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Thread: Posterior Tongue tie/lip tie caused my supply to plummet

  1. #1
    Join Date
    Feb 2014
    Location
    Texas
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    Default Posterior Tongue tie/lip tie caused my supply to plummet

    Hi all,

    I have read probably every thread on this forum about tongue ties and supply issues. I finally decided to join and I'm hoping someone here might be able to empathize and/or give me some advice on my situation.

    To start, I am working with an IBCLC and she is absolutely wonderful.

    DS weighed 7lbs 6oz at birth. By the time we left the hospital 2 days later my nipples were blistered, bruised and bleeding, but the doctors were happy to see that DS was still 7lbs 2oz. The LC at the hospital said his latch looked great and he was having plenty of wet and dirty diapers, so I would just have to deal with the pain until he got the hang of things. Then my nipples would start to heal. And they did by day 3. On day 5 my milk came in full force. I was leaking and choking my poor baby at every feed. By that night I was in urgent care for a high fever and hard-as-a-rock right boob. It turned out to be mastitis. During the first 2 weeks DS started having fewer wet diapers and his jaundice was still lingering, yet the pediatrician wasn't concerned so I brushed it off. By week 3 I knew something was not right. DS would scream at the breast, was never satisfied and was still 7lbs 4oz (always the same scale). I felt like a total failure as a mother.

    That is when I met with my LC who diagnosed a posterior tongue tie and a tight upper lip tie. We have been supplementing quite a bit with formula over the last few weeks while I pump every 3-4 hours in addition to nursing. We finally had the tongue and lip ties released when DS was 6 weeks and he has improved some over the last week (he's 7 weeks now). We are doing the stretches and exercises and he seems to have more good nursing sessions than bad, however it's very clear that my supply is still not where it needs to be. He can get 1.5oz from nursing in a good session early in the day (per before and afters with LC) and needs another 1.5-2 from a bottle.

    My main concern now is why my supply is not increasing. It has increased slightly since week 3 but it's barely noticeable and I have not noticed any increase since DS started emptying both breasts well. In addition to pumping I am taking More Milk plus and doing all of the oats, greens, mother's milk tea, lots of water I can stand. I have just ordered Goat's Rue and Shatavari. My thyroid and iron levels are normal. I've tried decreasing supplemental bottles by a half oz every other feed but DS just loses it without that last half oz. Could I just be one of those women who can't make enough milk? What else can I possibly do? Has anyone had success with the Goat's Rue?

    Also, Reglan is not an option for me with my history of anxiety. Not sure about domperidone as I also have a history of benign heart palpitations (probably caused by anxiety). I haven't spoken to a Dr. about either, though.

    I realize that I rambled a bit but I've noticed that a lot of background info is helpful here. Thank you for any advice/insight/empathy you can give!

  2. #2

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    I'm glad to hear you're working with an IBCLC! It sounds like a stressful situation and it's good that you have knowledgeable, in-person support.

    Is your LC doing weight checks? Has there been any change in the rate your baby's been gaining the last couple weeks?
    Karen
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  3. #3
    Join Date
    May 2006
    Posts
    21,355

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    avd what sort of pump do you have and how often are you pumping?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4
    Join Date
    Feb 2014
    Location
    Texas
    Posts
    9

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    Thanks for your replies!

    He is gaining well now but that is due to the supplementing. He is getting about 10oz of formula per day. Every time I meet with the LC we do a before and after weight check and the most he has ever gotten from me is just under 2oz.

    I am using a Medela Pump in Style advanced. To be honest, I have never pumped in place of a feed, only after or between feeds, so I don't actually know how much I could pump. I should probably try that.

    Also, I started taking Goat's Rue a couple of days ago and have since woken up to feed LO both nights after a 4-5 hour stretch with engorged breasts. Both times he has been content after the first breast and falls asleep while on the second. I have always had to give him a bottle during the night. Is it normal for the difference in supply to vary so much between day and night? I know that LO nurses more during the day but it seems like I should be seeing some increase in the day with that much of an increase at night.

  5. #5
    Join Date
    May 2006
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    21,355

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    The PISA is a good pump. When mom is having difficulty pumping and getting a good supply going, I think it makes sense to go one step up and use a hospital-grade rental, and to make sure that your shields are correctly fitted.

    Don't pump in place of a feeding. Just keep on pumping in addition to nursing. The more pumping sessions you can fit into the day, on top of the nursing, the better. The fact that your baby can sometimes get just under 2 oz at a feeding is encouraging because the average feeding is just 2-4 oz.

    It's totally normal to notice big fluctuations in supply, and to have more milk in the wee hours. Levels of prolactin, the milk-making hormone, tend to peak overnight. So a lot of moms find that they feel more full at night and first thing in the morning, and somewhat less as the day wears on.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    I am going through almost the exact same thing. My LO damaged my nipples in three days before I saw an LC. She told me that he had a tongue tie, but said he could work around it. I was forced to supplement due to no weight gain while breastfeeding. After he made virtually no improvement in how much he could take in during breastfeeding, I took him to a pediatric dentist for laser revision of his posterior tongue tie and lip tie on Tuesday.

    LO will be 5 weeks on Monday. I think he is nursing better, but I strongly suspect he only yes 1 ounce during breastfeeding. I can only pump an ounce at a time. I still am giving him formula -- about 10 ounces a day, which is less than two weeks ago but still more than I want to give.

    Since we are pretty much in the same spot, I don't have any suggestions for you. I hope you have success increasingly your supply. Please keep us updated!

  7. #7
    Join Date
    Feb 2014
    Location
    Texas
    Posts
    9

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    Well, I thought we had finally made it. We have been exclusively breastfeeding for over a week and, although slowly, LO was still gaining. He was still cluster feeding a lot and getting fussy at the breast later in the day and at night, but I thought we were working it out. However, today I all of a sudden have almost no milk. It may have been a little lower for the last couple of days but it wasn't very obvious until today. LO has been nursing for about 30 seconds on both sides and then getting really mad. I had to break down and give him a bottle of formula because he hadn't had a pee diaper in a while and was obviously very hungry. I pumped for 15 minute after he nursed and took the bottle, and got just under a half ounce. That's pretty typical for me after nursing though. I'm waiting now for him to wake up so I can feed him, but my breasts have not felt full since the middle of last night. It's been 2.5 hours since I pumped and they still feel empty.

    I did get what I think was my period at 6 weeks pp (DS is 9.5 weeks now), which I know is early. Since then I have had off and on light spotting. Could this be an issue? My OBGYN didn't think it was concerning at almost 8 weeks pp but I think it's a little strange.

    What could cause such a sudden drop in supply? I feel so defeated because we were so close to successfully breastfeeding. Now I feel like I'm right back where I started with my supply.

  8. #8
    Join Date
    May 2006
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    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    I'm sorry you had such a rough day, mama!

    The first thing to remember is that there's a big difference between having milk and feeling milk. Once supply and demand are well-matched, it's normal for a mom to feel "empty" pretty much all the time. Feeling full or engorged- that's something you get only when you're making more milk than the baby is taking. So it's quite possible- even likely- that you still have plenty of milk even though you're feeling low.

    However, the lack of pee diapers is concerning and while I am not completely sure supplementing with formula was indicated, I can totally understand why you did it. At this point, I think you want to do the following:
    1. Go back and see the LC. Have her do a before-and-after weigh in, and have her check baby's tongue again.
    2. Go back to pumping after feedings. My guess is that your baby just isn't a perfect nurser yet, and that he just needs a little help when it comes to maintaining supply. If you can keep supply a bit higher using the pump, that will give him time to become a better nurser.

    Regarding the "period" you had at 6.5 weeks- in a nursing mom, flow at that early point is very likely to be a last little bit of lochia. Likewise with the continued spotting, though 9.5 weeks is quite a long time to still be seeing it. Are you taking any form of hormonal contraception, including Mirena? And when your baby was born, were there any issues with the placenta? Did it come out in one piece? Retained placenta fragments can cause continued bleeding and can also impact milk production, so it might be a good idea to discuss this possibility with your doctor, who should have either a record or recollection of how your placenta appeared.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  9. #9
    Join Date
    Feb 2014
    Location
    Texas
    Posts
    9

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    Thank you so much for taking the time to help me! I spoke to my LC this morning and she helped to calm me down as well. I have been pumping after every feeding since last night and started taking the More Milk Plus again. I had tapered off of them finally about 2 days ago because I thought the fenugreek in it may have been causing my bleeding. I seem to be back to normal supply today. I'm not sure exactly what it was but if I had to guess I'd say it was stopping those supplements that made my supply drop so suddenly. I will continue to pump after as many feedings as possible and keep taking that More Milk Plus!

    About the bleeding, my midwife said at 8 weeks pp that it looked like my body was trying to ovulate already (had a pap done) and my supply was VERY low up until then. I'm not on any birth control and don't plan to mess with that until LO is at least a year given all of the supply issues I've been having. My placenta came out all at once. I remember my midwife mentioning that it was healthy looking and all in one piece. Is it possible that the fenugreek is causing me to have spotting? I haven't noticed any yet today and didn't have any when I wasn't taking the More Milk Plus anymore.

    Do you think at this point that it's possible for me to ever have enough of a supply that I won't have to worry that LO is still hungry? Right now he eats every 1-2 hours and cluster feeds in the evenings. He has a really hard time going to sleep at night because he can't get a full belly. Thanks again for all of your help!!

  10. #10
    Join Date
    Mar 2014
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    59

    Default Re: Posterior Tongue tie/lip tie caused my supply to plummet

    First of all, props to you - you are working so hard on this and doing a great job. You are a hero for overcoming all these struggles! My daughter had posterior tongue tie too, we had it released at about 5 weeks. The pain is so horrible - I used to sob while feeding her. I do feel somewhat cheated out of those first weeks of building a good supply, and I'm taking supplements now. We have definitely had our struggles even recently, but I feel like we're finally in a decent place.

    To answer your question, I totally think it's possible for you to have enough of a supply to feel like you're satisfying your baby - you're doing absolutely everything right to increase your supply. But in my opinion, you shouldn't feel bad about giving him a bottle of EBM or formula if you feel like he needs it - only you can make that call.

    Like you, my supply is a lot lower in the late afternoon/early evening right before bedtime, and then I get engorged in the middle of the night (still, at 4.5 months!) This has been a struggle with going back to work... since she gets bottles of EBM at day care what I have been trying to do to fix it that has been working decently well is to pump as much as possible early in the day (like every 1.5-2 hours) and then take a longer break before I see her (3.5-4 hours) to build up enough milk so she'll be satisfied at her bedtime feedings. I'm still not quite keeping up with her, and I may have to eventually supplement a bit with formula once my freezer stash is gone - but this way helps both of us stress less at the end of the day. It is such a sad feeling when she doesn't seem satisfied after I try to feed her!

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