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Thread: Frustration after tongue tie

  1. #1

    Default Frustration after tongue tie

    19 days old, just found out we had a tongue tie 3 days ago and had it fixed same day. We haven't been able to latch without nipple shield and even with that sometimes she starts pushing away my breast before we even get started. I feel like the nipple shield gets knocked off about 10 times before we feed. She tends to fuss and pull off several times before she stays on for more than a few minutes. I am pumping some and we are surviving feeding to feeding, barely. I have wanted to give up so many times! Would love to hear ANY stories or advice about 1) feeding after tongue tie corrections in general and 2) experience with weaning from nipple shield

  2. #2

    Default Re: Frustration after tongue tie

    I am going through this same exact thing. My daughter is 19 days old too and I am on the verge of quitting but I would really like to stick with it. She has all the characteristics of being to tongue tied, but there is no apparent tongue tie, according to the lactation speacialist. We are going to another specialist to get her potential tongue tie evaluated. The nipple shield was so frustrating because it would fall off several times before I could get a decent latch. One day I couldn't find the nipple shield and tried breastfeeding without it, and she did just fine. Not sure what the correct manner is to wean the nipple shield off, but my daughter seemed indifferent to me using or not.

  3. #3
    Join Date
    Jun 2009
    Posts
    10,695

    Default Re: Frustration after tongue tie

    Hi. I have experience with nipple sheild use and weaning off it.

    First, I want to mention that it is common that frenectomy does not immediately solve latch issues. After care of some kind is often required, either because baby needs to learn to nurse better now that baby can, or because there were other latch issues that need to be addressed and solved (while tongue tie can certainly cause latch issues, most of the time, problems with latch are not related to tongue tie.) Have you seen an IBCLC since the frenectomy? How did that go?

    If at this point a nipple shield is helping baby get a good latch and be able to nurse, then the nipple shield is doing its' job. If baby can latch without much struggle without a shield and transfer milk when nursing, no need for the shield and it should not be used any longer.

    For weaning off the shield, first you want to work on any existing latch issues. This can usually be done by using some of the many latch and positioning techniques that may help. Sometimes time itself helps. Some babies seem to respond to bodywork of one kind or another. These are all things an IBCLC should be able to help you with or at least, identify, as a possible strategy, at an in-person consult.

    Otherwise, I found that being both patient and persistent paid off when weaning baby off the shield. Patient with myself and with baby as progress could be agonizingly slow. Perisitent in that I did not let a day go by without attempting to latch baby without the shield at LEAST once. Usually more often. I would try until it seemed counterproductive to continue to try, and that is going to be a different place for each situation.

    I also found we could wean from the shield on one side couple weeks before the other. Days also came before nights. This will differ situation to situation, I am just saying you may find that progress is piecemeal. It is ok.

    As long as baby is nursing with a shield, the typical recommendation is to pump to protect milk production, as shield use is linked to situations of reduced milk production.* There is no need to supplement baby with this milk that you pump, assuming baby is gaining normally at the breast. Supplementing adds additional complications to the process of getting baby nursing well, so generally should be done only as much and if needed.

    *How often a mom using shields needs to pump is open to debate. Some do not need to pump at all, others need to pump 8 times a day, and everything in between. (Many moms are told to pump after every nursing session, however that is not likely to be needed and would probably be overly exhausting to the point it was counterproductive. Babies this age easily and normally nurse at least 12 times in 24 hours. Even moms whose babies are not nursing at all are usually only told to pump 8 or at most 10 times in 24 hours to have the best chance at normal milk production. This is because 1) While a baby takes a different amount each time baby nurses, with many small feedings interspersed with larger ones, mom can make sure she pumps long enough to "empty" the breast every time she pumps and 2) "Pump 8 times in 24 hours " is a compromise that does not correlate to how often babies actually nurse because it is understood pumping is much harder than nursing most of the time and it iws not helpful to drive mothers insane with pumping. If baby is not needing the expressed milk as a supplement, you would probably be on the lower end of how often to pump. But again this is so individual, best to consult in person with an IBCLC.

    More in nipple shields: http://kellymom.com/ages/newborn/nb-...s/wean-shield/

  4. #4

    Default Re: Frustration after tongue tie

    Wow, thank you SO much for the thorough reply, I truly appreciate the advice you shared. I have not gone back to see our IBCLC yet, I was going to give it a full week after the frenectomy and then have her assess where we were at that time. Turns out that we got latched last night without the shield thanks to my husband insisting that I try! And we have latched several times today without the shield!

    I am definitely still struggling with how much to pump, how long, etc.
    I have been pumping when the feedings have not lasted at least 15 minutes and for the most part I've been using the 2 or so ounces I pump to top her off bc her she lost an ounce since our 2 week appt and has stalled out! Yikes!

    I definitely know we still have a ways to go. It is helpful to hear a reminder that I need to be persistent and patient. It has been a difficult journey with lots of tears, but I am taking all advice and encouragement to heart.

  5. #5
    Join Date
    Jun 2009
    Posts
    10,695

    Default Re: Frustration after tongue tie

    Wow that is great baby is latching without the shields at least sometimes. It took us almost 6 weeks to get to that point...

    As far as how to much to pump, that is something to see or at least talk with your IBCLC about. Of course you are alarmed with the weight check, but there are so many variables that can happen I suggest try not to be unduly alarmed. Of course baby should get supplements of your expressed milk if needed. But how much supplement is needed- or even whether any is needed- can change rapidly. Aside baby getting better at nursing, for the first month and a half or so, your milk production is gradually increasing.

    Aside from gain, you can get a more immediate idea of whether baby is getting enough to eat looking at poop output. When baby is weighed, make sure it is the same scale each time, with baby naked or in a dry diaper, and that the check is done carefully and numbers double checked.

    Maybe at this point your LC could do some before and after nursing weight checks. It is best to do more than one, just to get the most full picture. What you want to see is baby capable of taking in about 2 ounces or more in a normally length nursing session (about 20-40 minutes, both breasts.) Your LC may have slightly different numbers in mind, but that is the general expectation at this age according to the textbook Breastfeeding Answers Made Simple. Of course sometimes the nursing session results in lower intake and that can be entirely normal, babies do not always eat the same size meal all the time! What is nice about seeing the 2 ounces in a reasonable amount of time is it offers some reassurance baby can transfer milk normally. If baby can transfer milk normally, all that is then needed is that baby is nursing often enough to get enough overall.

    Oh and for supplements you may want to consider using paced bottle feeding method for giving bottles to breastfed infants. Did your LC show you how? if not or if you want to learn more, let me know I can direct you to good videos and info.

    You are doing great, hang in there. It gets better, I promise.
    Last edited by @llli*maddieb; June 19th, 2017 at 10:59 PM.

  6. #6
    Join Date
    Nov 2012
    Location
    Ontario
    Posts
    726

    Default Re: Frustration after tongue tie

    Neither of my babies latches improved immediately post frenectomy. I was rather disappointed about that to be honest, but I feel like it probably made more of a gradual difference over time so I don't regret having done it.

    My LLL leader sent me some good exercises to do with my last baby when we were having latch difficulties. Here's one for little rhythmic movements you can do to try to relax baby
    https://www.youtube.com/watch?v=VR_OCKpIhyo&authuser=0 I tended to do a few when we were doing diaper changes. And here's some other little mouth/tongue stretches to do https://www.youtube.com/watch?v=-llmAhDoKno&authuser=0 . I also found it was helpful to just lightly massage her jawline to help her relax.

    Who knows if any of this will help, but sometimes it feels good to just be trying something! Sorry I don't have anything to add about nipple shields though!

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