Latch issues, hyperactive cat napping baby!

[@llli*mommard]

Hi all,
I just found this forum a fortnight ago, and have been all over it to find answers to my many questions!
A little background:
10 week son, born 27/09 at 40w1d at 2.14 kg, (that's abt 4.7 lbs)...no iugr, docs said constitutionally small baby ( me n DH are 5 feet odd). Born via c section, latch established on day 3, gave formula even when I nursed due to his low birth weight. A weight check this friday at 10w1d showed a weight of 4 kg (about8.8 lbs). I put in a lot of effort, cluster fed for HOURS in the first few weeks ( against everything my family said - "you have low supply/you are starving the baby/give formula).
We cloth diaper and change at every pee and he has at least 15 wet diapers a day. Poop was once every 3-4 days the first month and half and now regularized to once a day.

DS is a catnapper. He takes 20-40 min naps. Mostly 20. My uncle who is an OB/GYN thinks its because DS "snacks" and hence catnaps. Our feeds are already 1 hr +. I can hear DS swallow after the first couple mins of suckling (he has a shallow latch, lipstick shaped nipple) but the swallowing is after increasing number of sucks. I have been trying to get DS to open his mouth wider (he barely opens it half inch) hoping that deeper latch = more efficient milk transfer. I had huge doubts the first few weeks on low supply as DS would fuss every evening Nytime between 4 pm to 7 pm (after reading kellymom I figured that I have adequate supply) and that DS fusses mainly due to being over tired.
At nit he sleeps mainly in a 3-2-1 hour cycle (3 hrs then 1 hr nursing then 2 hrs then 1 hr etc) and that's abt it.. Rarely will he sleep a couple more hours.
I wold have gotten him to sleep 2-2.5 hrs in the afetrnoon maybe a max of 3 times in the last 8 weeks. He is also a hyperactive child, impatient on the boob (eg when I switch sides using cross cradle hold) with short bursts of happy time. As he snacks he feeds literally all day, anywhere between 15 mins -1 hour between nursings.

Now, my questions:
1. Feeding: what am I doing wrong? How do I get DS to be an efficient nurser, take a proper feed and sleep/nap at least 2hrs? And also feed for lessor time!
2. sleep: DS also ONLY sleeps on nursing.. So I have to nurse to put him down.. I have tried everything - rock/shush/pat/sway etc
3. Latch: I have seen an LC and we've tried getting DS to open wider. He does that sometimes and hen during the feed slips back to grabbing mostly the nipple. This has resulted in sore nipples!

All of the above has resulted in NO sleep for me for the last 10 weeks and I am losing it!
To the point that I now find it very difficult to fall asleep with the fear tht he could wake up any moment!
Help!! I go back to work in a week and at this rate can never leave him with anyone (have not been able to get a free hour to myself outside the house in the last 10 weeks!) and am freaking out!

Sorry for the long post but wanted to give all the background so it's easy to understand.
TIA!

[@llli*mommal]

Welcome to the forum!

It sounds like you've done extremely well despite a rather difficult start. Your baby's weight is still on the low side, but he's gaining weight and in a manner which is consistent with the growth curve for a breastfed baby (see the charts in this link: http://kellymom.com/health/growth/growthcharts/). He's still at the bottom of the charts, or perhaps below the bottom line- but as you said, he's constitutionally small and comes from small parents. Ethnicity matters, too- my SIL is Thai and she was 6 lbs and change at birth, and she laughs and says "That's big for a Thai baby".

Now, your baby's napping pattern is normal. Some babies take infrequent long naps, others prefer frequent 20 minute power naps. Your uncle the ob/gyn may know a lot about how babies are born, but it sounds like he doesn't know much about babies after they're born, because "snacking" is a 100% normal eating pattern for a breastfed baby. Many breastfed babies- especially young babies- eat every 1-2 hours or even more frequently, making uo for relatively small meals by having many of them. An eating pattern where the baby takes in infrequent large amounts of food- i.e. "meals" instead of "snacks"- is more associated with formula-fed babies, because formula-fed, bottle-fed babies tend to be overfed and because formula digests much more slowly than breastmilk (that's "slower", not "better").

It is also normal for young babies to spend pretty much all their time at the breast and to sleep primarily in association with nursing. Young babies and even older babies and toddlers often need to nurse to sleep. However, if you find that your baby feeds literally nonstop- never releasing the breast for more than a few minutes at a time- or falls asleep easily while nursing, then you may want to see a lactation consultant, preferably an IBCLC, for an in-person assessment of breastfeeding.

The soreness, lipstick-shaped nipple, and slipping back on the nipple that you describe is all another excellent reason to see a LC. The one thing that concerns me from your whole post is that you're sore- and soreness combined with very long, very frequent feedings sometimes points to an issue with milk transfer. That can mean baby isn't getting enough overall, but it can also mean baby is getting plenty, only he's getting it...very...slowly...

Hang in there, mama! I think you're doing a wonderful job and I really hope you can keep going. I know a lot of people say "oh, breastfeeding gets easier by (insert artificial time limit here, usually 6 weeks)" but that isn't true for all moms. It can take much longer, but it's still worth doing!

[@llli*mommard]

Thanks for your quick reply Mommal!
I do plan to stick this out for at least 6 months; just hoping it gets easier and quicker and more pleasurable! I do enjoy the bond I have with my son, but I need some practical changes to take place if I want to think of getting back to work.
I will try and find an IBCLC near me.

[@llli*mommal]

Let us know how it goes when you do see the LC! I'm interested to hear what she will have to say.

[@llli*mommard]

Thanks Mommal will definitely update.

Just a couple questions till then:
Can I try solving the latch issue by manually holding down my son's chin/lower jaw and trying to ensure that he takes in more than the nipple? Is it true that the lower lip is flanged and mouth open with head tilted back?
My son does not lit back and I can see his lower jaw perpendicular to his face...

Thanks again!

[@llli*mommard]

an unrelated question -
My right breast makes evidently less milk than my left one... DS prefers the left also. Due to this, my right is way smaller than my left but also a point of frustration for my impatient son! After he absolutely refused that breast about a week ago, I started offering the right one first after his naps. He still only sucks for half the time on it (I also feel it has a slower flow than the left which he does not like) and only takes the left when fussy.
Is there any way I can increase the amount of milk coming in my right breast?

Thanks!

[@llli*mommal]

This link covers lopsidedness and what to do about it: http://kellymom.com/bf/got-milk/lopsided/

Basically, you want to increase stimulation to and milk removal from the underperforming breast, until supply on that side is more equal to supply on the overachieving side. But keep in mind that some degree of difference in production between breasts is normal and to be expected. Human beings aren't perfectly symmetrical, after all!

[@llli*mommard]

Thanks for your reply.
I did meet with an IBCLC. She said that I do not have a latch problem and am doing fine. I did show her my sore nipples but she still felt I had no problem. She only asked me to hold DS closer to my body.

I now have a milk blister on my larger breast (which DS favors and it's hurting terribly!) and it's refusing to go away!

[@llli*carm3]

Is there another LC you can see? I'm not sure how she can say that you have 'no problem' when your nipples are sore! It may be worthwhile to get a second opinion, if possible. What have you tried to get rid of the milk blister? Here's a link about possible treatments http://kellymom.com/bf/concerns/mother/nipplebleb/

[@llli*mommal]

Is there another LC you can see? I'm not sure how she can say that you have 'no problem' when your nipples are sore! It may be worthwhile to get a second opinion, if possible.

my thought as well.