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Thread: New latch issue

  1. #1

    Default New latch issue

    Hi,
    I am going to give the quick version here, and then the longer story, because I think the details will be helpful to know for anyone who has advice. Thanks in advance! The short story is, my baby is 8 weeks old, and in the past 2 weeks has seemed to develop a latching problem. He latches on fine, although I often assist him with the sandwich technique. It doesn't hurt at all while he's nursing. His mouth opens very wide. I sometimes have to flip his lower lip out. But when he's done, my nipple has the lipstick shape. Read on for the back story.

    Had an all natural childbirth, immediate skin to skin, and he latched well in the hospital. Around week 2 we learned he was not gaining enough weight. He was nursing constantly, but often falling asleep at the breast. Had a LC come over, and started a nursing, pumping, supplementing regimen to give him energy and get supply up. He started gaining steadily, and has been ever since. We're still not totally sure what caused the initial problem (sort of a chicken or the egg question), if it was my supply or him not able to nurse effectively. LC suggested possible tongue tie. We had it clipped right away (around 2.5 weeks), along with upper lip. The ENT actually said he was not technically tongue-tied, but that the frenulum combined with his overbite were preventing him from opening wide enough. We did the exercises, continued with the regimen and all seemed good.

    By his 5 week appointment at pediatrician, he had passed birth weight by enough that she was not concerned. He's on the low end, but so were his parents as babies

    Around 5 weeks, I decided to stop watching the clock, and allow him to nurse for as long as needed. The pediatrician's advice of 15 min on each side was terrible! ("Dont let him use you as a pacifier"). He wasn't just sucking after 15 min, he was still eating. Upon allowing hour long nursing sessions, he had even more poopy diapers and seemed happier in general. The poopy diapers are less frequent since week 7, but I'm not too concerned given his age. Should I be? We haven't returned to doctor for a weight check, but I had him weighed elsewhere and he gained about 20oz in 16 days (give or take, given possible scale differences).

    There is a new issue that started presenting itself around the time I started doing the marathon nursing sessions. Now, when he's done nursing, I very often have lipstick nipple. It's not accompanied by a sharp crease, but the shape is there. Also, my nipples are quite tender when I'm not nursing. Olive oil helps. It also helps to change positions, so I've been doing more football hold. But with cradle hold, it's a lot of lipstick nipple.

    Any thoughts on what could be causing this or how to help correct this new latching problem? He still takes about 45-60 min to nurse. Could the slow nursing and the lipstick nipple be related. Given our rough start, I'm always concerned that he's not getting enough. I hope to someday feel more confident about this!

    Thanks again!

  2. #2
    Join Date
    May 2006
    Posts
    24,794

    Default Re: New latch issue

    I'm so glad you decided to ignore the doc's stupid "15 minutes per side" advice! Feeding times vary widely with young babies, with some getting all they need in just 5-10 minutes, and others taking closer to an hour to complete a feeding. No need to be concerned about the reduced poop frequency as long as the baby continues to gain weight; after 6 weeks, it is common for breastfed babies to poop anywhere from multiple times per day to as little as once a week.

    Since you're not limiting your baby's time at the breast any longer, and are now doing "marathon" nursing sessions, my guess is that your baby is losing his latch at the end of the feeding. He has a good latch at first, gets most of his nutritional needs met, and then as he transitions to nursing more for comfort, he relaxes a bit and slips up onto the nipple. Result: compression and tenderness.

    Do you feel the baby slip up onto the nipple? If you do, you could always stop the feeding and relatch him.

  3. #3

    Default Re: New latch issue

    Thanks for the response. Sometimes I think the bad latch happens at the end, when he's just sucking. But sometimes I know he's latching poorly from the beginning. I can tell because I unlatch him to check and it's already in the lipstick shape. What's weird is that it really doesn't feel that different while he's nursing. I can only tell it was a bad latch when I see the results. He's doesn't visibly have a shallow latch. Anyway, I'm working on getting a better latch from the beginning by sort of retraining him by having him suck on my finger before I give him the nipple. That seems to be helping. This lipstick nipple was interestingly not a problem when he wasn't transferring milk well in the beginning.
    I feel so worried at every step with him and breastfeeding, since it's been a rough road. So I hope this isn't causing a transfer of milk issue now. My fear is that any transfer of milk issue will cause my supply to go down (or that my supply is still low, and that's what's causing him to need 45-60 min to nurse...). It's hard to feel confident.

  4. #4
    Join Date
    Jan 2014
    Location
    NY
    Posts
    707

    Default Re: New latch issue

    Are you supporting your breast from underneath?

    Btw, even though I believe my baby latches well, sometimes I'll see a lipstick shape, here and there. But I attribute it to my positioning, how I hold him and all that.

  5. #5
    Join Date
    May 2006
    Posts
    24,794

    Default Re: New latch issue

    If you're worried about milk transfer, watch his diaper output. That's where inadequate intake would likely show up first. I also think it might be a really good idea to see a LC, preferably an IBCLC, for some hands-on help with latching and positioning. Have you tried the "breast sandwich" technique?

  6. #6

    Default Re: New latch issue

    I see the LC that I worked with every other week at a local support group meeting, so I'll have her look at him and me at the next meeting. In terms of output, he has tons of wet diapers. He doesn't poop every day. He seems to store it up and then have a really big one or two every 2-3 days. At 2 months, from what I've read, I need not be too concerned, although I would prefer more frequent smaller ones, since he seems a bit uncomfortable leading up to that big one. I am slightly concerned that the bad latch means it takes him longer to get that milk. So, I just keep unlatching him to reposition and check, and hopefully i can retrain him to get the good latch again. We had it for a while! I have been doing the breast sandwich, although I think I wasn't doing it quite right until recently. I wasn't bringing him to the sandwich as much as putting the sandwich in his mouth. So, I'm now bring him to the sandwich, making sure the bottom jaw is very low, and the top jaw comes in right above the nipple. It seems to be helping, although we do sometimes still have a soft lipstick nipple. I say soft, because it's the lipstick shape, but without a crease at the top.

  7. #7
    Join Date
    May 2006
    Posts
    24,794

    Default Re: New latch issue

    That all sounds good! A lipstick with no crease means the latch isn't as shallow as it could be. I hope the LC has some good suggestions for you.

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