Breastfeeding a disaster, don't know where to turn

[IJustWoreMyTrenchcoat]

Hello, I have a beautiful week old baby boy, and am determined to keep breastfeeding but feel like everything is going wrong. He has lost 9% of his birthweight and is due to be weighed again tomorrow but I know he has lost more and I feel so helpless and bad for him. I have a feeding plan to feed at least every 3 hours for 30-40 minutes then offer the other side, and give him the breast in between if he wants it. The trouble is he just falls asleep, even if stripped down/tickled etc.

He fed for about 55 minutes about an hour and a half after birth (had skin to skin right after birth but then baby went to my partner while my stitches were done and a catheter inserted). It seemed fine, but on the ward I had trouble latching him on and with him staying on. One of my nipples is slightly tethered and I was given a shield but the Midwives and Healthcares were all pretty negative about it and wanted me to stop using it as soon as I could.

I stayed in hospital for 2 nights and struggled with cracked, bleeding nipples - my baby seems to open his mouth wide then draw back and take only the end of the nipple. I know it was stupid but I was so desperate to feed him I just put up with the pain as if I took him off and tried again he eventually became so frustrated he just screamed and refused the breast.

I know I am producing some milk because it is collecting in the shells I have been using for painful nipples. I also have a breast pump as the Midwife recommended getting one to try to empty the side I have not been feeding from as much. I have pumped for a while today and only got a tiny amount (a couple of mls) which is really worrying.

I have good support from the Midwife and am going to phone the peer supporter today but just wanted some reassurance really. Sorry for the epic post but I feel like I am falling to pieces. I have had no sleep for the past few nights.

Why do you have a feeding plan? You should feed on demand with no time limit - which for a tiny baby I would expect to be more than 3 hourly.... So I'm not sure you're feeding enough.

Please speak to a BF counsellor who will know their stuff - MWs typically don't as they do not have sufficient training.

Read these links: feeding a newborn NCT

And give nct a ring on 0300 330 0771. They offer great advice and support.

Also it sounds like he might have tongue tie - my dd couldn't open her mouth fully, her tongue was restricted so she would slip to end of the nipple.

Feed on demand not on a schedule that is where i went wrong initially and thought there was something wrong when in hindsight there probably wasn't but by the time i realised that he was on top ups to address the weight loss and he was 100% FF by 8 weeks. Speak to a BF counsellor good luck with the weigh in.

He does feed more than 3 hourly but the Midwife said to not let him go longer than this and just keep offering him the breast. I am just unsure if he is getting anything. He falls asleep more often than not, I have read this can be a sign of a poor latch. If I try to take him on and off too many times he gives up.

I have wondered about tongue tie. There is a specialist feeding co-or donator, would she check for this?

What you describe re your baby pulling back onto the end of your nipple sounds like a definite red flag for tongue tie.

You need to see a specialist as soon as you can. Many midwives and almost all GPs have no training in this area at all so they won't necessarily be able to recognise it.

Do you have access to either NCT or La Leche League breastfeeding counsellors where you are?

Ok well yourMW talk rubbish (sorry). Not sure what her logic is.

Yes they should check but they might not always know what to look for. However given his poor latch that is the first suspicion I'd have. Ask for someone who knows what they're talking about - I've been there and it was hard when so called experts just didn't know but fobbed me off!

Maybe but they are not always trained or experienced in tongue tie. You need someone who really knows what they are looking for. It's very common to be told your baby doesn't have one when they do :(

*talks.

Where are you OP?

I don't think the is anything wrong with your 'plan' so long as you feed whenever he wants it also.

It can be really really tough to establish bf. cracked nipples are horrible, and a real obstacle. You need RL support. I second getting the tounge tie investigated. Practically, things like kamillosan or similar for healing your nipples is essential and investigating what a proper latch looks like.

If you were my RL friend and were struggling I would advise you and baby to go to bed with a huge drink for you and your ipad/magazines/whatever and just keep on trying.

Good luck! And congratulations on your squishy newborn!

Your story sounds very like my beginning to breastfeeding. Sleepy baby and problems latching on to less than ideal nipples. . (we didn't have tt but you might well have this problem too!). We ended up in a & e after 3 days where they basically forced me to give DD formula - wouldn't let me even try and express but that's another thread!
To give you hope, I am right this min bf my 8 month old DD who is as bonny as can be. The single most helpful thing I did was have a lactation consultant come and see me in my home. Mine cost £80 as I paid privately but some nct counselled will come for free I think especially if you dud their antenatal course. I can't recommend 1 2 1 RL support enough. A good support group is a good second best but it's stressful getting to them sometimes and I always felt pressured by the fact that others needed help too so didn't want to take up too much time. Paying for help liberates you from all this.

I think if you google ilbc (?) you might be able to find local lactation consultants?

Good luck OP I know how stressful it is right now. Really hope you find a way through soon.

PM me if you want more detail on our story.

IJustWoreMyTrenchcoat sympathies you are having a miserable time as well as worrying about your babies weight. It is a good thing that there is a level that intervention is offered for the babies benefit. However the rest is all about you. You are working very hard. Please get in touch with the breast feeding coordinator as soon as possible. Use the shells if they help. They are not recommended because quite often there is no hormone stimulation to keep your milk coming. BUT being in agony wont help either. in the meantime try to keep pumping if it is easier than feeding and offer breastmilk to your baby in a different way. Offering in a bottle is another set of skills you may not want to try. try a medicine syringe or a teaspoon until you find out if he has tongue tie. You can probably try google to see how the tongue looks if there is tongue tie. The most common appearance is that the tip of is tongue will have a little indentation and look like a heart. Good Luck you are doing your very best.

Ps I understand the rationale behind the feeding plan - 'feed on demand' doesn't work that well if your baby doesn't demand cos they're too sleepy! Perhaps you could up to offering at least every 2- 2 and a half hours though? (I well remember how hideous this suggestion sounds when you spend an hour trying to get your baby to suck for what sea to be long rnough, then only have an hour til the next time- especially when you're also expressing / washing bottles etc!)

I third getting tongue tie investigated. Please find an expert as many HCPs are not well informed about tongue tie. There is a huge thread on here about HCPs who were wrong with their diagnosis of "no tongue tie"

I know reading stuff is probably the last thing on your mind just now, but if you can, have a look at this and this and www.kiddsteeth.com/articles.htmlthis

Check the upper lip too. There are pictures of the different grades of lip ties in Dr Kotlow's articles.

IF tongue tie is the problem, and if you are willing to go private, there are a couple of dentists in the UK who use laser and will revise lip ties.

Please get tongue tie checked. Both my DDs were tongue tied. The difference in latch (and pain) after they had the snip was instant.

If you are in London and need a recommendation of a private tongue tie clinic (and/or lactation consultant) do PM me.

A lactation consultant can help a lot if the latch is the problem but if its TT they will advise a snip before they help you with latch.

That should have been co-ordinator!

Thank you for all your replies. I am in the middle of nowhere, but there is an NCT mothers and babies group which has a breastfeeding councillor. I have sent her an email to enquire if she does one-to-one sessions or knows somebody who does as I feel I need some intensive help as soon as I can, and as accentuate says you feel bad for taking up too much time.

I think I will struggle if he has tongue tie at being took seriously, the Midwives have just kept saying it is a bad latch and blaming my nipples. TMI, but they are sticking out but are 'tethered' apparently. I didnt think it would be a problem if he is meant to take a mouthful of breast.

Trenchcoat :( :(

You do need help, and it is not taking up people's time...what is more important than making sure a newborn is fed?????And that his mum is comfortable and pain-free?

I'm not going to add anything to the suggestions you already have, except to say 30-40 mins on one side may not be right for you....instead you need to be watching for your baby's cues, and switching sides when he seems to have lost interest in side one (which might or might not be 30-40 mins). If someone tells you the 30-40 mins thing, they need to explain why because generally speaking, watching the clock like this is not helpful.

tiktok you are right about the clock watching! It is such an ordeal trying to get 30 minutes out of him. We have to strip him down/tickle him etc. I keep just trying to offer him the breast all the time. Somebody said to me they fed little and often and that worked for them, but would he ever get the hind milk that will actually put some weight on him feeding like that?

Also, is there an easy way to spot why he is not sleeping? I think he is hungry because he falls asleep at the breast so doesn't get enough milk, but could he have colic/wind etc. I have tried winding him, but nothing. Then when I lay him down he often brings a bit of milk back up.

To join your tmi, my nipples were /are inverted but one definitely more strongly tethered than the other. It was bloody agony while DD basically broke down the adhesions but it did eventually work and became completely pain free. Once it was sorted I could see how much longer the nipple grew while she was feeding.

No substitute for one to one help but if you haven't tried it al ready have a go at laid back breastfeeding. It was the only way I could get a deep enough latch which was extra important with the nipple issues. Google it if you don't know what it is or speak to your nct person about it. Basically you lie back and lie baby on you vertically and let them latch themselves on, they have to tip their head back and somehow it worked better for us. Not every time but enough times.

Thinking of you!

Google "breastfeeding support " and see if there are any private lactation consultants or IBCLCs in your local area perhaps? Also I know www.milkmatters.org.uk cover all of the UK but I don't know how/if they can come out if you are miles away, but worth giving them a call?

Trenchcoat, you definitely need a review of the 30 mins thing - this really is not working for you, and if the explanation you have been given says 'because he needs to reach the hindmilk' then you can be sure the person supposed to be helping you has not understood how milk is made and how babies gain weight - they have misunderstood and sadly it's not uncommon.

Babies don't 'reach' the hindmilk after a specific number of mins. Babies fed according to cues, and (in the case of small, slow-to-gain babies) switched to the other side when they cue to switch, will stim. sufficient milk and will drink sufficient milk, and we really do not have to worry about foremilk/hindmilk.

This blogpost explains it: thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html

Please get decent help soon from people who can observe and who know what they are looking for and what they are talking about.

Yes we did 'switch nursing' in the early weeks with sleepy DD. I would feed one side til sucking slowed then the other then repeat as long as I could bear it it felt like she was still drinking. I have notebooks from the early weeks filled with entries like '0430 L 5 min R 7 mins (good sucking!) L 8 mins (to sleep)'!

I was always aiming for about 20 mins total of actual sucking to make it 'count' as a feed but not entirely sure whether someone told me that or I made it up!

Tiktok is a much better expert than I am, I also lurked on here and followed her advice! (which was v much on the sames lines as advice i got from lactation consultant )

One thing I would add is don't get too wrapped up in how much weight he has lost, DS lost 12% of his birth weight and the MWs were having a fit saying he needed to be weighed again the next day and might have to have formula top ups. He went on to gain weight after the initial loss and although he was born on the 75th centile the weight loss took him down to the 25th and he's stayed there ever since.

Don't ignore the weight loss but don't let it cause any drastic decisions, AFAIK at this age weighing them each day is not going to prove anything.

Oh, and congratulations!!

Oh, and listen to Tiktok, she's awesome

Hi, just a quick update. I have had an NCT breastfeeding councillor come out to us tonight and my baby has had a good feed and is flat out for the moment.

She watched me try to latch on without the shield and agrees he seems to slip forwards. She said to use the shield for now as it is more comfortable, but helped with positioning so baby is coming at the breast from a better angle. I took him on and off a few times until he had a wider mouth than normal. She doesn't think there is tongue tie.

Re the timing on each side issue, I don't know if what she said contradicts what you are saying tiktok. She said to keep baby on one side for a total of an hour and a half or so over however many feeds that took and not to obsess with trying to get him to feed for half an hour at a time. This would allow him to get the hind milk. she thinks he has maybe been getting too much sugary fore milk. With your method what cues should I be looking for to know to switch sides? Do I need to ignore any time limits at all?

I will read your link later, but am going to try to get some food now while I can.

Thank you so much for all the advice, it is so reassuring.

Trenchcoat - can you PM me?

What your bfc has said sounds incorrect, and it worries me.