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Thread: 6 weeks & struggling - poor latch, tongue tie *LONG*

  1. #1
    Join Date
    Jun 2012
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    Default 6 weeks & struggling - poor latch, tongue tie *LONG*

    This is my first post although I have been reading the forum for a few weeks now. I hope someone can offer some advice, apologies for the long post but a lot has happened.

    My son (first baby) is 6 weeks old today and we have struggled with breastfeeding from the start. His birth was quite traumatic – a lot more painful than I had expected, and not the natural water birth I had hoped for. His heart rate was dropping with each contraction and the doctors said he really needed to be born quickly, once labour was established it was very quick (I went from 5 cm to fully dilated in 1 hour) and I ended up having a spinal block and he was delivered by forceps. He was fine though, great APGAR scores, and he latched on 20 minutes after he was born. I remember all the midwives saying what a great latch it was, and although it was a bit painful, that was to be expected.

    I fed him all that day and night, and the next morning my nipples were bruised, so he clearly hadn’t been latched properly. I showed a midwife and all she said was ‘oh, he’s given you a love bite’ – nothing about him not latching properly or what to do next. We asked a lot of people for advice while we were in the hospital, and the general consensus was that it does hurt at first but would get better, though when I rang a breastfeeding helpline they said that was rubbish and it shouldn’t hurt.

    Anyway, it didn’t get better, and the first 2 weeks were very painful, with sore, cracked and bleeding nipples, and me dreading every feed. It felt to me like his tongue or gums were rubbing the underside of my nipple, and when it came out it was shaped like a new lipstick. I could also see that his cheeks were sucking in, although the midwives and health visitors kept saying it looked fine. I also discovered he was tucking his bottom lip in (I have tried flipping it out when he is feeding but this causes his latch to become even more shallow). He got weighed 2 weeks after he was born and he wasn’t quite back up to birthweight, and I was still in constant pain – this was when I was advised to express and bottle feed, and top up with formula if necessary. This really upset me but I was so tired and in pain, and worried I was starving my baby, so I followed their advice, although I was worried it would make his latch worse.

    Over the next week or two I went to several breastfeeding support groups but just kept hearing the same advice on how to latch him on. I felt like screaming ‘I know how to do it but it just doesn’t work!’. We have tried every position including the laid back breastfeeding but nothing helps. I kept hearing ‘take him off until he gets it right’ but he never got it right! I have also read books, browsed the net etc.

    The third week I paid for a very experienced and well-regarded private lactation consultant (IBCLC) to come and help – she diagnosed a 50-60% tongue tie and did the operation there and then. She said it would probably take at least a couple of days to see an improvement, and that if he could not breastfeed comfortably, I should not feel guilty about expressing and bottlefeeding, as this would be preferable to damaging my nipples and him not getting enough to eat. She also recommended he have cranial osteopathy as he seemed tight on the left side, he has a receding lower jaw, and because he had a forceps delivery. He had 2 sessions but it didn’t really help.

    Six weeks later and I feel like we are on a downward spiral with nothing and no-one able to help. The bottles have got more frequent and the breastfeeding less. I have tried spending hours in bed with him and there has been the odd day where he has fed all day, but eventually I get so sore I have to stop. I have also noticed him getting tired and unable to latch on, so even if I can cope with the pain, I give him a bottle because otherwise he will be hungry. I am also reluctant to feed him because we both find it very upsetting when it doesn’t work. Not once since his birth has he latched properly and stayed latched. Finally, yesterday I saw the lactation consultant again and she said he needed his tongue tie clipped again. She did it and since then he has been grizzly and struggling to feed, even from a bottle (although he is managing it). He also saw a different osteopath during the same session, and we are going back next week for a follow up. He does seem to be able to open his mouth wider, but to me his latch feels the same as before, with his tongue rubbing my nipple and the latch being shallow.

    We were using Philips Avent bottles but I bought some that are meant to be more like breastfeeding (the Tommy Tippee Closer to Nature and the Breastflow, they only arrived today so I’m not sure which is best yet). I have been pumping like mad to keep my supply up and to make sure there is enough milk for him. We have just about managed but on his hungry days we have had to give him formula as the milk has run out. I bought an Ameda Lactaline double electric pump (I think it is called the Purely Yours in the US) as I heard it was a good make, but I am wondering if it is powerful enough (I get around 60-80 ml every 2-3 hours, more if I haven’t pumped for 5 hours e.g. at night) and whether I should hire a hospital grade pump. I am so worried about my baby being hungry and about my milk drying up (I have read this can happen if the baby is not feeding efficiently and the mother is relying on a pump as they don’t extract the milk so well). He has gained weight but only an average of 142g a week, which I know is less than ideal (other than that I have no concerns, his nappies are fine, he is very bright and alert, smiling, active etc). He does get milk but I don't know if he gets enough.

    So six weeks on and I am feeling very unhappy and stressed about it all. I desperately want to breastfeed and will be heartbroken if I can’t – it means the world to me. It is partly a selfish thing – I love the bonding, I know it will be very convenient if we can get the hang of it, and I find the pumping tedious and time consuming. And I don’t want to give him formula for health reasons. I really don’t know where to go from here. It means so much to me, and I don’t want to give up without feeling we have tried everything (including giving it time). But it is making me extremely unhappy, it is stopping us going out as I can’t feed him properly in public (and if I use bottles I will still need to pump). I am getting obsessed and not really enjoying motherhood (although I love my baby), and I don’t know how much longer we can carry on like this. If I knew it would get better I would persevere for as long as it would take, but it's not knowing that is difficult

    Any advice would be much appreciated (although please don’t suggest we stop using the bottles, we have tried alternative feeding methods and they are not something we feel we can do). Can things still improve, or is it too late? Should I continue to feed him even though he has a poor latch? I don’t know if it is a good thing to continue feeding him this way (so he can practise) or if we are just reinforcing bad habits. I would also love to hear from anyone who has struggled as much as we have and overcame their problems.

  2. #2
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Quote Originally Posted by @llli*indigoelectron View Post
    I desperately want to breastfeed and will be heartbroken if I can’t – it means the world to me.
    Your motivation is your strong point. I hear your frustration, your pain, your confusion. You have tried every pathway. you are committed to this journey.
    Your sons' health and well being is your guiding beacon.
    Every step you take to enhance his health is a step in the right direction.
    I applaud and support your mothering choices.
    You are not selfish, far from it!
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  3. #3
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    Jan 2010
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    I had the exact same experience with my first son. You can do it, I know how painful it is, hang in there! At 8 weeks I had to start pumping and bottle feeding because my son just smashed my nipples and they were so damaged I had to let them heal. But, I kept nursing him as well as much as I could handle it and eventually he caught on. My belief is that we can do everything they tell us to do in terms of getting them to latch correctly but ultimatley, sometimes they just have to get bigger and stronger so they can suck hard and get a good, strong latch. Also, after having son number two, spending hours on these forums and learning alot about my breasts I realized that part of the reason that my first son didn't have a nice deep latch was because I had a very fast milk let down. It helps to nurse lying down if you think this may be a problem for you as well, but again, ultimately what will help is time and the baby getting better at handling the milk flow as he gets bigger.

    About bottles: My husband was exasperated every time I came home with all new bottles as I was desperate to find one that supported breastfeeding and didn't choke the heck out of my baby,(even some of the slow ones were too much for him). After tons of research I finally found a great article that recommends Playtex Natura-latch slow flow nipples. These are the kind that go with the bottles that you have to use the inserts with. That turned me off at first but it ended up being just fine and brought a great sense of relief to know that he was comfortably eating and the nipple was one of the highest rated for supporting breastfeeding. Don't waste your money on the expensive ones!

    Also, pumping alot because you are afraid you will lose your supply is exactly what I did but if you have very full breasts and are trying to nurse that can also be overwhelming to the baby if he is having trouble with the flow. Just make sure your breasts aren't overly full when you are breastfeeding. You may also want to rule out thrush. That ended up causing sore nipples for me even after my son started to latch on well. Because my nipples were damaged for so long, it made them more susceptible to yeast. If you have thrush nursing can be extremely painful, just thought I would mention that, although it seems like latch is your main issue and obviously you can tell my looking at your nipple after you are done feeding whether or not the baby had a good latch. You can do this! I know it is hard but it get's so much easier. What it really takes to be successful for those of us who have had issues is time and the desire to nurse your baby. I was too stubborn to give up and I refused to give my baby formula. It does get better, I promise. Just make sure that you are working with very qualified lc's that can assist you because there are alot out there that don't give the best advice!

    One more thing! I am glad I stuck with it but in hindsight, if the pain just get's to be too much, there are alternatives. I didn't want to give formula but sometimes I wish I would have cut myself a break and made my own life easier by doing so. I just so badly wanted that bonding with my baby and to give him the best start that I possibly could. Just take it day by day and keep trying. Time will make a big difference. I believe by 16 weeks my son was back to nursing 100% of the time. It was a long haul but so worth it. Just do what's right for you and your family, whatever that may be
    I'm Chris
    Proud mama to my two boys, Elijah and Archer and one baby girl Elsa.
    my 6 month old daughter and with number 4
    with my husband Tom

  4. #4
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Can you see an ENT doctor to have the tongue tie checked? It is possible that it wasn't properly clipped. I've heard that can happen. This comment from your LC...

    Quote Originally Posted by @llli*indigoelectron View Post
    She said it would probably take at least a couple of days to see an improvement, and that if he could not breastfeed comfortably, I should not feel guilty about expressing and bottlefeeding, as this would be preferable to damaging my nipples and him not getting enough to eat.
    ...sounds pretty flip to me. I would feel a bit disappointed that she didn't follow up after clipping the tongue tie. This attitude and lack of follow through has me questioning her methods. I think a second opinion would be a good idea. An ENT shoud be the most qualified person to follow up on this.

    I don't have first hand experience with tongue tie, so I will leave it to more experienced mamas to give you more ideas on how to approach this.

    I'm so sorry you are going through this. I hope things start improving for you soon!
    K. Sophia - Mama to my little lactivore, the amazing Mr. X (11/10).

  5. #5
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Great big s momma. I've been there, both of my kiddos have been tongue andupper lip tied. DS was a struggle to feed for the entire time we breast feed, but it did get to a point where we made it work. At one point we pumped and bottle feed exclusively for almost two months because I couldn't stand to have him latch. Eventually I decided we couldn't continue that way so we went back to working on his latch and it got better. I was never totally painfree while nursing him but it did get tolerable. Like you I was determined to breastfeed. I don't really have much advice but I wanted to say s and I've been there
    Married to my High School sweetheart 5-15-04

    SAHM to:
    born 6/1/10 tongue and lip ties nursed 13 months with sore nipples and mutually agreed it was time to quit!
    born all natural 1/27/12 nursed for 16 months and lost interest
    1/1/14

  6. #6
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Be back later when I can write. Don't give up. Don't plan to EP.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  7. #7
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    Jun 2009
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    I want to keep this brief as I can but I just want to say I hear your frustration and I feel for you. I struggled with really difficult latch issues and having to pump around the clock for about 3-4 weeks with my oldest, nothing like what you are experiencing but still I have a small idea. I know you are beyond exhausted but you have gotten this far, I suggest your keep trying if you can, I see signs of hope in what your have written. Trust your heart, you will know if and when you are well and truly done and ready to let go of breastfeeding.

    OK- a couple of things- 1) Pumping: Ameda purely yours are certainly generally considered good pumps. (every mom has their own favorite.) But like all personal use pumps, they are designed for moms who are pumping 2-4 times a day due to separations once supply is established. That is not your situation. For as long as you are primarily pumping rather than nursing, the pumps usually recommended are (in the US) called "Hospital Grade" and your rent them for as long as you need as their individual cost is prohibitive. Ameda makes one, Medela makes one, there are others, I don’t know what is available where you are, your LC or hospital should know.

    Tongue Tie: TT is often a physical barrier to a baby being able to breastfeed. So all the latch and positioning ideas you got before the clip did not work well because your baby needed to be clipped and perhaps needs clipping again, that can certainly happen. But when/as that physical barrier is removed you can try all those ideas again. (Laid back, asymmetric latch, breast sandwich, etc. Try everything and then try everything again, and make any adjustments to them that make sense to you.

    A couple of years ago I attended a lecture by Dr. James Murphy, a US (San Diego) based physician who is a tongue tie expert with the Academy of Breastfeeding Medicine. He suggested that, post clipping, issues can sometimes arise due to scar tissue forming and tightening things up again. As I recall, he said he tells moms to apply gentle pressure with a clean fingertip several times a day to the site of the clip to help it heal more loosely, I guess. Of course I am paraphrasing and frankly I have not seen this recommendation anywhere else but he definitely said this.

    I would also suggest getting a second opinion re: the tt and/or to discuss with your LC if there may be other issues like lip tie going on as well. If you have confidence in your LC I would stick with her, (you can get a second opinion as well) if not, find someone else. On the face of it I don't see anything wrong with what your LC said, often it does take time after a clip for latch to feel better, sometimes re-clipping is required, and the fact is it is physically possible for some moms to EP and feed baby breastmilk or at least partially breastmilk that way, and some moms prefer doing that to formula feeding. Whether that is the road for you is yet to be determined, however. I know it feels like you have been doing this forever but it is actually early days yet.

    Bottles: When bottle feeding the breastfed baby, or the baby your hope WILL breastfeed, it is important to do so in a breastfeeding supportive way. Choosing the right nipple for you baby is important but this goes beyond what kind of nipples or bottles you use, as the fact is there is not a bottle nipple on earth that can replicate what a breast does during nursing, plus there are aspects of breastfeeding that can be replicated while bottle feeding that have nothing to do with the nipple. Try the ideas here: http://www.llli.org/docs/00000000000...astfedbaby.pdf

  8. #8
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Excellent advice from the PPs! I especially second lllMeg's advice to obtain a hospital-grade pump. Exclusive pumping with a Lactaline is not a good idea- the machine just isn't powerful enough.

    Are you currently nursing baby at the breast? If not, I strongly encourage you to keep the baby at the breast for a couple of feedings per day, or as many as you can stand. As long as your baby remembers how to nurse, you're keeping your options open. It's very likely that your baby will ultimately grow out of his latch problems. Newborns have tiny mouths and cannot get the deepest latch even when everything is perfect. But babies grow fast, and their mouths and tongues grow too, enabling them to get a deeper latch with less effort on their part and less assistance from mom.
    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!"

  9. #9
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Oh, mama. I hear you. I am on my phone, so can't type much, but we have been in the same boat with our third baby (who is now 3.5 months old). Look around Dr Kotlow's website and see if any of his posterior tongue tie information sounds familiar. Regardless of what sort of tie you have released - anterior, posterior, labial - you will need to do stretching exercises to keep it loose and separated while it heals. We struggled mightily for 11.5 weeks before finding someone to release my daughters posterior tongue tie and upper lip tie. It and follow up craniosacral therapy made a world of difference. Ultimately, though, despite the exercises, my daughter's tongue has formed some restrictive scar tissue, and we have to travel again to have it reassessed. It definitely happens. I will know to stretch for much longer than the 2 weeks this time. Is there anyone where you are who can assess posterior tongue tie? If you can't find anyone, email Dr Kotlow. He will take the time to help you assess by email and also find someone up help solve this. I'm so sorry! I know firsthand how devastating and all-consuming the pain and frustration can be.
    Teal

    25 May 96 and 14 January 08 and 27 February 2012

  10. #10
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    Jun 2012
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    Default Re: 6 weeks & struggling - poor latch, tongue tie *LONG*

    Thank you all so much for taking the time to reply, it means a lot to have support

    Regarding our LC, she is very well qualified and experienced - I checked her out before I made the appointment, and lots of people on various forums were saying how good she is. She also trained with one of the tongue tie specialists in this country (the UK) so I don't have any doubt of her skills. She said the reason she needed to do the tongue tie operation again is because scar tissue had formed, which I was aware had happened. I find her very sympathetic each time I see her and she always manages to reassure me.

    I should have said that she did give us aftercare instructions and I spoke to her on the phone a couple of time after the operation, as well as seeing her the following week (this was at her weekly clinic but we didn't have an appointment so she wasn't able to spend much time with us, also Toby was asleep so she couldn't look at his tongue properly! She gave us an appointment for the following week, which was the last time we saw her).

    Duckpond, what exercises were you told to do? We were told to get Toby to suck on our little fingers, and try to draw his tongue out, also to tickle his lower gum on the right then the left, and his tongue should follow. Finally, we are meant to stick our tongues out so he can copy! I have seen on the internet about people being told to rub the wound gently but that's not something we were told to do.

    Mamamountin, it is interesting what you say about fast let down - when I pump the milk does seem to come quickly, and I have also noticed Toby sometimes pulling away from the breast - is that also a sign?

    We are continuing to use the Breastflow bottles as Toby seems to be getting on well with them. Meg, I had seen the pdf on bottlefeeding the breastfed baby and we are putting the techniques into practise (although my husband is better at it than me!). What is interesting is that I think Toby did actually manage to latch on properly yesterday! He hasn't done it since but it has given me hope, and we are continuing to try.

    As for the pump, I will be looking into a rental tomorrow as I agree the Purely Yours isn't powerful enough. I have a choice of the Ameda Elite or the Medela hospital grade pumps, which is better?

    Finally, thanks again for the support. I realise it is partly a matter of time and I need to be patient, it is very hard though. I will keep you all posted

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