6 month old STILL struggles to breastfeed.

[JustMePlus3]

I emphasise the still because this has been a consistent problem since birth, nothing new. Every feed while she’s awake is a battle, she latches on and off, cries, arches her back, rolls on and off the boob, she will only feed in side laying position while doing all the above things, any other position and she will scream and refuse completely,

we’ve done elimination diets, no caffeine, no soy, no milk, no wheat, no gassy foods, the job lot and it made no difference.
shes on liquid omeprazole for reflux, hasn’t made a difference.
all the burping and gas elimating things we can think off, no success.

im just at a total loss on what to do now, im not even looking for advice at this point because everything people have suggested we’ve tried and nothing helps, im just wondering if anyone else has been through the same, and if so did it get better or am i wasting my sanity on this? I wanted to nurse her into toddlerhood but i dont think she’s going to want to 💔 it just seems to cause her so much discomfort.

im ordering a electric pump next week and going to try introducing some bottles to try save my sanity but even that breaks my heart to do, i just want to nurse my baby without her getting upset I don’t understand why something so natural just isn’t working even after all this time 😢

we’ve been to see a paediatrician the only response you get is ‘colic’ but at 6 months I’d of expected to see at least some improvement and just nothing, absolutely nothing, we’re in the same position we was months ago I just don’t know what’s going on 😣

@ChateauMargauxthank you 🙌

I also think it sounds like TT. We didn’t get my first ds one snipped and honestly it was our biggest mistake, I dreaded every single feed as it was painful and such a struggle and also had mastitis several times. She also had delayed speech and struggled with certain pronunciations of words. We switched to bottled around 6 months and realised she also had a CMPA, switched to a hypoallergenic brand and everything became so much easier.

My second dd was diagnosed with TT at a few weeks old as she wouldn’t latch for more than a few seconds and got hers snipped the same day. She was a dream to feed and never had any more problems.

if you can, I would definitely pay to go private.

While I agree a tongue tie, high palate etc should be checked I would consider trying to see an IBCLC for a full feeding assessment. Sometimes NHS infant feeding specialists are IBCLCs but it depends on the trust so you may have to consider going private.
The behaviour you describe is also sometimes seen if mum has a fast letdown as babies will back on and off the nipple to try and control the flow and often it appears as if they just don’t like feeding as it’s never been a relaxing experience for them. Sometimes it can be a combination of a lack of tongue function paired with a fast letdown so they don’t have the ability to control it properly.
It sounds like you’ve done really well to get this far and really determined so I hope things get easier soon.

My daughter was like this it was severe silent reflux and a lot of food allergies - 20 at final count!
The reflux has been difficult to treat she only responds to omperazole at doses above 2.5mg/ml so has to be on the highest doses for her age, she needs infant gaviscon to thicken liquids and domperidone to speed up the emptying of her stomach. She's nearly 5 and still on this medication combination!
Her refusing to feed turned out to be a really early indicator that I had eaten something she was allergic too. The one time I ate beef she was refusing to feed 20 minutes later and by 24h she was inconsolably crying.
She possibly has a slight tongue tie. It wasn't picked up in any assessments but around 1 year it was clear that she had poor mobility up and down compared to her good mobility in and out. It couldn't reach the top of her mouth. I'm not sure if this would have made a difference to our experience. We had to tackle both the reflux and allergies together to make progress.

@Superscientistshes on 5mls now but doctor has said they is some wiggle room to go up a bit if she needs it, I may mention it tomorrow when we’re there, unfortunately she’s got thrush again for the second time so might as well kill to birds with one stone while I’m there. We did ring a private clinic before to see if they’d be happy to do us a pin prick test is it called? On her but they wanted to wait until she was a bit older.

What strength is the liquid? It will have something like 1 or 2 mg/ml somewhere on the bottle this tells you how many milligrams of omperazole is in each millilitre of the liquid. We have only used the tablets so I'm not sure about the liquids. If that is 1 mg/ml that would be quite a low dose for a 6 months old of typical weight.
Paediatric medication is dosed according to weight. Omperazole doses range from 0.7 mg/kg up to 3 mg/kg. Say your baby is 5kg on the bottom dose they would need 3.5mg of omperazole (or 3.5ml if 1mg/ml liquid strength) up to 15 mg of omperazole on the top dose. You can see there's quite a difference in normal doses. My daughter's gp was only adjusting her dose for her weight and when that wasn't helping didn't move her to higher doses. It took seeing a paediatrician for something else to get her on the highest dose at 4.5 months. He said the GP should have put her on this dose weeks earlier. By 6 months she was on the maximum dose for under 2 year olds (20mg) which is why other medications were then added it as it could no longer be adjusted for her weight

There are two types of allergies in babies IGE and nonIGE. IGE or immediate allergies are what most people think of as allergies and cause rashes, hives and swelling this can be detected on blood and skin prick tests. NonIGE or delayed allergies cause more gastric symptoms like vomiting, loose stools or constipation. These don't show up on tests and can only be identifying by slowly removing the foods seeing if symptoms change then reintroducing them to see if symptoms return. My daughters allergies are in this category so we haven't had any testing and only identified them with careful food diaries and a lot of trial and error!

i struggled with BF my son a lot in the early days, he had a small tongue tie which they did snip (at about 4 weeks) but it didn’t make any difference. I persevered through a lot of pain (to be fair, I don’t think he was in pain and he was gaining weight well) and he is still feeding twice a day at 15 months 😊 it stopped hurting so much around 3/4 months and was mostly completely fine from about 7/8 months. So you may find some improvement still and you may be able to continue longer term if that’s what you want.

i found the majority of NHS help including health visitors well meaning but useless. See if there’s a la leche league or NCT BF support counsellor as I found them much much better. Plus probably a private tongue tie assessment. Good luck.

@Superscientistsorry I meant to say she’s on 5mg now, she takes 2.5mls in the syringe, got my mls & mgs mixed up, ideally I could do with weighing her tomorrow to get a more accurate updated dose as she’ll have gained weight since they initially prescribed her it, she’s meant to take laxido as well but I can’t for the life of me get her to take it 🤦🏻‍♀️ she doesn’t actually seem constipated and her stools seem normal but the paediatrician wasn’t happy with the amount of time she was going in between passing a bowel movement (26 days at one point!) I was concerned about Hirschsprung’s disease at my son has it but paediatrician wasn’t concerned but when our gp checked in after our appointment to make sure we was satisfied which we weren’t she agreed it should of been taken more seriously due to it being genetic so has now done us another referral but to sheffields children’s hospital this time where my sons currently treated.

her older sister suffers with allergies quite badly and usually it presents as eczema on her skin and belly ache ect but the baby doesn’t seem to be having bad bowel movements vommiting or skin issues (until a couple of days ago she came out with a slight rash on her face so just trying to figure out where that’s come from but have just started weaning and think it’s vanilla as this was the only new thing she had when the rash appeared)

@modgepodgeunfortunately id have to agree, all well meaning but if the basic techniques they try don’t do the trick they seem stumped, hoping a combination of upping her omeprazole and getting her tongue tie assessed will help us move forward a bit, will look into breastfeeding support in the area, thank you.

OP, you've done brilliantly to get to six months. Deep down, would you be relieved to stop now? Or are you really invested in keeping on?

On tongue tie, I think it's terrible that they seem to have stopped treating this. My dd2 was never bf (adopted) but her TT caused marked speech delay. We were told it would only be considered after two rounds of speech therapy. We finally got speech therapy and did the two rounds (took two years because of the compulsory breaks - called 'consolidation'). Then we were told, oh you'll need to wait for evidence that she has fallen behind academically. By this time she was 6 and couldn't even do her phonics. Luckily our GP referred to a surgeon who basically said bollocks to the protocol and did the surgery. It would have been so much simpler and easier to do it at birth!

I'm saying this just because, though the bf is your first priority, you shouldn't forget the possibility of TT.

You mentioned thrush... it can cause feeding discomfort/pain (for both baby and mother), although if it's the root cause and it's been successfully(?) treated once, I imagine you'd have seen an improvement for a period of time.

A cranial osteopath might be worth seeing, in case there's any stiffness/discomfort.

Regarding tongue tie, there are ways to get it assessed for free that don't involve a doctor or paediatrician (in fact, pediatricians don't always know that much about tongue ties and/or breastfeeding...). It would be worth seeing whether there are any HV/midwife led breastfeeding clinics in your area, as they can check. Sometimes private IBCLC midwives also run drop in clinics. As well as tongue tie, it would be worth assessing for lip tie, as that can sometimes cause issues (especially if baby can't get a deep enough latch as a result of the tie, which can cause frustration).

@Ketzelei think the idea of doing bottles is daunting and I guess just don’t remember how any of that stuff even works? I bottle/formula fed my eldest but that was 11 years ago so iv completely forgot and don’t know how I would even go about transitioning especially when she’s refusing to take bottles right now, I breastfed my son until he was one and we had a beautiful breastfeeding journey together and I guess I felt like this time around I’d got the experience and knew what to do ect and thought I’d have it nailed down but that just hasn’t been the case at all, going to explore the last few options with the TT & reflux medication and if that doesn’t work then there’s nothing more I can do than try find her a bottle she will take, done some research and think the ‘nuk perfect match’ bottles are gonna be the closest thing to the breast so ordered some of them ready to try, was meant to be trying her with them this week but just discovered she’s got oral thrush again this morning so think it might be in our best interest to stick to breastfeeding till it’s cleared up to try minimise the risk of her spreading it onto everything then when it’s cleared up try her with the bottles and see how she gets on 😮‍💨 nothings ever straight forward is it

To echo everyone else's comments on tongue tie, it really does sound like it.

They should do a proper assessment, not just visual. I can't remember fully what the lactation consultant did for my DC to check but I remember her popping a finger in his mouth to see if his tongue could follow it in a lateral move.

A friend of mine recently had her DD's tongue tie lasered off. Her GP & health visitor said it was mild & didn't need to be done, but she went privately for it. The difference it made was huge. No reflux, better feeding, better nappies. She was told by the tongue tie clinic her let down was so fast her daughter had no problem gaining weight.

And just to say, well done on getting to six months of feeding under difficult circumstances. ❤️

My baby is very similar... nearly 5 months now. Won't feed anywhere but a dark room with white noise and sometimes whilst I'm rocking her if she's really resistant. I DO have a very fast flow which she isn't keen on. She has some mild tongue restriction but nothing that could be cut as such but she has a very high palate and that can cause her to swallow too much air. Maybe your little one also has a high palate? You can check this yourself .
how is your babies weight? She is 6 months so at least you can start her on some solids and I would recommend a straw cup and you could express and feed her that way at least for some of the feeds.
It's mega stressful! I do feel for you, I've tried introducing a bottle also but she will not have one. I also have a 3 year old to think about and sometimes we are stuck in because baby won't feed properly. Shes 98th centile as well and as happy as anything but just think she gets wind, reflux etc from various factors. Sorry I've waffled on but you are not alone.

@Poppins2016yeah she had it about a month ago we treated it for 3 weeks, 2 weeks of actual treatment and an extra week to be sure it was gone (doctors advice) but it seems to have come back, I think that may be my fault though as I was using a manual pump with the wrong size flange as I didn’t think it would matter that much as I was only pumping 1/2 ounces a day just to get a little stash in the freezer just incase and it made my nipples really sore so think they may have been cracked slightly which is apparently a breeding ground for infections like thrush, first time I’m sure it was down to bad/shallow latch as she was struggling to maintain a latch for very long, both just speculation though obviously I can’t be 100% sure, latch does seem to have improved since then but still have the odd bad days and needs a lot of help from me to stay latched but it is very difficult when she’s as frustrated as she is when trying to feed.

@Elisabeth3468iv just bought her a cup with a straw yesterday, will give it a go tomorrow, her weights good she went from 45th centile to 65/70, can’t remember for sure but I know she jumped up quite a bit, but I put this down to our dream feeds at night, when she’s sleeping and isn’t aware she does seem to feed so much better, although has been getting a lot fussier at night this last couple of weeks but hoping it’s just a growth spurt or something, and don’t apologise it’s nice to know I’m not alone, thank you

Iv just found a lady who runs a clinic every Thursday in Sheffield called babytobreast, consultations £125 for tongue tie and feeding assessment with an additional £125 if the tie needs releasing, going to book in with her at the end of the month when we’re back from holiday, hopefully she can help even if it’s not tongue tie she might be able to get to the route of the cause for us, worth a shot

Assuming she's over 5kg that would be quite a low dose of omperazole there's definitely scope for the dose to be increased not just adjusted for weight.
How long has it been since the dose was adjusted?

@Superscientistshe was 15.13lbs on the 8th of may, I believe it was last updated around 3 months ago, doctors ended up re-doing our thrush prescription over the anima health portal rather than us going in so gonna pop another message on there and ask for them to re-evaluate her dose

You're a saint. I couldn't have been doing with this! It sounds unnecessarily stressful. Please do make sure you enjoy your baby as you don't want to have regrets in their 1st year. Personally, I would check for allergies and use formula milk in this situation.

I'd call you HV about getting her weighed then get a medication review with the GP about the omperazole.
That's about 7.2kg so the dose was 0.7 right at the bottom of the therapeutic window and if they have gained weight in the last month as you'd expect it's probably now below the therapeutic window.

Just weighted her she’s now 18lbs as of today, gonna message the doctor and ask her to change it for her

I would suggest waiting for the tongue tie consultant before buying a pump. If it's thatshe'll struggle with bottles anyway and you'll have wasted your money on a pump you won't use.

health visitor/breastfeeding support worker has just called me back and is popping out to see us on Wednesday to see if they’res anything she can suggest to help, she said failing that it will be a couple of weeks wait but she can refer us onto the lactation consultant who would be able to assess her for tongue tie or any other oral issues that may be causing her problems, so fingers crossed we get it resolved if that does end up being the case

My DS is now 20 year old but we had exactly this in fact, it was so bad I couldn’t feed him whilst he was awake after 7 months - I had to get him sleepy by rocking/dummy then pop him on…. I fed him until age 13 months like this! He had severe silent reflux and no meds worked. After age 13 months he took milk from a cup! So no help, just sympathy!