Bad latch?

[Olithar]

I’ve been exclusively feeding my 13 w/o little boy, and he continues to gain weight (95th percentile), and he has lots of wet and poop nappies throughout the day. However he still has the top lip feeding blister, his lips are never puckered like a fish, his cheeks suck in whilst he is feeding and my breasts don’t often feel fully drained, there is nipple pain but it’s not unbearable, so all those signs suggest he is not latching properly. But on the other hand, with the weight gain, and wet/dirty nappies he’s doing great. Am I just worrying for no reason if he’s doing alright? Is it one of those things that will become a bigger problem as he continues to grow or not? What’s other people’s experiences in this situation?!

Thanks :D

It certainly sounds like he is getting plenty of milk, but the combination of signs you've mentioned does suggest the latch is not optimal, particularly the cheeks sucking in and breasts not feeling drained. It probably means your baby is having to work harder and longer to get the milk he needs, which could be tiring for him. My first thought is a tongue or lip tie or both. They can range in severity and often prevent effective feeding.

Is it both lips that don't flange like a fish? Or just the top one? You can help by gently flicking them out. If it's the top lip, that could be lip tie. Two of my four kids have a lip tie, and top lips didn't flange properly, but it was only the one that had a severe posterior tongue tie too, that had feeding problems. The other meant pain for me for a few weeks, but baby was getting plenty of milk.

I would get your baby looked at my a lactation consultant or breastfeeding counsellor or midwife/HV who is very experienced in that area. Without seeing you and your baby it is hard to judge as I would normally. It could be that as your baby grows and mouth/tongue flexibility improves, everything else improves too, especially as his weight gain is currently fine. But it is worth checking out for now. If your breasts aren't draining properly, it can lead to mastitis. You say you get nipple pain. How do they look? Any tiny white spots on them? These can be milk blebs and although tiny, can be very sore and occur as a result of a sub-optimal latch. They are blocked milk ducts in the nipple. Also, what is the shape of your nipple after a feed? Normal or lipstick shaped or pinched looking?

My 4 week old had symptoms you describe and I got her tongue tie snipped two weeks ago and it has made breastfeeding so much easier. My first was like yours and I didn't know any different as the pain eased a bit. He was diagnosed with tt at 15 months but it was a bit late and didn't affect his speech so wasn't snipped. Second was diagnosed at 1 week and snipped at two weeks and now third. As pp said get a lactation consultant or even a dentist can check for you.

@Somethingsnappy it’s the top lip that doesn’t flange, as far as I can tell the bottom one does flange. After a feed my nipples are fair long and the tip is white - not as in little white spots, more as in no blood flow white - if that makes sense? I think I will ring the health visitor on Monday about it, because if it is lip tie then it can be an easy fix? I’ve tried the pitching of the breast and I’m putting my nipple to his nose so I know he’s opening wide enough. It would make perfect sense about him working harder and getting tired, the last feed at bedtime takes an hour and a half because he keeps falling asleep at the breast but when I put him down, he wakes up still hungry straight away, so we do this a number of times before he has finally eaten enough.
Thanks for your response!

@Mishmased thanks for your reply 🙏🙏 I will get it checked to see if it’s lip/tongue tie

Yes, a tongue or lip tie definitely sounds a possible liklihood, especially after your second post. There isn't so much research into lip ties as tongue ties, but do discuss with your HV or alternative specialist. The two actually often go together. So do check properly for a TT. Posterior ones are harder to diagnose and spot than anterior ones, so if this is the caee, it may be why it has been missed at any previous checks. Look at your baby's tongue when he cries... Is it flat and raises up or does it form a U shape? A U shape often indicates a posterior tie. Babies struggle to raise their tongue up to fully compress the breast and makes feeding difficult. I'd it's not too bad, they sometimes find ways to compensate, but as we've both said, can be very tiring