Re: we're still struggling at 10 weeks - clampdown bite refl
Welcome to the forum!
When babies clamp down, they're ussually doing it for a reason. And that reason is usually that the flow of milk is too fast for them, and they need to slow it down. Clamping down is like crimping a straw. Compress the nipple, and the flow slows down (and a white line, ridge, or crease is created by the compression). When a baby clamps down due to flow speed issues, there is usually an underlying cause for the fast flow issue, and that is usually milk oversupply. And when there's a milk oversupply, babies tend to gain weight very quickly and mom generally will have little trouble meeting baby's needs when pumping. Because your baby has struggled in the weight gain department and you have been forced to supplement with formula, I think it is unlikely that your baby is clamping down for the usual flow speed reason.
So if the clamping isn't a response to a fast letdown, what is causing it? The three possibilities that spring to my mind are 1, that baby is tongue-tied and cannot obtain a deep latch, or 2, that baby loses her latch over the course of the feeding as she becomes tired and the breast drags down on her little mouth, or 3, that something like reflux is making her uncomfortable and leading to her trying to eat less when nursing.
All that being said, I am not sure that your issues aren't being caused by fast letdowns and oversupply! Your pumping output is normal; most women make about 1.5 oz of milk per hour when supply is well-matched to demand. You mention that your breasts do get full, and that really only happens when baby takes less milk than mom is making. You've had mastitis twice and recurrent plugged ducts, and those two conditions are often associated with oversupply, though they can also be caused by a poor latch.
I would see another LC, preferably an IBCLC, for a hands-on evaluation of the possibilities above.
A couple questions for you:
- Clamping- does it happen primarily at the end of the feeding, or is it present throughout?
- Pain- are you experiencing any and if so, when do you feel the most pain? When baby first latches on, or towards the end of the feeding?
- How often does baby nurse?
- How much supplement do you offer after nursing?
- What sort of pump are you using?
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