9 day old still will NOT latch... how to get back on the boob?

[Buglife]

My 9 day old baby fed well for the first 4 days but on day 5 was sleepy and jaundiced and fed very badly (pulling off, halfhearted sucking, getting tired and sleeping a lot) and by the time the Midwife did or check that afternoon was onbviously dehydrated. We have been supplementing using pumped milk and some formula, however now it’s not so much supplementing as he is very reluctant to feed from the breast at all now. As it’s been so hot and he’s so small and was jaundiced I was reluctant to push it too much in case of dehydration/weight loss (I try at the beginning of every feed but he quickly gets frustrated and wound up so I’ve been giving the bottle fairly quickly) but now he’s 9 days old and I think looks visibly chunkier (weigh in tomorrow) I’m scared he’ll never take the boob. For example I’m in bed skin to skin with him now and he’s refused to latch on one breast, cries a bit when I try too much, latched onto one breast and have about a minute of on and off sucking and then licked it a bit before closing his eyes and going back to sleep. This is pretty much all feeds. I don’t know what to do about building it up and also he often will just sit with the nipple in his mouth and not latch. I had a visit from BF support advisor and she said positioning and latch were all fine (he actually fed a bit still then so she saw it) and that when he was bigger and stronger he should get a full feed out... but now I’m not sure. She did not recommend stopping too ups as obviously he’s very little and it’s so hot etc he does need frequent feeds. But then it’s so hard to find the time window to really attempt to get him feeding from the breast.

Has anyone tried using a supplemental feeding system? There is a Medela one which has thin tubes to tape to the breast which delivers supplement milk next to the nipple. Only issue that seems like a huge faff and I have another child to look after as well so I can’t just sit all day trying to feed DS2...

I don’t know how hard I should make him work for it really, I know why he’s not feeding from the breast (it’s too hard and he’s forgetting how to latch) but I can’t just force him to do it (so frustrating to sit with a nipple in his face/mouth that he just sees as an annoyance before he gets properly fed). I have very large breasts and initially my nipple was massive in his mouth but using Rugby ball hold we were getting over that issue.

Any advice would be much appreciated. (I really can’t just bf

Posted too soon! I really can’t just say that’s it on BF now because he’d not get anything like enough milk.

Somebody who knows better than me will be along I'm sure, but I wonder whether nipple shields might help as they're more like a bottle teat? Not sure if that'll just create more latching issues long term though.

While the term nipple confusion gets bandied around a lot - the bigger challenge imo is this - a baby developing a preference for the bottle.
There’s a possibility he’s learned that feeding from a bottle is easier/less effort and is therefore choosing that over the breast. Nipple shields may help (although they tend to make it harder for the baby to get milk so may be counter productive)

Posted too soon. Try some bottles that are more like a breast (munchkin latch is good) and make sure you’re feeding responsively fromthe bottle so he’s doing the work rather than it dripping down his throat.
Have you tried expressing some milk onto your nipple before starting feeds (and/or hand expressing to let down so the milk is flowing when he latches). Also maybe breast compressions while he feeds

My dd1 was v reluctant to latch. Exclusively expressing is an option. I did it for a year. Have a look at kellymom.com

Yes, he much prefers feeding from the bottle, I just didn’t think he’d switch so quickly and stop latching all together. That’s why I was interested in the supplemental feeding system, but realistically, with a lively 3 year old in tow how am I going to be able to pump milk then tape tubes to my boobs every two hours... I just want to be able to sit and get him to have at least a good amount of feeding from the breast even if he still has a couple of bottles a day. It seems to be all or nothing.

We have the Mam bottles as I’d read they were good for babies who didn’t take a bottle. even though I have the opposite issue it seems. I have been expressing off and had expressing some milk into boob/into his mouth but he just licks it off the nipple. I have been hand pumping a bit before a feed which gets my nipple into a handy shape for his mouth and gets the milk flowing but while that worked for him a couple of days ago it doesn’t now. I have been trying to take the bottle out of his mouth after a few sucks to pace him a bit.

It may be worth asking to ve referred to the infant feeding coordinators at your hospital or through the health visiting service. In my trust if baby is under 28 days old the feeding coordinators at the hospital will see you and baby, and they have their own dedicated Clinics. Other places to get support are the national breastfeeding helpline and the la leche league. Face to face support from an ibclc lactation consultany would be ideal too, but that depends.on availability and your budget ( i saw one which cost £30 for initial 2 hour consultantation but think in other areas they can be £££). The infant feeding coordinators/lactation consultant will be able to fully assess baby and help.devise a feeding plan to wean from bottle to fully breast. I have known women use a Sns but you could also cup feed top ups, feeding cups are cheaper than sns. Also look up paced bottle feeding in the meantime so that baby is having to work for the milk just like in breastfeeding

Sorry for the typos!

Thank you. I have the number for breast feeding support as she came out on Thursday. Tomorrow I have my One to One Midwife coming and the Health Visitor on Wednesday and there’s a La Leche League meeting 5 mins away on Friday so I can speak to loads of people next week! I will try topping up from a cup. It’s just so hard with DS1 around and DS2 gets upset quite quickly and the heat makes him want to feed so often.

My first baby was like this from the start - never sucked for any good period of time. Had large weight loss on day 3 so readmitted. Supplemented with formula and like you always first offered both breasts at every feed.

Turned out she had a tongue tie; was better once it was snipped. My milk supply never really came in tho so we mix fed for almost six months then moved fully to formula. I considered the supplemental feeding system too but even with only one child at the time, decided it was too much faff. The only way to sterilise the capillary tubes at the time (may have changed) was to boil them for ten mins in a pan. I just didn't have the energy.

Looking back I completely exhausted myself with trying to bf - pumping every 2h, rounds and rounds of sterilising and hours sitting trying to get her to latch, seeing lots of hcp's. My second dc is due any day and I've told myself that I'm going to try my best to bf for a couple of weeks and if it doesn't work, give myself some grace and move to formula. The colostrum is the most important stuff and to me with hindsight, a balanced family life is more important than exclusive bf. This is a personal decision though.

If I were you I'd try to get your ds assessed for tongue tie by a specialist midwife ASAP, and then just keep trying to offer the breast. If it doesn't work out though it will still all be ok. Formula is fine too. Hope it all goes really well for you.

DS1 has sleepy issues as well so
It was very hard to feed him, but had quite a dramatic weight loss so we ended up doing the same with him on day 5. DS2 hadn’t lost much weight though so initially he must have been feeding fine. I thought this time just feeding feeding feeding all the time and offering the breast as much as I could would mean that didn’t happen, I never considered that he would not feed enough if offered it. Especially as he was latched fine. I am certainly not having a third child so I’m just starting to get a bit upset and shellshocked that at day 9 breastfeeding might be over without me ever really having a chance to do it. I did get him to latch on both boobs earlier and he sucked for a few minutes. And when he pulled off and whinged I gave him a few sucks of expressed milk and then took it off him and offered boob again. So it kept him trying. He did cry a lot though and still ended up drinking 60mls of expressed, but he was latching and sucking at least.

He has been checked for tongue tie btw and doesn’t seem to have it.

DS refuses to latch initially. We used Medela contact shields and eventually he decided these were too much effort and switched back to the breast

Vanessa feltz had a breast feeding expert on her show a couple of weeks ago. I think it may have been Clare Byam cook (google search rather than memory) Her views were that breast is sometimes too big for the mouth and needs to be squeezed into a smaller shape. Hope you succeed

I have Medela shields, he didn’t like it (and I couldn’t seem to keep them on as he thrashed and unlatched constantly) but I may give them another shot!

rose69 I definitely think my nipples are big for his mouth. Even when erect I was kind of having to stuff them in and constantly shaping them. He seems a bit better now but takes a few goes to get them in his mouth even before he then has to think about latching. That’s on top of having H cup boobs 3 times the size of his head. I’m sure he would be fine a bit older but I need to keep him latching and feeding and keep milk coming until then!

Watching with interest as I am in exactly the same situation. DS2 born on 28th June, prem and couldn’t latch (small mouth, my big nips!) and then needing to go onto a feeding programme so we just had to stop trying and bottle feed with expressed and formula. Ds2 definitely finds the bottle an easy win.
Currently expressing four times a day but can’t imagine fitting it in when DH goes back to work and I have DS1 and DS2 solo.

Sorry no advice, but solidarity!

DS was 28th June and two weeks early. He has fed for about 5 mins from each breast at his last two feeds which is an improvement. Lots of messing about and not much sucking but I’m sure he was getting milk out. Still not enough to tempt him it seems!

All I’ve been told is that as he gets bigger / stronger he will get better at it. But the bottles are so much easier for them.

When are you offering the breast? First? Are you expressing a bit to get things started for him?

Can I just say I was in this exact position 2 weeks ago. Early sleepy baby, would only bottle feed expressed milk as she was too tired to attempt to latch. As she got bigger she then would not latch, just waiting for the bottle. I had to top her up with a bottle of expressed milk after every feed anyway on paediatricians plan so she was just waiting for it.
It’s taken 2 weeks but gradually she’s just learned how to do it and we have no more bottles. We did use nipple shields for a few days. I also wear the awful nipple shells all day as they make my nipples a bit more manageable for her little mouth.
You may find that slowly and surely it just happens. I didn’t ever think it would for us.
Good luck.

Thank you Spoonspanner X

That is good to hear. A discouraging night/day where he really won’t latch and cries a lot when I try. My midwife told me yesterday as he’s now put on weight and is fine I should just stop bottles and “make him try harder” which has made me feel a bit crap as if it were that easy I’d be doing it.

Another screaming and crying at the boob session with no latching, my milk dribbling all over his face and then he’s fallen asleep. How am I supposed to make him do this?!

Spoonspanner how old is your DD? When did she start feeding from the breast again? I know he’s only 11 days old but he seems so set in his ways...