Breastfeeding - advice needed!

[Lxii62]

DD is 3 weeks old and we are struggling with breastfeeding.

During every feed she clicks constantly, will take 3-4 attempts to latch as even when I wait for wide mouth, chin to breast and latch her she will then slip right back to a shallow latch... Then get annoyed and frustrated! She is quite fussy at the boob now and can sometimes arch backwards away from the breast. She often has longer feeds (latched for 40-60 minutes) but will fall asleep on the boob and not unlatch herself, I'm assuming because she's not satisfied as if I then put her down she's crying for more.

My nipples are normally lipstick-shaped or ridged when she's finished feeding and I can often feel her clamping down during a feed so I assume her tongue isn't covering her lower gum. Nipples are also sore, cracked and have bled.

If given a bottle, she also clicks during these feeds and will dribble milk from the side of her mouth.

I think she has a high palate (photo attached). Could our issues be due to this?
Could she be tongue-tied? It was checked at the hospital but I know these things can be missed.
Has anyone been in the same position at 3 weeks and seen big improvements?

I've tried breast compressions, flipple, sandwiching my breast. Today I've been pumping and giving bottles as HV suggested I give my nipples a break to stop permanent damage being done but don't want to do this long term as think it'll be detrimental to her latch and our chances at breastfeeding long term.

Any help/advice/positive stories from people who have had similar would be amazing!

Recommend seeing a lactation consultant and checking for tongue tie, then going for the release and getting help with attachment and, after that, latch. I went from being in tears constantly for the first 6 weeks to then breastfeeding for 14 months.

Breastfeeding is the hardest thing I've ever done. It shouldn't hurt and don't let any healthcare professional tell you it should. The nhs midwives I had were not trained in spotting tongue tie (one said she 'might' have a 'slight' tongue tie - lac consultation explained this isn't possible, baby either has one or doesn't, no such thing as 'slight') and the advice online is extremely confusing and varied.

The only other thing I can say that was helpful is that breastfeeding is something you both have to learn together. If you can stick at it, do, it's worth it. If you can throw money at the problem, do. If you can express and get your partner to give a bottle to give you a break, do.

When my baby clicks, the thing that works for me is holding him with my left arm, and holding my breast with my right hand. Hold it so it creates a smaller shape that will fit in his small mouth easily. (My baby is only 3w too but I fed my dd for 2.5y so confident at BF!)

If you do this, your breast won't slip out of his mouth easily

Edit: I mean Her not His - I was thinking of my own baby haha

Ps don't be afraid of breaking the latch and starting again, repeatedly. It helps the baby learn. Also don't focus on chin to breast: focus on nipple to nose. It's the same thing really but is more foolproof ime

I second the advice to get a lactation consultant in (and you may be lucky to find one who is also able to assess tongue ties and release them if needed). My little girl had a posterior tie and high palate and whilst we got the tie snipped, I also was shown how to do the koala hold feeding position and the combination of these meant I was able to keep breastfeeding her

Lactation consultants are so helpful, it could be a missed tongue tie. The hospitals don't seem the best at spotting them all the time.

Re the cracked nipple - do you smear a bit of milk over every time, after she's finished? I was told to do this and never had cracked nipples. I don't know if everyone does it and so it's just never mentioned, or no-one knows to do it?

@Borgonzola interestingly I was told, by a tongue tie specialist, that DS had a “slight” tongue tie.

It was measured on a scale based on shape of tongue/mouth and overall movement. If you score over a certain number indicates it could be problematic. It’s 2 years ago now but we got two numbers and he was 1 point over for one and 1 point under for the other. It wasn’t a pronounced tongue tie even though he has a really prominent frenulum.

I had sore bleeding nipples so I sympathise OP. I remember waking in a bloody milky patch. It was about 16 weeks before it was comfortable. DC2 latched immediately and it was a completely different experience. It definitely shouldn’t hurt and your nipples shouldn’t be pinched. Definitely see a specialist.

You’ve had some great advice already, and I’ll say exactly the same. Try and find your local lactation consultant and get them to check for tongue tie and also check your positioning. I did this and whilst initially we tried with some better positioning, we ended up having DS tongue tie snipped. It did take a few more weeks to completely crack it but then he fed until just shy of his 2nd birthday.
Don’t continue with pain, it shouldn’t be painful and this alone is a sign that something isn’t right.

Of course see a specialist, but in the meantime you could try nipple shields - the super thin silicone ones. They saved the first weeks of breastfeeding for us, even with specialist advice and support!

Both of mine have had high arched, ‘bubble’ palates and both have had very significant tongue ties. Apparently the two commonly go hand in hand due to how the roof of the mouth develops in relation to the tongue, DS1 had lots of difficulties with latch and DS2 destroyed my nipples. Please please see an IBCLC who also specialises in tongue ties ASAP.

Hey, we paid for private tongue tie consultation it was £150 but they did a full assessment of babies mouth, my breasts and shape, latch position everything. He was tongue tie like and I mean from his front gum backward so that was additional £80 to be snipped. Honestly best thing we paid for the advice was so much better than any HV or nhs midwife we’d seen. She even said one of my boobs was shaped different and advised on a better position for that!

My baby was slipping straight into a shallow latch even after a good one like you describe. The midwife encouraged me to really hold her head tight against the breast whilst in the good latch until she started sucking, even though she struggled and protested! Then relax once she was sucking nicely on the good latch. It did work after a few goes even though it was quite unpleasant as It does feel like you're forcing them.

(Agree with PP as well, to seek a consultant)

You've had lots of spot on advice but just to echo - nipple shields (some people feel against them but they saved us in those hard weeks) and what a PP said about breaking the latch and trying again if it isn't right, both you and baby are learning it's best to try and get it right to prevent problems.

And also in answer to your question re good news - yes I remember crying on babies head in the middle of the night during the early weeks it was so hard - all got a lot easier with time and various interventions until it was the easiest thing breastfeeding baby and so very convenient 🤣❤️

Ps i just looked at the photo of your little one and it looks like my baby's trapped wind face - sometimes it could be as simple as burping more!

I know it's cliche but sometimes we search for big answers like tongue tie or neck problems but often it's the simplest answer like trapped wind

Tongue tie, fast letdown, reflux and allergies are the things to spring to my mind. With my daughter it was a little bit of a fast letdown and mostly allergies/reflux as the allergies caused worse reflux but she does have reflux separately to the allergies

You need nipple shields for the interim, speak to the infant feeding team at your hospital or a lactation consultant if you can afford it.

Thank you for all the responses!

I do break the latch regularly (much to her annoyance) if she hasn't latched correctly and am currently using silver cups between feeds, with a few drops of breast milk in them to try and promote quicker healing.

A little update...
We paid privately yesterday to have her assessed and get some advice and were told that position and latch were both good. Turns out DD had a posterior tongue tie which prevented her moving her tongue left and right, she couldn't cup a finger (therefore also can't cup my nipple) and couldn't lift the back of her tongue at all so couldn't breastfeed effectively. Had this snipped yesterday morning and pleased to say we're already seeing improvements! When my nipples are fully healed, for the first time ever, I can actually see us sticking to this and doing it long term!

Ah, this is a lovely update. My DS had a posterior tie too. It’s great to hear that you’re already seeing some great improvements. Good luck. x

So glad to read your update! Your original post described my son as a newborn exactly and he also had posterior tongue tie. After getting it privately cut latch massively improved and we're still breastfeeding now at 21 months!

Aww glad to hear that’s been sorted! Nhs won’t always do it anyways.. so sounds like a good outcome 😀 xx