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Thread: Stopped latching - tremendous pain

  1. #1
    Join Date
    Apr 2012
    Location
    Montreal, Canada
    Posts
    123

    Default Stopped latching - tremendous pain

    First, I feel like I post each week with a new crisis. Sorry. She's 6 weeks today and I really thought we'd have it together by now. I'm depressed and discouraged.

    DD has never had a fantastic latch. We've been to two LC's and each have ruled out tongue tie or any problems. In fact, we latch great when an LC directs her. At home, not so much. But we can get there. Last week and this week, however, she just will not open wide! She refuses to open her lower jaw in particular. Adding to our problems, she will only latch well in cross cradle for a little bit -- maybe 5-10 mins and then she goes to nipple sucking or a latch that's more shallow. We have never ever successfully fed laidback. We came to that position late and neither one of us has any idea how to latch. In that position -- and from any angle -- she goes straight for the nipple.

    Is it supply? I can get 3 ounces if I pump in about 10-15 mins -- again, I only have one breast so I can't switch and see how she does on the other side.


    I know we're getting to a 6th week growth spurt. She's more irritable and wants to be on me constantly -- from 3:330 to 1 am yesterday. We went from having a cluster feeder but a great sleeper to a non-stop feeder and a never sleeper. I hurt. My nipple is blanched. And she's hungry.

  2. #2
    Join Date
    May 2006
    Posts
    20,613

    Default Re: Stopped latching - tremendous pain

    You have been such a trooper, mama! I know a lot of the time people say "Oh, it all gets better at 6 weeks". Often that' true, but sometimes it isn't. For a lot of mamas, 6 weeks is still very rough. All I can say is that it's probably not a supply problem- 3 oz is normal supply even for a mom with 2 working breasts. It's probably another growth spurt- they tend to hit at 3 weeks, 6 weeks, and 3 months but can happen at any time. It could be teething. It could be colic. All that combined with a young, small baby... It's going to be tough. Just keep on hanging in there. You're doing a fantastic job!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Stopped latching - tremendous pain

    First the easy question-if you can pump 3 ounces in 15 minutes I seriously doubt the issue is supply. That is a lot to pump. But it is important to look at the big picture as well. Is baby gaining appropriately? Up until now, has output been appropriate? (Around 6 weeks, poop frequency can lessen considerably and that is perfectly normal, but annoyingly that means poops can not longer be used as a reliable gage of baby getting enough-unless of course baby continues to poop at least 3 "OK" size poops a day in which case you can be reassured by that.) Sometimes mom has enough milk but baby is not gaining due to a milk transfer issue.

    Now the harder stuff- nipple blanching-do you mean vasospasm? Does it hurt after baby nurses? If it is vasospasm what are you doing for that (applying heat after nursing, meds?)

    OK on to latch, nipple nursing, open wide, laid back, etc.
    When nursing baby in a laid back position, it is often not necessary (and not really possible, in some cases) to make sure baby opens wide. This position tends to lead to baby self attaching, and yes that will often look like baby is ‘going for the nipple.” That is what they are going for. This is not a rule, I am not saying you must allow baby to self attach or anything like that. I am just trying to explain that what the research on laid back positioning showed was that in a laid back position, typical latch techniques such as getting baby to gape wide prior to latching, asymmetric latch, and/or deep latch, were shown to be not universally important when it came to nipple pain and baby getting milk. Even many babies who were 'nipple nursing," when nursed frequently in a laid back position, got enough milk and nursing did not hurt mom. Is this universal? No, nothing about breastfeeding is. But it is a fascinating aspect of laid back positioning that many are unaware of. Many breastfeeding helpers have deeply internalized the idea that a wide gape and asymmetric latch aka deep latch is vital for pain free nursing and Colson’s research on laid back showed otherwise. Just a thought.

    If you want to keep trying laid back but baby will not latch, I suggest 1) latch baby in an upright position and then lay back after baby is latched and/or 2) Remember that laid back only refers to the mothers position and has many variables. Mom can be reclined just slightly past vertical, as when you sit back in a chair, to almost (but not quite) flat, like on a bed propped up with a couple of pillows, or in any angle of recline in between that works for you. And baby can be on you or beside you and approaching the breast from any position. So you can use cross cradle and do laid back. They are not mutually exclusive.

    Do you need to pump? Remember pumps can cause nipple injury too. When pumping be very careful it is not painful or damaging.

    It took me 3 one hour plus visits with two different LCs, a nipple shield, tons of pumping due to the shield, and lots of pain, frustration and tears to nurse my oldest 9 years ago. So while it is unusual to keep having latch issues this long it is certainly not unheard of and there is still a good possibility you will be able to nurse you baby without pain.

    BTW diagnoses of some types of tt require a complete oral exam which many LCs are not qualified to do. For example around here, an LC would not diagnose tt one way or the other. Certainly they may suspect it, but in any case, if there is ongoing severe latch issues that have no other clear cause, moms are typically refereed to an ENT or pediatrician who is trained in diagnosing and treating the 4 recognised types of tt.

    Oh and when baby gets on and the latch is painful, how do you deal with it? The typical recommendation is to unlatch baby and try again but that does not always work well for all moms & babies. Other idea are to adjust babies position (entire body) while they are latched, (simply shifting babies bottom can help) and/or to gently pull baby’s lips out, chin down, etc. while baby is latched, or to try to push a bit more of your breast into babies mouth while baby is latched.

    more on laid back: www.biologicalnurturing.com and https://breastfeedingusa.org/content...-breastfeeding
    Last edited by @llli*lllmeg; May 20th, 2012 at 12:38 PM.

  4. #4
    Join Date
    Apr 2012
    Location
    Montreal, Canada
    Posts
    123

    Default Re: Stopped latching - tremendous pain

    Thank you so much for the long and detailed answer. It's reassuring. I think cradle and upright positions are getting harder as she gets heavier. My LC advised to pump to help w/ slow gain (we always had good poops and pees). LO gained 12 ounces and then 8 ounces in 2 weeks. I think I over worried and misunderstood laidback. Tonight I latched her upright and then laid back. It seems to help. Everything feels looser, if that makes sense, but it was pretty painless until she gets restless and starts to writhe and pull at the nipple. I'll take her off - sometimes she wants back on, sometimes not. I'll keep an eye on output to make sure it's working. I'd love to get through the growth spurt while caring for her and reading a book to boot.

    Yes, definitely have had vasospasms. Will look for how to treat.

    Thanks again.

  5. #5
    Join Date
    May 2012
    Location
    New York
    Posts
    175

    Default Re: Stopped latching - tremendous pain

    I know you've had an amazing answer from PP's above, but I just want to reassure you that 3oz from one breast in 15 minutes is stellar! It takes me a few pumps to get 4oz from two breasts! I have to pump a few times a day to get that!

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