9 weeks and BF still not working... miserable...

[BongoWinslow]

So I've been trying to EBF DS for 9 weeks now and it's still not working. He'll feed for hours but then still be hungry. Or he'll fuss. Or fall asleep on the breast. Or not latch. Aargh. On top of which he's had a cold and dropped from 75th to below 9th centile and HV is now worried about his weight (he's less than 500g heavier than he was at birth).

I'm so worn out with trying to make this work and not knowing to fix it. Been to so many lactation clinics, baby cafes... Have been feeding plus expressing like mad and still can't get him full. Finally cracked one night and gave him some formula which he lapped up and he's been so much happier ever since I added a top up at night when I run of expressed milk, so it seems he was hungry all this time.

He has a mild tongue tie but doc says it's not relevant to the feeding but DH wants to have it snipped. I don't know anymore, doc referred us but was pretty unsupportive.

Anyway, ramble over. Just wanted to moan a bit I guess.

def get the TT snipped I would say

sorry you're having such trouble I'm shocked the doc said not to get the tounge tie snipped when my ds had a tounge tie they said if you had any weight gain issues they rushed you to the front of the snipping queue. I would double check with the midwife/hv

you need a lactation consultant

Have lactation clinics said that there is anything wrong with the way you are feeding him? Have they looked at your positioning and the way he is feeding?

If he is latching on and feeding then maybe there is something else going on. The fact that he has gained so little weight really suggests that there is a problem which is outside of your control.

If the dr said that it was not tongue tie then he should be able to suggest an alternative diagnosis or refer you to a paediatrician.

Sorry this is long...

Doctor blames it all on his cold which became a very mild chest infection. Ditto HV kept saying 'you dont have breastfeeding problem'.

It went like this:

Wednesday last week - had his check, getting over cold (which had lasted 10 days)

Monday this week - I still felt feeding wasn't working so I went to the lactation clinic - they said feeding looked totally fine but that he was very underweight and suggested expressing to give top ups.

Tuesday - HV worried about weight and doc listened to his chest - found a 'crackle' which he said was infection post-cold and put him on antibiotics. But DS had no cough, no snuffly nose, no fever, was bright and bouncy... frankly, he didn't look ill at all.

He also had his immunisations that day on their advice.

He was then fussy and very hungry all week (I know fussiness normal after jabs). Gulped down food. Even with me feeding 6-8 times a day the pumping and giving him EMB top ups he's still hungry all the time hence formula... I'm feeding him every 2-3 hours then I express what I can and use that next feed to top up if needed (almost always is).

Basically I spent this week shoving every bit of milk I could into him to get his weight up. Eg yesterday - 7 feeds + topups totaling 1300ml!

Friday - doc said 'crackle' gone. We asked for referral for snip and he wasn't keen but we pushed the point and he agreed.

Doc reckons he's now feeding heaps because he's getting over the infection. But he just often doesn't seem to get satisfied after I BF. He has done in the past, but it's hard and takes forever (at least an hour). He's much less grouchy since I started topping up so much.

. I think we'll just get him snipped and I've contacted a lactation consultation. I just don't understand why the doctor is against it. We had actually asked weks ago when he struggled hugely to regain his birth weight (only achieved that by expressing and topping up like mad).

Sorry that was so long. thanks for comments, esp beachavendrea - that's very helpful to know about your experience.

Even quite a mild tongue tie can effect how well they transfer milk - I'm sure by 7 weeks feeds were taking less than an hour for me, so it sounds like your ds is having to work hard for the milk.

My ds had his tongue tie cut at 3 weeks, and it was really a 2 minute procedure - he complained a bit and there was literally a couple of drops of blood but that was it.

Gosh you been through the mill! Well done you for carrying on.

Do you offer 2 or more sides for each feed (e.g. start on L then R then L again if DS still seems hungry)? Have you tried to encourage DS to keep feeding? This might help DS get more milk at the breast whilst you wait for the TT to be snipped.

if i were you, i would def go for the tongue tie snip. ds had it done at 5 weeks and it's really improved feeding for us no end, even though TT was only tiny. dh was with him when it was done and said ds was more upset about being swaddled to have the snip than the snip itself. we had v similar problems to you until TT was gone and now ds is piling on weight like nothing else. Though lactation consultant said it doesn't work in every case, I would say it's certainly worth a try.

Yep, tried breast compression, swapping sides, changing nappy mid-feed, lived on KellyMom for a week!

ok, you've helped decide - I'm going to have it snipped. Worst case, it doesn't change anything but it doesn't seem like it's risky.

thanks so much for the support and sharing your experienced. I feeling utterly knackered but determined to keep on BF so I'm going to do have it corrected.

DH will be very grateful that you've settled our debate!

do you pump after feeding to increase supply? try to pump after almost every feed, you need to do it at least 6 times a day. you should see an increase in your supply, if that is part of the problem

I had a similar problem with my youngest when she was a baby, she had a cold that lasted about 2 months and in the end we gave a bottle because it was stopping her latching because she couldn't breathe. Getting her strength up really helped.

Another thing I did was to only feed on one side for a few hours then swap over and again only use that side for a few hours. If your supply is fine then it's a good way of bulking up a baby. I was pumping too and tandeming so supply wasn't an issue.

am expressing after every feed and think supply must be good - I got 700ml yesterday on top of feeding 8 times. that's partly what worries me - I can feed him for an hour and then still get 100ml by expressing which is why I don't think he's getting milk out of the breast properly.

I'll try that confuddled, thanks

oh, and if breathing is a problem at the mo with his cold, you can get saline drops to give just before a feed and they help loosen everything up so breathing is better during feeding. hope it works out for you soon as i know how disheartening it can be and how much of a strain it puts on everything else when every day seems to be all about feeding. good luck.

BongoWinslow - What confuddledDOTcom described is called 'block nursing'.

Block nursing is a last resort technique used to decrease supply in mothers who have babies who are not coping with the forceful let downs and large volumes of milk that over supply brings, when other techniques/positionings haven't worked.

Kellymom explains here how to block nurse and why.

If it applies to you/baby then yes block nursing may be the way forward but, apart from your ability to express large volumes , it doesn't sound like you have over supply, though obviously I haven't seen you or your DS so I couldn't say for certain you don't.

Try watching these videos which show effective feeding ('Really Good Drinking' and 'Good Drinking') and ineffective feeding ('Nibbling') to see if you can spot behaviour that your DS exhibits during feeding. Hopefully it will reassure you but if DS is 'nibbling' then thing can be done to help latch though it may take getting tongue tie snipped to make a real difference.

Yes but block nursing also helps when your baby is struggling to take feeds because of a cold as they get more of the fat. It's what was recommended to me by two of the best BFCs in the West Midlands.

As I said they told me the fact I was expressing anyway (preparing for a work conference day) and tandeming meant that I wasn't going to cause problems with my supply, especially as it wasn't going to be for long.

It does sound like this is about breathing through a cold more than latch or supply issues.

Don't worry about how much you express, your boobs aren't bottles, they'll keep producing whilst you ask them to.

I remembered another thing that helped us, I used to feed her sat on my lap. It's a little fiddly but it stopped her nose getting too stuffy during a feed if she was lying down.

Thanks TruthSweet - looking at that, I don't think oversupply is the problem. He's over the stuffy nose, now, and it's still hard to fill him with milk via the breast.

Having looked at the videos, his drinking looks like 'Good drinking' even when BF counsellors say latch is good, so my theory is that he's latched, but has to work harder to get a big wodge of milk to swallow due to the tongue tie - does this make sense? It would explain why the latch looks fine but the feeds are long and don't satisfy him.

What do you think?

After a wretched morning, things have been better this afternoon. Managed to satisfy him for an hour after one feed (that's good for us!) and have expressed enough so he's full without formula (also very good news!). And DH braved the snow to buy me some flowers and mince pies to cheer me up!

I think we'll get the tie snipped and then re-assess. Are there any downsides to doing it? I can't work out why our doctor and health visitor aren't more keen on just doing it and taking it out of the equation - does anyone know?

Thanks for the support, BTW, it's really really helping.

No idea why they're not keen, we had the opposite experience! Midwife reffered us to the tongue tie clinic as soon as she spotted it, even though it wasn't actually effecting his feeding as far as I could tell. We went along to chat to the doctor but weren't sure we were going to get it snipped but he talked us into it.

The doctor's argument was that it's such a small procedure it's worth doing even if it isn't impacting on breastfeeding as it can cause problems later for the child with eating solid food and speech. If you wait til they are a toddler to have it cut it's a traumatic thing involving sedation/anaesthetic which of course has it's own risks. With a little baby it was literally a snip with scissors while DP held DS on his lap, DS cried for less than a minute, there was a tiny drop of blood and that was it.

This was at a "Baby Friendly" hospital were they are very keen on breastfeeding support though.

I think they are usually keen on intervention because a diagnosed tongue tie that was left that then causes speech problems or effects oral changes that need orthodontic treatment in later life leaves the trust open to claims of malpractice (i.e. why a cheap 2 minute procedure that could save thousands of pounds and years of orthodontic treatment and/or speech therapy wasn't performed - could be sued over).

So in your case I really don't understand why they are being obstructive and I would ask them to refer you OR give you a cast-iron written guarantee that not having it done will not result in any of the usual problems that can occur with an un-corrected TT.

This is a list from Brian Palmer DDS's website (US dentist who has researched TT and other oral abnormalities and their effects on bfing and in general):-

Heart shape of tongue when raised.
Cannot extend tongue out to a point.
Tongue curves down when extended.
Usually leads to a deviate swallow.
Possible speech problems.
May have trouble swallowing pills.
May have digestive problems.
Difficulty in licking ice-cream cones.
Difficulty in kissing.
Snoring and sleep apnea.

Full presentation here I'd print out some of the more pertinent pages and wave them under the nose of your HV/Dr if they still won't refer on (pages 4, 17, 20, 21, 22) - don't go past slide 38 if you are squeamish as there are later slides that show a Z-plasty op (what would have to be done on an older child/adult for some TT types NOT the frenotomy that would be done on a baby). Slide 17 list the effects TT has on the bfing infant and long feeds is one of the effects (as you well know!).

Well, HV is on her way to weigh him and I mentioned on the phone to her this morning that we were wanting the TT sorted (after extracting a referral from doc on Friday) and she just said "hmmmm" in an ominous manner...

We're determined to do it now, esp after hearing people's stories here, but I'm also determined to find out why they won't just say yes. He's nearly 10 weeks so we need to get it done soon so am calling the consultant now.

tks so much for that TS and MUA

we had ds1's tt snipped at 4 weeks. he'd been following his birth centile (50th), but was on 99.6th for length and was feeding pretty much continuously 24/7. after the snip, feeds got shorter, and he shot up to 98th centile in just 2 weeks, where he has remained ever since.

dt1's was snipped yesterday (12 weeks), and immediately it felt like she was actually sucking rather than just gulping down the let down. will have to wait to see if it affects frequency of feeds (she's been feeding hourly the last few weeks).

In both cases GPs and MWs had said small posterior tts didn't need cutting, and in any case the babies were feeding fine. glad I persisted to get them cut. do hope the consultant can fit you in soon.

Bongo - did you get an answer? Hope baby Bongo has put on some weight. IF he hasn't and they are still refusing to sort out his TT do they realise THEY are the ones who are responsible for any resulting health issues? Argh makes me mad when HCP won't do things for the benefit of the baby (are the local NHS trust under budget cuts?)

yep HV said it was because there's no clinical evidence that it makes a difference. I cited the studies where mothers reported a huge change plus anecdotal (ie here, friends, even my mum who had my brother's done) and she said if I want to do it fine, no problem but will need to go private to get it done soon and will be tricky to find somewhere to have it done. am in oxfordshire.

in good needs, lovely baby Bongo put on 400g in a week! but was a mammoth effort - feeding loads + supplemented early 6000ml (yes, 6000 - 4000ml EBM, 2000ml formula).

MamaChris tks for sharing your experience - we'll definitely get it done. his is a small posterior one too.

will keep you posted

Bongo - See here for contact details to get tongue tie divided in Oxford or try this database for Lactation consultants who may be able to refer to a private Dr or this Cons. Paed is based in Windsor and can see babies with in a week (usually on a Wednesday). All from Google not from personal experience by the by .

Hope you can organise something soon and may be you could see a LC or BFC to work on latch afterwards as it sounds like baby Bongo is working v v hard for not much milk. Definitely not a criticism of you or baby Bongo - just that, that large a volume of milk being supplemented could be indicative of not much being taken at the breast. You are doing a fantastic job at meeting your baby's needs and fighting for his future ones too!

No evidence that it makes a difference??? splutters

It's like this, babies with TT can't latch properly, babies who have it fixed can. How can that not be evidence??? The only way her argument works is if breast and bottle are equal.