What to do next?

[anne74]

DS is now 5 1/2 wks but born at 34+5 and has had Tongue tie done twice, once at 3 wks and again a few days later. I have seen infant feeding advisors (from the pct) 4 times in the last 2 weeks and now feel they have washed their hands of me as they don't know what else to advise. The last comment made was to try and persevere for 'a few more weeks' as he was prem and had the Tongue tie issues. I feel abandoned and need help.

DS is having real issues latching on. He doesn't open wide enough and so doesn't get a deep latch. His tongue feels like sandpaper on my nipples and both are agony. One nipple tends to end up lipstick shaped and the other is pinched into a ridge.

I rang the NCT line and didn't find them that helpful. I was considering seeing a lactation consultant privately but am not sure if there's something else I can do. I dont want to give up. My goal was to at least bf til his due date which was yesterday but I do really want to keep going. The lady on Thursday tried a nipple shield but it didn't seem any less painful so she said not to bother. I dread feeds as it's so sore.

Can anyone help?

I'm using the medela ones. They only come in one size and were recommended by the LC. There is a graze on the areola from where it's been rubbing.

I'm now getting a bit worried as I haven't expressed since I fed with the nipple shields at 1am. I have rung someone to hire a pump but she was at tesco so I'm waiting for her to call back. Should I just try my normal pump and hope it's not too sore? I don't want to jeopardise my supply as it's been pretty good. I've been able to express 60mls each time.

I wouldn't stop expressing.

The Medela contact shields come in small, medium and large but only medium is available in most shops so you'd need to order others online.

I used medela contact shields too, started with the small but moved onto the medium when I found small too painful. Think the cut out part goes under the nose so baby can still smell your skin, I don;t think it should affect effectiveness if the other way round but I imagine it might make it harder for the shield to stay on since baby's chin is not holding it in place.

When I used the shields again a week or two off I found it initially painful but it eased, and was less painful than the sore nipples I was trying to protect.

I've used mepilex wound dressing, it's pricy but good, you can cut each sheet into quarters and put a patch over each nipple to help with healing. You can stick it higher up your chest and reapply after each feed until the stickiness goes (if you leak a lot that could be quite soon!). Don't use any lanolin under the dressing, can't remember why but think it stops air getting to it, midwife told me to use either a lanolin (lansinoh or purelan etc) or the mepilex.

I've also tried Bepanthen Plus cream on my nipples on the advice of a lactation consultant, I slathered it on at night and washed off before feeding. Seemed to help healing a bit, may be worth a try.

Keep expressing ,def worth trying a new pump if you find your painful. I have a fancy schmancy Ameda lactaline double electric and you can reduce the pace/pressure so when I have sore nipple I just put it on low and wait longer.

Good luck!

I've managed to get the Ameda lactaline double pump on hire and if I dont return it after 2 months, it's mine to keep. It was much more effective but I haven't quite got to grips with doing both sides at the same time but I guess it just takes a bit of practice.

The dressing has been ordered by the chemist and will be there by Friday morning.

I've got an appointment at 4pm tomorrow with the consultant at kings so hopefully I can get this tongue tie issue resolved.

I don't know what size the nipple shields are. I didn't think to look at the packaging. An assistant in boots had got it off the shelf. Having been in there today I saw that there were small and medium. I'm not going to put him anywhere near my boobs though I don't think until we've had this appointment tomorrow.

The secretary who phoned me with the details said that the surgeon had asked her to tell me that he wouldn't necessarily snip the tongue tie. My worry is that he might say it doesn't need doing. If he does I don't know what we do next. I have a feeling that will put an end to breastfeeding which would be really sad. I guess I'll just have to cross that bridge when we come to it v

Thanks so much for all your support. It really helps.

Tell the consultant that. If it might help and could make the difference between bfing or not, it should be considered imo.

Well we had the appointment yesterday and he did cut it again. I've been told to bf strictly every 3 hrs for 5 days and also to do vigorous massage under his tongue twice a day for the next 5-7 days. It bled a lot but he was put straight onto me to feed and he did ok. He just ended up with a face covered in blood.

Whilst he has definitely got more movement in his tongue, the other issues still persist - not really tipping his head back, rubbing his tongue against the nipple. The feeds during the night were so sore and I've ended up with another blister on the left nipple. I have the dressings now though so hopefully they might help with the state of my nipples.

The consultant said I have to feed him for at least 15 mins each time but can then give a bottle if I need to. The problem is that he just doesn't seem satisfied after feeding on me and I'm wondering if he's got used to feeling full quicker when he's had a bottle. I'm worried that if I finish the feed with a bottle he'll get too used to it so I pushed him longer on my boobs. I think I might get the LC back for more help.

The consultant did mention that DS has a high palate and a small chin and that those things might play a role in a poor latch. I can't do anything about those though.

Quick question - if he has to feed every 3 hrs, would you time it from when he starts or finishes the feed? The last couple have gone on for an hour or so because of having to take him off and reposition him all the time

Timing is from the start of a feed. Very normal for feeds to go on for an hour when newborn so you are feeding them for a third of the whole time! My dd was a marathon feeder, sometimes over an hour, only just getting down to 40mins ish now she is 2mo.

Thanks. Unfortunately I thought that might be the case! The feeds were so painful last night I had to very reluctantly give him a bottle to finish the feed and get him to settle. I really didn't want to but I guess that the priority is being able to manage the 15 mins which have to be done. If I wreck my nipples too much I'll struggle with that and I've got to last til Tuesday. The LC is coming back on Monday night so hopefully she'll be able to help. It seems a bit mean to DS to put him through this and then end up bottle feeding.