Will I ever be able to breastfeed?

[Imicola]

My girl is 3 weeks old. She was 2 and a half weeks early, and just under 6 pounds when she was born. She was not able to latch due to a combination of my inverted nipples and her small mouth /weak suck. I expressed within a few hours of her birth, and was encouraged to keep expressing 8 times a day.
I've never been able to produce enough milk for her (just under 50% of what she takes at the moment-about 300ml a day) so use a combination of formula and expressed breastmilk, and I have struggled to manage expressing 8 times a day... Was probably doing 7 for the first couple of weeks, but an now managing 8, but it gets me down as it takes so much time, takes me away from my baby and also hampers outings. We've been trying to get her to latch with no success. She can latch and suck on a nipple shield, but she is not sucking effectively and so is getting no milk through. An Nct counselor and an independent lactation consultant both thought she had a mild tongue tie which would make latching more difficult, but 2 midwives and the health visitor disagree. I should hopefully be getting an appointment at the breastfeeding clinic this week.

Just wondering if anyone had been in a similar situation? Any advice? And at what point should I call it a day on trying to initiate breastfeeding? I have lots of questions really... Can I still improve my milk supply while expressing only? What happens if I reduce to 5 or 6 pumps a day? At what age does it become impossible for a baby to go from a bottle to the breast? And do babies really just suddenly grow enough that they can latch effectively?
My mum had similar issues which she felt tipped her over into severe postnatal depression, so I an very aware that I need to look after my own mental health.
Thanks in advance for any advice!

If tongue tie is suspected, have you seen a Tongue Tie Practioner?.

I’m sorry, but I don’t feel able to answer all of your questions. Are you getting any RL support? Is there a LLL group near to you?

I've not been in your situation but I'll try and answer best I can.

Call it a day when you want to. You sound like you want to breastfeed, so I'd say keep trying. But if it ever gets too much, that's when you stop, and don't doubt that decision. If you have a good dp make sure he knows the signs for pnd as it can difficult to spot in yourself.

You can improve your supply only expressing, but only really if the expressing is efficient. Are you getting progressively more as time goes on? How long does each session take?

If your trying to increase your supply reducing the number of pumps isn't ideal. But if you can get the same amount of milk from fewer sessions you should be fine.

There's no age limit to starting breastfeeding. But I would think it would become harder as they get older and more mobile. If you've got a baby that likes cuddles the window is probably bigger that if you have one that's easily distracted. So basically it depends on the baby - as above stop trying if you think you're last wanting to try anymore.

Some babies latch better when they've grown a bit, others dont, no-one can tell whether yours will. (Mine did)

Based on the opinions you've been given I'd be inclined to think she has Tounge tie, so try and get that followed up.

I'm your position i would be focussing more on trying to get her to latch than the pumping. Have you tried getting the milk flowing by pumping and then putting her on so she makes the milk association? (Sorry if that's really obvious)

My partner is giving plenty of support, although he is now back at work, and my mum is also staying a couple of nights a week to help out, and they are both on the lookout for signs of depression. Think I'm doing OK at the moment but in week 1 and 2 I was finding it much harder to cope and almost gave up then.

We'll be heading to the breastfeeding clinic next week, so hoping if there is a TT that they will be able to recognise it. But if not, I may try an independent practitioner. I've also had help from Nct and an independent consultant.

Each session I am pumping for 15 to 20 min, and my output seems to have improved slightly over the last couple of days after stagnating somewhat... Seems my right breast needs more suction than the left to really get going!

And I think she isn't too easily distracted. She definitely enjoys a cuddle, so I'll just keep persevering for now, at least until after the Bf clinic visit. Let down while she tries to attach is not an issue, I usually leak all over her, and drawing the nipple out using the pump before trying to attach her doesn't seem to have made any difference. The main difficulty is fitting everything into a day, and not having enough hands to manage baby, leaky boobs, Nipple shield plus bottle for when she gets frustrated! Need to be an octopus I think!

Thanks for your replies, and it is good to know that waiting for her to grow might help the latching.

Update on this-the breastfeeding clinic agreed there was a mild posterior TT, but not enough to hamper feeding. Main problem is small mouth along with inverted, but large {when they do evert) nipples. She said as baby is still interested and trying hard to latch, I should persevere, and as she grows we may have more success. I think she is the only person who has given any indication of when to give up (when baby loses interest in trying to latch) which is really helpful.

Interested to hear from others who have had latch problems at what age baby successfuly latched?

If you’re having these problems and there’s tt, I really would look at getting it divided. My DSs tt wasn’t picked up until much later and we had massive problems with colic like symptoms, sleep, Weaning and speech.

I had almost exactly the same situation as you. My son is now 21 so I can't remember all the details but he couldn't latch and had a poor suck. I also didn't seem to be able to produce a lot of milk (which I now understand may have been because I was anaemic). Spent weeks and weeks solely trying to breastfeed and expressing and topping up with formula. It was soul destroying and completely stopped me bonding with him. But with all the breast is best mantra and pregnancy hormones I genuinely felt like I was poisoning my baby by giving him formula, if was awful. He also cried constantly when not feeding.

From memory his latch improved after 3/4 weeks but he then seemed to want to breastfeed continually which I think was partly because I wasn't producing enough still. We eventually ended up in the children's hospital as he started to lose weight where they monitored us for a few days/nights, I carried on continually breastfeeding and topping him up and they offered very little else by way of advice.

I have HVs, the hospital, various breastfeeding counsellors involved. If one person involved in our care would have said maybe you want to think about stopping as this is affecting your baby's health, your mental health and your bond I think I would have but I got stuck in some weird breast feeding tunnel and couldn't see the wood for the trees.

At about three months I think it was I eventually said "no more" and decided to just offer him the breast but if he wouldn't latch, or was coming on and off and not really sucking I stopped straight away and gave s bottle.

It was such a relief. I finally started to bond with my son. And was no longer spending my entire life breastfeeding or trying to express tiny amounts of milk. He stopped crying constantly, he slept better, he gained weight.

If the same thing happened again (Too old now though!) I would try again but I would definitely stop much earlier.

If you feel done, just stop. And don't beat yourself up about it. You have given it a good go and done your best.

I'll admit that this is way outside my experiance, but I'll give my opinion and you're free to disregard it.

Previously breastfeeding problems were almost exclusively blamed on small mouths and wrong nipple shapes. In the same way that now problems are mostly blamed on supply. And the internet seems to always warn of toungetie. I don't doubt that all of these are very real problems, but I do think that they are overdiagnosed. If you agree with the professional advice you're given then it then that's fine. But if you have any doubts then push further if you have the will to do it. Pushing to see an expert isn't going to cause any harm - and you know your baby best.

In case it's not clear, I'm suggesting pushing for the tt referal. It may or may not be causing problems, so why not get an expert to check. It might not be enough to hamper normal feeding, but might be exacerbating the small mouth and large nipple problem combination.

My son was born at 35 weeks and had trouble latching so we used nipple shields. He managed to latch directly onto the breast just after his due date. I just kept on putting him to the breast and once he was strong enough he jlgot it and we're still feeding now at nearly two.

The Facebook group UK Breastfeeding Support is amazing if you need any advice.

Hi Imicola, I could have written this exact post a month ago, although I have no supply issues. I kept being told my daughter's mouth was too small/my nipples were too big/she'd manage when she'd grown. Her problem was an extremely shallow latch. She was checked for tongue tie but was told there was none. I was expressing 6 times a day and trying her at the breast at every feed - it's exhausting and so time consuming. I had some success with shields - took a few brands to find ones that suited, MAM was best for us. But she never seemed satisfied and her latch remained poor. I made it to 7 weeks and then decided to stop. It was taking up all my time and I felt I wasn't actually bonding with my baby. I also have a toddler whose behaviour nosedived as I wasn't able to give her enough attention. I'm still expressing now but am winding it down and my daughter is mostly formula fed now at 10 weeks.

Do you have any breastfeeding support groups near you? I found them so helpful and the volunteers extremely knowledgeable. Dr Jack Newman and also the Milk Meg have really good Facebook pages. And it's great you have good support at home.

Your baby has had the best start so just remember that. I think all babies will be able to latch at some point but I just couldn't dedicate any more time to trying. It took me a long time to decide to stop but when I did I knew it was the right decision and I don't regret it.

As a PP said it does feel like your life is all about breastfeeding but it does get easier. My friend went through the same thing for 6 weeks and then baby managed to latch and they haven't looked back.

For supply I found expressing for at least 20 mins each side was best. Do you have a double pump and pumping bra? They made it much easier for me as I was hands free. Also make sure you always express at least once a night when the milk producing hormones are highest.

Thanks everyone for the replies, and it is good to hear from people with similar experiences. Still going for the moment... Like the feeding specialist suggested, I will keep going unless she seems to lose all interest in the breast. Last night it seemed she sucked a little more before giving up, so perhaps there is still hope!

I have a double electric pump, and some pumping bras. Now also have batteries so I can go mobile... Need to work up to pumping somewhere that is not at home! Eating lots of porridge and also taking fenugreek. Had my iron levels checked, and all OK on that front. I think another issue for my pumping is that my nipples are really elastic, so no matter what flange size I use, they rub along the sides and its a bit painful, but hopefully they will toughen up over time. I've never known so much about breasts in my whole life!

OP if you find breast pumps painful, you might be more comfortable with expressing by hand. Babies themselves don’t make their main effort by suction, they rhythmically clamp and release on the base of the nipple where it joins onto the breast. If you make a mouth shape with your thumb and index finger, then use that to do the same squeeze and release motion, you can express milk quite effectively. Just aim carefully into the bottle to avoid mess!
I found breast pumps horribly uncomfortable when DD2 was in SCBU for a week, but manual expression was much better.