Having a feeding nightmare...any advice at all?

[highlove]

Am at my wit's end really. DD is 10 weeks. Feeding has been bloody hardworking from the off, started with terrible positioning and latch, cracks, poor weight gain and (prematurely) pushed into formula top-ups, followed by nipple confusion. We eventually found our feet and things started to improve, her weight gradually went up and I weaned her off the top-ups and she's been fully EBF since three weeks. Then we got thrush and weight slowed a bit. We're now basically better but I'm left with a nasty crack on one side that isn't healing, despite me feeding her in a different position. It's very painful and I've resorted to limiting her time on that breast in a desperate attempt to heal it and because it hurts so much. Unfortunately, for reasons I don't understand, she doesn't appear to feed very efficiently on the other side - she sometimeslooks like she's got good latch (and I've seen the lovely BF counsellor a million times) but just doesn't suck very strongly. It's a battle to get her well latched as she just doesn't seem to open up wide enough. When we do get a good latch, she will often immediately just pull back to suck in the nipple. I know she's getting something but it takes forever and I'm sure she's not getting all she could. After a feed that nipple is never fully erect/pulled out like I think it should be, and is slightly lipstick shaped. I never really know when a feed is finished; I tend to make a guess about when she's done but will stick her back on if she still seems hungry. I don't think I have a supply issue as there's always plenty more there - I can almost always still squirt it across the room!

She's been checked for TT several times but apparently not and I'm not sure it's that anyway - she can stick her tongue way out!

Her weight gain has now really tailed off and she''s fallen well off her curve - from just over 25th to the 9th. HV is nice but no real help, said to offer expressed top-ups. However, I put off offering her a bottle after the earlier nipple confusion and now she don't take one at all. DH had tried a few times and she just gets very upset.

So now I'm at a loss. She's not gaining and I don't know what to do. Feeds are increasingly stressful and my heart kind of sinks as they approach which I feel dreadfully guilty about. I feel under enormous pressure and that I'm failing her but I don't know where to turn. My HV has me marked out for PND because I cry at every check but I really don't think that's the case - I'm just enormously stressed out and also very upset that this is robbing me of this precious time with her. I love her to bits and she's perfect but apart from odd moments, I can't say I'm enjoying her or being a mum at the moment.

There doesn't seem to be a lactation consultant who covers my area. I wanted to EBF for six months but would now mix feed to get the weight on, except she's voting with her feet on that by refusing a bottle.

Sorry this is epic. Any help or advice gratefully recurred.

Gratefully received I meant!

Also, worth mentioning - loads of wet nappies and regular dirt ones too - often every few days but then 2 or 3 enormous ones in quick succession.

Nipple trauma, not opening wide, sliding off and "nipple feeding", slow weight gain, lipstick shaped nipples after feeding, not being satisfied after lengthy feeds.

These are classic tongue tie symptoms.

I would suggest having her checked again by somebody who specialises in tongue tie. Sticking out the tongue does not rule out tongue tie, especially a posterior one.

Agree with mawbroon - we have just had DS's tongue tie cut at 7 weeks, posterior tie diagnosed by a lactation consultant after we initially thought it was fine. He could stick it out no problem but couldn't get it to the roof of his mouth.

Some of our feeding issues (which were different from yours) already seem to be substantially improved, 3 days later.

Good luck!

I could have written this, although my dd was a big un and her near constant hunger and feeding meant she maintained weight.
i found I just needed to wait for her to nail her technique. painful lipstick appearance of the nipple (poor latch) will mean she has to feed longer and hopefully she will make connections with correct latch and sucking with a fuller tummy in less time.
I can't say I would have been so relaxed on the low centiles though. I would maybe get a gp's opinion if the centiles get worse but then many Mnetters think they're bollocks.

to clarify dd wasn't tongue tied.

Ok thanks all for responses. I've flubd something called Milk Matters which seems to cover my area and know about TT, so am waiting to hear back. Didn't know that being able to stick tongue out didn't rule it out - I know the symptoms do sound like TT.

It's a nightmare - am so worried my poor baby is permanently hungry. Just really feel I'm letting her down.

What about a supplemental nursing system medela do one and its about £30. I have been having similar issues regarding weight gain and latch and to be honest have reached the point where I am giving her full quota of food by bottle and anything she gets from me is extra as I have spent her first ten weeks constantly stressing, trying to reduce the top ups and then her weight not improving despite wet and dirty nappies. And I now just want to relax and enjoy her rather than stressing over trying to breast feed and spending every day inside as feeding constantly. But in your position the nursing system might help as still feeding from you still stimulating you to produce more milk but hopefully still gaining weight? And you can use expressed milk in it or formula as far as I know?

Can she get her tongue to the roof of her mouth? When babies cry their tongue should go up. My 5wk old has posterior tongue tie but looks like she can poke hers out a bit. Does the tip pull into a heart shape when she does?

In the short term have you tried breast compression on the less painful side? I do this to ensure she gets the richer hind milk. Make sure you do all angles though, to avoid mastitis like me...Oops.

Good luck-maybe try different bottles? Medela calma get good reviews for bottle refusal.