Breastfeeding causing a lot of stress

[Magstermay]

I'm hoping someone can tell me they've had similar problems! Apologies for the long post!

DS is nearly 4 weeks old and is my first. Birth was fine but he never latched on to the breast and always just fell asleep. To cut a long story short, no one could get him to latch, they were very busy so we ended up going home bottle feeding expressed milk (I didn't get on with cup feeding).

We discovered he was throwing his tongue back and even very experienced people at the breastfeeding clinic couldn't get him to latch with nipple shields. We tried cranial osteopathy then a private lactation consultant diagnosed posterior tongue tie which was snipped at 2 weeks. We started trying to breastfeed and he would latch after this with nipple shields so a few days later (when DH was around) we started to exclusively breastfeed. Some feeds took ages but all went ok for 4 days til I got mastitis, then feeding started taking even longer and was fairly constant. Health Visitor advised on Friday to top up with EBM or formula as thought he was too tired from all the feeding and had not gained as much weight as she would like. We have been doing that for 24h now and I am worried we won't get back to breastfeeding. I also find the nipple shields frustrating as he keeps knocking them off with flailing arms. It feels as though all I have done for 4 weeks is feed or express or think about feeding him. It is reducing me to tears quite frequently!

I struggled with breastfeeding with both of my children. Both different reasons. I have no suggestions for you. But you have done amazing so far. Don't feel guilty whatever you do ( well you probably will because it's a default for all mums) or stress yourself.

Does your hospital have breastfeeding support team? Or can put you in touch with one.

Gosh, sounds incredibly stressful & well done for perservering.

IMO, HVs are not necessarily the best people to advise on bfeeding as they're not experts & tend to just look on the bottom line - ie weight gain. This isn't helpful as bfed babies do put on weight at very different rates. You definitely need to find a bfeeding support group for advise here.

The mastitis screams poor latch to me so that definitely needs to be addressed ASAP. Nipple shields are fine to use, but shouldn't be used indefinitely.

Have you googled Biological Nurturing? Basically sit up straight & get baby to latch on by dangling his legs either side of one of your thighs. By sitting him up straight with his mouth below your nipple, you'll encourage him to tilt his head back & open his mouth wide. Once he's latched on, recline back (make sure you have plenty of cushions behind you for support). If you're big boobed, tightly roll a flannel & stick it under your boob for support - make sure you don't raise your boob too much as that will block off some milk ducts.

Another (very unorthodox) way of helping latch on is to make a "breast sandwich" - you take the aereola between your thumb & forefinger so that the nipple & part of the areole are protruding. You then tickle your DS' top lip with the nipple & then as he opens his mouth quickly bring him onto your breast. This does take a little practice.

I do sympathise - I started bfeeding when my DC was only 4lb & we had no end of problems, but we got there in the end. You really really do need some expert advice though so try a group or LLL or pay a private lactation expert if you can.

Good luck & come back keep us updated!

I just wanted to empathise - we are in the same boat with our 3week old DS. We have just started cranial osteopathy which I'm hoping will help, and I was given exercises to do by the midwife who divided his tongue tie - putting a finger in his mouth and gently pressing th back of the tongue down, and trying to get him to mimic me and stick his tongue out. Maybe try those?

The positions GinGinGin describes are absolutely worth trying - we haven't got on with biological nurturing but the breast sandwich has had some success.
I've been feeling overwhelmed and for the time being have given up trying to latch without a nipple shield, but have booked a visit from a lactation consultant who has seen us before and am hoping that will help.

All the very best, Magstermay, I know how emotionally and physically exhausting it can be X

Ps DS currently has at least one bottle of expressed BM a day which doesn't seem to effect things. I express after pretty much every feed (finish off the breast he was on as he only feeds for 10-25 mins, always use breast compression too) but I'm thinking of stopping expressing as it's so time consuming on top of feeding. I'm not going to beat myself up about one bottle of formula a day when the rest is BM.

DS did similar. We had to do suck retraining. With a clean finger, you stroke the cheek and lips until they gape, then put your finger in the mouth, on top of the tongue, pushing it down if it's being thrown back and then let them suck.

It really worked for us, he was such a poor little thing.

Biological nurturing worked for my dd. She could latch on the left, but not the right. I was having to feed from the left and express from the right, but she hates bottles so was just having to freeze the ebm.

She's 6mo, now and I still occasionally use it, if she's fussing or overtired.

It sounds like you are doing a great job. You can't beat specialist BF advice, from an expert, though.

My DS3 had posterior tongue tie and it took two weeks to get bf'ing sorted afterwards. It is v common for PTT to reattach (DS3's did but not enough to be a problem). I would contact the private lactation consultant again and ask for a review.

What is the weight gain? At 4 weeks unless he's actually losing or barely gaining at all it doesn't seem like there's been enough time for there to be concern enough to justify topping up. It seems to me this is just adding an extra strain which could disrupt all the hard work you've had to do already :(

Has he crossed any centile lines since 2 weeks old?

You can get back if you want to, but you need good, informed advice and I am worried that your HV is perhaps not a good source for this.

Do you have a LLL group in your area?

Lots of good suggestions here already and I would agree that a review with the LC would be beneficial.

Is your baby back to birth weight yet? What weight gain was the HV looking for?

I just want to say do not give up hope, my baby is 12 weeks old today and we had the same start to breast feeding as you. He wouldn't latch and we were giving bottles of expressed and formula from the start. I spent first 8 weeks in despair as it wasn't working but then 4 weeks ago we made progress and now he feeds from breast all day with no top ups but does still have bottles at night.

Do not give up hope that he will breast feed just because he has had bottles, many get you to believe it but is not true for me.

Good luck, it is hard but you will get there

I really do sympathise. We had a very difficult start but have made some progress on the latch, although we are trying cranial osteopathy next week whilst waiting for an appointment for tongue tie division.

All I can suggest is that you try your best to get your baby on before he actually realises he's hungry, so that he's not so frantic, and definitely join your local LLL group or another breastfeeding support group. Good luck and bloody well done for getting this far! :)

Hi again

I wanted to say thank you for all your replies, it is really helpful and reassuring to know others are going through the same thing and also come out the other side.

I have looked at LLL but the nearest group is about 1/2 hour away so may be useful when we are a bit more capable of getting outside! We did go to Baby Cafe this morning and saw a breastfeeding counsellor. She seemed to think the latch with the shields was ok and very excitingly we managed to get a latch without them!! It has given me hope and means I have the confidence to try biological nurturing again or lying down to feed, I had tried BN before but he was never happy with the nipple so it was just disheartening. I'm sure there is still a long way to go but any improvement is good!

I would persevere with the BF. Sounds like you have actually had a victory with it after a tough start. Health visitors talk an awful lot about weight the more you feed him the better your supply will be and things will get easier and easier. I had problems at the start and it was really hard but for a lot of us that is just something you have to put up within the first month or so. Drink lots of water, eat healthily and sleep when baby does for a while - just my humble opinion but I managed to EBF for ages (will do it again with my twins soon) after a very difficult start because it's what the baby needs it to form a healthy gut. That is part of why they actually say 'breast is best'.