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Thread: Poor Latch?

  1. #1

    Question Poor Latch?

    I'm trying to decide what to do (if anything) about my 3.5 week old daughter's poor latch, and was hoping for advice. She exhibits some symptoms of poor latch, but not others. My nipples are commonly lipstick shaped after nursing, but not sore. The thing that worries me most is the constant nursing, which has been the norm for the last 5 days. This involves 8-9 hour stretches of nursing with no more than 15 minute breaks for short naps/diaper changes/etc. She will fall asleep nursing, but wake up within 5 minutes when moved. Oh, and she has a upper lip tie, which I diagnosed (not confirmed by doc yet).

    Weight gain seems respectable, a little less than an ounce per day on average over the last 2 weeks, and the number of dirty diapers is on target, so I'm not worried that she is eating enough, just concerned that it takes so much work to get there, and exhausted. I wonder if a poor latch is to blame, and if so, if it could be fixed.

    I live in a rural area, so my options for a board certified LC are at least 2 hours away. The closest LLL chapter is 1 hour from home. There is also a designated lactation nurse at my local clinic. Any thoughts? Should I even be worried?

  2. #2
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    Default Re: Poor Latch?

    Does nursing hurt you at all? Any nipple injury?

    how many times a day does baby nurse?

    How many times a day does baby poop and what is the color, size and consitency?

    When sleeping, is baby mostly held by you or someone else, or put down in crib or bassinet?

    Can you provide a weight check history starting with birth weight, including dates?

    Thanks

  3. #3

    Default Re: Poor Latch?

    Nursing is painless on the left breast, slightly painful initially on right breast, but this doesn't last for more than a few seconds.

    Not sure how to count the marathon nursing session... But outside of this 5 times, every 2-3 hours in the evening, and 3-4 hours at night. Then typically all day from 9-5.

    3-4 BMs per day, size varies from a silver dollar to covering the diaper. Yellow in color, very loose, stringy, and seedy.

    During daytime cat naps she is held by me, or is laying in the boppy. At night she sleeps in the bassinet or swing.

    She was born on 8/14, 7 lbs 11 oz. Down to 7-5 oz by 8/16, and 7-1oz by 8/19. Still at 7-1 on 8/21, then 7-5 on 8/24. Currently at 8-3 oz. We have a precise scale and weigh her daily; she has gained an average of 0.9 oz per day sine 8/24. Since the long feedings started she has gained 1.25 oz/day. We were supplementing with formula when her weight was the lowest, but have weaned off this in the last few days, mainly because she refuses to drink it. I am also taking Reglan.

    Thans much for your quick reply!!

  4. #4
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    Default Re: Poor Latch?

    Can you possibly do the math for me and give me an approximate total number of nursing sessions per day? For the cluster nurisng I suggest, count each hour as one session. So if baby nurses at 2pm and at 2:15 and at 2:30, and then again at 3:30, count that as two nursing sessions. I am making this up but that is how I would do it.

    But I think, except for the initial slow gain, Everything sounds generally normal and good -except the owie latch on the one side. That may simply resolve but you want to keep trying different latch techniques/positions and keep an eye on any pain.

    Have you noticed a difference with the reglan? How are you feeling on it?

  5. #5

    Default Re: Poor Latch?

    So I would say that the cluster feeding includes 8 feedings total. I feel fine on the Reglan, and def noticed an increase in supply after I started it. I'm in the middle of day 6 of day-long cluster feedings

  6. #6
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    Default Re: Poor Latch?

    Well, cluster nursing is normal esp. in the first 6 to 8 weeks and, in and of itself, this is not a breastfeeding problem. It sounds as if baby does take longer stretches at night and cluster feeds during the day, and that is (presumably) better for you than the reverse.

    So, it is 8 times in 8 hours, then (average) 5 more times during the remaining 16 hours?

    That gives you a daily total of 13 times. Typically, a newborn must nurse a minimum of 10-12 times a day. So 13 or even slightly more nursing sessions per day is not unusual.

    However, since you think latch is possibly a problem, IF your scale is a very accurate digital infant scale, what about trying some before and after nursing weight checks? Intake normally varies session to session, so you want to take several, at different times of the day, to get a more accurate picture of average intake.

    Weigh baby in dry diaper, write it down, nurse, then weigh baby again after zeroing out the scale, wearing the same diaper. I think...

    Mommal is that how to do a before and after nursing weight check?

  7. #7
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    Default Re: Poor Latch?

    Yes, LLLMeg gave good instructions for doing a before and after weight check. You want a scale accurate to the 1/10th of an oz, and you definitely want lots of data. The more the better, IMO- when I was doing weights I discovered that my baby's intake could vary from 2 oz to less than 1/2 an oz, and I couldn't tell the difference between a good feed and a not good one.

    Often this will happen: you'll weigh baby and start to feed her, and then she'll poop and you'll need to change her halfway through the feeding. The diaper change will throw off your calculation. So here's what you do:
    -Weigh baby
    -Feed baby
    -If baby poops, weigh her in the poopy diaper and subtract the initial weight from the poopy diaper weight
    -Change diaper
    -Weigh baby
    -Continue feeding
    -Weigh baby again, subtract the second dry diaper weight from the end-of-the-feeding weight
    -Add the two weights together to judge intake over the course of the feeding
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  8. #8
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    Default Re: Poor Latch?

    Thanks mommal. Thanks for ths diaper clarification I always wondered about that.

    It also just occured to me that around 3 weeks is when "growth spurts" reportedly occur, and that is a time SOME babies will nurse way more often than "normal." I say reportedly because I think of ~ the first two months as one long giant growth spurt when most babies nurse like mad but that is me.

    Also you can try breast compressions to help baby get more milk during each feeding if you think that is the problem. http://www.breastfeedinginc.ca/conte...agename=doc-BC

    Again, imo, as long as baby is gaining well and nursing does not hurt and is comfortable for mom, there is no breastfeeding problem.

    If you are uncomfortable during these marathon sessions please let us know!

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