High tongue latching - weight loss

[IceLemonGin]

DD2 is a week old, plenty of wet and pooey nappies. We have struggled with bf since birth - lost 11% birthweight on day 3 which dropped to 9.6% on day 5.

I fed DC1 for 16 months with no issues so know something is wrong.

I went to my local BF clinic today who said DD has a very anterior frenulum which is surrounded by structures beneath the tongue and told to go back in 2 weeks to review to see if they should take action.

In the meantime I'm to work on her latch but I'm really struggling as she constantly has her tongue in the way. I keep relatching to try and correct it but it frustrates her and she tires quickly.

I have large breasts so feels like I'm juggling. I'm so sore and feeding through the pain.

Has anyone else been through similar? Should I try get a second opinion or referral? 2 more weeks of this makes me feel anxious!

Given that you are an experienced bf'er, I'd be inclined to push the issue.

A snip is such a low risk procedure, and tends to be more beneficial the sooner it's done (i.e. Before the nipples are shredded and the HV is insisting on top ups..,)
www.tongue-tie.org.uk] is the professional body, who list NHS and private providers.

Thanks Lizard, that has confirmed my feelings. My nipples are sore and cracked, not sure how persevering for weeks is going to help. Apparently it is a complex case but surely all the more reason to get it fixed sooner?

I'm due a midwife visit tomorrow, apparently if DD hasn't gained a certain amount, I will have to express but then that concerns me as I don't want an oversupply.

I agree, sooner the better.

Expressing is generally a good idea for this sort of situation though, as TT babies tend to be inefficient feeders (hence slow weight gain) so pumping helps achieve a full milk supply to meet their needs, and provides the milk needed to top up (if required to help with weight gain).

Just don't go crazy, try to match what you pump with what she drinks, and all should be well.

The aim is usually back to birth weight around day 14, much longer than that would be an indicator for supplementing. WHO recommends supplementing with expressed milk as a first choice.

Also, the evidence supports moist wound healing for cracked nipples, so slather some Vaseline/lanolin (both are equally good according to a Cochran review) on a breast pad between feeds - it stops scabs forming, which prevents as much scar tissue, and helps faster healing. Soap and water twice a day to prevent infection, and wipe the Vaseline off just before feeding, as slippy nips are harder for babe to latch on to.

In the meantime, keep your supply up (with a pump if necessary), keep the baby fed (top up if her weight is struggling, and that buys you time to work on latching and feeding directly.

Any chance of getting it done privately where you are?

Agree don't wait two weeks before getting it assessed again, then you would have to wait again to get it cut.

Have you tried the flipple technique to help with her latch in the meantime.

I wouldn't worry about oversupply, that can easily be corrected. If you do express, make sure you do 'paced feeding' with any bottles you give.

Anything the midwife says that doesn't sound right/you're unsure about, phone and speak to a good lactation consultant as often midwives aren't experts in b/f, especially with things such as complex tt.

Sounds like you're doing great anyway.

Thanks for the responses, MW weighed DD today and she had lost 30grams so I've got myself a pump and some syringes to top her up with EBM at the end of each feed - MW said to aim for 30ml, does this seem right? I managed about 15 ml earlier but will keep trying. Syringe feeding is messy work!

MW isn't concerned, said she wouldn't have weighed her until day 10 but is coming again to weigh her tomorrow. I'm really hoping for a gain. She had a look in DDs mouth and said she just thinks she has a short tongue...not very helpful

That's good news about expressing. I am also going to try the moist wound healing too, I've been rubbing BM in then putting lansinoh on but didn't think about the breast pad absorbing it.

I have booked to meet with Milk Matters in Huddersfield on Saturday as waiting doesn't seem wise. The lactation consultant seems lovely. Not sure I'd manage to speak to anyone on the phone as I'm very emotional!

I've not heard of the flipple technique - off to google. I will give anything a go!

Syringe feeding is indeed messy, but it's a great solution for this particular problem.

30mls sounds like a good place to start, the main thing is to get the weight on an upward curve now, so if she seems hungry for more, that's also okay. As long as you're expressing it, the supply and demand will be matched, and all is good. Over supply is better than undersupply!

I'm glad you have an appointment for some face to face support - was that the earliest they could see you?

(Also, short tongue? Pfftt. Pretty unusual to have a tongue so short it can't latch, very common to have a tongue tie. Which do we think it might be?...)

When is the best time to express? At the end of a feed? Should I give DD the EBM when she finishes at the breast?

She has been feeding 2 hours now. I'm exhausted!

Milk matters are excellent, glad you've got an appointment with them. If they see your DD has a tt they will do it for you on Saturday so at least you won't have to wait if it is that. If not, they will definitely be able to help work out what it is.

I wish midwives and other HCPs would just say they don't know and advise you to see someone else. There are obviously issues if you are sore and can see that your DD is struggling with her latch, especially as you've breastfed before.

You can hand express directly into syringes. Sometimes it's easier than pumping for small amounts and transferring into the syringe.

Flipple can be good for poor latch caused by tounge tie so worth a go. The milk meg has a good video.
Good luck

Thank you @littledinaco glad to hear they are well regarded. I'm hoping they can fix our issues.

It was a lactation consultant who assessed DDs tongue at the bf cafe said she has a high palate - I'm not sure if that's connected too. Weirdly she never watched me latch or feed, that was done by a trainee HV.

I had a brief try of the flipple earlier, I struggled as my breasts are so big but will keep trying!

Ds had a similar tie but it wasn't diagnosed until he was 5 months. Even at that late stage, the snip was a very quick fix. He was more indignant at being held down than he was at the actual procedure, so hopeful at your dd's age it will be very easy. Best of luck and congratulations on the new arrival.

Yes, high palate is connected! Lact cons told me that the thinking (5 yrs ago anway) is that the tongue lifts and rubs along the palate to flatten it. The tight frenellum stops the tongue lifting high enough. Ds is a thumb sucker, has been from about a week old. He rubs his thumb across his palate when he does. I find it fascinating.

Did you ever manage to find a comfortable latch Kanye? I had heard that it can sometimes take a while for them to relearn to latch after the division.

So it does sound more and more likely that it is a tongue tie with the high palate too. I'm really hoping for a weight gain tomorrow!

www.mother-2-mother.com/nipplepain.htm#HighPalate

This gives some positions to help with high palate (you might have to scroll down to get to high palate bit).

Hopefully you will find something that works to at least get you through until Saturday.

It can be worth seeing a really good criminal osteopath after the tt is cut as it can help baby to use the muscles that have been restricted due to the tie. It can also help with feeding too and reduce the possibility of it reattaching.

It's better if you can see one as soon as possible (a day or two if you can) after the tt is cut so may be worth looking into/booking in before you go to Milk Matters.

Football was probably the most comfortable. But I had to change about a lot as I got a lot of blocked ducts due to him not always draining the breast efficiently (and looking at the link above, I had forgotten I had a few milk blisters too).

Ds is and was a savage beast, so other than being cross at having the snip done, he latched and fed fine about 2 mins after it was all over.

I think little means a cranial osteopath rather than a criminal one ;)

Kanyeslunchbox that's really interesting what you say about high palate. Ds1 had a stubborn tongue tie that took 4 snips over 4 months to resolve and as a result we bottle fed expressed milk a lot, and he has a bubble palate (or at least did when he was 4 months old, I exclusively bf for another 14 months so possibly it changed after that?) But he is a thumb sucker, and also rubs his palate as he does it. His younger brother, whose tt was resolved within a week and who has had maybe a dozen or so bottles in his first year, also sucks his thumb, but no palate rubbing. The tt runs in my family, and we've all got incredibly narrow jaws and crowded teeth- you're right, it's fascinating.

That link is fab little I tend to gravitate towards those positions without realising so maybe a few tweaks and we can find something comfy. Milk matters have a recommended osteo that I'm going to contact tomorrow.

I tend to mostly use football hold too kanye. I'm so glad you had no trouble afterwards, I'm hoping for the same.

I really appreciate the replies. Much more reassuring than any contact I've had with HCPs

Slightly jealous that you are regional to Milk Matters by the way- you're in very good hands !

Glad to hear another positive post about milk matters.

I'm having a panic about expressing, I've not been able to get any more out tonight. I'm so worried about DD not getting enough

I found nipple shields helped my daughter latch on until her tongue tie got snipped, have you tried them? My daughter struggled most with latching when my breasts were really soft and empty (so in the evening and at night) and using nipple shields just when she was struggling worked for us.

We also had slow weight gain initially, I found switch nursing (swapping sides every couple of minutes so they get the quick bit of milk release) and breast compressions (Google for videos) helped.

Tuck, that's interesting about your Ds rubbing his palate too. The dentist was very when I mentioned it, but Ds has a very narrow mouth too. dentist only cared about stopping the thumb sucking. Good luck with that When you look into his mouth he has a very high and steeped arch. I'd love to know if your boy's is still as pronounced, since the tie was snipped earlier.

I had the opposite problem to Panda and needed to block feed to avoid over supply. You might need to change things around as you go, so don't get too set on what is working if it suddenly isn't.

Does the palate change as they grow? I wonder how/if detaching a tongue tie affects it.

DD has explosive poos that seem to give her a bit of tummy ache before hand. Is that likely due to the poor latch too?

I managed to express and get around 20ml into her and expressed more for after next feed too. Am I right in thinking if I pump after every feed I will increase supply or should I pump between feeds also?