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Thread: 1 mo old w/ inefficient latch. Too late to correct?

  1. #1

    Default 1 mo old w/ inefficient latch. Too late to correct?

    Hello fellow mothers (and fathers)!

    So, after a month of nonstop feeding, I have finally figured out (or at least I feel as though I've figured it out) that I may have a slow let down or that baby girl has an inefficient latch, or both.

    - She feeds at least once an hour for 30 minutes or more
    - falls asleep at the breast
    - gets fussy occasionally where she pulls on my nipple but doesn't release the latch
    - cries at times when breast feeding and pulls off completely then screams bloody murder till she gets back on.

    I'm exhausted and finally found information that suggests I may have slow milk flow or that she has an inefficient latch. If it is an inefficient latch can it be corrected? I feel as though she needs more areola in her mouth but when I try and readjust the latch, she chokes like maybe I've pushed her too far onto it. I just ordered fenugreek and some Mother's Milk tea so am waiting on those to come in. I also just started trying to pump to help increase supply and increase flow of milk and in three pumps (just 3 breasts) I got a little over 1 oz milk. And, I also started breast compressions, but I feel as though it only helps occasionally.

    So frustrated and tired.

  2. #2
    Join Date
    May 2006
    Posts
    21,175

    Default Re: 1 mo old w/ inefficient latch. Too late to correct?

    Welcome to the forum and congratulations on making it through the first month of nursing!

    I have some questions for you, which might help us figure out how to help you best:
    - How does nursing feel?
    - How has baby's weight gain been? (It would be helpful if you could provide a complete history- birth weight, lowest weight, weight at each check-up.)
    - Has baby been jaundiced at all, and is she still jaundiced?

    When a mom has a slow letdown, you're correct to suspect a difficulty with latching. But it's not always the latch- sometimes a baby will have a great latch but will be sleepy or a "lazy" nurser and won't be particularly good at stimulating a good fast flow of milk. Sometimes the issue is that the baby has a tongue or lip tie which prevents the baby from getting a good latch. Probably the most common cause of long and frequent feedings is just the nature of the newborn baby- they tend to be relatively weak, relatively slow feeders, and it can take several months for them to become efficient and effective at the breast. If you're just patient, this problem will almost surely go away- but hopefully we can figure out a way to accelerate that process!
    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!"

  3. #3

    Default Re: 1 mo old w/ inefficient latch. Too late to correct?

    Thank you for replying!

    -Nursing feels allright. I occasionally get sore nipples but not always, and it's not bad. The first week was the worst.

    - Baby's weight and weight gain have been good. She was 7lbs. 2.6 oz at birth, dropped to 7 lbs. 0.7 oz at discharge the next day. Was 7 lbs. 6 oz. at her week checkup, and weighed 9 lbs. 8 oz. at her 1 mo. checkup. She's in the 56% for weight and has been about that for each checkup.

    - She was slightly jaundiced at birth and still has slight jaundice that doctor commented on but is not concerned about right now.

    She's been feeding on average about 21 times a day. I feel as though the breast compressions may be helping some. I also started the fenugreek yesterday morning, and last night I was leaking a lot during feeding, and she was swallowing/drinking more rapidly, less sucks between swallows. Not sure if that is a coincidence or not but I hope not.

  4. #4
    Join Date
    May 2006
    Posts
    21,175

    Default Re: 1 mo old w/ inefficient latch. Too late to correct?

    Thanks for posting the additional information! Based on what you've posted, I'm thinking that your baby's long and frequent feedings can probably be explained solely by the facts that she is still very young and has been a bit jaundiced. Young babies generally aren't that efficient at nursing and take a long time to nurse (though there are plenty of exceptions to this rule!), and jaundice makes babies a bit dozy which can also contribute to longer feedings.

    The good news is that if nursing generally feels okay and the baby is gaining weight at a nice rate, then the baby's latch is probably good. That means that most likely all you need to do is to wait for your baby to grow a bit, to give her time to become a more efficient nurser, and to pass out of the jaundice stage. Definitely keep doing the breast compressions and take the fenugreek if you feel that it makes a difference- there's no harm in it and it may well do some good. I know this is a super frustrating time in your life- trapped by non-stop demand from your baby! But I promise that it will pass. Just lay in some snacks, the TV remote, and nurse, nurse, nurse! You're doing great!
    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!"

  5. #5
    Join Date
    Jun 2009
    Posts
    5,629

    Default Re: 1 mo old w/ inefficient latch. Too late to correct?

    I agree with mommal. Your baby is growing great & nursing does not hurt (or only hurts a little? I am unclear) and normally, that indicates all is well. BUT, I will add, if you are still thinking baby is not able to latch or suckle entirely effectively, that is an issue that CAN be addressed and no, it is not too late, at all.

    Yes, frequent and long nursing sessions are very normal in the newborn period and do not usually indicate an issue assuming baby is growing well. However, I would say a baby nursing for ~30 minutes ~20 times a day, every day, could indicate that baby is unable to transfer milk as well as possible. This certainly may improve as baby gets older and stronger but it is still frequent enough (and sessions are long enough) that it raises a question in my mind.

    Is this a problem? It can potentially be, for two reasons. 1, you are finding this exhausting. Exhaustion is 100% normal for this time but again, its a matter of degree. 2) If baby is truly unable to nurse effectively, perhaps due to some physical barrier such as tongue tie or some other latch issue, then over time milk production may diminish and baby may start not gaining as well. Many moms tend to make lots of milk early on and then it may taper off.

    What to do about it? This is up to you. You have found that breast compressions and fenugreek appear to be helping, and as mommal says, you can continue with that and see how it goes. Again, since baby is gaining very well this is not an emergency situation and you could take a wait and see approach.
    If you would like to be more proactive, you could see if there is a local IBCLC you can see who can help you assess breastfeeding and to see if further intervention may be needed. It sounds to me as if you know a lot about breastfeeding and what is normal for the newborn period. If your instincts are telling you something is wrong, it may be a good idea to get some hands on help.

    Your baby is gaining well, so I do not see the issue being one of low production, at least, not yet. (as I suggested before, that could occur over time if there is some latch or sucking effectiveness issue.) I would suggest that pumping is used as a tool if baby cannot gain well exclusively nursing or will not nurse well or often enough and mom is feeling over full or engorged as a result. Certainly your baby nurses often enough, and at least well enough to get enough milk to gain well. So I would suggest that in your case, pumping is adding extra work for perhaps not much return. Certainly, I would not expect you to get much milk when pumping as it seems to all be going into baby.

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