first he used to latch so perfectly, I haven't had ANY bleeding and I didn't have any pain at all in the first 2 weeks which I know is quite unusual. I didn't even bother using lansinoh most of the time. But recently it's like he slips and the latch is shallower, or something anyway is causing pain. I've tried unlatching him (which is hard) and it helps a little. It's worse on the right than the left but even the left isn't as comfortable as it was, it's like he's stretching the insides?? The right one just feels like the nipple is rubbing on something. It doesn't help he's been clamping down when he gets wind - maybe it's just sore from that.

I don't know if it could be thrush maybe, but he came off the antibiotics 4 weeks ago today so it seems unlikely. No white patches in his mouth. He has a dummy, because he was overfeeding and puking, but we sterilise them. Could it be nipple confusion??

It's so weird, I breastfed DS1 for 4 years and I was a peer supporter and I never really anticipated having problems! Indeed many things have been easier this time around but this is baffling me.

[BertieBotts]

That was so long anyway I have got a bit more clarity now after really paying attention at the last feed.

Left boob is fine.

Right boob - feels like he has a mouth full of teeth and is chomping on me. Tried rugby hold in case it was position and this made no differ3nce, actually, it was worse. Is almost unbearable to the point I'll take him off before he's really finished, so that boob is now about twice the size of the other. Slightly concerned by this, as j don't have a pump or any other way of draining it. Maybe I can just feed him in the nice left one??

[maygirl]

Could you have a nipple bleb/milk blister or a plugged duct on the right boob?

[ICJump]

Bertie congratulations! I’ve seen your supportive and thoughtful posts before. If you are feeling out of your depth to work out what’s going on could you see a an IBCLC?

Something you could try biologically nurturing/baby led attachment, feeding in the bath, starting on the left side and then switching after the first let down

[BertieBotts]

I did wonder about a plugged duct as there was a lump further up which has seemed to work its way down.

I've tried biological nurturing a few times with him and he seems unable to latch in that position, it's really strange! For the same reason I'm not sure I'd be happy to feed in the bath. Switching at any time, starting on either boob etc doesn't seem to make any difference or position or anything - left boob is fine and right is excruciating, have to breathe through it and grit my teeth kind of thing. It's fine when he just has the nipple in his mouth and isn't sucking but with every suck it's like razorblades.

I did think about a bleb because someone in my antenatal group has that but I can't see anything.

I notice a difference in how the nipple looks even after feeding which is strange. The left one looks round and normal, but the right one tends to end up long and pointy with the areola a bit irritated, like the pictures of when you use a pump with a too-big funnel. But other than the pain, the latch feels identical, it's really strange.

I will probably try the local BF cafe on Tuesday if it's not sorted itself out by then.

[BertieBotts]

And thanks :)

[NameChange30]

Tongue tie

www.tongue-tie.org.uk/Mobile/m-tongue-tie-information.html

[Shelley54]

I had the same. DS did have a tongue tie, which we got sorted, but also I was putting my boob in his mouth rather than his mouth on my boob. It was a peer supporter who spotted it, the week I had a full fledged bleb on the same boob.

I think you’re on the right lines of what the issue might be but perhaps it’s worth you going to see someone? I was going to a weekly drop in at the family and children centre where I got help but it was a private lactating specialist who caught the tongue tie.

[BertieBotts]

See, I thought tongue tie would mean that it would always hurt, but it's fine on the left? And was fine up until the last couole of days really. And he can open his mouth nice and wide too. I'm aware of it so kept my eye out for it just in case but it doesn't seem to fit the description I'm familiar with. I'm not trained to spot one of course though.

[NameChange30]

As you say, you’re not trained, so get a proper assessment from a professional (preferably a lactation consultant but a good breastfeeding counsellor might be able to spot it).

Read the link I posted, there are lots of signs - a couple of which you’ve mentioned in your posts.

My son had tongue tie and fed ok on one side but the other was EXCRUTIATING. The TT specialist said his tie wasn’t symmetrical, he was more restricted on one side than the other, so that might have been why.

[ShinySloth]

DD had tongue tie and one side was fine and one was agony! I would definitely get it checked out. Congratulations

[BertieBotts]

Yep I have the contact details for a good lactation consultant who sorted out my friend's baby's tongue tie, so if it carries on I'll definitely get in touch with her.

Touch wood though... it actually seems to be better this afternoon. I thought about that "baby to breast, not breast to baby" thing as this was my mantra in hospital and perhaps I'd forgotten about it since. Was very careful to do that today and it seemed better - coincidence? I wonder if perhaps it wasn't anything to do with the baby's one-sidedness but mine - attaching with right vs left hand?

Anyway I will keep an eye out and defo keep tongue tie in mind.

[ICJump]

I’m pleased things are improving. Feeding a newborn is different to feeding an older baby. Maybe you just needed a bit more newborn practice.

[BertieBotts]

Yes probably - DS1 is about to turn 10 so it's been a long time :)

[Shelley54]

Glad to hear things are a bit better. I also found one boob was fine and the other was difficult. I was so worried about him latching on rightie I’d shove it in his face without thinking. It does get easier as they get bigger but as you say, every so often you have to repeat all the phrases in your head. Like driving you get a bit lazier / used to doing it your own way.

[BertieBotts]

Yes absolutely like driving, I hadn't thought of it like that :) I'm trying to do all of the lazy older-baby tricks but forget the baby doesn't know that yet

[Shelley54]

^ That was what saved me in bf DS2. The MSW who saw me on day four told me I was trying to feed him like an older baby. He was small and needed certain things that he wouldn’t need when bigger. It was what I needed to hear.