On the verge of giving up bf, any advice? Can we make it work?

[ClemFandango]

DS2 is 3.5 weeks old. I was desperate to make bf work this time having failed to bf DS1 and becoming very down as a result. Things seemed to start well, however DS2 lost weight resulting in us being put on a feeding plan. I then found feeding increasingly painful and we found out he had tongue tie. I carried on feeding, expressing and topping up with formula - we give top ups in a bottle as cup feeding was no longer doable. Had tt snip last Tues and was hoping for a big change, however initially things got much worse with baby refusing to latch at all for 24 hrs. Following the tt I had to give him a bottle as he wouldn't latch, I was devastated, the lady who did the tt snip just said 'oh it's because you gave him a bottle' and left us to it. I have since managed to work to get him back to latching on at every feed ,however it is a masive struggle, he gets angry at the breast and even when i do latch him on he pulls back on the nipple and writhes around. I despair that this is ever going to work, I am going to a support group and health visitor came yesterday and was sympathetic but couldn't offer any answers. At the support group my latch was observed and i was told it was fine and he was feeding well, however overnight last night I could hardly get him to latch on at all and he pulled off several times during each feed. I have been pumping and feeding him as frequently as possible to maintain my supply, I don't think I have loads of milk but this morning I had to give baby a bottle as he just would not latch on and both of my breasts were leaking milk as I was feeding him - so demoralising! Sorry for massive post, just need to hear any advice or encouragement at this point. I have spent a lot of the last few days in tears, I know the midwife and DH are worried about my mh, I am almost at the point of giving up but don't want to be consumed by guilt and misery if I do.

Hind milk as something separate to the milk at the beginning of a feed is sort of a myth so you don't need to worry about that, TBH. He'll feed for as long as is necessary for him to get the milk he needs, be it long or short. Kellymom (the absolute go-to site for BFing if you haven't yet discovered it) explains it here.

She's suggesting block-feeding which is a good strategy if you have a forceful let-down. Is that a problem for you? I remember DS2 did sometimes just want to comfort suck in the early days and got thoroughly pissed off if he ended up with a let down so I did get in the habit of starting each new feed on the side I'd finished the previous one. I think that's probably what she means rather than just sticking to one boob per feed. Definitely still offer the second side (and third, and fourth, especially in the evening, until he conks out).

Are you topping up with formula at the end of feeds? If weight has now stabilised, you really don't need to be and will only slow your supply from building. Babies will always take a top-up from a bottle (formula or EBM), even if they don't need it, a bit like us 'finding room' for dessert. They're a bit of a captive audience on a bottle. They'll suck out of reflex, and will have taken several mL before they go, 'hang on...' If you want to make sure he's had enough, switch feed as described above (go back to the first side again after the second, and keep repeating until he doesn't want anymore). This will build your supply the fastest and get him more and more used to latching and re-latching without recourse to that bottle which he finds so much easier (and possibly partly why he's still screaming at feeds - 'why can't I have that easy option, dammit! Why are we pissing about with this awkward lark!')

Oh, and YY to pulling back on boob. Both of mine did that. DS2 now does it so he can watch the TV while feeding but as a newborn, it will be one of two things. One is it could be him trying to stimulate a let-down. The other, is that it could be related to the TT release and him coming to grips with the new set-up in his mouth. I'd relatch DS2 using a rugby-ball hold as I described in a previous post, so I had both hands free, prising his chin open with the thumb on one hand, and getting my nipple in right to the back of his mouth with the other to stimulate the soft palate. Hold your boob a bit like a hamburger (glamorous...) with your thumb on top, pulling your thumb back slightly, so the nipple is tilted upwards as you go in.

The Rolls Royce of breastfeeding advice is an IBCLC, here is their website where you can see if there's one near you:
www.lcgb.org/find-an-ibclc/

Some are private rather than NHS, but if you do have a bit of spare cash you absolutely wouldn't go wrong ringing for advice and maybe booking a home visit.

I've just remembered something else to stop the pulling on the nipple thing.

I got into the habit of doing breast compressions with DS1 to improve milk transfer (if you're not doing this already, do so, definitely) so did them with DS2 as well. Because, indoing this, I was already holding left boob with left hand or right boob with right hand, I'd use my free arm/hand in cross-cradle, and clamp him across the back of the head with my hand in a c-shape around the base of his skull. I'd basically get him latched on, then keep him pinned like this, boob held in his mouth and head clamped on so he couldn't move back a millimetre. It felt like I had to feed like this for weeks on end, but since I've only just remembered it now (vestigial memory triggered by the completely anti-social hour, obviously ) it was one of those shining examples of 'this too shall pass'.

I got in touch with an IBCLC but she is quite a way away so would be v expensive. I am trying to switch back and forth till he conks out but he gets to a stage if fury where I just can't latch him on at all and that's when I offer top up. Sometimes I can give a small top up of ebm and then go back to boob. He screamed from 7 til 10 last night and wouldn't take boob at all, very little bottle. Even tried dummy to no avail. The amount of bottle is reducing but I don't feel I can just cut it out when he sometimes refuses breast altogether. Not been weighed since last Fri but weight has been going up consistently. Expressing after every feed to try and boost supply.

Have used rugby hold to good effect, also was shown breast compressions and have been trying those too. No idea about mg let down, sometimes he pulls off and chokes a bit at first does that mean it is fast?

I used expressing to control the flow in the early days.

If let down is slow, and he's getting frustrated, pump until your milk is flowing so he can start feeding straight away with no effort.

If you have a very fast let down he doesn't like, either feed from the same side as last time until he gets going, and offer the full side second. Alternatively express until you slow down a bit.

Good luck!

Unless he's not fed for well over four hours, or he's not producing wet and dirty nappies, I just don't think you should be offering the bottle at all at this stage since going on the boob is what he hates. The more you continue to offer a bottle, the longer the rage is going to last for, as he's going to want that easier option. If boob is his only option he will settle down.

Evening range is pretty standard, as I'm guessing you know from your DS1. Warm bath, white noise and skin to skin in dark room from 7pm, with offer of boob every now and again was what I did, plus or minus a bit of pacing. If the screaming continued, well, there was nothing to do but ride the mo fo out since I was addressing every need, but it pretty reliably calmed both of mine down.

Just wanted to say thanks for the help. Still breastfeeding at 8 weeks, DS2 feeds almost hourly in the day and 2-3 hourly at night so it is hard going but I am ploughing on in the hopes it will get easier.

Really well done! I had a very hard start with DS1, and it did get easier at some point, I fed him until he self weaned just before his 2nd birthday and now mostly remember the cuddles.
Not that it is relevant, but today while I was feeding DS2, he (3 years now) started telling me that he was drinking daddy's milk when he was a baby. Oh no, you definitely didn't! Not that I expected any appreciation :) But it is amazing seeing them grow and develop just drinking your milk, despite being biomedical scientist, I still find it a bit of a miracle.
Hope it gets easier soon and you feel happy with your choice! Lots of chocolate and biscuits for now :)