I need some help and support please.

[Titsalinabumsquash]

I didn't know where to put this, it's sleep/feeding all rolled into one.

I'm at breaking point with DD, she's 14 months and my last baby of 4.

She sleeps in our bed and has since day 1.
She's breastfed and will not eat any solid food at all. She's due to see a dietician to start working out why and how to proceed.

Most health professionals i have seen have said to stop breast feeding her to make her eat, I have tried this briefly but if didn't work, she ended up dehydrated, miserable and unsettled for days on end.

I don't think she's refusing food because she prefers milk, she actively takes food from her and my plate and will put it in her mouth and chew and chew before spitting it out and taking more, she likes green food, broccoli, peas and olives she will go for.
I can occasionally tempt her with sweetened yoghurt and she'll suck a chocolate button into oblivion before swallowing it.

I always offer 3 meals a day, at the table with other people and all food generally gets swept into the floor before a she starts crying to get down.
I try both purée and whole foods.

She also won't take anything from a bottle or any type of cup.

She has never fallen asleep with ouch feeding and at night she feeds all night. Literally.
I'm so sore and tired!

I need to drastically cut down if breastfeeding, it's making me so stressed and the dietician thinks DD is anaemic but she won't take a vitamin liquid, she also won't take calpol when I'll I have to use suppositories.

I know dietician and Dr's are working with her but I could really use support in the mean time.

I'm not a medical professional but is she actually physically able to swallow solid food?
It sounds incredibly tiring :(

I don't know, she swallows yoghurt and the odd pea in her nappy suggests she does very occasionally swallow something even if not on purpose.

It is tiring and I'm getting a lot of "well you've spoilt her by feeding on demand and carrying her everywhere" which isn't helping.

I don't know where to begin to try and help her. I don't know how to find out if she physically can swallow solid/textured food or not. 9 times out of 10 she won't put food in her mouth and the green foods she chooses to put in and chew are spat out.

I should add she was slightly prem (35 weeks) and tiny when born, she didn't gain weight for a few weeks. She's still small now. Just 16lbs and her height isn't even on the charts.

I think she has a top lip tie, the skin that joins the lip to the gum is between her top teeth so she has a huge gap, I can't see an obvious tongue tie but I know there's different types. It's made feeding hard and she spent the first 6 months with awful thrush in her mouth but I've been told that her mouth if fine and tongue/lip ties are a 'trendy' thing that's talked about now but isn't really a big deal, that was the old hv but we have a new one now who referred to dietician.,

I always offer food before milk.

Is she hitting all her development milestones? Does her muscle tone seem ok?

You haven't spoilt her :)

So she was IUGR, Titsalina? there is a small proportion of IUGR babies who go on to have problems with feeding and growth, sometimes severe.

I answered a post like this in Child Health a week or so ago, and recommended contacting the Child Growth Foundation.

Yes, how is her development? Can she hold her head up, crawl, pull up to standing?

Don't cut out the breastfeeding as little babies can have problems with blood sugar.

Sorry, I don't want to bombard you with irrelevant info, but being small with no eating rang several bells with me. Many years ago when I was going through it, a lot of local health professionals were well-meaning but clueless.

Yes, I agree carry on breastfeeding. I was told to cut out milk and child would feed but what actually happened was child got thin. I must say we saw a specialist dietician though who really was good, so hopefully you'll find the same xxx

She's perfect with all other areas of development, walks/climbs etc. Muscle tone is ok but she does see a physio for very lax ligaments but hyper mobility syndrome in females is in the family which is why I was induced so early, I can't carry to term because of it.
I'll read the link and make contact.
She's due some blood tests to check her iron and other vitamins etc.

I don't know what IGUR is sorry! She was just 5lbs at both but dropped right down to 4 in the first week and then took so long to get back up. I went in and out of hospital with her and they said to just keep her warm and feed as much as possible and up the fat in my diet.

Sorry, Intra Uterine Growth Restriction, or being small for dates (also Small for Gestational Age). From memory, if she was 5lbs at 35 weeks, I don't think she was technically IUGR..

That's great she's meeting all developmental milestones. You must be exhausted though.

I'd still make contact with the Child Growth Foundation. They are a lovely, helpful charity and community. In the meantime, I wouldn't cut down the breastfeeding, as exhausting as it must be.

Is there any way she might take a bottle? Then they/you could start to give her high-cal milk / nutritionally complete milk to take the pressure off her eating. Anyhow, I'm probably getting ahead of myself.

I had a quick look at that link, she did poo before she came out ( left me with a lovely infection!) and she really struggled to maintain her temp, I carried her around all bundled up in lots of layers in a sling for the first few weeks to keep her warm.

She won't go near a bottle or cup, she clamps the mouth shut and turns her head, we've tried so many different types, we've even tried a syringe to get milk into her another way but she spits it out.

IUGR is intrauterine growth retardation, ie baby is very small for dates when in the womb. 5lb is pretty average for a 35 weeker I think so sounds like she wasn't IUGR.

As well as the dietician, I would ask your new (and sounds like better) HV for a referral to a feeding and swallowing specialist - they are a branch of speech and language therapists but specialise in swallowing rather than talking iyswim.

The old HV who told you tongue and lip tie is just a trendy thing is wrong. For many it causes no major issues but for a few it can cause real difficulties that continue into childhood. It all depends on the shape of the tongue and mouth and jaw. Look up posts by mawbroon about her son. If your DD has a major lip tie then it's likely she has a posterior tongue tie as well.

The best person to diagnose a lip/tongue tie is a good lactaction consultant, unfortunately this tends to involve paying to see one privately - could you afford that? (usually £75-150 ish). Also at 14 months it would involve general anaesthetic to cut any tie (although I think a few specialist dentists eg Malcom Levinkind do it with laser without GA).

Oh also, did she have any breathing support when born, ie was she intubated? As that can lead to feeding issues later.

No breathing problems thankfully.

I will go to the HV tomorrow for clinic and ask to be referred to SALT.

The dietician appointment isn't for a while yet.
I can afford a lactation specialist when I get paid so I'll look into that too.

Thanks for the advice.

Sorry but aww, that reminds me of my tiny baby when he was little. Once on bottles, used to drink the tiniest amount (1 oz at 5 months) then turn his little head up and away and clamp his mouth shut. (Obviously at the time I didn't find it quite so cute - it was just baffling, and so much of a worry.)

Back to you though, I still don't know what to suggest. Even for IUGR babies, the strategy seems to be still a mix of muddle-through, and supplementary - or total - tube feeding for some years.

You've tried chocolate buttons -that's good. Have you tried the 'melty' crisps like wotsits? (Honestly, it sounds awful, I remember reading up and thinking, 'no toddler of mine will ever eat wotsits'. But your principles kind of have to go out the window - it's all about the calories.) Sainsbury's brand ones don't have any heinous ingredients in them, or there are those baby brand ones, although their texture is slightly less melty.

Often, babies with feeding issues like quite strong / spicy tastes, so maybe worth trying (interesting that she likes olives, for example). I'll have a bit more of a think.

I also think she should see a paediatrician to look at allergies / reflux / any other medical issues.