Day 7 and want to give up -bad latch, possible tongue tie

[Layladylay234]

Have even paid for a lactation consultant to come out today and observe me. She can latch on but more often than not,isn't. My boobs are sore. Lactation consultant think she has tongue tie but NHS aren't clipping and it's £200 to get it confirmed and clipped. I'm exhausted. Have tried holding across the body,rugby ball,flipple....everything. Baby also doesn't want to open her mouth wide enough and it seems like such a battle.

I did feed my son for 3 months and just presumed I could do it again this time. Partner is supportive of me but is a bit baffled why I'm putting so much pressure on myself. I reckon I have another week in me at most before giving up. Can anyone offer any advice? I've joined FB groups, we've watched videos and I'm just at a loose end now

[Megan2018]

If it’s tongue tie you are on a hiding to nothing until it’s cut. I’d pay the £200 if I could (as you’ll spend that on formula).

I doubt there’s anything you can watch or do that will improve unfortunately.

[Layladylay234]

Brill,thanks.

[catmg]

Agree. I BF my DS with a tongue tie for 8 days after he was born until I paid privately for a woman to come to my home and fix it. Best money I ever spent, the difference was immediate though my nipples were so damaged by that stage that BF remained painful for a while afterwards. But I did then end up BF-ing until after 12 months. Definitely worth it, and sooner rather than later if you can.

[AsMuchUseAsAMarzipanDildo]

Feeding problems are the pits. As if recovering from birth and sleep deprivation aren’t grim enough.

I’m sure you’ve tried already, but just in case you haven’t... laidback/biological nurturing position might help bring your baby’s tongue forward.

Also, if you have very full breasts, try softening a little by hand expressing or reverse pressure softening - sometimes tongue tied babies struggle more to cup and shape a very full, firm breast.

It sounds as if your baby is very tight in their lips too - if they have a tongue tie, they’re likely compensating by pursing their lips. Anything that encourages them to relax their jaw and the circular muscle around their lips will help - lots of facial stroking from ear to chin, from nose around lips to chin.

Why are the NHS no longer cutting them? Because of covid?

[AsMuchUseAsAMarzipanDildo]

Facial massage feedthebabyllc.com/suckling-exercises/

[TintinandSnowy]

My DS had tongue tie and I had a bad start to feeding because of it. Luckily we managed to get it snipped (on NHS) at 10 days old, and it made an immediate difference to feeding, and he was able to stick his tongue right out of his mouth - before the snip his tongue stayed inside his mouth.

Can you see it when your baby cries? It can make the end of the tongue look heart shaped instead of pointed.

[Layladylay234]

The tongue tie isn't obvious, the midwives couldn't see it on Monday at her 5 day check up but yesterday the LC did a more thorough check (fingers in mouth etc) and concluded there was possibly one but to try and fed around it. She said there was no NHS service because of Covid as it has to be done by an Ent specialist and they were all front line. So our wasn't a definite "it's tongue tie that's causing the problems" and she can latch on - she did whilst LC was there. So we're wary about paying out £200 if it may not solve the issue, particularly as we don't have it to spare atm.

Thanks for all those offering advice. If anyone else had any advice/support, please feel free to add

[Katnip0520]

Im in exactly the same position as you are. My baby is 8 days old and has quite a bad tongue tie. She can latch on ok but slips during a feed causing me so much pain.

Currently coping with nipple shields but part of one of my nipples has turned white and I’m not sure how quickly I want to try to give feeding without them a go again!

Can I ask where you found the details for a private lactation specialist ?

I’m pretty sure I’ll have to get my babies tongue tie snipped.

[haba]

Please do consider getting the TT snipped even if you have to abandon feeding- my DH still has difficulties- not eating, but with speech, and it's painful for him to put his tongue out if his mouth.
We were lucky that the bf team spotted DS' TT at two days, mainly because I turned up the second they opened and said he hadn't stopped feeding for the last 12 hours! He just wasn't getting enough milk.
I knew how bf should feel, as I'd already successfully fed dd.

Can't believe NHS won't snip though . That's so bad, when baby is struggling to feed, and causing pain to mother!
(Think my nephew had the same though, I'm sure DB said they had had to pay)

[AsMuchUseAsAMarzipanDildo]

Rubbish that the NHS aren’t willing to cut it. For a start, it needn’t be an ENT doctor - plenty of midwives are trained to. And before anyone jumps on with the “coronavirus trumps all” line, it does in certain pockets of the country such as Liverpool and London, but for the majority of the UK, hospitals are being under-utilised and doctors and nurses are frustrated to be turning away patients. My local hospital (very big regional trauma centre) has 3 cases of CV...and literally hundreds of empty beds and thousands of cancelled operations that will all we’d doing eventually.

Anyway, rant over, sorry to derail.

OP can you give us a bit more information on what exactly is happening? Does your daughter ever open wide or not at all? Once she’s on, does she stay there? When you say your boobs hurt, is it nipples or all over? Just when she feeds? Or after? Any misshapen nipples after feed or cracks? Is she otherwise healthy - gaining weight, weeing and pooing? Any problems in pregnancy/birth?

[AsMuchUseAsAMarzipanDildo]

katnip have you tried laidback breastfeeding (sometimes called biological nurturing)? It usually helps with babies that slip off.

You can find lactation consultants via lcgb.org and/or people trained to divide tongue ties at www.tongue-tie.org.uk/

[Layladylay234]

Thanks for the replies. So I've taken a day off today, breastfed once or twice and feel like I'm figuring out the problem more. She CAN open her mouth wide enough and she CAN latch on. But what happens is exactly the same as the other poster. .she defo changes something when feeding after a few mins and it goes from feeling ok to being painful. I've ordered some nipple shields which should be arriving tomorrow.

The private lactation consultant I found through the LLL FB group page. Tbh,apart from her giving her a good examination by putting her fingers in her mouth,she wasn't much help and only stayed for 20mins "due to covid." So had I known that,I wouldn't have bothered as it wasn't worth the £40 for 20 mins visit!

I completely agree with you about the whole Covid isn't an excuse. I'm fed up of hearing things like cancer being missed and ops being delayed. This is just another way of our children,even newborns,being screwed over by this pandemic.

Having said that,I actually called the midwives office today to check about the whole "not snipping tongue tie" and they confirmed it. The only other people I can find who will do it are private practitioners.They did say they could send a community midwife out tomorrow so fingers crossed she'll be more helpful. Also hopeful that the health visitor can come next week if things still aren't better.

I know what you're saying about the tongue tie and getting it snipped despite the cost,its just because we don't know how bad it is, or whether this IS even the issue she has with breastfeeding, we're unsure as to whether to proceed or not. If we were told,she DEFO has tongue tie and snipping it will DEFO improve breastfeeding and stop her having speech problems, we'd go for it. It's the uncertainty. Maybe it is her latch and I just need to work on it a bit longer? Maybe my nipples just need to toughen up?

[Layladylay234]

Oh and yes,have tried the laid back position. She works best on the cradle hold so far.

[Layladylay234]

Oh yes, more info! Boobs...sore at the top above the aureola on both sides. Nipples sensitive straight afterwards but ok after a min,no cracks/bleeding etc

Otherwise healthy and gaining weight no probs...from the 1 weigh we've had!

[BertieBotts]

Maybe it is her latch and I just need to work on it a bit longer? Maybe my nipples just need to toughen up?

Honestly both of these are extremely unlikely. It will be the latch, but I've never heard of a latch which can be improved by working on it, it's not a muscle that needs to be exercised, it's either working or it's not. If it could be fixed by positioning and attachment, that would be a pretty instant fix. Nipples don't toughen up; in a correct latch the nipple isn't making contact with anything that is going to damage it.

Tongue stretch exercises may help but are not usually enough by themselves. Cutting the tongue tie would almost certainly help but does need to be backed up with good support otherwise it can reattach and then you've done it for nothing, which is possibly one reason why they aren't cutting them at the moment either. It is a good point above that you'd probably end up spending £200 over time in formula... but I appreciate that doesn't help with the question of what if it doesn't work and also what if you don't have £200 spare right now.

Nipple shields may work. It would be then whether you're happy using them potentially longer term. Sometimes latch issues do improve as the baby gets bigger, but not always.

It's beyond crap that the NHS won't cut but I do think that likely is the best option. I'm sceptical the health visitor will be able to offer much to help but perhaps they can argue the point for the TT division??

This is a very interesting article about how it's not always latch in itself which is the problem - but that pain shouldn't be ignored.
www.analyticalarmadillo.co.uk/2010/09/effective-breastfeeding-its-not-all.html

[AsMuchUseAsAMarzipanDildo]

I can see why you were so frustrated by the LC visit. It doesn’t seem to have been especially helpful.

The pain on top of the areola rather than the nipple and the way the latch “changes” after a few minutes makes me think of a few things, but it’s so difficult to figure out without the mum and baby in front of me.

It could be a posterior tongue tie - and baby is compensating for loss of suction by clamping their jaw tighter.

It could be a strong letdown - and your daughter is clamping down to slow the flow - although given that feeding isn’t better laidback, this seems less likely.

Regardless of the cause, it sounds as if nipple shields might help you to continue to breastfeed. Just keep an eye on her weight gain (tricky with covid, I don’t imagine there’s much weighing going on at present ) and ensure she’s having at least 6 wees and 2 poohs a day, as shields can reduce how much she takes.

I’d also look at regularly doing exercises to encourage her to move her tongue and relax her facial muscles. They sound pretty airy-fairy I know, but at this age she’s learning so much about using her muscles - so the more practice she can get at stretching her tongue (stick yours out, run your finger along her gum ridges, drip milk onto her lips to encourage her to lick etc) the more she’ll develop the muscles and stretch any mouth ties or tight muscles.

[Layladylay234]

@AsMuchUseAsAMarzipanDildo

Yeah I've messaged the LC and asked her to just send me the details about what her examination found. So we'll see when she writes it down and sends it to me. I don't remember her saying "posterior tongue tie" and partner remembers her saying "possible tongue tie" so we're really no clearer!

Her nappies are fine at the moment and we are topping up with formula a couple of times a day,could that be problematic do you think? We've done this since day 1 though and she seemed fine latching on at the start We have a weighing scales so can keep an eye on her weight

Will have a look tomorrow at the facial exercises. Thanks for those.

You seem to know a lot....you wouldn't be an LC who's doing Zoom consultations would you?!

[AsMuchUseAsAMarzipanDildo]

I've never heard of a latch which can be improved by working on it, it's not a muscle that needs to be exercised, it's either working or it's not.

Afraid I disagree with you there. While exercise doesn’t break a fibrous tongue tie, the pain that results from it isn’t due to the frenulum itself - but how the baby’s muscles compensate to maintain suction and swallow. The way a baby latches is of course dependent on its facial muscles. The tongue alone is made up of 7 muscles. The OP has clearly said she can not afford an appointment for a tongue tie revision - particularly when she’s not wholly convinced that is what is going on - so it makes sense to explore ways of making what small adjustments she can. Even with revision, the baby still needs support to recruit the right muscles in the right order. In countries with better funded breastfeeding support, it is accepted that prior to frenotomy babies are given oral exercises.

[Layladylay234]

Wow,what a fab comprehensive answer. Thank you!

[AsMuchUseAsAMarzipanDildo]

we are topping up with formula a couple of times a day,could that be problematic do you think? We've done this since day 1 though and she seemed fine latching on at the start

It could be nipple confusion, but it seems unlikely as that tends to cause sore tips of the actual nipple, folded or lipstick 💄 nipples. I would also expect a LC to quickly see that this was the problem, as a “bottle feeding latch” is very obvious.

It’s interesting that you weren’t having these problems on the first day. I wonder if it got worse when your milk came in. A Term, well baby can cope with the increased milk flow and volumes. But for a baby that has an oral restriction and/or is finding it hard to coordinate muscles, it can be much harder to cope with moving bigger volumes of milk to the back of their mouth. It does sound as if, at some point, seeing a tongue tie specialist might be useful. But equally you may find that the nipple shields, oral exercises and time (her growing jaw and tummy time should also help to bring the tongue forward) are enough for you to continue. Go easy on yourself. Feeding difficulties are hard enough when the NHS is “open for business”.

[Layladylay234]

Thank you. We did manage to latch on earlier and whilst I will say it wasn't pain free,it was more uncomfortable than painful. Having said that,I'm only managing to last a few mins before she does something with her mouth/tongue and it becomes painful. It feels like she starts manipulating my nipple with her tongue if that makes sense. I've started to really get upset now as I feel this is something I should be able to do and unlatching her makes me feel awful. She doesn't cry when I do it and is getting mouthfuls of milk and she seems really chilled when she does come off,but it still makes me sad.

Btw,this is what the LC sent me today after I asked her to write down what she found.
She lateralised more to her left than her right. But it seemed more like she was twisting the tongue more than actually moving it freely
She did hold her tongue over her gum butthere was an element of snap back
When i swept my finger under her tongue it felt like there wassome degree of attachment posterior attachment.
Falling asleep on the breast frequently, slipping off andthe soreness all point to a tongue tie. Difficult to say exactly how much of a tie but i leave that to a practitioner

[AsMuchUseAsAMarzipanDildo]

I feel like this is something I should be able to do I think it’s very human to make ourselves wholly responsible for feeding, but you’re a team. You can take a horse to water... it sounds as if your daughter’s really trying to breastfeed, but (through no fault of yours or hers, just bad luck) her tongue just can’t make it. She’s probably being really determined and trying to hold on with her lips and gums (which is likely why it’s so uncomfortable for you). At the moment, you’ve probably got lots of milk and she’ll continue to thrive with her slightly unusual way of latching. But once your supply settles down, you might find she’s more frustrated, on and off the breast.

The main issue is how sore it is for you. No-one can keep feeding with a painful latch indefinitely. It’s too much to ask and risks more trauma, mastitis etc. Hopefully the nipple shields will at least buy you a bit of time and breathing space and your daughter‘s latch might improve.

Only you can know how sustainable this feels. LC’s aren’t allowed to explicitly “diagnose” as it’s beyond their remit. They can “suspect” and refer. Reading between the lines though, it does sound as if your daughter has a posterior tongue tie and while she can stretch the tie to extend her tongue for a little bit, pulling on the tie will start to feel uncomfortable and tiring - hence it snaps back and likely why after a few minutes into the feed the latch suddenly feels worse and she slips down. manipulating the nipple I wonder if this is like a quivering feeling? Again points to her tongue muscle tiring from working against the tie.

I’m so frustrated for you that the NHS isn’t cutting them at the moment. I really hope the midwife today has some extra clout or inside knowledge of when the hospital is likely to restart elective work. My local hospital is slowly doing this now, fingers crossed yours is!

In the meantime, try the nipple shields, try the exercises and tummy time (the back of your tongue is funnily enough anchored to a bone on the front of your neck, so anything that encourages your daughter to lift her head will help). Ultimately though, you might want to give yourselves a deadline by which you say if things aren’t improving, then you’ll borrow or scrape the money together to see a tongue tie specialist x

[Layladylay234]

Thank you for all your help and advice. I think you're right,I guess I just have to weigh up now the best option for all of us.
The private practitioners I have found aren't letting partners attend the appointments which would be problematic for me as my memory and auditory processing is terrible,so I'd really need my partner there to take in what she's saying/the advice they're giving.

Then there's the question of...am I trying to continue with breastfeeding for the wrong reasons if she's taking a bottle happily? Would I be taking her for a procedure that might not work mainly for my benefit? Before all this and with my son,I was really laid back and said if it doesn't work, we'll just revert to bottle. But I found I really enjoyed breastfeeding her for the first 5 days when it wasn't hurting. So now I've become that person who desperately wants to continue breastfeeding.

Anyway,I plan to give the nipple shields a go,have my appt with midwife today (although I think it can only be me and her in the room) and then give it until next week before I make a decision. I'm hoping if I try and relax a bit and give it some time,it may stop hurting so much. I also have a feeling my milk supply is decreasing as I'm not getting out as much from my pump and hakka as I was a few days ago.

But as I said,thank you for your advice x

[tinydinosnore]

I've just had similar experience with my LO now 8 weeks. I think his mouth was wide enough but pretty sure a tongue tie was stopping proper feeding at first. He wasn't gaining weight very fast and had jaundice and I had extremely painful nipples. Felt like razor blades some days and got that lipstick end. He's now doing great with it and I wanted to let you know our story in case it's any help to you.

So this time round I felt more confident as I'd had the same thing with his brother who's now 7. Ended up that neither of them regained their birth weight till 3 weeks and my 7 year old is totally fine btw, one of the tallest in his class etc.

My first DS had a kind of ambiguous tongue tie and it wasn't snipped until 2 weeks. Milk supply (and my head) suffered as a result as I found it too hard to do all the pumping as well. However we persevered and I managed to do combination feeding. He dropped breastfeeding at 8 months and it felt like my supply had never really established properly and was getting less and less, and we kept increasing the bottles. It was still a really rewarding experience however looking back I sort of wonder why I gave myself such a hard time to keep on, as it would have been special anyway.

This time round I think our new LO has got a tongue tie too, certainly felt similar with clicking and coming off etc, but not as bad. Midwives didn't even really want to look cos they couldn't offer any treatment. Anyway, obstinate head kicked in and because of previous experience, and also because my partner was around more, I decided to give it a try and managed to keep the pumping going with bottles to make sure he's gaining weight. Some days I totally sacked it off but I tried to get 1 or 2 pumps in. I decided to be flexible but aim to keep the bottles at 90 ml, giving 4 or 5 bottles a day after breastfeeding. If he was still hungry I tried to eek a bit more from the boobs after the bottle as well. Ouch.

At some point around 3/4 weeks it felt like his latch changed. He woke up a bit, maybe his mouth had grown? At the same time my milk started coming in better, getting the occasional flooding which was exciting for me. He's now feeding well, still has about 4x 90ml bottles which he doesn't always finish, and I think for us it will continue ok. I'm not pumping anymore, I think I stopped around 5 weeks. He's had another growth spurt and he doesn't seem hungry after having a good go on the boobs, so it's looking ok for now. Does take ages to feed though!

Sorry if long winded, just wanted to give you another perspective, and maybe hope to hold on a little longer if you can bear it, but if it's feeling just dreadful then don't, cos everyone's situation is going to be a little different.

Having a mare with naps, wind and night waking now but that's a whole other matter!! Good luck with it whichever route you choose. It's so stressful and you've got the birth to recover from too, plus I guess you've been trying to do all this in the ridiculous heat wave temperatures.

I also had an idea for meeting with the private practitioners. Could you perhaps explain your auditory processing and record the meeting to play back later?

Key things that helped with me:
*Feeding with good upright posture when he'd gone off the latch again to reeducate his mouth. Especially in the day, then I could be a bit more slack at night
*Making the latch quite deep by really pushing his head into the boob so the nipple hits as far back as possible
*Drinking lots of water and eating nuts, avocados, chocolate etc
*Lanolin!
*Making sure he has 2 goes on the boob before moving to the other one
*The shallow lapping can be important part of the feed not it's just nuzzling for comfort as I'd thought, your midwife will be clearer about that
*Feeding him in a nappy to stay awake
*Skin to skin when I could and occasional all day in bed
*Pumping when I could, very important. I learned that the action of pumping for 10 mins each side soon after breastfeeding is stimulating even if not much comes out. Some midwives said unrealistic things about pumping 12 times a day ffs, but i think my top was 4 and usually 1 or 2, these got put into the bottle and made up with formula to get 90ml

• Hot flannel on boobs and the odd bath
  *A back rub would have been nice but I don't think I got one.... Hmmph
  *Trying to be flexible and not do my own head in
  *Repositioning him further round me on one side seemed to help.