Difficulty with newborn latching on and supply

[FreddieRocks]

Hi, I'm wondering if anyone might be able to help me.

My fab DS was born on Friday after a fairly long and difficult labour. I lost quite a lot of blood and ended up having a transfusion yesterday afternoon.

I was (and continue to be) very keen to BF him but haven't been able to get him to latch on. The midwives were really helpful at the hospital and tried many techniques/positions to try and get us going but we only managed to crack it once, after trying for a long time with a particularly determined midwife. On Friday I was able to express quite a lot and syringe feed him but was able to get less and less yesterday (as I looked more and more pale and interesting due to low iron) and haven't been able to get more than a drop or two today. We have therefore ended up giving him some formula as a last resort.

The trouble with the latch is he puts his tongue on the roof if his mouth and/or just sucks his lip and tongue. Even if I do manage to get my nipple in his mouth he just won't suck. The plan I came up with with the midwives was that I'd continue trying to express and do skin to skin etc and hope that that's enough to get my milk to come in when DS might find it easier/more productive to start latching on properly. I'm planning to talk to a BF counsellor tomorrow but wondered if anyone thought this was a realistic plan or had any advice in the meantime?

Sorry, hadn't realised I was going to write an essay - first night at home from hospital and am fretting I've ruined my chances if establishing BFing.

Thanks!

Has he been checked for tongue tie? My DS wasn't able to lat h and it was a tongue tie. It was snipped when he was 8 days old and e lat he'd immediately after.

You need someone who really knows about TT to take a look. I used Ann Dobson, a private lactation consultant who comes to your house and spends at least 10-15 mins feeling how his tongue moves. GP and HV are notoriously bad at diagnosing it

They checked for tongue tie in hospital and said he was fine. Hadn't considered they might have missed it.

Congratulations! I also had my DS on Friday and I am EBF.

He took quite a few times of determined trying to get him to latch on, but it was like once that little switch in his head clicked he just got it. At first he would just poke his tongue put and not open his mouth , when he did open it he didn't suck just sat there with my nipple in his mouth. But I would just say keep going, he will get there in the end.

Don't worry you have plenty of time to get breast feeding established. Go and see the bf counsellor tomorrow and she will be the best person to help sort it out. Remember they really only need tiny amounts at this stage.

Oh and congratulations!

Thanks everybody, with each feed we give him I worry we're missing our chance but reassuring to know we can still save the day!

Congrats to you too NewlyWed, how're you getting on otherwise? When we got home with a crying baby yesterday afternoon DH and I did have a moment of looking at each other wondering "what do we do now?!"

I was so happy when he did latch on once, and successfully feed, and think if that midwife had stayed on shift it might be a different story (how selfish she wanted a home life!) but we tried for about 30 mins the next three feeds in various holds etc and he still determinedly didn't get it. Fingers crossed we can get some help today.

Congratulations! I had a similar problem with Ds1 as he was traumatised & tired after the birth & just point blank refused to feed / latch for the first 24hrs. I know how heartbreaking & frustrating it can be & no one tells you before that it can be so hard to do something that the books say should be easy. Well done for persevering so far, it's really not easy!
You're doing the right thing by getting hands on help early. We after all else had failed on the advice of a sympathetic midwife eventually used the medela contact nipple sheilds just to give him a bit more to get hold of / suck & draw my nipple out to make it easier for him to latch in the early days & then when he got the hang of it phased them out & he didn't miss them. Re your supply do you have access to a breast pump? If you don't already can you get one? That way you can express whenever he wound be feeding from you so that your breasts are still being stimulated to help bring in & maintain your supply & then at the next feed you can give him what you've expressed.
Don't worry about what you see when you express as you're milk may not have fully come in yet as you're only just on day 4 & if can be a bit slower after a difficult birth. Also I've found that if you focus on what's in the bottle when you're expressing I actually express less than if I don't think about it. I've always found watching tv a good distraction!
I think everyone has that 'eek what now?!' moment when you first get home, I know we certainly did first & second time we did too! Just remember it does get easier in every way, no matter how tough it seems at the start your ds is worth every second of it & being a Mummy is the most amazing thing you'll ever do!

Other than that he was fine he had his first midwife check yesterday and she was hAppy with him, he's pooing and weeing as he should! how is your DS settling in?

He's ace, we're both completely devoted (having worried in my case I'd find the complete dependence tricky).

I've been expressing by hand, with a complete lack of success yesterday, must admit i probably didn't do it as often as i should, was a bit distracted by being home. I do have a borrowed breast pump so will set that up today. How long should I be pumping for?

I tried nipple shields in hospital but, having done some reading around on here, think they might be too big so will see if I can get hold of the medela ones.

The midwife is coming to visit us today so will discuss it all with her (and BF counsellor) but thank you so much for helping me feel like I've got more of a strategy.

Congratulations Freddie

If your mature milk hasn't come in you may do better with hand expressing. Google marmet technique and make sure your technique is good- it's easy to squeeze like a piping bag which will make you sore. Length of time expressing isn't as important as frequency- at least 8x in 24 hours including once between 2-4am.

If LO is having formula from a bottle you can bottle feed in a way to encourage bf habits- hold skin to skin, tease the top lip with the teat and wait for baby's big wide mouth before putting the teat in.

Wishing you all the best, you'll get there

Hand expressing is tricky (& messy!) so n if you've got a pump, preferrably an one use that as its much faster.They usually say 15 - 20 minutes each side & certainly for as long as milk is coming, then an extra 5 minutes to help increase supply. Time consuming I know but worth it. You can also try double pumping, both boobs at the same time, to save time & this is also supposed to maximise supply.If you Google expressing there's loads of websites that give advice on expressing effectively. Also make sure you're drinking plenty of water, eating well & sleeping when you can. Forgot to day before don't take what you express add an indication or measure of supply as not everyone can express, loads of women have a great supply but can't express at all or only get a little bit & nothing is as effective at emptying your boob as your baby when he gets the hang of it!

Agree with celticpromise in that if you've still got the sticky colostrum then hand expressing can be easier for this but as this changes then you could try switching to an electric pump. Colostrum is quite difficult to express & don't worry if you only get a tiny amount, baby only needs a tiny amount!

UPDATE!!

Small boy currently latched on and sucking away!! Did one side, then gave him small amount of formula but now on other side and has been for a good 10-15 mins I think. Wowsers!

So, can I assume he's getting something/enough and sack off the formula? Guess it depends how often I can get him to feed today?

Hurrah for progress! You all rock.

Well done! Really pleased for you! Definitely drop the formula ASAP if you can & maybe have a day or 2 or more if you can just having loads of skin to skin & feeding at every opportunity.

Only just checked back. Well done! Hope everything is still going ok

Highs and lows. Latching him on became tricky, he got v stressed but it seems my dairy cow genes are strong as I'm managing to express quite a lot. Yesterday and the day before he was probably on 50:50 formula:EBM whereas today should be exclusively EBM. I also managed up BF him this morning using a nipple shield.

Am seeing a BF counsellor tomorrow and am hoping she'll be able to help too

Thanks for checking back, has been do useful to have everyone's advice/encouragement.