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Infant feeding

Get advice and support with infant feeding from other users here.

At my wits end

19 replies

Slowfeedingbaby · 10/07/2024 11:48

Strap yourselves in everyone, this is a long one 😔

I am at my wits end with DD2's feeding pattern. She is 13 weeks old and around 2nd centile. We have been combi feeding since birth - mostly because initially her blood sugars were affected by the labetalol i took for preeclampsia and then very slow weight gain / drop every time we stopped formula top ups. She took 3 weeks to regain birth weight. I combi fed my eldest due to a NICU stay and so im happy with combi feeding. Our pattern is 10mins on each breast and then formula top up.

However the issue is it is taking her over an hour to drink around 100ml formula (barely enough to maintain her centile line). She often falls asleep half way through a bottle and needs around 10mins-15mins sleep in the middle of a feed. She will take 30-60ml ok but then needs winding or a break every 5-10ml for the rest of a feed. I'm constantly having to stimulate her to keep her awake.

No reflux that we know of, poos are a little mucusy and a little bit of back arching but no other signs of CMPA - no rash, sleeps really well, doesnt really cry during feeds, alert and content inbetween feeds. She recently had a tummy bug but the issues predated this.

We saw a number of specialist breastfeeding support in our area, midwives and specialist HVs. All have checked her latch and positioning on the breast and have said it is fine but the suction is very poor. I suspect the milk she is getting is whatever is effectively expressed by milk as a result of the compressions i do. We then saw a IBCLC and tongue tie specialist at 7 weeks who identified a 90% tongue tie. This was cut at 8 weeks. It has healed in a cruciform rather than a diamond, but her movement is hugely improved. However the bottle feeding doesn't seem to have improved. HV observed a terrible feed and referred us to SALT for a feeding assessment. They have identifed a high palate, weak suction, and dropping her chin whilst feeding so she's working extra hard and getting really tired. They have asked our GP to refer her to Paeds but I've no idea how long that is going to take. In the meantime, its incredibly stressful to get anything more than 60ml into her.

Other things we've tried are different bottle types (nuk, dr brown, mam), different teat sizes, lots of skin to skin, stripping off during feeds, tickling feet during feeds.

Feeds in total are taking up to 90mins. I have a 3yr old toddler who is difficult to manage whilst all this feeding is going on. I cant drop the bottles as the breastfeeding wont maintain her weight but if i drop the breast, it still doesnt fix the bottle issue. In any case, on the occasional time that i havent breastfed and she's just had a bottle from either me or DH, then it hasnt sped up the time it takes for her to take the feed.

We are obviously being supported by professionals but whilst waiting for the services has anyone else been through this? Any ideas on tips or causes or other services i could try and access would be amazing. She is my last baby (Im pretty sure!) and i was really hoping to enjoy this mat leave after suffering from PND during my first mat leave, but this is just trapping us from doing anything because every feed is just such a palaver.

OP posts:
Mumoftwo1316 · 10/07/2024 18:06

The first thing I'd try is switching sides far more often than 10mins. You also imply you only do each side once.

I'd go for 4-5mins on each side and do at least four-six sides LRLR-F or LRLR-F-LR (ie back to the breast after formula). This will increase your supply and help keep the baby awake.

Slowfeedingbaby · 10/07/2024 18:29

Mumoftwo1316 · 10/07/2024 18:06

The first thing I'd try is switching sides far more often than 10mins. You also imply you only do each side once.

I'd go for 4-5mins on each side and do at least four-six sides LRLR-F or LRLR-F-LR (ie back to the breast after formula). This will increase your supply and help keep the baby awake.

Thank you! We tried switch nursing early on and DD was really fussy and wouldnt latch on the second time round but i think you are right that its worth trying again, especially now she is bigger and betterat latching. I could do 5 - 5 - 5 - 5, which would still keep the feeds from getting too long. I guess i always worry that if i unlatch her in the middle of a feed to switch over, when i go back, we might have lost momentum but thats probably an irrational fear!

OP posts:
Mumoftwo1316 · 10/07/2024 18:58

Slowfeedingbaby · 10/07/2024 18:29

Thank you! We tried switch nursing early on and DD was really fussy and wouldnt latch on the second time round but i think you are right that its worth trying again, especially now she is bigger and betterat latching. I could do 5 - 5 - 5 - 5, which would still keep the feeds from getting too long. I guess i always worry that if i unlatch her in the middle of a feed to switch over, when i go back, we might have lost momentum but thats probably an irrational fear!

I think perhaps it might be the opposite amd you'd keep the momentum easier this way... I find that the baby only gets sleepy if/when the flow slows down. If you keep switching then you give the breast a moment to refill. And doing breast-formula-breast also gives it a chance to refill so hopefully it'll help.

Let us know how you get on xx

RappersNeedChapstick · 14/07/2024 08:20

Sounds like you're really struggling and I haven't got any answers unfortunately.

I would try and chase up the appointment though and speak to your HV about how you're feeling and how you're worried about developing PND again Flowers

Eccentricthesnowman · 14/07/2024 12:12

I could be completely wrong but when I was struggling to get my baby to drink more the lactation consultant suggested reducing top ups to 60ml- interestingly the amount you said she will take for you. It made things so much less stressful for both of us. It meant we were feeding every hour and a half/ 2 hours but there was a tiny recovery break in the middle for us both!

RappersNeedChapstick · 14/07/2024 12:40

Eccentricthesnowman · 14/07/2024 12:12

I could be completely wrong but when I was struggling to get my baby to drink more the lactation consultant suggested reducing top ups to 60ml- interestingly the amount you said she will take for you. It made things so much less stressful for both of us. It meant we were feeding every hour and a half/ 2 hours but there was a tiny recovery break in the middle for us both!

I agree that 100 ml sounds like a lot. It might be worth talking it through with a Lactation Consultant?

Have you read [[https://kellymom.com/health/growth/weight-gain_increase/ this article from Kellymom too OP?

RappersNeedChapstick · 14/07/2024 12:40

Sorry, it's here Blush

RappersNeedChapstick · 16/07/2024 21:42

How are you all doing now @Slowfeedingbaby? Flowers

Slowfeedingbaby · 17/07/2024 09:37

Hi @RappersNeedChapstick , thanks for following up and for your kind words. Ive read all the messages and have tried some of them out. The first lactation consultant that i went to see a couple of times, i havent really warmed to. I'm going to see if i can find another local one. I used kellymom loads with my first baby but i havent read that particular page so thanks for sharing.

My HV is amazing - she is the same HV as for my eldest DD, and due to how poorly she was, she did weekly visits until DD1 was 12 weeks and then monthly visits until 1yr, so she knows us as a family. She raised PND during her last visit and asked if i needed any help. At the minute, i feel like how i am feeling is directly connected to the feeding issues. I just really want the paeds referral to come through so that we can keep things moving and try to get some more answers.

@Eccentricthesnowman thats interesting on the volumes. The LC suggested increasing the top up to 100ml as when she was weighed having 60ml top ups, she started to drift below her centile. However, that was at 2weeks post tongue tie division and we are now 7weeks post division, so i wonder if she's getting more breast milk now? She was weighed last week and increased from 2nd to 4th centile so maybe there is some scope to drop down slightly and see what impact that has.

@Mumoftwo1316 we've been giving switch nursing a try and DD2 seems to be taking to it a better now than when we tried it before. So we are going to keep persevering with it! Shes still ridiculously fussy at latching on the left side but i took her to an osteopath a few times when she was a newborn, so i might go back and see if they can identify an issue there.

OP posts:
RappersNeedChapstick · 17/07/2024 20:46

Seeking out a different, local LC or BFC does sound like a good idea. It must be hard to work with someone if you're not gelling, especially at a time when you're possibly vulnerable.

Have you had a look to see if there are BFing Support Groups near to you?

I'd also have a read of this article on weaning from, or reducing supplements? Flowers

Aliceismyfavourite · 27/07/2024 20:38

Hi I’ve just read your thread (you’ve commented on mine as well!) she’s been told she has a high palette too. I wonder if it would be worthwhile to see SALT as well.. 😕

Slowfeedingbaby · 27/07/2024 20:48

Aliceismyfavourite · 27/07/2024 20:38

Hi I’ve just read your thread (you’ve commented on mine as well!) she’s been told she has a high palette too. I wonder if it would be worthwhile to see SALT as well.. 😕

I've just read your update! Interesting the comments on silent reflux because ive been wondering about this over the last few weeks. Maybe worth a bit of a parallel investigation alongside the SALT findings?

OP posts:
Aliceismyfavourite · 27/07/2024 20:51

Slowfeedingbaby · 27/07/2024 20:48

I've just read your update! Interesting the comments on silent reflux because ive been wondering about this over the last few weeks. Maybe worth a bit of a parallel investigation alongside the SALT findings?

Absolutely! Honestly, there’s nothing I won’t do for this baby. I just want to get this sorted. Their nutrition is such a big part of them. Believe me, I can love and keep her warm and happy all day long, but if she’s not getting what she needs I’m failing then really aren’t I?

Aliceismyfavourite · 11/08/2024 11:48

@Slowfeedingbaby just wondering how you were getting on? Have you made any progress?

we seemed to be making headway but it’s gone back to how it was again 😕

Slowfeedingbaby · 11/08/2024 22:48

Aliceismyfavourite · 11/08/2024 11:48

@Slowfeedingbaby just wondering how you were getting on? Have you made any progress?

we seemed to be making headway but it’s gone back to how it was again 😕

Oh no, how frustrating! Do you think there was anything you did differently when things got better?

We've had a bit of a mixed few weeks as well. We had our Paeds review and they ruled out lots of very serious reasons, which is good! But also means we are basically left with the option that maybe she is just really slow? They've asked SALT to keep monitoring us, so we are seeing them on Tues.

I spoke to the GP about reflux and we've started on infant gaviscon which does seem to at least make everything calmer. We are just doing a half dose to avoid constipation issues. So thank you for that suggestion.

I think the hot weather is helping a bit as well as she wants to drink more? So more opportunities to get milk of any form in!

OP posts:
Slowfeedingbaby · 11/08/2024 23:01

I should that our initial SALT review identifed some issues with her suction (as I suspected). But in the 4 weeks since I first posted, she has started poking her tongue out more and it has stopped drifting off to the right in her mouth. I'm interested to see what SALT think on Tues, but I'm now wondering if it was all related to the tongue tie she had? Maybe she just took much longer to recover full movement and strength.

OP posts:
Aliceismyfavourite · 12/08/2024 21:23

Slowfeedingbaby · 11/08/2024 23:01

I should that our initial SALT review identifed some issues with her suction (as I suspected). But in the 4 weeks since I first posted, she has started poking her tongue out more and it has stopped drifting off to the right in her mouth. I'm interested to see what SALT think on Tues, but I'm now wondering if it was all related to the tongue tie she had? Maybe she just took much longer to recover full movement and strength.

Oh wow; this all sounds quite positive! Happy for you.

I went to see the tongue tie people today for a wound check and they said it looked ok (it’s 2-3 weeks since it’s been cut) so it’s just scar tissue at the minute but to continue the stretches and it should loosen up? Same, she’s drank a smidge more today because of the weather so I’m hoping she’ll get a taste for it and we can keep the momentum up.
we’ve also been advised to go back down a teat size, I was a little sceptical but she seems to be doing ok on it so I’m hoping this will help. Still drinks better when she’s asleep than awake. The osteopath doesn’t seemed to have helped which is disappointing. Currently in the midst of the 4 month sleep regression (I’m hoping, because if this isn’t it I’ll be seriously questioning my life) so that’s been fun seeing every hour of the night 🙃

ineedtogwtoutbeforeitatoohot · 12/08/2024 21:38

Have you tried using a syringe? Babies can also drink from a tiny cup

CountingMeIn · 12/08/2024 21:49

Hi OP,

You are doing such an amazing job there. I hope you are okay yourself with all this incredibly demanding work.

No advice, but just wanted to say that I hear you on how much your care about your baby, and I think you are doing a brilliant job.

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