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Thread: Re: Need Advice: Blisters, cracks etc former tongue tied

  1. #1
    Join Date
    Nov 2006
    Posts
    7

    Default Re: Need Advice: Blisters, cracks etc former tongue tied

    Hi Kitty,

    I am suffering the exact same problem. Here is a question I submitted to the LLC help page. I can understand exactly how you are feeling as I have had loads of ups and downs with this. I keep thinking get to the next health visitor meeting or get to Friday etc etc. I am also pumping, but It takes an age and you only just finish only to start again. I have also drawn blood feeding and had to bite on my shirt to help the pain. I just can't figure this out?!! Keep me posted and I will you if you find a solution!

    My question to LLC
    I would be very grateful for your help with my problem.

    I had Luca 3.5 weeks ago and we have struggled with breastfeeding from the start. It has become more and more painful as time has gone on. I have had 8 different midwives and health visitors watch me feeding him and none note any problem with my technique.

    He feeds for about 5 mins, but after that time I suffer greater and greater pain until it becomes unbearable. When I extract my nipple it is flattened at at 45^ angle and the tip is rigdged and had red sores on. Initially 1 midwife wondered if he was tongue tied, so we had his tongue snipped. Having read your articles on tongue tie this seems to be the exact same symptoms I am suffering from:
    1. Sore Nipples that become more painful the longer we feed.
    2. Long Feeds - he never comes off from his choice and will feed / suck for hours. I tend to take him off after 40 mins.
    3. Very frequent feeds (he is not getting milk out effectively?)
    4. He is chomping at the base of my nipple / areola which begins to feel bruised.

    He didn't put on any weight until 3.5 weeks, and kept loosing weight. We had a weigh in before and after 15 mins of feeding and he put on very little weight 20g.

    As breastfeeding has become unbearable I am mixing breastfeeding with expressed milk feeding. I am also offering top up feeds with formula as he seems so hungry. Sometimes he takes 3 fluid oz and sometimes non - 0.5 fluid oz. I am trying to limit the formula, but he is unsettled and hungry so I feel this is the best solution.

    I have also been treated for Thrush as has Luca as one midwife wondered if this was the cause. We are finishing off the treatment, though I was never convinced I had this and the treatment does not seem to have had any effect.

    When expressing I am able to express 2-4 fluid oz at each session (every 3 hours during the day, 6 sessions per 24hrs) I have been feeding Luca every 3 hours as feeding on demand did not work for us. He was very sleepy week 1 and 2.

    Luca has also done lots of wet nappies, but was almost 2 weeks without a dirty nappy. He is passing lots of wind.

    Our birth was very straight forward. No drugs and water birth. We had skin to skin for 1hour after birth. He is a very contented baby and only unsettled when hungry.

    We did give Luca a dummy at in week 1 as 1 midwife suggested he might be a sucky baby. The dummy has settled him after a feed, but he only needs a dummy if he hasn't had enough. If I feed him then top up with either expressed or formula he is very settled and no need for a dummy.

    My theories:

    1. My technique is poor?
    2. My nipples are too big (they are big) - but he is a big baby.
    3. His mouth is too bit / small?
    4. He developed a habit prior to the tongue tie op and is continuing it (he had the tongue tie op at 2 weeks.
    5. I have over sensitive nipples?
    6. He has a very strong suck - he is a big strong baby.

    Any suggestions very welcome as I am totally at a loss!!

  2. #2

    Default Re: Need Advice: Blisters, cracks etc former tongue tied

    Hi Caroline
    I copied this post into a new thread so people will see your questions

    1. My technique is poor?
    2. My nipples are too big (they are big) - but he is a big baby.
    3. His mouth is too bit / small?
    4. He developed a habit prior to the tongue tie op and is continuing it (he had the tongue tie op at 2 weeks.
    5. I have over sensitive nipples?
    6. He has a very strong suck - he is a big strong baby.
    I'm sorry you're dealing with all of these problems. Based on what you describe, it sounds like he's latching wrong. If you do have thrush, that will certainly add to your pain. Even if the baby has a very strong suck, breastfeeding should not be painful if baby is latched correctly. I see that you're in Scotland. Is there a LLLI in your area? You can click the link in my signature to find out. I'd suggest you have someone look at the latch in person to see if they can help you.

    Hugs
    Jen
    "Mothers are designed to be available to their babies--to help them make the transition into this big, wide world. To teach them to trust, and love, and feel good about being alive."
    --Elizabeth N. Baldwin, Esq., So I Nursed Him Every 45 Minutes

    Click here to find your local LLL Group
    How to tell if your breastfed baby is getting enough milk!

  3. #3
    Join Date
    Nov 2006
    Posts
    7

    Default Re: Need Advice: Blisters, cracks etc former tongue tied

    Hi Jen,

    thanks very much for the advice. I will indeed see if there is someone in my area. I might have to travel a bit, but it will be worth it. I think it is a problem of latch slipping! I get him on OK, but he slips off the sleepier he gets.

    thanks
    Caroline

    Kitty - here is the response from LLL Looks very helpful. I am going to try the exercises:

    Dear Caroline,

    Thanks for sending your questions to LLL!

    I think I can come up with some tips to help you.

    First, I want to address the fact that your son was tongue-tied and had the frenulum clipped. It may be that he compensated his latch by eventually clamping down with his gums. Often, a baby can extend the tongue over the lower gum-line, but tires after a while. The tongue will then retract back. (Sort of like a rubber band.) because the frenulum, (the piece of skin under the tongue) is stretchy and he can't maintain the extension.

    Even though he got his tongue clipped, he may still be in the habit of retracting his tongue. One thing that may help would be some tongue exercises. You can let him suck on a clean index finger, rotate your finger so the pad is on the roof of the mouth. You want to also assess where the tongue is. Do you feel the tongue coming over the lower gum line? After letting him suck with your finger pad on the roof of his mouth, you can rotate your finger so that the pad of your finger is on top of the tongue. You then can slowly slide your finger out, pressing the tongue gently down while removing your finger. Sometimes this exercise will help him to start keeping the tongue down, forming a trough cupping the breast.

    Second, I want to address the latch. You always want to make sure you have the best possible latch. You want to make sure he is latched on deeply enough. He should be drawing in a good mouthful of breast tissue. It should not pinch or be painful. With having large nipples, make sure he is latching on well past the nipple, taking in part of the aerola. Both lips should be flared out, they should look like "fish lips". You should see a nice wide "V" at the corner of the mouth. When he sucks, it should feel like a firm pull or tug, not pinch or hurt. If it is "pinchy", take him off and re-latch him more deeply. Try not to let him keep injuring the nipple tissue.

    If it is too painful to latch him on, then you need to pump. You indicate you are doing some pumping. You may want to consider renting a hospital grade pump for a week or two. If you don't feel he is feeding well, you need to pump after each feeding. You will then have more milk to use for supplemental feedings. It would be better to increase your pumpings to 8 times a day. By increasing your milk supply, your milk will "let-down" and make it easier for him to milk the breast. You could also try pumping a few minutes before the feeding to bring the milk down. Hopefully, with getting a mouthful of milk he may use his tongue more correctly as well.

    It sounds like your midwives have been helpful, however you may benefit from working with a board certified lactation consultant. She would be able to assess your baby's suck, give you some other ideas, and work with you on an ongoing basis. You can check the IBLCE website for a lactation consultant in your area. The website is: iblce.org

    Another thought, a nipple shield may be helpful in your case. It could help your son learn to keep his tongue down since it would be firmer and fill his mouth. A lactation consultant would be the best person to make that call after assessing you and the baby.

    To re-cap a plan, here: 1.) You want to make sure the baby is fed well. He probably needs 3-4 oz. per feeding to gain & grow. 2.) You need to protect your milk supply by pumping. Pump after each feeding attempt. Use any milk you pump out as a supplement. 3.) Get the best latch possible. Latch the baby on deep enough and re-latch if it is uncomfortable.

    I hope these ideas are helpful. Let me know if I can give you more ideas.

    Take care,

    Connie

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