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Thread: 3 weeks old - is this gas? And nursing after tongue tie

  1. #1

    Default 3 weeks old - is this gas? And nursing after tongue tie

    Hi, I'm a first time Mom, and have had a rocky start to breastfeeding with my daughter. Her latch was very painful from the start, and by day 4 my nipples were cracked and bleeding. I saw an IBCLC, who noticed that she had a severe tongue and lip tie, and, when we weighed her before and after feeding, actually wasn't transferring any milk. I saw a pediatric dentist, who corrected both ties, at 9 days old. In the meantime, I was exclusively pumping and feeding her with a SNS tube on my finger, which she was able to suck. For the first few days, since she hadn't actually been removing any milk up to that point, I was still only producing colostrum, and not enough. So, for about 3-4 days, we had to supplement with formula, before my supply finally increased (around day 8 or so).

    I worked with the IBCLC on her latch after the tongue tie revision, and it took her about 3-4 days to really get a good one that didn't hurt, and where she was transferring well. I've since been going to breastfeeding support groups weekly, where I can continue to weigh her before and after feeds to make sure she's taking in enough, and for the last little over a week we've been exclusively breast feeding, no more supplementation.

    Now, however, we're seeming to have the opposite problem, in that I think I may have a strong let down and she's getting too much at once. Almost every time she latches on my left side, after sucking for a few moments, she pops off and chokes, coughs, and gasps for air. I sit her up, and pat her back until it passes, then she re-latches. It may happen 2-3 more times then during the duration of the feed. I've also noticed that, on both sides, she seems fussier while nursing. She'll make a kind of straining, grunting sound, and pull her head back (usually while still clamped down on the nipple), or flail her hands. I can also hear her clicking a few times in the early part of the feed, which is totally new for her, but I usually also see milk pooling around and out the sides of her mouth during these points, so I'm assuming she's just getting too big of a mouthful and is breaking her suction because of this. I can also audibly hear her swallowing and her stomach gurgling while she's feeding, and it sounds like a lot of air being taken in.

    Many times a day, she also seems to be uncomfortable with what I'm thinking might be gas pains. She grunts and strains, drawing her knees up to her chest, then thrusting her legs out. She'll even turn red in the face and really look like she's straining. This can happen before feeds, after, when she wakes up from a nap, or sometimes during feeds. Sometimes, after a bunch of straining, she'll poop, and then seems relieved. Sometimes she'll just pass gas, and this doesn't seem to relax her as much. I'm worried that, with the fact that she's now choking on my let down and regularly seems to be taking in so much air, these are gas pains she's struggling with, but I'm not sure how to correct the issue.

    Since I've been able to exclusively breast feed her, I've stopped pumping altogether, hoping to just let my supply get regulated to her demand now. She was eating about every 2 hours during the day and 3 hours overnight, but lately she's switched those. She now sleeps for slightly longer stretches during the day (can easily go 3 hours without waking if I let her), and wakes every 2 hours, almost on the dot, for overnight feeds. I'd love to switch these around again, but had also been wanting to go by her schedule and not try to alter it too much.

    Any advice on what I can do to help with this? Does this sounds like gas pains? If so, how can I help her get some relief?
    Also, does it sound like I have an overactive letdown, or might her choking, or breaking suction while nursing now be something else? I don't ever see anything spraying out when she pops off, and I've never been able to feel my own letdown, so I don't know if it coincides with that. She has been gaining quite a bit recently though, nearly a pound in the last week alone, but I was also thinking that might be still making up for what she lost in the beginning, not having taken anything in the first 4 days, and getting less after until we started supplementing.

    Any thoughts appreciated, and sorry this is so long!!

  2. #2
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    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    hi jgreiff and welcome! First I want to be sure - is nursing now comfortable for you?

    If so, then what you are seeing is possibly related to the milk flow being a little faster than baby can easily handle. Fast weight gain + the gasping and choking are classic signs even without the gas. This is NOT in any way a major problem. The vast majority of the time, it will resolve entirely on it's own over the next several weeks as your milk production levels off to what baby needs rather than more than enough.

    Ok so in the meantime, here is what helps the most with fast let down: Nursing frequently and changing nursing position to help the flow slows down a bit.

    Nursing Frequency: This helps because the less time milk has to accumulate in the beasts, the less the flow. This will NOT increase your milk production like pumping extra would because baby will just eat a bit less each time. To nurse more frequently, all you need to do is encourage your baby to nurse more often. It won't hurt you or baby even if this means gently waking baby some times, day or night. Often all it takes is picking baby up or (if you are already holding sleepy baby) moving baby to the breast. You may not need to actually wake baby. Babies can and will nursing entirely in their sleep as well. Since baby is waking every two hours overnight, you can leave overnights alone and encourage more frequent nursing during the day.
    If baby prefers taking one side at a time, fine. If baby wants both, also fine.

    Positioning: Did your LC show you "laid back" nursing positioning? Have you tried anything like this? Basically all it means is for you to be more "under" baby and baby on top. Usually this is most easily done if mom reclines her body (leans back) somewhat - or a lot. How much depends on the mom. There is lots of variation for how far to recline and baby can be in any position. Play around with it to find what works for you and baby. If you need more suggestions, let us know what you have tried.
    Nursing sidelying also helps with fast letdown.

    Gas is a normal byproduct of digestion and may have nothing to do with baby gulping too much air. Babies, like everyone else, experience intestinal gas discomfort. What is different with babies is they have not learned how to deal with it. While a fast letdown may lead to more gas, gas pains themselves are entirely normal and part of being a baby.
    If burping is helping baby be more comfortable immediately after burping, fine. Otherwise, probably no reason to burp as a routine thing. Baby will let you know if they need help to burp.

    Overall, most babies are most comfortable if they are held most of the time, snuggled into mom's chest or shoulder or those of another trusted adult, with their heads above their tummies. Some babies like the magic baby hold and other variations when they are gassy.

    Again fast letdown and gas are not serious issues. Baby is gaining great, Yay! Assuming nursing is comfortable for you that is ALL you have to worry about. Do not let people confuse you with talk about hindmilk and foremilk as those are not real issues. Also I would suggest do not consider block feeding at least not yet. Block feeding is usually only appropriate when there is serious enough over production that it is threatening mom's health. Again it is normal to make a bit of extra milk at this point. This is probably mother nature's safeguard against issues like your baby had with tongue tie. Your production should naturally calm down as needed over time.
    Last edited by @llli*maddieb; February 27th, 2017 at 11:19 AM.

  3. #3

    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    Thanks so much for your reply!
    Yes, nursing is now, for the most part, comfortable. Occasionally it will still be painful when she first latches, but that goes away as soon as she starts sucking. Also, she has a tendency sometimes to pull away from her initial latch and just want to take the nipple, which I've associated with her trying to control the flow and get less. When this hurts, I break her suction and have her re-latch. Usually she latches on pretty quickly too, but in the past few days, every now and then, when I put her on she'll just keep her mouth open and not latch until the 3rd or 4th try. But when she does, she tends to be good from then on.
    Another question I realize I didn't include: her poop has been more runny in the past week or a little over, and this has coincided with the increased straining and grunting that I assumed were gas. It's still mustard yellow and smells the same, but the consistency is closer to egg whites. She's still going probably 3 times a day, but I feel they're more spaced out, like she'll sometimes do 3 between 4am and noon, and then nothing the rest of the day until 4am the next day. According to our parents, both my husband and I had a yeast allergy as babies. Is a possible allergy anything I should be concerned about?

    Thanks for your other suggestions! Yes, we have tried other positions, but I mostly use the cross cradle, because it seems the most comfortable. I can hold her in that and recline and she does stay latched, so maybe I should try that more often. At night, we usually do 1 or 2 feeds side lying and that works well too, though she has a tendency to get a latch that pinches more easily that way, so I haven't done it too often.

    Finally, if these are gas pains, would it hurt to give her an infant probiotic and see if that helps?

  4. #4
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    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    What you describe as far as poops is consistent with an issue of fast letdown. Since you are pretty sure that is happening, I think you can chalk the poop look up to that and not worry about any allergy. It is interesting that baby is not pooping more often, though. Are the poops pretty big?

    Yeast allergy? In a newborn? That has me scratching my head. A yeast overgrowth (thrush) might cause nursing pain for mom and hard to get rid of diaper rashes for baby. Thrush can be hard to get rid of even with proper treatment, so some moms have to change their diets to avoid things like too much sugar and carbs that are helpful to systemic yeast overgrowth. But that is to stop the yeast overgrowth in mom's body. Your LC would have most likely ruled out thrush while you worked with her, it is not all that common anyway. If you were going to avoid anything due to a possible allergy in baby, the food group to start any eliminations with is dairy. Again, not all that common for dairy to a be a problem but possible and surely much more common for dairy to cause issues in breastfed baby than any other food. But I think what you are describing is almost surely simply normal or due to the fast letdown.

    I think a probiotic is fine to try. Certainly there is some scientific evidence for that helping, while there is none for gas drops or gripe water. Also, some of what is going on may be due to the need for early supplementation with formula. The earlier formula supplementation is needed, the more likely it changes the normal gut biome. So baby's gut just may need a few weeks of only breastmilk to heal.

    Finding a comfortable latch and positioning that works for both you and baby is typically a continuously changing dance. A newborn is growing rapidly so growth alone makes it change. Your baby had ties so that also means latch is still something you are both still trying to figure out. This is all normal. Do what works while it works and keep experimenting as needed is really my best suggestion with latch and positioning.

    A common issue with sidelying position is mom puts baby too "high up" her body, rather than where the breast naturally lies. When sidelying, try bringing baby to the breast nose aligned to your nipple so baby can tilt head back slightly to latch. Also try snuggling baby's bottom more in to you, that will probably help get her whole body into an alignment that helps her get a more comfortable latch.

    Also ask the folks at the breastfeeding support group to demonstrate laid back and sidelying. Always remember every mom and baby fit together slightly differently from every other nursing pair, so use what you find there and online regarding latch and positioning as places to start experimenting rather than rules.

    Yes reclining positions do often also help with babies who pull too much on the nipple.
    Last edited by @llli*maddieb; February 27th, 2017 at 01:03 PM.

  5. #5

    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    Yes, I'd say there's generally a lot of poop when she goes - I usually hear 3-5 'squirts' in succession, then if i don't get her changed in the next minute or so, it will leak up the back or front. Usually the whole diaper is pretty full

  6. #6
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    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    Ok got it. Baby is gaining well and that is consistent with lots of poop when baby goes, so there is clearly no problem with intake and that is good. Baby may start pooping more often now that she is getting so much more milk, and that may help baby be more comfortable. But, some babies do poop less often than others and there is nothing wrong with that, although it may be one reason baby seems to be having issues with gas. Since the act of nursing encourages the bowels to move, this is another reason frequent nursing may be helpful.

  7. #7
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    Default Re: 3 weeks old - is this gas? And nursing after tongue tie

    with MaddieB. I just have one thing to add about gas pains. "Gas" is something that a lot of parents find really concerning, so much so that there are tons of products and techniques and special formulas that are supposed to treat it. But I think we need to reframe our thoughts about the grunts and wiggles and apparent discomfort that gets chalked up to gas as something normal for babies, rather than as a pathology that we need to treat. All humans get gas, and there's nothing inherently bad about that. It's just a normal facet of digestion. Babies are simply having their first experience with this quintessentially human thing, and they don't really know how to handle it with grace. They actually need to LEARN to coordinate the muscles of their digestive system and move gas out in a comfortable way. This is a lifelong skill that they are mastering. It's totally natural for them to act like it's an effortful learning process!

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