We've lost the latch!

[DebsCee]

Help please! I am due to see a LLL BFC tomorrow, but DS (9 weeks) has begun to nipple feed and I cannot get him to take enough breast into his mouth.
We saw a BFC when he was 4 weeks old because of poor positioning and sore nipples and with some help we cracked the latching, but steadily over the last week it's all gone to pot.

I am repeatedly latching and unlatching him but he continues to take just the nipple in his mouth and I cannot find a way to get him to tilt his head back and open wide any more.

I don't know if its the way I'm holding him, or his positioning in my arms, or the way I am lining him up, but I've got at least 10 more feeds before I get to see the BFC and my nipples are so sore.

The left nipple is worse, and the right, although no pain whilst feeding, is always blanched pure white on the tip after a feed. I know this is down to positioning and not thrush, but I cannot for the life of me get it right and it is really getting me down.

We do tummy to tummy and nose to nipple (though never really understood what that means in reality) and I've looked at every picture, internet support site and video going, but I still cannot crack it.

DS is not a small baby, so maybe what worked at 4 weeks won't work now, I don't know. I do know that I am getting desperate and dreading every feed.

Any tips at all please to get me through the next day?!

can you see a bfc again? or your Hv (if shes any good with bf advice)

it could be the positioning, but i think someone would have to look.

hope someone comes along soon to help you.

cx

try another position? lying down? rugby ball?

Have you tried lying on your side to feed DS?Dont know if it will help but I always found it quite comfy. Can you call the BFC for some advice or try the NCT number? Is there a local drop in near you?

We are going to the local baby cafe tomorrow, that's the earliest they could see me on a 1-2-1 basis, and I'm seeing the same BFC that i saw a few weeks ago.

I am going to try soem different positions today as suggested, but not particularly confident about it, but we'll try.

I cannot understand how we can go from being OK to this in such a quick time!

Debs, nose to nipple is only a way of ensuring the nipple enters the top third of the mouth, where there tongue isn't, and it is not compulsory to get to that by doing nose to nipple...there are other ways. Nose to nipple only applies when the babys mouth is closed....if it's open or half open you will miss the target

The things to ask the bfc about include i) tongue tie ii) the possibility your ds is trying to control an over-generous flow by moving towards the end of the nipple

The fact you say ds is 'not a small baby' makes me think of option ii) to be honest.

Thanks Tiktik - I was hoping you'd come along

Most of the time his mouth is at least half open, almost never closed, so I guess nose to nipple may be causing me one issue. So, how do I 'line him up' if his mouth is already a little open? The problem I think is that I can't get him to gape and I am also worried that I am holding him too high, so he's not exactly coming at it from below IYSWIM. We started off with him laying close to my tummy so that I could only see his one eye closest to me. And the weirdest thing is that I get almost zero pain during a feed, it's afterwards that they are sore and throb.

I don't think tongue tie is the issue as he is able to extend his tongue beyond his bottom lip when he is smiling! But I will ask them to check it out.

You may have a point about the fast supply - my letdown is certainly fast and furious, so I usually catch it in a muslin and then attach him, but actually he seems to get worse the less full the breast is. What else can I do to help him with the flow?

I think I understand all the technicalities in terms of bringing him on so that my nipple is pointing towards the roof of his mouth but he doesn't oblige by opening his mouth wide at all, sometimes even curls his top lip in.

It doesn't help that my breast/nipples are nothing like any of the pictures I've seen! My nipples kind of point outwards IYKWIM, and the left one always looks slightly odd when it comes out of his mouth!

No substitute for having someone really look at what's happening, Debs....it's good you have some insight and understanding and have done your own observations. It will all help tomorrow. Hope it goes well.

Thanks TT - I hope tomorrow helps - I seem to be losing my perspective on the problem and getting more and more down about it the longer it continues, but I am determined to BF DS2 for as long as I possibly can do, so I have to get this sorted.

I had the same problem yesterday and the community midwife came to my home and spent two hours with me. My baby is 5 days old, she was having trouble latching because her nose is quite flat at the moment and bunged up from the labour mucus and also my breasts are so engorged it's hard for her to latch on so she would break off after a while.

Midwife taught me to pinch either side of the nipple to make a 'burger' shape. She used the analogy that it's easier to eat a burger held horizontally rather than vertically. This also gave my baby a 'ledge' to latch on to. I know some people say pinching the nipple can stop the flow but my baby seems to be taking in lots of milk when she pulls away she has milk on her lips and chin and when she's suckling i can see milk around the edges, so she is getting a good feed and she no longer unlatches, but feeds for up to 40 mins straight.

Another tip i got was to practice the hand around the back of her neck so that you can easily manouver (sp?!) her head so that you can put her head back to get her mouth open wide.

Make sure her tongue is down (my baby was sometimes crying and the nipple would go in under her tongue)

And when the baby opens its mouth wide, be very quick and firm with the latch on because the MW explained that the baby is disorientated and by being quick and firm you are telling her where to attach.

Hope some of this helps?!

Hang in there i was so desperate yesterday i was ready to start bottle feeding!

also just thought to add, i've used Lansinoh if i feel its needed and it keeps the nipple really soft, and i've been taking Arnica tablets for the stitches i had to have after the labour, but wonder whether it's helping me in the nipple department too because i've had very little problem with cracking. The initial latch is a little painful but it settles down.

Thansk Asampras - that's reassuring to hear.

I have gritted my teeth and got through today and counting the hours till tomorrow now.

Just wish I could suss what has changed since we last saw the BFC, we had it cracked then!

Try expressing a bit before feed to help with flow so not engorged. All mine got lazy with opening their mouths at some point, this sounds a bit rough but it was shown to me by a midwife so is fine to do. Hold his head and basically dig his chin / bottom lip firmly into your breast to the side of the nipple (ie where you think it should be to latch on or perhaps a little further away from the usual position) so he can't move his chin / bottom lip out of position and then still holding the head firmly bring the mouth / top of the head down to latch the top lip on. I can only describe it as a bit like a lever action attaching the bottom then top lip - as I say you have to hold the head quite firmly but it does work - ie you are basically manipulating his head into position by digging his chin / bottom lip into your breast a bit away from the nipple he has to open his mouth wide to reach across to the nipple and then you firmly bring the top of his head towards the breast putting the top lip in position. Its not recommended you rely on this method all the time but it does get you past these tricky stages. Hopefully you will have lined him up so the nipple is towards the roof of the mouth when you attach the top lip. You just have to keep taking him off every time the position is not right and repeat until its right. As I say the trick is to dig the chin in at a place where to reach the nipple he has to open his mouth really wide. If you feed and the soreness doesn't get any worse - even if it is no better then you are on the right track.

Thanks everyone for the words of encouragement and support.

I saw the BFC at lunch time today and we seem to have sorted out the problem with the latch - I was about 3 inches out - or rather I was positioning DS2 directly in front of my nipple!!! I now understand that nose to nipple is not straight on but at an angle and baby needed to be much more wrapped around me and left to open his mouth and reach up for him self with a pretty forceful push on from me when in position and gaping wide.

Since then we have had 3 good feeds and already my nipples feel better, there is still a lot of relatching when he slips back on to just the nipple, but overall I'm feeling much happier about things. And I have decided to go to the Baby Cafe every week now just to keep myself motivated and within easy reach of regular support.

Thanks again everyone - cannot wait until DS2 can get himself latched on now

Well done DebsCee!

M ust admit there no substitute for having someone observing you and telling you where you're going wrong and working out a technique personal to you.

I was surprised too how firm and forceful you had to be when going in for the latch on!

Keep it up, and if it's any reassurance, i saw my community midwife about the latch on, on Wednesday and ever since i've not had any problems and my confidence has really grown making breast feeding a pleasure - and relatively pain free due to correct positioning!

Really good that you got this sorted out DebsCee - can really sympathise. DS1 (15 weeks) still alternates between huge, gaping fish mouth with a great latch, and a mean little nibble - it seems to depend on mood, energy levels and just a degree of bloodymindedness (not unusual in our family). I guess the only other point I try to remember is just to stop and start over if the latch is wrong, even if it means frustrating the lo. Good luck!