Tongue tie help :(

[@llli*weaholt]

Hi
My baby is 3 days old and and has tongue tie. We are awaiting an appointment next Monday to have the procedure carried out to correct the problem. I have been breastfeeding her until today but it has got to the point that I can no longer physically take the pain. My nipples are so damaged that I have to peel my bra off because of the blood and after the last feed this evening I could not take any more.
On the recommendation of a bf counsellor I tried shields but these did not make a jot of difference to the pain, so tonight I have started expressing. I tied cup feeding but this did not work so have had to move to bottle. She took some earlier, but because I am playing catch up with getting milk ready for her, I have reluctantly bought some formula just in case I am unable to express enough for her. I tried her with this before and she would not take it, which leaves me feeling nervous about tonight as I currently only have 2oz of expressed milk available.

I have quite a few concerns......I nursed my first daughter for 3 years and felt so proud, I currently feel like I am letting my baby down by not providing her with the best. I am also concerned that when I try to return her to the breast following the tongue tie correction and my nipples healing, that she won't want to go back. I am unsure how I am going to be able to get ahead with the expressing so that she mainly has breasts milk and as little formula as possible -mid she will actually take it.

Any experience or reassurance would be greatly appreciated
X

[@llli*carm3]

Nursing a tongue-tied baby is definitely a challenge. My best advice would be to express/pump what you can if you're not able to nurse her. Has your milk come in? You definitely need to keep up your supply. My next thought would be to get a script for some all-purpose nipple ointment to help your nipples heal.

[@llli*lllmeg]

How are you expressing your milk? In the very early days when it's colustrum, it is now thought that hand expression typically works best. But if you are starting to have more abundant milk, a pump may be better. (hospital grade preferred.) You can certainly do a little of both. But if baby is not nursing you do need to pump or hand express as frequently as you can-10 times a day if possible.

Why did the cup feeding not work? Were you shown how to do it? Here is a video that may help. It's near the bottom of the page. http://www.nbci.ca/index.php?option=...id=6&Itemid=13

If you cannot cup feed or do another alternative (finger feed, syringe feed) then you could try paced bottle feeding. http://www.llli.org/docs/00000000000...astfedbaby.pdf
The potential issue with bottles is the milk flows from them in a completely different way than the breast, and this MAY lead to baby having difficulty nursing down the line. The various alternatives slow feedings down and give baby more control. However, if your babies tt is making it difficult for your baby to take a bottle or feed at all, this may not be appropriate. I just don't know...

However I would not worry overmuch about getting baby back to the breast. This is very early days and hopefully you can get right back with nursing as soon as the tt has been taken care of. Meanwhile you could keep offering the breast very occasionally maybe???

Kellymom has a good article all about nipple healing. http://kellymom.com/bf/concerns/mother/nipplehealing/

A three day old baby does not need a ton of milk or formula. Remember this is the time milk, which starts off very scant in the first couple of days, would typically be just beginning to become more abundant- I can't tell you exactly how much to feed your baby, but I believe that a typical breastfed baby at this age would only be taking in an ounce or two per feeding at most-but nursing 10 or 12 times a day at least.
Are you under the care of a board certified lactation consultant (IBCLC)? if not I would very much recommend you see one, preferably one familiar with tt.

Feeding the non-latching baby: http://www.llli.org/docs/00000000000...ching_baby.pdf

hand expression: http://www.llli.org/docs/00000000000...expression.pdf

[@llli*mommal]

with the PPs.

I especially second the advice to nurse the baby at least 1-2 times a day, if you can. Just a couple of nursing sessions per day can help your LO retain her ability and willingness to latch.

[@llli*weaholt]

Thanks for the replies.

We are actually using the madela special needs feeding bottle which does not allow the milk to flow freely. The baby has to suck to get the milk and there are also points to line up with the nose so that you can vary the intensity of the suck required to reach the milk. The shape of the test also makes the baby keep its tongue underneath the teat and not at the back of the mouth. I am hoping that this will help when we return to the breast.

I will have a read of the links kindly included, but can I just ask one thing? My milk started coming in yesterday and today. My breasts are huge and hard and very uncomfortable - this is in addition to the original discomfort from the nipple damage. I am worried because despite pumping I am hardly getting anything out. I have tried my electric pump and also hand expressing. I have actually hired a hospital grade pump which is arriving tomorrow, not sure whether that will help? I have done lots of massaging, striking, warm compresses, bath.... But no luck! Is it quite normal to express do little when the milk is just coming in?

Thanks in advance
X

Ps - although I contemplated returning my daughter to the breast for a few feeds I simply can't. The pain is so great

[@llli*weaholt]

^^^ stroking

[@llli*lllmeg]

My milk started coming in yesterday and today. My breasts are huge and hard and very uncomfortable - this is in addition to the original discomfort from the nipple damage. I am worried because despite pumping I am hardly getting anything out. I have tried my electric pump and also hand expressing. I have actually hired a hospital grade pump which is arriving tomorrow, not sure whether that will help? I have done lots of massaging, striking, warm compresses, bath.... But no luck! Is it quite normal to express do little when the milk is just coming in?

My milk started coming in yesterday and today. My breasts are huge and hard and very uncomfortable - this is in addition to the original discomfort from the nipple damage. I am worried because despite pumping I am hardly getting anything out. I have tried my electric pump and also hand expressing. I have actually hired a hospital grade pump which is arriving tomorrow, not sure whether that will help? I have done lots of massaging, striking, warm compresses, bath.... But no luck! Is it quite normal to express do little when the milk is just coming in?

This sounds like classic engorgement and can be a real problem. What can happen is the sinuses in the breast can actually get congested and milk removal becomes difficult. The milk is there, but it's hard to get out.

It is very important to keep doing everything you can to get at least some milk out frequently. Don't worry about how much you get each time, but go instead by how you feel-getting enough milk out to relieve the tightness/pain is what is important.

Milk ejection can really be helped by relaxation. try deep breathing, visualization-whatever works for you in terms of relaxing.

If all you can do is massage milk out in the shower or into a towel, do it. It's a shame to 'lose' the milk but that is only temporary. Prolonged engorgement can hurt supply and lead to plugs and mastitis. So for the long term, most important to get the milk out any way you can. Frequently!

Try cold compresses. it may be the heat is exacerbating the swelling.

[@llli*weaholt]

Thank you.

I used a cold compress which made my breast feel less firm but it didn't enable me to pump any milk. I have just gritted my teeth and put my baby to the breast which seems to have helped a little. She did not want very much and is now sleeping again. I will feed her again at her next feed. It is so painful

[@llli*weaholt]

I have been nursing my baby for every feed despite the pain, I was worried that my supply would suffer. It is so painful but will be worth it.

I just have one question. She nurses during the day and seems to get a good amount of milk. I hear the swallows and she seems to gulp. But in the evening she seems to struggle. She fusses a lot and wants to go on the breast every 20-30 minutes. I don't see any milk around her mouth. Last night she nursed almost constantly from around 10pm to 2am and would not settle. During the day she nurses and then seems content and will sleep.

Does this sound like a problem? Do I have a low supply at night?

We are having the tongue tie procedure tomorrow so am hoping this will ease the pain.

Thanks

[@llli*carm3]

Babies are often fussier in the evenings, and cluster feeding then is really common too. Your baby sounds pretty normal to me!

Good luck with the procedure!