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Thread: Vasospasm from poor latch with 9 week old

  1. #1

    Default Vasospasm from poor latch with 9 week old

    Hi all,

    I have been through the gamut with this experience. More than anything I want to be a mom who can say "I stuck with it and now it's going great!" But I'm worried that won't be the case. I'm really looking for encouragement.

    In the first few weeks I got a series of infections and my nipples were severely damaged and my LC advised that I pump and bottle feed until we could clear it up. I did that for about 2 weeks. During that two weeks I took DS to cranial sacral, multiple lactation consultants, chiropratic, tongue tie specialist, and occupational therapy (to do a suck study) all in hopes of trying to correct his tongue thrust that kept blistering my nipples. He had no tongue tie, but he had a high but not prohibitive palate and lack of coordination with his mouth. We had a planned c-section (because of previous c-section) and he was term with no other birthing challenges.

    Anyway, I brought him back to breast about 4 weeks and luckily there was no rejection or nipple confusion, but we still didn't have a great latch. He seemed to be shallow and would rub the walls of my nipple between his gums. My nipples were/are so sore from this! I saw another lactation person and we did some changes and things were getting better. But she said all things from the outside looked great. And for me it was "tolerable" but not comfortable. We kept at that until this last week when things started to go bad again. I can feed him through the day but by evening my nipples are so sore and tender I want to cry. I have my husband do a night bottle so my nipples can rest. By morning they feel ok and the first feed is not so bad but by lunch they hurt again. By evening I'm struggling. I don't think its an infection because they seem to be ok in the morning if I can let them rest.

    I'm really not sure what the problem is. It feels like he's bringing his tongue in and rubbing my nipple with it. My nipple is actually stinging when it is in his mouth. This is usually when he's slowing down. When he's actively feeding he is rubbing so hard I can actually feel his gums meeting over my nipple. Now I'm having Vasospasm and in typical fashion the nipples hurt for at least an hour after each feed. It's been getting worse and I know it's because of nipple trauma and not raynards. So my question is, what can I do next?! Is it just a "wait until he's older" type of thing and is that actually true? Can we get this right if I just hold on and do nothing differently? Has anyone had an experience like this? I'm not sure if I should just go back to pumping full time...

    Any advice would be greatly appreciated!

  2. #2
    Join Date
    Jun 2009
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    10,754

    Default Re: Vasospasm from poor latch with 9 week old

    Does heat help the vasospasm?
    Growth certainly can improve latch issues/latch pain. I have talked to many mothers who experienced that. However, it is not a sure thing, whether it would happen in your case cannot be predicted I suspect, but certainly talk to your helpers about that.

    Since you are getting sore throughout the day, what about trying to see if baby can nurse less but get the same amount- have you tried breast compressions and/or switching sides to help baby get more, quicker?

    Also make sure your pump is not exacerbating the problem. A malfunctioning or ill-fitting pump can do lots of damage to breast tissue.

    Thrush ruled out?

    What positioning/latch techniques are you using or have you tried?

    I would suggest do not go back to pumping full time, yet. It is something to try if things keep getting worse, but there are so many downsides it is something like a last resort. Of course, some moms will pump for a couple days to heal their nipples. But even that has risks. It sounds like things were improving after you saw the last LC, but then took another downturn. Sometimes it goes like that, and at least it sounds like there has been overall improvement, if frustratingly slow. If you can and you liked her, maybe see her again for more tweaking?

  3. #3
    Join Date
    Mar 2014
    Location
    Central FL
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    Default Re: Vasospasm from poor latch with 9 week old

    Are you still doing any of the physical therapy exercises with him? Mine used to be really bad about clamping down on me and having him bite down on my pinky on either side to strengthen jaw muscles so they would be less likely to fatigue (which can cause more clamping) helped along with doing other mouth exercises with him. I worked with a speech therapist for 6 weeks and was doing the exercises with baby 5 times a day.

    How is your supply through all this? Latch issues can sometimes cause a drop in supply (are you pumping overnight when bottles are given?) And a lower supply and use of bottles can also cause some poor/shallow latch habits. Of course it can also be the other way, OALD can also cause clamping and pain.

  4. #4

    Default Re: Vasospasm from poor latch with 9 week old

    Quote Originally Posted by @llli*tclynx View Post
    Are you still doing any of the physical therapy exercises with him? Mine used to be really bad about clamping down on me and having him bite down on my pinky on either side to strengthen jaw muscles so they would be less likely to fatigue (which can cause more clamping) helped along with doing other mouth exercises with him. I worked with a speech therapist for 6 weeks and was doing the exercises with baby 5 times a day.

    How is your supply through all this? Latch issues can sometimes cause a drop in supply (are you pumping overnight when bottles are given?) And a lower supply and use of bottles can also cause some poor/shallow latch habits. Of course it can also be the other way, OALD can also cause clamping and pain.
    Hi,

    Thanks for the response. My supply is good. I do pump at night when husband gives bottle to stay on track with baby's demand. We also have pretty short feeds ((never longer than 15) because my let down and flow are quite strong. And he's gaining great. And each time we have weighed baby after feeding he's stripped enough milk for a whole feed (usually from one side only). I don't think I have OALD but my LC did comment that baby was gulping when evaluating us. I tend to stick to cross cradle now but I lean back so baby has deeper latch and doesn't choke on flow (not that he has but I was hoping to get a deeper latch). He doesn't usually clamp at beginning though. Most frequently at the end when he's more tired. It's also when he's doing something in his mouth that feels like licking at the nipple face but I know is not because I can feel his tongue next to his lower lip. But it's a quivering that ends up exacerbating the nipple soreness.

    I was working with an occupational therapist for a couple weeks and we only had one exercise for bringing the tongue out. It helped but no other exercises were offered. The OT was nice but not particularly helpful. Do you have any references for mouth excercises? What did you use them for?

  5. #5
    Join Date
    Mar 2014
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    Central FL
    Posts
    1,575

    Default Re: Vasospasm from poor latch with 9 week old

    Here is a vid that shows some of the exercises I also did with my LO
    http://youtu.be/0BgGWNp0-GA


    A lot of the different exercises are really just to stretch/strengthen muscles that might be weak or fatigue easily which often will cause the latch to deteriorate as baby gets tired.

    Exercises we did
    Tongue walk
    The lip and cheek things like in the video
    We also did additional stretches of the upper and lower lips (my LO still doesn't flange out his upper lip very well because his lip tie didn't get cut early.)
    And the whole clamping down as he got tired, having him chomp on my pinky on each side (2 sets of 5 on each side, 5 times a day if you can get him to do it) definitely seemed to help his jaw strength so that it didn't fatigue as soon and he was less likely to start clamping down, I know it seems counter intuitive but fatigue often causes clenching.
    He still sometimes starts to have a painful latch when he switches from active nursing to comfort sucking.

    What happens when you unlatch him as it starts to get uncomfortable, does he want to re-latch or is he already asleep? When he re-latches is it better? It might just mean you have to re-latch part way through because he has slipped back to a shallower latch. Seeing as he is gaining very well it isn't like you have to fear poor weight gain from disturbing him a little bit.

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