Different LC's & very conflicting advice

[@llli*vivsmaman]

Ladies -- I'm here again with yet more questions.

I wrote last week that my then 7 week old was still feeding constantly when awake -- every hour and sometimes several times within the hour -- though that was coupled with comfort feeding. The possibilities raised here were 1: normal fussies 2: GERD or 3: OS. My sense is that the real issue is a shallow latch & lots of feeding to get what she needs. Supply on my end is good her diapers and weight are good too.

We went to the ped and now have her on Zantac. I haven't seen much of a difference, but then again we're not expert at keeping the medicine down.

Today we met with a new LC who thinks DD has a tongue tie and a facial asymmetry that requires craniosacral therapy. Ummm... we've seen 3 other LCs who have ruled out TT (all IBLC and connected to our hosps breast clinic) and have never raised CST, which I don't know much about. I have to be honest, the new LC is IBLC certified but I'm just not sure I trust her or got what she was doing. I wanted to weigh DDs intake and we didn't do that. The clinic LCs haven't done that either as I suspect their big concern are babies w/ weight loss and hurting moms. That's not us. I just have an 8 week old who still feeds 18-20 times a day.

DH is getting really discouraged and feels like we're going to people looking for problems when, all in all, our girl is doing well. I looked at some CST links and found it a little too "new age" for me (lack a better term and mean no offense).

Should we just wait this out and see if she becomes more efficient with growth? She's more alert, social, and physical everyday. Could her feeding habits change too? Just frustrated and confused.

So confused.

[@llli*phi]

I would personally consult a pediatric ENT to confirm the tongue tie before starting craniosacral therapy. It may just need to be clipped to solve the problem. Or it may not be a problem at all. I would trust an ENT over an LC to determine this.

Is there pain with the latch? If not, then it is very possible that the feeding frequency is normal and you might just want to invest in a sling or carrier so that you can nurse all day and still have the freedom to do as you please. Because diaper output and weight gain are good I wouldn't be overly concerned unless you are in pain, in which case whatever is causing the pain needs to be addressed.

[@llli*mommal]

I am sorry that no-one has yet been able to figure out what- if anything- the problem is. I think your idea to get hold of a scale is an excellent one. If you rent one and do several days' worth of data collection, you will gain a highly accurate picture of what your LO's intake is on a per feeding basis. If there's some sort of milk transfer problem, that data will expose it.

If you just wait, I think there is every reason to think that things will change a lot. Your baby is still so young, and even under the best of circumstances newborns have confusing behaviors and are challenging to nurse. I was nursing my toddler to bed just now and thinking about how much things have changed over the last two years. From oversupply and OALD to normal nursing to teething to all-night-nursathons to distractibility to toddlerhood... Change is really the name of the nursing game.

[@llli*lllmeg]

Does nursing hurt you? Why do you suspect shallow latch? You have probably tried everything but I have to ask-Have you tried various postions to make nursing more comfortable for you? Or other comfort measures for baby (that may help with gerd?) For long nursing sessions have you tried breast compressions? Also some babies just nurse a ton for no other reason than that is who they are. As suggested above, this will change. Again, finding other comfort measures may help you get a break. Sling etc. as mentioned above great suggestions.

As far as conflicting advice goes, I suggest you trust your gut. Just as there are LCs who have a hard time diagnosing the various forms of TT, there are others who seem to see TT in every other baby. This is not really their fault, unfortunately doctors and breastfeeding professionals are still trying to establish clear guidelines for diagnosing the different forms of TT. If you are in the US, my understanding is that LCs are not really even supposed to make this diagnoses one way or the other. With the LCs I know and trust, if they suspect TT (or cannot rule it out) they refer mom to a TT knowledgeble and proactive pediatrician or ENT for confirmation and treatment. They may or may not also suggest cranial sacral therapy.

I know nothing about CST but I have spoken to moms who felt it helped with painful latch particularly when due to palate issues, which sometimes accompany TT.

[@llli*amysmom]

If she's putting on weight well and your diaper output is good, the only problem you have is the frequency then right? I agree with learning to nurse in a sling will help you out a bunch. At a minimum, it will free up your hands. You might also want to try learning to nurse laying down. At least that way if she drifts off to sleep, you can nap too.

So much changes from 8 to 12 weeks. It really does. You said she's already becoming more alert and social. More is to come!

Go back to the LC that you clicked with the most. Your gut is the best gauge.

[@llli*aprilsmagic]

If she's putting on weight well and your diaper output is good, the only problem you have is the frequency then right? I agree with learning to nurse in a sling will help you out a bunch. At a minimum, it will free up your hands. You might also want to try learning to nurse laying down. At least that way if she drifts off to sleep, you can nap too.

So much changes from 8 to 12 weeks. It really does. You said she's already becoming more alert and social. More is to come!

Go back to the LC that you clicked with the most. Your gut is the best gauge.

[@llli*vivsmaman]

Does nursing hurt you? Why do you suspect shallow latch? You have probably tried everything but I have to ask-Have you tried various postions to make nursing more comfortable for you? Or other comfort measures for baby (that may help with gerd?) For long nursing sessions have you tried breast compressions? Also some babies just nurse a ton for no other reason than that is who they are. As suggested above, this will change. Again, finding other comfort measures may help you get a break. Sling etc. as mentioned above great suggestions.

Thanks for asking. The latch is not painful though I do feel some slight pinching. She's a loud eater -- clicks and slurps when she initially latches on, which I thought meant shallow. She'll suck vigorously and take a few good swallows at the initial latch but after a few minutes she pulls back and stays on the nipple. She's not chomping down as if to slow the flow but rather is sucking the nipple harder, I think, to get a faster flow after the first let down (I've never felt a tingling so it's hard for me to judge let downs). She can do this for 40 mins at a time with burp breaks in between. Also, and I know this isn't a good measure, we're nowhere near "looking" like a good latch -- wide portion of areola with lips flanged. When she pulls back on the nipple her lower lip is always tucked in.

We do laid back which has helped me with sleep -- I can nap while she nurses. She doesn't get a large amount of breast in her mouth but lips "look" right when laid back. Tonight I tried to wrap her and nurse. She was incredibly patient but that's going to take a lot more practice on my part. If we don't get it with the stretchy wrap I'll look into other carriers. Fortunately, there's a wearing store in walking distance that lets you test carriers for 3 days.

Since the "problem" -- in quotes for a reason -- is frequency, we've decided not to pursue CST or even the TT. I'm going to adjust by trying to wrap and nurse and we'll reassess in a few weeks. We did try to give her an expressed bottle tonight. I hardly pump, mainly just have bottles from hand expression to relieve engorging when she sleeps for longer stretches. She totally rejected it. 3rd bottle in a row she's rejected, which is a compliment, I guess?

Thanks all for the feedback.

[@llli*lllmeg]

The latch is not painful though I do feel some slight pinching. She's a loud eater -- clicks and slurps when she initially latches on, which I thought meant shallow. She'll suck vigorously and take a few good swallows at the initial latch but after a few minutes she pulls back and stays on the nipple. She's not chomping down as if to slow the flow but rather is sucking the nipple harder, I think, to get a faster flow after the first let down (I've never felt a tingling so it's hard for me to judge let downs). She can do this for 40 mins at a time with burp breaks in between. Also, and I know this isn't a good measure, we're nowhere near "looking" like a good latch -- wide portion of areola with lips flanged. When she pulls back on the nipple her lower lip is always tucked in.

I have heard that loud eating is a sign of a not great seal when latched, and thus ONE sign of tt. But in my experience, often it is either 1) your baby is a loud eater or 2) forceful letdown. Forceful letdown can run from short and mild spurting right at letdown (and yes perfectly normal to not feel letdown) to a huge firehose, and it can be a big issue or no issue at all, depending on several factors. Based on what you are describing, it does not sound like it's an issue for your baby even if it is forceful letdown.

The current thinking on latch is simple: If latch is comfortable for mom and baby is getting enough milk, then latch is good. Period. How it looks (or sounds) is irrelevant except as clues when there is an issue with pain or poor milk transfer. The researcher who developed the ideas/theories about Laid Back via observation of mothers nursing their babies found that many babies nurse right on the nipple with no pain for momma while getting plenty of milk. She found asymmetric latch, making sure baby 'gapes' before latching, making sure lips are flanged, all that, was not at all necessary for many babies. I think those techniques/ideas are helpful when a mom is experiencing painful latch or baby cannot latch, but otherwise, not anything to even be concerned about. How much of a problem the "pinching" is depends on degree, I would suggest keep working on eliminating that, nursing "should" feel like a gentle tugging but no real pain. (Usually; of course all babies pinch or clamp etc. occasionally.)

Frequent nursing is not a breastfeeding problem unless baby is not getting enough despite nursing frequently. It's a parenting problem, if it leads to momma feeling worn out. Your plan sounds like a good one but I would suggest avoiding bottles and pumping for now, that usually just results in more work and less rest for mom and is also a potential cause of more latch issues. However if you want to pursue that there are ways to give baby your pumped milk that may cause less issues, like cup feeding or paced bottle feeding.

[@llli*happynewmom]

I am a new mom and in no way an expert, but I have had similar experiences to yours so thought I would pitch in and give my two cents.

My baby is 6 1/2 weeks and also nursed constantly. She still nurses about 12 times a day, sometimes more, but is definately doing better than she was at first. I suspect that she has an issue with mild reflux, the doctor has told me that her behaviour and spitting up is normal but my gut tells me that she has reflux. Doing small things to help her with this has decreased her feeding frequency, like walking around with her upright, burping her much more frequently, etc.

My doctor was not very supportive, said she wasn't getting enough milk from me as she wasn't gaining weight quickly enough and should supplement with formula. But when I saw a lactation consultant she did the weighing before and after a feed, and it was determined that she was in fact getting enough from me. And she does have noisy drinking with lots of gulps. So I would say not to worry too much and definately try weighing before and after a feed. I wouldn't go ahead with any kind of surgery yet, I would first try taking measures to help with GERD because it could be that.

[@llli*james.mama]

I would first try taking measures to help with GERD because it could be that.

^^

Our DS has GERD and when he was weighed at the pediatrician's office, they recorded his weight incorrectly and for the first week the Zantac didn't help much (probably because he was still healing from some mild esophagitis as well). After they corrected his dose, he has been a totally different baby. He is a frequent eater too, but it has become considerably less (other than when he is about to have a growth or developmental spurt) ever since he got on the correct dose of medicine. You could try seeking out a pediatric gastroenterologist too if you still think that there are problems. They might be able to get your LO on a better dose or see if there are any other digestive issues.