To not force feed my child

[Cantfeedwontfeed]

Posting in AIBU for traffic - please help me!

DS is 3 months old - born on the 50th centile and dropped to the 9th within 6 weeks thanks to poor latch. Tried everything to stick with EBF but no joy, so started mix feeding - BF first, then bottles of both expressed milk and formula.

This seemed to work and DS started gaining properly, following the 9th centile. However, 2 weeks ago he decided to start refusing bottles - he now won’t take them at all from me and only when he is starving from DH. He’s dropped off his curve again and is heading rapidly towards the second centile.

What on earth do I do about this?! He’s still rubbish at breastfeeding so it can’t be his only source of food. I can help maintain supply by pumping but then he won’t actually drink it so what’s the point?! Advice so far has boiled to down to just forcing him to drink, which i really don’t want to do.

Sounds tough. Not sure how you'd actually force a 3 month old to drink if they didn't want to. Have you tried breast compressions while feeding to get more flow out?
Maybe think about some early introduction of solids in a month or so (I might get flamed for this but there are some babies that just really prefer solids to milk!).

Have you tried cup feeding? Just use a small open cup.

Was baby checked for tongue tie?

Have you had any advice from a lactation consultant or gone to a local la leche league group?
Just wondering if he might be helped by tweaks to your positioning to help his comfort?

laleche.org.uk

Id see a lactation consultant, some are qualified to deal with tongue ties where I live, but you might need a GP for that. It's good to have that checked. A lactation consultant can help with latch and advice on how to build supply. They might also be able to help with supplemental feeding if necessary.
There is a way of supplying extra milk while breastfeeding, it's called supply line feeding or using a supplementer. Involves a thin tube attached to a bottle and baby gets extra milk through it while on the breast https://laleche.org.uk/nursing-supplementers/

I don’t really think you can force him to drink from a bottle - my EBF baby wouldn’t use a bottle at all after a few weeks old.
I agree with advise to check latch
Also some sippy cups state they can be used from 4 months I believe
Have you tried different bottles? I’ve heard good things about the NUK closer to nature although didn’t work for me 😂

What a difficult time for you. You obviously want to do the best for your child. Please people, don't accuse me of victim blaming, because I'm not, but OP- are you giving yourself the 'best chance' of breastfeeding? Or are you trying to do too much and keep everything else going as if nothing else has happened? Many women try to do it all and often it's just not possible. So what works for many people is making breastfeeding a priority: YOU need to rest, at least on the sofa with your feet up and not be running around doing laundry/shopping/cleaning and cooking. Other people can do those things. You need to make sure you are eating and drinking enough. You need to be offering the breast to the baby frequently and if he sucks for comfort that's OK. The idea of scheduling feeding is unhelpful when you're trying to get breastfeeding established, especially if it hasn't gone as well as you'd like. The more your breast is stimulated by her sucking, the more milk you will produce. Has anyone checked your positioning again (as you mentioned a poor latch in the past?) Personally, I don't see how you can 'force' a baby to feed. There must be something ging on which makes him reluctant to do so. I've heard of babies refusing the nipple as they are put off by the mother's smell (products they've used) Is this a possibility? if it is could you use unscented soap/shower gel on your breasts and less scented hair products. Has he been checked again for any physical problems, esp in his mouth (ulcers or other soreness) . What is your HV or GP saying? (I know they're not always mega-helpful ain all circumstances, but they do have a responsibility to advise you on the areas they are responsible for. Personally i found La Leche League very helpful in a one-to-one situation. I know LLL are unpopular on MN atm because of the attitude of their Head office about trans women. But that doesn't mean that all LLL Counsellors or Peer-to-Peer support is rubbish.
I really hope you can get the emotional and medical support you need. Please remember that you are this babies mother and you are doing a great job and obviously highly motivated to do the best for him. xx

You need quite urgent medical advice IMO. A baby this young refusing to feed unless starving and dropping centiles is concerning. I understand you don’t want to force him, but equally you can’t allow him to become dehydrated or fail to thrive. I think you need to speak to a GP and possibly get a paeds referral.

As suggested above I would see an IBCLC as soon as possible. You can find your nearest on the lactation consultants of great Britain website. It is important to work out the underlying cause of the feeding and weight gain issues, and see what can be done to.improve it (tongue tie snip, change of positioning etc).

I think you need a referral to your infant feeding team ASAP. Best of luck x

Sorry rushing out but just wanted to throw a slightly off-the-wall suggestion in - have you tried feeding/breastfeeding in the bath? Someone once suggested this to me when my LO was on a feeding strike.

Are you using a fast flow teet? My DS would only have fast flow. I think he hated the effort with the others.

Thanks all. Sorry for drip feeding but didn’t want to make the original post too long. I’ve seen a lactation consultant back when I first knew there was a problem. Her view was that positioning is fine, and I am trying all the right things - but his latch just doesn’t seem fixable.

There doesn’t seem to be a definitive reason for this - she suggested a potential posterior tongue tie but I am wary about having this snipped, as he does also have very recessed chin (regtrognathia), which can cause feeding problems and mimic the symptoms of a tongue tie. Apparently attempting to snip a tongue tie with retrognathia can cause breathing problems, and we’ve got enough problems already!

I like the SNS idea and might give that a go - I’ll ask the lactation consultant if she can help.

Also just for clarity - it’s the bottle he’s refusing not the breast. He’s quite happy to breastfeed - just won’t take bottles anymore and isn’t good enough at breastfeeding to sustain a proper weight gain.

Think we will probably will end up with some sort of feeding clinic referral - but have been there before with my older one (different problems!) and was desperately hoping for an easier ride this time!

Sounds a bit similar to my girl, she struggled with her latch a lot and lost weight but wouldn't take bottles. I don't know what happened to this day but her latch corrected around 12-14 weeks, she also struggled a lot with weaning when the time came. I just kept pushing through with bf and followed all the advice.
Sorry I don't have any useful advice but I hope you have a similar outcome in terms of latch.

This might be a feeding issue but equally could be many causes of failure to thrive. See your gp to rule out medical causes and they can ensure you’re referred to the feeding team via HV aswell.

Has anything been said about the regtrognathia? That can be a marker of a genetic issue.

Not wishing to scaremonger but this, plus feeding issues, definitely warrants medical input rather than just breastfeeding consultants.

Have you tried a cup? Breastfed babies can manage them - just sit up him a little. Another option is a supplementor if he just likes the cosiness of the breast.

You can also get special bottles with silicon teats that feel like nipples. This is an example but do your research because lots of brands have them

https://www.googleadservices.com/pagead/aclk?sa=L&ai=DChcSEwiI2bqjtqKKAxWlqYMHHVvpGX8YABAaGgJlZg&co=1&gclid=Cj0KCQiAsOq6BhDuARIsAGQ4-zhUaoPT6TEPBRTUjQpcBPq0MpR2jTuHb7A-R79oZpULW9fTj8R2AlUaAmFeEALwwcB&sph=&ohost=www.google.com&cid=CAESVuD22HupU2XkAvvGcwhm15jOUbYpsaMzmtKMFFMKh47i-jjlfi4fkGLEjjgHE-6V9aCppVgW99gnjXMJVO0nQjT3YzB-lj66RDmNn3MPZ2xbMklGAqo&sig=AOD6441gvhiZyM4zfl8SHMwPfc5XubaXhA&ctype=70&q=&ved=2ahUKEwjRt7WjtqKKAxXlh_0HHS4rM98Qwg8oAHoECAYQMA&adurl=

I would try a faster flow teat if you can. He might be frustrated that the bottle is too slow (I remember being recommended to keep a slow flow teat when trying to breastfeed as babies prefer whatever is easiest for them or something).

Could you try a different brand of baby milk?

Could you try making the milk warmer or cooler than you have been (all of my boys preferred the milk warmer)?

Could you try different brands of bottle/teat?

I'd also try not being anywhere nearby when someone else is feeding him with a bottle in case he is seeing/smelling you so wants you to BF instead?

Good luck, it must be very distressing to see him losing so much weight.

Interesting you say this about retrognathia but we often see it as going hand in hand with a TT and the jaw being able to move forward once the tension under the tongue is released. We refer on a lot of babies with both TT and recessed jaw to the local hospital and not once has a baby been refused for that reason.

Having said this, you urgently need to speak to the infant feeding team if your baby is refusing to feed at all.

Hi OP - something similar happened to my baby at about 3 months. Had happily been feeding expressed milk from the bottle then suddenly refused. Plummeted down the percentiles. Infant feeding team told me to dream feed him twice overnight which worked for the first two weeks but then he got wise and woke up and refused. Then said I couldn't force him and he would eat when he was hungry. But he didn't!

Eventually I changed the teats from the MAM ones he'd been using since birth (tried all the flows!) to the lansinoh ones, and he suddenly guzzled the milk. Gaining weight again. Worth a shot with a different teat! He also quite liked an open cup but it's not the easiest. It's so bleak when they aren't eating, sending solidarity!

I'm a Paediatric nurse and I agree with this. It's not normal. But in the meantime try different bottles or teats.

Has he been assessed for a cleft palate? They are sometimes missed if it's a cleft of the soft palate.

Particularly if he has retrognathia. There is a condition called Pierre Robin sequence can cause feeding and breathing issues

We had some similar issues and ended up with a referral to a speech and language feeding team. They deal with tongue mechanics and swallowing issues. The referral was made by our HV. They were able to advise on specialist bottles and did several monitored feeds then lots of over the phone support.

The SALT team also got us a referral to paeds to rule out certain genetic conditions associated with weak tongue / poor feeding.

We did end up having to do a lot of really awful feeds / almost forcing the milk down. It was a horrible time and we had fortnightly HV visits as I think my (really wonderful) HV was very worried about me developing PND as well.

I see lots of people on the thread have recommended cup feeding, but we were told this can be very dangerous with a tongue tie that has not been divided, as the milk can pool under the tongue and cause choking. So I'd seek specialist advice before going this route.

I agree with pp that i think you need to urgently see either infant feeding (although ours wouldn't see me after 28days old) or SALT feeding or paeds.

It's so stressful when they aren't feeding properly and so absolutely reaching out for help is the right thing to do. Sending you lots of solidarity, OP.