Expert advice needed - is this tongue tie?

[Natmu]

My 4 week old DS2 is very unsettled generally. I have been told by hv and GP that he probably has reflux and colic so we have tried Gaviscon which made the problem worse. DS2 is ebf and appears to latch on ok but then often pulls off again frequently during feeding and appears very uncomfortable and squirms constantly. He seems to gulp down lots of air with the milk and I can hear his tummy gurgling all the time. He often feeds for just a few minutes and then falls asleep. When he finishes feeding my nipples are flattened and white at the ends which then returns to normal after a few minutes. He was checked for tongue tie by hv and midwife and both said he was fine but I'm not sure. Any advice?

have you had anyone watch you feed from start to finish?

As what you discribe could be poor latch or tonge tie. I think you need to seek more experienced help, is there a local breastfeeding group near you. They are often run in your local Childers centure. Or you could ring one of the national breastfeeding helplines.
www.nhs.uk/conditions/pregnancy-and-baby/pages/breastfeeding-help-support.aspx#close

You are certainly describing symptoms typical of a tongue tied baby and you need somebody who knows what they are doing to assess your baby for it.

Milk matters can put you in touch with local help or advise you of your nearest options.

this will help to give you an idea of whether there is tt or not

There may well also be a lip tie lots of info about tongue and lip ties here

And there is also an excellent tongue tie support group on facebook.

In the meantime, if you try an exaggerated latch (have a google for it) or biological nurturing then you may be able to achieve a better latch.

Glad you made it to the feeding board Natmu, how are things now?

Hadn't realised that your nipples were going white, have a read of Nipple Blanching and Vasopasm too .

Things are very confusing. On Monday night LO was very calm and settled. He even managed to get himself off to sleep without any help then slept from 9 until 3. Feeding was calm and relaxed.

Last night he screamed on and off from 5pm until 1am unless I was cuddling him. He slept for a total of 20 minutes during that time and feeding was back to how I described it before. DH arrived home from his night shift at 1 and took over to let me have a couple of hours sleep but then we were back to the same pattern after his 3 am feed.

What I was thinking was if it is a tt then surely every night would be bad? In which case could it just be a poor latch? Either way I'm about to head off to see the bfc in a minute so hopefully they can shed some light and save my sanity as I've just been crying all day today with frustration.

I know you suggested bringing him into bed with me but I've always been nervous about doing that. Is it safe? I'd be really scared about squashing him.

Thanks for the tips mawbroon. Will definitely try the exaggerated latch. It looks like a good idea.

Co sleeping is safe as long as you follow the guidelines, did your MW give you a copy? Know what you mean about your sanity, I've ended up sharing my bed with both of mine, not through choice but because it was the only way I could get either of them to sleep and let me and everyone else in the house sleep too.

Hope the BFC is helpful today.

Nope, not neccessarily the same every night. I can testify to that! DS1 would be a nightmare and then things would be ok for a couple of days and then we would be back to square one. So please don't rule out tt just on that!

Well the BFC took a thorough history from me and had a quick look in his mouth but when she observed him feeding she said it was due to an over production of milk and a fast let down. She said he's struggling to cope with the speed of the milk and is getting too much fore milk and not enough hind milk. She said the high lactose content in the fore milk is giving him the tummy ache, wind and explosive nappies. She's given me some tips to help slow it down and get more hind milk into his belly. She said it might take a week or two to have an effect.

Fingers crossed.

How do you feel about it Natmu? Do you think it could be forceful letdown too?

But did she check for tt?

I think she could be right although I am annoyed that she didn't do a thorough assessment for tongue tie as well. Like the midwife and HV she looked at his tongue whilst he was crying but that was all.

Having said that I have already started putting the advice into practise; I'm feeding him whilst laying back and expressing the fastest bit of the letdown. He settled himself to sleep tonight without any crying whatsoever and has just now woken calmly for his first feed of the night. There's less squirming and no pulling off so far. To be honest I'm willing to try anything at the moment and I guess fast letdown and oversupply need to be ruled out before we try anything else.

Jilted you're amazing! You have a link for everything!

Glad he is more settled tonight. Did the information on forceful letdown sound like what is happening?

TT can be so easy to miss, as you said that most of the symptoms of TT seemed to apply, it wouldn't hurt to get someone else to have a look at him too.

Yes definitely although a lot of his symptoms are the same as with TT. There's certainly been a massive improvement though. We'll see how it goes. Thank you for all your support and encouragement

My ds2 had severe tongue tie, managed to feed very sucessfully using a "rugby-ball" hold as recommended by bf advisor. Basically baby held under arm not across body, seemed to slow things down and stop gulping, even when tongue tie operated on at 6 months old never changed to traditional position as this so easy.

I would encourage you to pursue the tt line tbh. You need somebody who knows about tt. Unless a LLL has taken a special interest in it, it's unlikely that they are an expert.

He could possibly have a tongue tie. You need to see an expert. If you are in the north west, I took DS2 privately to an expert and had his tt fixed.

I told DH on day 1 that DS2 had a tt as he didn't feed like DS1. All the midwives said no. But I could tell that DS2 wasn't as settled but was putting on weight so I ignored it. Finally at 6 months, I got tired and took him private. The doctor said he had a slight posterior tt but he didn't know whether feeding would improve as DS2 was already 7 months. I asked him to cut it anyway.

Feeding improved massively. Before that DS2 never completely drained the breast. In fact if it hadn't been for DS1 feeding as well I would have ended up with severe mastitis.

I typed out that long essay to say please get the tt checked. I always regret the fact that I didn't follow my instinct and get DS2 checked earlier.

And not by a HV, etc. By a proper specialist. You can Google for one in your area.

There is a different bfc at my local baby cafe who seems to be the TT expert. I've seen her doing very thorough assessments of other babies tongues and I thought I might ask her to take a look to rule it in or out.

Yes rule out tongue tie.

I have an over active letdown etc and dd had reflux. And she had tongue tie but she kept putting on wait because the milk was easy to get (but with loads of air too).