Am I un-helpable?! Breastfeeding support

[lilyb84]

I have a 16 day old DS who I've been exclusively breastfeeding since day 3 after a rocky start in the hospital. He's putting on weight and has enough wet and dirty nappies.

However, he's started taking AGES to latch on, and no matter how early on I pick up on his hunger cues he's frustrated and angry at the breast, which means his hands get in the way and he's too worked up to latch. This last feed it took me more than 25 minutes to get him on during which time he was screaming and I very nearly resorted to formula (but don't want to do this).

When he's eventually latched he seems to be on fine 90% of the time, although sometimes he's not and it's very painful so I feel like I need a bit of help a) to check my latch and positioning and b) to figure out why he's so angry when it comes to feeding.

But. Every time I try to get help, the person helping ends up as frustrated as I am, and DS refuses to latch full stop - either getting too frustrated or losing interest completely. I haven't yet managed to actually feed in front of someone as just can't get him on - midwives in hospital, health visitor at home and yesterday at a breastfeeding cafe - no one seems able to help. People keep recommending all this support but it's doing nothing for me and just leaves me feeling like more of a failure.

Is there such a thing as getting help at home, or do any of you have any experience of breastfeeding support organisations who can actually help? I'm hoping this struggle to latch is a blip and I know he's still tiny but it's so frustrating when it takes so long and I don't know what I'd do if he didn't manage to latch at all to feed (which we came close to this morning) - I think it's too early to be expressing but should I have a little expressed milk in the fridge just in case so I could potentially give him a little bit from a sip cup in the event I actually can't get him to breastfeed at all?

Sorry this is a bit of a ramble!

Hey, that sounds really tough. My DD was the same her first week. Struggled to latch on and then get too worked up to feed! It was very distressing for both of us. We also had the same experience when midwives tried to help, she just got angry. They suspected tongue tie but weren't sure and referred us for an appointment.
But a couple of nights later she got to grips with it and by the end of the week she was feeding fine so we cancelled the appointment. Here is what helped us:
Nipple guards - she instantly latched on using these. I would then remove them part way through and she would carry on without them. Used them on and off for a week until she didn't need them anymore.

Also our local children's centre has a breastfeeding support team that will send out a consultant to your house within 2 hours during the week. Maybe your area has something similar?

Can I second the use of nipple guards? Without them I would have been unable to bf either of my children.

I had no trouble ditching them a little way along the line when the babies were a little older. I bf for 3.5 yrs in total.

Does he make a clicking sound as he feeds or can you feel his tongue 'prodding' at you? My dd had a tongue tie which was disgnosed right after her burth and sorted at two weeks. She had difficulty latching on. A breastfeeding cafe etc should be able to check for this and advise you how to sort it otherwise just help you with the latching. BFing can be difficult, so don't worry that you're the only one!

Hi Lily, I don't think you are beyond help. I'm a breastfeeding peer supporter, probably educated to the same level as whoever you saw at the cafe. Be aware that most midwives and health visitors have no formal training in breastfeeding, and although they may have been very well meaning I can't tell you what they said was helpful or counterproductive.

You can seek out lactation consultants who have a lot more training, but you usually have to pay for them unless your health authority runs a lactation clinic.

It's hard to diagnose over the Internet but some things I have found with new mums that may or may not help are:

• as soon as baby starts opening his mouth like a little goldfish, licking lips, it's time to try to get him on. Hands to mouth and moving head about is the next hunger cue, the more you wait the more agitated they get and finally they scream blue murder.

• try not to hold baby's head whilst placing him to your breast. Instead support the neck giving him the freedom to throw his head back and take a good swig of booby milk. Often new mums are frightened that baby will hurt himself, and feel they need to support the head. Baby maybe fighting you if he feels restricted.

• a baby needs to take most of, if not all of your nipple into his mouth to get a good latch, if he doesn't then he will have to work very hard for his milk. Usually they will take a few short intense sucks until you let down and then they should slow down and swallow less often as the milk enters their mouth. A sore latch and an irritable baby does sound like he is not on properly.

• putting baby on the breast, you bring baby to the breast and not breast to baby, you need to be comfortable in order to aid let down. So when your son opens his mouth wide it's time to bring his nose to your nipple and stuff him on. Be bold he needs to get right in there, you will not suffocate him, his little nose will ensure enough air gets through the mass of boob. If you have big flat nipples like me (tmi sorry) I used to find squashing my boob flatter with one hand to make the nipple area more elongated helped. So a 'c' shaped hold of boob in one hand and baby held with the other, and a quick positioning on the boob was how it worked for me. I think YouTube has some videos demonstrating this and the 'flipple' technique.

• skin-to-skin is important in the early days. Get your top and bra off, baby in nappy only. Let him smell your milk. So avoid scented shower gels, moisturisers and perfumes. Little babies have very poor vision. Squeeze milk out of your nipple to help him find his way.

• if this is still not working then push for a tongue tie referral, some can be very hard to spot. A health visitor or midwife is not an expert on this. Tongue ties are very very common and basically make it hard for baby to draw your nipple in far enough. The NHS is a bit lacking IMO in diagnosing and treating tongue tie.

Sorry if I'm only telling you what you've already been told. Good luck.

How about swaddling as a temporary measure to keep his little hands out the way?

Captainproton has some great ideas.

You can pay for a lactation consultant to come to your house. If you do, please ensure she is an IBCLC (as anyone can call themselves a lactation consultant). But there are no guarantees that an IBCLC will have more knowledge than a peer supporter - I've known people with latch issues that IBCLCs just didn't address.

What part of the country are you in?

My children's centre organised for a breastfeeding consultant to see me at home free of charge with my dd. My ds sounds very similar to your baby and is now 6 weeks old. He has reflux so feeding is painful for him and I'm hoping he is happier about feeding when his meds kick in.

My ds also had oral thrush which can make feeding painful.

Another explanation is that he gets frustrated when he can't feed immediately, which my ds also did! This happened only tonight when he then wailed and woke my dd up too. I find it so frustrating but at the end of the day they're tiny and didn't read a breastfeeding manual! Get a breastfeeding consultant to help with your latch as you suggest, and to also consider other factors that might play into it. I can promise you this will improve though I know it's so hard to experience at the time. You're doing the right thing seeking support and I can see some great advice on his thread.

A baby will use his hands to stimulate your breast tissue into letting down milk so I wouldn't recommend swaddling. They may get more agitated the more you restrict their movement at the breast. So I dot think swaddling is the way to go, sorry!

Hello, Well done for keeping going this long. I had exactly the same problem and gave up after two weeks.

One thing to try, is your baby very very hungary? My son was desperate, the same as Queazy, only it was every time! I was sore and ended up in tears alot.

If you have a rough idea of when your baby will want feeding, wake him up 20 mins BEFORE, or, get him to latch on whilst asleep. You may find that he latches on beautifully when he's not paniciking. Also, if you are not getting upset by his crying etc, then it will also help him.

Don't worry about routines, just get him used to the idea that dinner's coming!

Thanks so much for all the advice!

I hadn't considered nipple shields but can look into them - I think I have quite flat nipples so they might help? I assume you need to sterilise them?

captainproton I do have to give him a hand by squeezing the nipple into an easier shape so I give quite a lot of assistance to get him to latch which I've been told is wrong. But if I let him try to do it himself there's no chance, he just can't get anything to latch on to (those flat nipples I guess...?).

I'm in SE London, borough of Croydon. The bf-ing cafe I went to is a ten minute drive and only on Thurs mornings, there are others but they're further away or would require public transport which I'm a bit scared of attempting with him just yet. Also, how the hell do you a) leave the house in order to get anywhere on time and b) ensure baby's actually still hungry when you get there? He definitely seemed hungry yesterday but when I tried to feed him at the cafe he wasn't interested - of course as soon as I got home he was screaming for food. It's like he doesn't want to feed in those situations (I've fed him publicly in pubs with no problem).

8spiderlegs I was wondering how on earth to combat his anger at night when I'm clearly missing the early cues. He generally sleeps for about 2 hours at a time before waking to feed so I guess I could try setting an alarm and waking him? I was just hoping that he'd start going for slightly longer stretches at night and so was planning on feeding on demand only now he's over his birth weight, and so I get the odd couple of hours sleep here and there as well. Maybe that's just optimistic?

I need to keep reminding myself it'll get easier, it was quite hard to see that this morning when we were both so frustrated. My worry is I'm doing it wrong and it'll cause problems down the line but I don't seem to be able to get help to correct it.

I really can't afford to pay for a consultant - I guess I'll need to just go back to the cafes until someone can help me!

Oh and no clicking that I've noticed so don't think it's tongue tie...

lily you could phone the NCT or La Leche breastfeeding support lines and ask if they can advise you or even send someone to your house. NCT class fees were on a sliding scale so it's worth asking, if there is a cost for an an NCT counsellor to come to you.

Can you contact whoever runs the breastfeeding cafe and see if someone could come to you? Otherwise ask your midwife if there are maternity support workers who specialise in breastfeeding--i had one who came to us and it made such a difference. I don't know if your health authority has funding for them or not though.

Lots of luck, I hope it gets better soon.

There is no cost for a visit from an NCT breastfeeding counsellor - but they are not everywhere in the country so there may not be an available one near you.

Do call the helpline though and ask - all NCT bfcs are volunteers and may not be able to do home visits at short notice, but if we can help, we will! 0300 330 0700

A lot of what you describe sounds well worth someone observing, so yes, it would be good to have someone spend time just seeing what happens. Keeping your baby skin to skin with you, trying laid back breastfeeding, having a bath with your baby, enabling self-attachment....all these things may help. They might be better in your situation than actually doing the 'pay attention carefully to how he gets attached' sort of process, which sounds like something you have already tried.

Some of my friends did "dream feeding" where you don't actually wake them up at night, it may work for you. It may be worth setting the alarm in the night to try this, even if just for a few nights! It may also make you feel more in control of what is happening which will help you. Do as much napping during the day as you need to whilst this is going on, housework etc isn't important.

I think that once he realises that he has to latch on and suck to get the food then he will be fine, he's just impatient!

Don't feel a failure if you do end up giving him a bottle every so often.
My son is now 13 years old, it was the nights that are etched on my memory.

I think captainproton nailed it. I was told "nose to nipple, tummy to mummy" and every time it wasn't going too well I went back to that and it helped. Good luck, you will crack it. And Lansinoh and/or cabbage leaves are magic on sore nipples.

I had both NCT and NHS breastfeeding advisors visit me at home. The NCT one came the same day and was amazing!

My situation was a bit similar to yours but my DS never ever latched on once, not a single time. He just screamed and turned away every time, it was awful. In total I saw five feeding advisors (two we went to hospital to see after being referred by my midwife) and they were all stumped. Total refusal to feed is very rare apparently but there we were. I ended up expressing as he would take a bottle fine, which broke my hear to be honest but the boy had to eat! I continued for 6 weeks but full time expressing is very very hard and I wouldn't recommend it to anyone unless you have a fantastic supply, which I didn't after such a poor start.

I ended up moving to formula which was absolutely the right thing for us, but it helped to have all the feeding advisors tell me that I had persisted much longer than a lot of people would. I had a lot of support and they were all great.

I suppose the point of that ramble is that the support is available if you ask for it. If it seems unforthcoming then keep asking, your midwife should be your first port of call. I had tonnes of fantastic help and never paid a penny for it. Even in our strange situation we weren't a lost cause and if my mental health could have stood it I could have expressed indefinitely. It was making me depressed though and it wasn't right to continue.

Keep asking for help and good luck, it's incredibly tough when things arnt working properly and you are doing amazingly well.

Oh and nipple shields were the only think that got my DS even close to latching on, he did have a tongue tie though which over complicated things even more! Nipple shields are not the enemy, as some websites would suggest, they can be a very good solution and well worth a try. I also have quite flat nipples so suspect this might have been the issue with me as well.

Interesting about the swaddling captain, I suppose I'm a bit out of date! My DD used to do the hands thing and it would really calm her and improve her latch ( up to about 3 weeks old) didn't work on my ds at all.Sorry if I am giving dud advice!

Hi Lily, yes you need to sterilise nipple shields. I'm not allowed to recommend them because some babies can get nipple confusion. But I can tell you I have used them, but that was with a very sleepy and poorly baby who didn't have much energy to feed. So I am on the fence with these.

There is no problem to hold your breast in such a way that aids feeding. I am not sure why you were given the advice not to do this, unless you were somehow restricting your baby taking a massive gobful of boob? It's certainly something we recommend especially with a baby struggling to latch.

And sorry mudandmayhem - I think I may have been rude about the swaddling, if it worked for your baby then that's great. Each baby has their own personality and quirks but in general they use their little hands to help stimulate the let down in your breasts, and also to help guide the nipple to their mouths.

Breastfed babies at a young age won't sleep for long at night, nor in the day. It's really tough but once feeding is established and baby is a few more weeks older you will both become proficient, thinks will get easier, faster and possibly time between feeds may get more spaced out at night.

The advice is to feed on demand, and not try to space feeds out, but there is no harm offering a half asleep baby a bit of boob in the hopes they take it and go back off to sleep. In fact it's probably a good way to counteract the desperation if they wake up starving and thrashing about trying to get on the boob.

Getting out of the house is VERY hard in the early days. Is there anyone you know friends or family who can help you get out to a breastfeeding group? Don't force yourself to go out until you are both ready to face the world. stressed out mum and baby does not a successful latch make, you need to try and relax to get that milk flowing.

If you can get someone to come and see you at home then please do.

In my area all the people like me who run the groups are volunteers so we don't have the insurance to come and visit new mums. But if you can get someone from the NCT to come out to you then I'm sure they'd be able to help you.

Thanks, this is very reassuring. I'll try calling the NCT helpline to see if they're able to offer a home visit. Yesterday DS fed almost on the hour every hour from 9am until 11.30pm which was exhausting - I finally managed to get him latched on in a lying down position at 11.30 and he finally drifted off so we could both get some sleep! At least he's eating lots

Pat yourself on the back, you're doing really well. It will get easier...honest!