Bottle feeding difficulties

[Bananapancakes6]

My baby is 4 weeks old, he has always been bottle fed however he seems to have some difficulties with it. I use mam bottles and I started him on a size 1 teat (as I did with my other son from newborn) and he would splutter and choke a lot, so we switched to size 0 teats. He still splutters and chokes randomly and gulps the milk, or will spit out a bunch while feeding. He makes wheezy sounds a lot and will "gasp" while feeding too which makes a high pitched sound. He also takes a really long time to feed - up to an hour for 4oz.

He also seems to not realise the bottle / dummy is in his mouth sometimes and will accidentally push it out with his tongue - or cry because he wants food but doesn't realise its there for him!

I'm wondering if anyone has experienced similar? I've tried to look at his tongue in case it was tongue tie but I don't really know. Nothing was mentioned in hospital.

Sounds like tongue tie to me. Midwives and hospital were zero help, had to go private for consultation.

@MondayYogurt Do you mean they didn't pick up on it, or they weren't helpful in getting it sorted? How was your LO once it was snipped (if it was?)

Both. They seemed to want me to persist (combi feeding) and didn't want to examine further. I asked for a referral but was told two midwives had to do it. HV gave one referral, then I had to catch a bus to a drop in centre and wait over 4 hours to get another - which resulted in being told I would get a call with a booking, and I never got the call.
So I googled and went private. Money well spent.

Could try videoing baby feeding and send to a TT specialist first?

Thanks for your help @MondayYogurt I am going to take a video when I feed him tomorrow. I am taking him to be weighed in Wednesday so will ask about it then too.

Do you only half fill the teat by keeping it at a 90 degree angle? And I remember feeding ours sitting up holding their chin when they were very little to slow the flow right down. Sorry but can't remember when we started being able to lay them back more into a relaxed angle.

Good point @Franca123

There are lots of videos but this popped up first.

Thanks both of you. The video is particularly helpful, we do do all of those things except we don't hold the bottle horizontally, I always hold it so that the teat is full, I thought that was the way to avoid air getting in, whoops! Will try holding horizontal from now on.

Yes, that's what I thought. But our first was in NICU and this is how the nurses taught us. Very unnatural angle! My partner found it much easier as his hands were so big.

My first baby was like this. Milk would spill out the corners of his mouth and everything and took so long to feed. He had a really tight tongue tie so I would imagine that was the issue (wasn’t cut until 3 months old). Definitely get the tongue checked and horizontal feeding is good advice too.

The video doesn't show what I meant about the baby sitting upright on your thigh. The baby sits upright on your thigh and you use one hand to support by holding his head and the other hand to hold the bottle perpendicular to the baby. Slows the flow right down. We also used small bottles with only 4oz in which I imagine also shows it down. We had no trouble by doing it this way. Although feeding does take bloody ages at the start.

Thank you @Franca123 you've been very helpful. I try to hold him fairly upright anyway but iswym. The more I've googled tongue tie the more convinced I am that I have it myself! I had lip tie too but that was fixed when I was a teenager. Very interesting.