Bad jaundice, tongue tie, difficult latch and awkward boobs!

[Shantotto]

I have an 8 day old and desperately want to breastfeed. We seemed to start well, everyone in hospital saying how great the latch was. It got very very sore and I knew he wasn't getting much, he wasn't swallowing anything. A lactation consultant helped and diagnosed tongue tie. Got this snipped and first feed after was amazing - I could tell he was swallowing. This then went afterwards and we were back to the start with struggling to latch. His jaundice is still really bad and I have to top up with formula to make sure he is getting enough to try and shift it.

I know his tie is still healing but I find it so hard to latch him on well. My boobs are really far apart and the nipples point off to the side so the 'easy' cradle nose to nose thing doesn't work for me. On the right I can do rugby hold, baby is very long so is wrapped all the way around me and I still find latching hard as his mouth doesn't open very wide.
This postion on the left feels impossible to get it all lined up and his mouth to open wide enough. I really hate this position. I've tried laidback feeding and the poor thing just can't get attached and it upsets me to see him rooting so hard.

Also when he is on he barely swallows. I don't think I am letting milk down.

However with a lot of support at s bf drop in he latched well and obviously drank for 30 mins. I think at home I am to anxious to do it properly. Which doesn't help let down! All advice I've seen is to pump and try expressed milk while we learn but I can't pump more than a few drops. Again to anxious to let down?

I just don't know where to turn now. I think I can do this but seemingly not without help! I'm so upset about giving him formula but I am deseparate for him to feed well. If his jaundice doesn't improve by next week I'll be back in hopsital with him. He is doing wet nappies but has only done two poos since all his meconium came out in hospital.

One positive is midwives are ok with his weight loss so far. Any advice would be so appreciated!

It sounds like you are both having a bit of a rough start. When you say that you've spoken to "lots of people", are these trained BFCs or Lactation Consultants? I found that some probably well meaning MWs and assistants gave me advice that was very counter intuitive. I think in your position I would speak to BFCs or Lactation Consultants if you wish to continue Bfing.

In the day, could you try to feed him every 2 hours? It might sound overwhelming but 3 hours is a long time for such a little one. Have a read of this on sleepy babies.

Do you think that he may still have tongue tie? Do you think it would be worth having him looked at again? One thing to try in the meantime is the Charm Hold. I'd get your partner to help you with this one:

Lay the baby across his parent's lap face down toward the floor with his hips flexed (bent). The parent supports the baby's forehead with the heel of the hand and extends a clean index finger with smoothly trimmed fingernail for the baby to suck until the tight tongue relaxes and comes forward to snuggle around the finger. It may take several minutes for this to happen. It is called the Charm hold because it "works like a charm. " As soon as the baby's tongue relaxes, he can be gently turned right-side-up and immediately offered the breast. Carefully pull down the corner of the baby's mouth and peek to be certain the tongue is extended over the bottom gum and wrapped around the nipple. If the mother cannot manage this, the father or another helper could do so as the baby nurses

I've spoken to midwives who said he had a fab latch and I'd have no problems. However I had a feeling he wasn't getting much and I was getting really sore.

A lactation consultant and to see us and diagnosed his tongue tie. She suggested the rugby hold I have so much trouble with. Said cradle hold wouldn't work for him and my breast Breastfeeding counsellor helped a lot at a support group yesterday but when I'm on my own and anxious I can't repeat it. I know if I could do it right it works - I knew he was swallowing a lot yesterday as I could hear the difference.

The lactation consultant came out a second time and tried to get us tube feeding. However at this point we just decided if he needed formula and we were so tired and stressed we should just use a bottle. He didn't seem to be getting much through the tube either.

I do mean to try every two hours again, I just couldn't seem to wake him then ai would wait longer. I'll try that hold, thank you.

I'm trying to check his tongue tie every day and do some exercises with him - man he really hates them! It's very difficult to see but it looks like its holding the diamond shape that the tongue tie practioner said we needed. I called about the tongue tie clinic at the hospital but the earliest I can go is two weeks away.

Sorry, didn't mean that there might be a problem with the tt which has been divided, I think there is a chance that there is a further tt which has been missed. I think in your case it is worth getting it checked

What are your plans for tonight? Would your partner try cup feeding him so that you can sleep/express?

Oh sorry! Gosh I hope he doesn't have another. It sound awful but I'm beginning to worry about the money - I got the tongue tie practioner from that website the first time round.

Just had a small feed with I think a few swallows so feeling a bit more positive. Going to try and l rest for a bit. We'll definitely try and cup Feed his next top up. Thanks again!

shantotto, if you think baby is not taking in a lot milk at each feed and is getting sleepier have you been advised to go back to the hospital for further checks? Do you think that the latch starts off ok, he gets tired and starts to slip off and that's when you get sore? How long does he want to feed for?

If you do end up back at hospital requiring more light therapy that is not a failure on your part. Some babies need a bit more than 15 hours of light treatment, my own 1st needed 48 hours and 2nd 24 hours. They may also have breastfeeding supporters there who can help you. Honestly even just for peace of mind consider going and getting baby looked at? Btw I just knew your baby was a bit early, darling he is playing catch up with his peers who got to spend an extra 8 days inside their mummy.

As already mentioned not all midwives and health visitors have had BF training and their advice may not be correct.

One last thing do the midwives know if there are any electric pumps you can borrow that they use in the hospitals? My friend was lucky enough to get chance to use one. They are really good at getting your milk out. I used them in hospital when mine were under lights. We had to measure exactly how much milk they had and they got topped up with formula if my supply was not quite enough.

Pumps you buy in boots etc are not as good by far.

I have been mentioning to midwives and bf counsellors and they have told me to keep at it and he's being weighed regularly. They mentioned something about further treatment if things aren't better by Friday. When we were in hospital midwives were saying it was too early to try and pump. We went back in last Sunday came out Tuesday.

He does seem to be getting slowly more active. Just now I tried to feed at 5, got 15 mins with a lot of swallows and then 30 mins with some swallows at the start and he slowed down a lot towards the end - I had to take him off as I was about to collapse on him! He does seem sleepy once he gets on but perhaps because it seems a battle to get him on. I've abandoned attempts on the left until I go to a support group tomorrow, it's like we just don't fit in that side!

He has gone to sleep now so I'm pumping a few drops out, I've started fenugreek too as I'm worried about supply with the top ups.

Cup feeding didn't work at all, took a really long time for him to get any out of the cup, and he flails his arms so much he knocked it right out of our hands. I am seeing some progress I think. Another day with him in bed today!

Also going to get back in touch with the tongue tie practioner. His tongue moves a lot more but he repeatedly thrusts it up to the roof of his mouth not out!

Oh and when he is making what I hope are swallowing / gulpy sounds his breathing is quie huffy or a little wheezy sounding. Probably because latch is still poor?

My heart goes out to you, because this sounds horrendous.
Sometimes you look back at a time, with sadness, realising it shouldn't OUGHT to have been THAT hard.

Ds2 had to have his tongue tie snipped twice, because the first snip didn't work properly.

Really hope you get this sorted soon.

Good morning Shantotto, hopefully a new day will bring more progress. The breathing problems might be because he has a stuffy nose. Was he born by CS or possibly born quickly? Sometimes if babies don't get enough of a good squeeze in the birth canal they don't lose all the mucus. I am not sure what remedies there are available for a blocked nose. Possibly saline drops or a saline spray, but check with your midwife/GP it's safe to give a newborn.

If he is struggling to breathe that might be why he is struggling to feed for a long time?

It wasn't a cs - he was induced by tablet and I went from 4cm dilated to him being out in 6 hours - not sure if that is quick!

I'm having some success with right side rugby hold and his nose is very clear so maybe he is a bit blocked up...

It's been almost 3 hours since he last had some boob and he doesn't seem to want to wake for anymore!

If you are getting lots of wet nappies and he is staying on your boob for 45 minutes that is good. make sure you get lots of water and rest in between feeds too. It's hard work making all that milk.

I think you will get there in the end and you have come so far already.

It's pretty normal for them to wake often in the early hours and then be sleepy in the first part of the morning.

Your night feeds sound like they went well too, which is good.

You sound pretty tense, quite understandably. Is there anything you can think of that will help you to relax? Maybe watch your favourite comedy, read a funny book, have DH take lol out for a walk so that you can have a bath or get your bf over and have cake a chat?

Thanks everyone. I'm trying to watch TV shows I love so I tune out. It's the battle for a latch - good or bad - that stresses us both out!

This morning I managed 15 mins then about 10 / 15 mins later managed to get him on to same boob for around 30 mins. Swallowing sounds were much less frequent though.

When he did wake though and got him on barely managed 15 mins before he pulled off and showed no more interest. Going to keep at it and then I think I'll need to do his formula top up. We tried to make him more awake my changing and top and tailing - he hates that!

I definitely plan to have a bath today!

Have you thought of giving one of the Bfing helplines a call this morning and talking it through with a BFC?

If you are in Engkand or Wales you should have access to the MWs at the hospital too.

Yes I think I need to speak to someone agan. I rang LLL on Friday and they just kept asking me why am I giving him any formula at all. It wouldn't break down the jaundice etc. I spoke to someone else too who recommended laidback method but my poor boy just can't get that either. It's good to have someone to moan at though.

Wee update! Around 1hr 45 after a formula top up he woke up hungry. After a slightly trying time getting him to do a semi-good latch he stayed on for 30mins-ish. He does suck quite slowly with lots of breaks but there were gulps!

Im off to a support group tomorrow for help. There are 3 or 4 near me and I plan to go to all of them. I'm finding rugby hold unsustainable really, in very tall so to keep us upright and supported I need a tower of about 6 pillows or I end up weirdly hunched over and then get rib pain on the other side! Worth it though!

I'm a big fan of LLL but please don't let them make you feel guilty for giving him some formula!

My son had tt that wasn't diagnosed for a couple of weeks and wasn't snipped til 8 weeks. I can't quite describe how horrendously painful and depressing I found breastfeeding! I heartily wish, however, that I'd known then what I know now - that I could have given him some formula without being a failure or a bad mother. As it was, I battled on with bf and eventually it all settled down and we didn't stop until 19 months. I just wish I'd been able to understand that a) formula isn't failure and b) there's no reason that giving formula has to mean stopping bf, if you keep your supply up.

I'm pregnant again now and hope to God I won't be too stubborn to give formula if needed (by me, or by baby) when the time comes!

Anyway, it sounds like you're doing a brilliant job, OP - well done :)

Thanks. :) He's just spent 45 mins on right boob and hart made any swallowing noises. I managed to get him on probably very badly on left for 7 mins and again hardly any swallows.

I don't know if this is his lay h being bad still or me not letting down. I started fenugreek yesterday and am trying to pump regularly today. Nothing much comes out though but hoping this is stimulating something!

Are you using a manual or electric pump Shantotto? I found I never got anything with a manual but got absolutely loads with an electric. Other people find the reverse, so it might be worth trying whichever you're not using.

It's a medela swing. It's improving on the right but not much from left. He just fed for ages but he is still so hungry. I stopped him after 45 mins as he hadn't swallowed for ages. I'm going to give the tiny bit of expressed milk I have then just keep him on boob. I don't think I'm letting down.

I just want him to eat so badly :(

Ah the Medela's are meant to be great so maybe not that then.

You are doing so well to keep going. It's so frustrating when you can't get them to drink from the boob. I hope you can get some support after the weekend. x

With all that time on the boob I'd expect your breasts to be making milk. If you weren't letting down you'd feel pretty sore and full.

It could be he is suckling and getting little bits of milk and you just don't know it, the flow will be less the longer he feeds and they can go quite sometime between swallowing.

If your boobs feel soft, and you are getting wet nappies then be assured your baby is being fed. Unless he was very tired and floppy he would be crying with hunger.

I think part of what is happening is your baby is trying to build up your supply by staying on you for a long time and very frequent feeding.

Are there any centres you can go to get him weighed tomorrow perhaps if you could see how much he weighs you will know more about how much he is consuming?

I'm having short bursts of success with a koala hold where we sit up and he is upright on my front and I support him. He instantly starts swallowing. He's been staying like this for 10-20 mins then pulls off.

He's doing wet nappies quite regularly but no dirty ones. We're still unsure on his intake so are giving a small top up. I am getting more hopeful though.

We are off to midwife tomorrow so we'll see how his weight is. I have 3 bf support groups near me this week and I plan to go to all of them.

I think his yellow tinge is getting slightly better too.

for everyone! Thanks so much for your responses.

Little update. This week from Monday - Friday he gained 100g, so he must be getting a little out of me!

Am having some success cradle hold now. However I just can't get a deep enough latch regularly enough. I just don't know what I'm doing differently when it does work. We're both just getting more and more upset when it doesn't work. He seems so calm and content after a formula top up I feel guilty just battling with him to latch properly. I just can't enjoy him with stressing over this. I have a history of bad anxiety needing medication or CBT and I don't want it to come back over this.