Feeding a small mouthed, tongue-tied baby

[whatsinaname11]

Desperate for some advice on feeding my 3 week old DS. We had a brilliant birth but from day 1, feeding has been a nightmare.

He was EBF for the first week, but the pain was excruciating, worse than labour. I was in tears at every feed, dreaded him waking up to feed, nipples were bruised, bleeding, and painful between feeds, and nothing could sooth them, and had sharp pain during the feed as DS munched on my nipples. He lost nearly 10% of his birth weight in the first 3 days, and didn't have a dirty nappy on days 2, 3 or 4 or 6 & 7.

The midwives all said his latch was fine so no problem until we saw a private lactation consultant who said he was tongue-tied. We switched to expressing to give my breasts change to heal and he gained weight. His tongue tie was cut on day 10, but his latch and the pain during feeding hasn't changed.

My HV thinks he has a small mouth (which isn't surprising as I have a small mouth too) and a tight jaw. He struggles to open his mouth wide enough to get a decent mouthful, and when he does he seems to block the nipple with his tongue. We have been doing tongue exercises, and he seems to have more movement in his tongue, and lots of time on his tummy to help stretch and strengthen his neck and jaw muscles but nothing seems to be improving. Different position make no difference to the pain and my nipples come out raw and flat whatever!

We are now doing a combination of breast feeding until I can no longer take the pain, or he gets bored, expressing, then topping up with formula (as I also got mastitis which blocked the supply in one breast which I am only now getting back)

I am desperate to crack this - has anyone been through similar, or have any ideas of thing I can try to help make feeding less painful? I feel like I have tried everything but am getting nowhere and its heart breaking.

TIA

I went through exactly the same. It's shit! We ended up transferring baby onto goats milk formula (as close to breast milk as one can get apparently) at 10 weeks. We tried everything, cranial osteopath, kinesiology but with no success. I pumped exclusively for a bit but it was exhausting and she started to refuse to feed at all!! A change of bottles to mam anti colic bottles and formula was the only thing that worked for us. Pat yourself on the back for getting to 3 weeks in what is essentially a shit situation!

Thanks for replying @Nurse15, I'm so impressed you made it to 10 weeks, I will be so happy if I manage that long! Any coping tips?

People have mentioned Cranial Osteopathy, but its so expensive and there's no proof behind it, so not sure whether to try it.

Thanks for the goats milk tip, I hadn't heard of it, but will look into it. We're using SMA but only because we had to start with the formula at 3am on a very bad night!

Have you tried nipple shields? The only way I got my premature twins on the breast was by using nipple shields (they were tiny - 6lbs at 4 months old)

Another vote for nipple shields - they were so much easier for my prem baby to latch onto (they are smoother than actual nipples) and provided enough of a barrier for my skin to be able to recover

No problem at all :) not really to be honest. Chocolate is about the best I can offer! My nipples did toughen up at about 5 weeks or so and that helped a lot! I didn't try shields as the lactation consultant said they wouldn't help as it would only allow her to slip of the nipple easier as there's no friction with them! Honestly I beat myself up about it and continued till my little lady was losing weight - in hindsight I shouldn't have let it get that far, it was making me and her miserable! I can't honestly say I enjoyed her through that time and it makes me kind of sad!

We're trying nipple shields at the moment but he can't figure them out. He can't take the whole test into his mouth and as my nipple doesn't fill it he ends up just chewing on the end of my nipple. I have tried pumping first to make the nipple bigger but still no joy. Am I using it wrong? They are still coming out flat anyway so hasn't changed the latch!

I had this with DD. I was all swollen and she had a tiny mouth and couldn't latch properly, she'd try, then her tongue would just push me out when she tried to position it. I tried nipple shields too, but the lactation consultant said that would make everything bigger again and wasn't recommended for her. Basically she told me to pump and then try DD again when she was older and bigger.

The shield btw from what i understand should be fitted to your nipple and the nipple should be almost on the end of it, I had a gap between nipple and shield (even trying larger size) and she would just be chewing on the end and not getting much at all.

We ended up expressing for 6weeks, then switched to formulâ. I could only get 5 feeds out over 24hrs pumping every 3 hrs and as DH works abroad I couldn't keep that up with him gone

Same story (except for the mastitis, and we had the tongue tie cut on day 3). Painful boobs for over 2 months. She didn't really gain enough weight until off the formula top-ups (on these from 10 days - 10 weeks old due to slow regain of birth weight). At that point she started putting on good amounts weekly and I could finally also stop using the Lansinoh / paracetamol / gel dressings. The main thing that helped me in the early days was Fenugreek for supply - it made things easier for her after a slow start due to the tongue tie. I just never got very much expressing, and for some reason never tried shields as I was told it was more a supply issue (supply now is fine, at 7 months and going strong). Good luck, keep trying and sometimes time and baby getting stronger / bigger will improve matters greatly.

Are you still with LC or infant feeding team?

My DD lost 3% by day 5 but then continued to lose weight until day 15 when I was put on feeding plan.

My nipples were also very sore and can recommend cabbage leaves from the fridge and lanisoh. They do start to toughen up though you'll be glad to hear.

My DD had her tongue tie cut about 4 weeks ago now. Not seen a huge improvement so have given myself until end of sept in the hope her mouth gets bigger and she gets stronger.

I really would recommend you see LC regularly, I don't know if I'm lucky where I am but we have infant feeding team and thrice weekly clinics in and around oxford that I attend.

A good latch IS possible but you both need to persevere and find the position that works for you both.

My nipple still comes out lipstick shaped and blanched sometimes...the best position to elongate was lying down.

I had the exact same issue - small mouthed baby with a tongue tie (snipped on day 10) but to be honest it didn't make a difference.i used medela nipple shields until 16 weeks when I managed to wean ds off and are still feeding at nearly 16 months .
The pain was like nothing I have ever experienced.take care of yourself - I used to cry when I heard my baby cry for a feed. I hope you've got people around to look after you.
I tried every cream, breastfeeding groups to check latch etc, and the only thing that made it bearable were the shields.they are incredible.i was worried about supply but experienced no issues. Good luck

When you are feeding, you shouldn't feel it on your nipple at all. It should be so far in his mouth that he cannot be chewing on it. The issue is that hes developed a very awkward latch as that was he only way that worked for him when he had his tongue tie.
Experiment with using your fingers to squeeze as much of the area around the nipple together, then putting that in his mouth, as much as possible. If he slips down so he is just on the nipple take him off and try again. Its difficult but can take lots of gos. Don't just let him chew on the nipple, thats no good for him or you.
Both of mine had tongue ties, I know how hard this is. It is possible to bring them back to expressly breastfeeding but is very difficult and involves feeding almost constantly. If you find you just can't do it and it is too hard, don't be hard on yourself, it is just the bad circumstances, it is not your fault.

Have you tried medela shields? They come in different sizes, I used the small ones as DD would just choke on larger ones!!

Also - Google/youtube the flipple technique for getting a deeper latch. That's how I managed to get DD to latch properly after 3 months of shields (also due to a small mouth and poor gape!!)

Cranial osteopath worked for my DC, although the one that had snipped tongue tie never quite fed without it hurting a little bit. She just wouldn't open her mouth quite wide enough and because a produced plenty of milk easily she never had to learn to IYSWIM

I had to get small medela nipple shields.

Nipple shields come in different sizes - you've probably got a medium one; I needed a small, and that made a significant difference for us.

Your story sounds very similar to mine; we ended up combination feeding, with me expressing. Between months 2 and 4, I could just about produce enough for DD. At 4 months she refused to feed off me at all (I suspect a bottle is less effort); I managed to pump until 10 months, but my supply steadily fell.