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Infant feeding

Get advice and support with infant feeding from other users here.

Original poster

Help please! Friend is having feeding problems!

30 replies

nickelhasababy · 27/04/2012 10:41

got an fb message this morning (before i was awake - she was stressing and wanted to vent)
Friend's baby was born saturday night, breach vaginal, spontaneous, very bruised.
he's not feeding.
she's had him checked for tongue-tie, and he's got a very high palate and recessed chin.

i apologise for c+ping her message, but :

"feeding couldn't be going much worse. we're syringe feeding formula top ups after every feed in a desperate attempt to keep breastfeeding. He has severe jaundice we have latch issues I have supply issues and expressing isn't getting me more than 10 ml in 30 mins and he's not weeing or pooing. any 3/4 wouldn't be an issue but add in the lack of wee/poo to flush the bilirubin out and we're getting into serious territory. I spent most of yesterday in tears feeling a complete failure."

she's bfed 4 children already very successfully, and she's pumping with an electric pump, and she's tried all positions she can think of.

he's weed once a day, as far as she can tell, and hasn't pooed for days.
she doesn't want to formula feed if possible.
another thing she said was she thinks her nipples are really too big for his mouth, as he can't get right over. and she's got a vein that keeps getting pulled by the pump, so she's in agony.

they have talked about taking him into paeds unit, but she thinks that it will make him ill (too many sick children to go past)

any suggestions, please?

thank you Thanks

OP posts:
Hotpotpie · 27/04/2012 10:48

No suggestions just every sympathy, I had troubles getting my LO to latch and it was down to a tongue tie, shes doing much better now but there is nothing worse in the world than that feeling that your some how letting your LO down, I hope she gets sorted very soon

Original poster
nickelhasababy · 27/04/2012 11:03

thank you.
she's getting really upset and stressed about it.

OP posts:
MimsyBorogroves · 27/04/2012 11:08

Im no expert, but when I had massive difficulties latching DS1, I was taught to "sandwich" from behind the nipple with my fingers so that the area was compressed, then latch him on. I used the technique from birth with DS2 and it was brilliant.

A lot of people don't pump well. Can she hand express and syringe into his mouth?

As much skin to skin as possible, and REST.

Original poster
nickelhasababy · 27/04/2012 11:16

she's tried hand expressing too.
thank you for your suggestions - i will put them to her. :)

OP posts:
thegingerone · 27/04/2012 11:22

is there a infant feeding specialist in the hospital where she is? i had issues and only found out at five weeks in that there was a fab support team a few floors down. when i went to see them there was a mum in hospital gown with a tiny two dayer.
i was in the JR in Oxford just on the off chance she's there!!!!

Original poster
nickelhasababy · 27/04/2012 11:24

she's worried about going to the hospital, but i think she said that she's been getting help IRL.
i think.
I've linked her to the thread, so she can look. :)

OP posts:
thegingerone · 27/04/2012 11:57

Oh. i thought she and baby were still in hospital. glad she's getting help. sending positive vibes her way.

crikeybadger · 27/04/2012 12:05

Cranial osteopathy to get over the birth trauma?
Nipple shield may help in the first instance to get him latched on- not ideal I know but may be a short term measure?
Remember that expressing output is not an indicator of supply- you probably know that, but it's worth keeping in mind.

No poo for days in such a tiny baby is obv worrying so I really hope she gets some good help soon. Smile

Original poster
nickelhasababy · 27/04/2012 13:18

still at hospital?! Shock
Grin
she had a home birth - but unassisted because it was 1hour from waters breaking! they phoned ambulance and midwife but neither got there in time Shock

OP posts:
Original poster
nickelhasababy · 27/04/2012 13:19

thanks crikey - she tells me she's never been good at expressing, but is a veritable fountain of goodness Grin

OP posts:
narmada · 27/04/2012 14:07

HIgh palate and recessed chin can be associated with tongue tie (as in my son's case). Now, I know she says her baby has been checked for this but honestly, very few people are properly trained to spot tongue ties - and that includes (perhaps most) paeds, midwives and even breastfeeding counsellors. She needs to see a lactation consultant who specialises in tongue tie, and pronto. The hospital should at least be able to signpost her to one.

I think the jaundice and the lack of output should be a red flag and one that needs following up with some urgency.

thisisyesterday · 27/04/2012 14:10

has she seen a real life breastfeeding counsellor?

Original poster
nickelhasababy · 27/04/2012 14:40

i'm not sure who it is that she has spoken to - but i raised that too, and she said that the person knew what to look for.
i will make sure she follows it up just in case - she was quite sure, because I mentioned that not everyone knows what to look for.
from the sounds of it, she's had lots of people in an out.

OP posts:
narmada · 27/04/2012 14:53

Has someone definitely assessed the baby for a posterior/ sublingual tie? UNless you are trained in recognising and dividing this type of tie it is almost impossible to spot.

crikeybadger · 27/04/2012 14:57

An unassisted breech birth at home, wow - that must have been something!

Just one more thought on the pump too- if it's making her sore then maybe the breast shield size is not quite right.

When is she next seeing a mw?

tiktok · 27/04/2012 16:18

Is she doing biological nurturing/baby led attachment?

Original poster
nickelhasababy · 28/04/2012 14:08

i had a look at that on a link on another thread.
yes, she says she's tried all sorts of positions.
i've reminded her to do skin-to-skin.

it's not the nipple that's sore from pumping, just this one vein it's pulling at.

she was asked by the MW to keep a detailed feeding diary, then the next one didn't even look at it. Hmm
i think they're visiting her most days.

OP posts:
Original poster
nickelhasababy · 28/04/2012 14:10

crikey - apparently the mw was annoyed cos she wanted to see it - need the practice. although, she also said that they would have tried to transfer her into hospital. (because they're so out of practice)

OP posts:
Original poster
nickelhasababy · 28/04/2012 18:04

we've got some good news and some Hmm news

He's put on 1oz over the last day, and he's pooed 2ce and done about 6 wees.
Grin

but on telling the MW this, "it's not good enough" Hmm and they want more.

also, even though they haven't looked at the food diary, they thought that she was supplementing with 20ml of BM, when she's been doing 20ml formula, (BF then 20ml then BF - as much expressing as she can too)

She's getting blisters from the constant latching/expressing, and I've said to her again about the tongue-tie that was mentioned earlier (she hasn't had chance to look at this thread, but thanks everyone for their help). She's going to ring La Leche League to see if they can refer her to a proper lactation specialist in the area (she is willing to pay for private if necess) - especially as she is umming and ahhing over the MW's conclusion that he's not TT.
and someone has suggested that a dentist might be able to tell TT better than the MW team (not sure about with such a little baby though)

and one MW today said "he's not happy is he" because he was frowning (even though she told her that he was frowning because he was doing massive farts Grin)
rather than actually listening to her and basing advice on that Hmm

OP posts:
crikeybadger · 28/04/2012 18:51

The weight gain and output sounds exactly as it should be, so I wonder what else they are looking for. Confused

You can find a certified lactation consultant on the website here.

fapl · 29/04/2012 10:36

Another here with a son with receded chin and high palate. He also had a posterior tongue tie. Just repeating what others have said really, the baby must be checked by someone who is trained to spot a posterior tongue tie. Also, many babies with posterior tongue tie may also have a lip tie like my son. The official line in the UK is that lip tie does not affect feeding, but it can affect the top lip flanging out (so therefor, I and many others think it can affect breastfeeding). It is more complicated to cut than a tongue tie so it is not really normally treated although you can massage it.

Also, people often associate tongue tie with failure to thrive. This is not necessarily the case. At his 6 day check my son had put his birth weight back on.

Regarding dentists in the US dentists often cut tongue tie, like Dr Kotlow who has a good website www.kiddsteeth.com/ but I think in the UK dentists wouldn't know what to do with a week old baby. Your friend is best off seeing a specialist lactation consultant.

Regarding the receded chin, the breast feeding specialist I saw said she advises all mothers of babies with receded chins to breastfeed for AT LEAST 6 months. This is due to how it helps the mouth and jaw physically develop. Having a receded jaw leads to the bottom teeth becoming crowded and dental work alone will not fix this if the underlying cause of the crowded teeth is not addressed i.e. the receded jaw. Dental work may temporarily straighten teeth but if the underlying cause is still there the teeth will just move back. My husband and my MIL both do not like smiling in photos because of their teeth, both have receded jaws and have had dental work done (I laughed in my husbands face when he told me he had had dental work because his bottom teeth are so bad, a bit rude of me!). Sorry, not trying to lay on any more breast feeding guilt, just interesting info for your friend to take into account. Breastfeeding might help to strengthen the jaw and bring it out.

When your friend is over the initial breastfeeding stress of just trying to sustain her baby, Dr Palmer in the US has a great website website with great information based on his own research. www.brianpalmerdds.com/Default.htm
The presentations on The Importance of Breastfeeding to Total Health' and the presentation on SIDS I both found really interesting. As a dentist he is more interested in how the action of breastfeeding effects the mouth and therefor total health, rather the the nutritional value of breast milk as such. I think people get hung up on breast milk vs formula and how the action of breastfeeding effects development of the mouth is often overlooked, but when you have babies with high palates, tongue ties, receded jaws etc it is probably more important not to overlook this. All of this is more long term benefits type stuff, it won't help her with getting latched on initially but it may help give her the motivation to continue if she can see the benefits as being beyond just breast milk (and saving money in the long term on dental work if problems get addressed early, I will be keeping a close eye on my son so he is not the 3rd generation not to smile in photos).

Sorry, didn't mean to write an essay, just turned out that way!

Original poster
nickelhasababy · 29/04/2012 13:17

that's very interesting about the receded chin, thank you.
I have told Friend to keep an eye on this thread for extra bits of info/advice, so thank you :)

OP posts:
Original poster
nickelhasababy · 29/04/2012 13:18

(don't worry - I tend to go on, too! Wink
yours wasn't waffle - it was all useful info)

OP posts:
narmada · 29/04/2012 21:41

Yes, a posterior tie was what my son had too, Fapl. MIssed by most health professionals and only spotted by a specialist Lactation Consultant.

fapl · 29/04/2012 23:13

Sorry a bit off track, I was really upset to have just read on another thread that Dr Brian Palmer whose website I cited above has recently passed away. Just last month after suffering serious depression. I had written a message to him about 6 weeks ago letting him know I wanted to make a small donation to his research and maintaining his website, asking him if he could take donations by paypal or some other easier method of transferring a small payment. He sent a lovely reply telling me his grandparents were from the UK and he had lectured in Leeds a number of years ago, and asked me to make a donation to LLL instead. :(