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Thread: 2 week old- latching problems

  1. #1
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    Jul 2017
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    Default 2 week old- latching problems

    My baby is 2 weeks old and I can only get her to deep/wide latch correctly maybe 80% of the time, and when she does- she immediately (literally like 1 second) pulls back to turn it into a shallow latch. I have large, long nipples and I wonder if maybe her mouth isn't comfortable opening wide enough? I always hand express before putting her to breast, so there doesn't seem to be a problem with delayed let down.

    It is so frustrating. As such, I have only been "practicing" breastfeeding 1 or 2 times a day then exclusively pumping and bottle feeding breast milk for the rest of the day. I want to increase nursing time because I can't keep up with pumping-- I'm only producing about 3 oz per 20 minute pump session and she consistently takes in about 3.5 oz per feed.

    Back story information: We were dealing with high levels of jaundice (bili levels at 18) which are now steadily decreasing. We were exclusively bottlefeeding with my breast milk so we could make sure she got enough food to help decrease the jaundice. Since she is now at her original birth weight, the doctor said it's okay to now start working in breastfeeding.

  2. #2
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    Default Re: 2 week old- latching problems

    Hi lpetix. I am sorry you are having this concern. I will try to offer some suggestions, try whatever sounds good to you.

    It is early days, and many breastfeeding moms and babies who had a rough start figure this out and go on to exclusively breastfeeding. But you will want to be proactive about really trying to get baby to nurse and getting professional help or at least local peer support if needed. The earlier you get baby nursing, the easier this will be for both of you.

    You have done amazing getting baby gaining normally after a shaky start. Now that doctor has given the official ok to start breastfeeding, I suggest try to nurse your baby a normal amount of times a day, which at this age would be at least 10 times per 24 hours. Newborns normally nurse 10-15 times in 24 hours at this age. If baby seems to need supplements as well, they can be given without avoiding breastfeeding. Babies learn to nurse by nursing and so do moms. The more time baby spends at the breast the faster you will both learn.

    As long as you are supplementing, make sure you are pumping with a good pump that is working properly for you as often as you reasonably can. At least as often as baby gets supplements or at least 8 times in 24 hours (whichever number is lower.) Why 8 if baby nurses 10 times or more? Because everyone knows that pumping is very hard and 8 times a day is the compromise. Also because a pump that is working perfectly will extract milk overall more consistently in amount (but not overall as consistently in effectiveness) as a normally nursing baby.

    Try no longer hand expressing before nursing, at least not every time. This is helpful when baby needs that instant reward, but if baby is latching this may not be needed. An alternative to keep baby at the breast is to dribble a little expressed milk on the nipple after baby latches...If needed. The reason I am suggesting to not hand express to get the milk flowing is this:

    It is normal that a baby must suckle for a bit before any milk comes...this is not delayed letdown, it is normal letdown. Any bottles should be given to baby the same way- with baby not getting the milk flowing into babies mouth immediately. Baby must suckle first.*

    It takes baby sucking for at least a few moments to get the milk to flow, all babies must learn this. Also, baby may be pulling off because they are not ready for the milk to be flowing so fast so quickly- in fact the behavior you describe is much more commonly caused by the milk coming a little too fast for baby, rather than too slow.

    Try leaning back breastfeeding, with you leaning back (while supported and relaxed) and baby on top. This helps with the pulling off issue two ways. 1) Baby is being held to the breast by gravity, rather than being pulled away 2) it helps the milk flow to be a little less forceful.

    When supplementing, stop feeding baby 3.5 ounces at a time. It is way too much for a 2 week old baby. A baby this age will normally take in about between 1 and 3 ounces per nursing session and it will vary session to session how much. If baby actually needs that much at once, you are not feeding baby often enough. Usually what is happening is that baby will keep taking whatever is in the bottle because baby is compelled to suckle. To avoid overfeeding with bottles, use paced bottle feeding technique (*properly done this also lets baby experience the need to suckle before milk comes) or better yet, use an alternative feeding method. (Cups, spoons, syringe, lactation aid)

    Overfeeding when supplementing is a serious problem when trying to get baby to learn to nurse. A baby who is getting all they need and then some when supplemented cannot be expected to be very interested in nursing effectively.

    Try different latch and positioning ideas until you find those that work best for you and baby.

    If these ideas do not very quickly get you to the point where baby is nursing mostly and the need for supplementing and pumping is diminishing rapidly, it is vital to see an IBCLC if you possibly can for breastfeeding assistance. In fact since baby is at this point already basically entirely supplemented with little to no nursing, I would suggest see an IBCLC asap. Jaundice or no jaundice, it is not normal for a healthy baby to not be able to get enough milk by nursing at the breast. If this is happening, it means something is not going right with breastfeeding and an IBCLC is the proper professional to see for such issues, not nurses or doctors generally speaking, as they usually have no training at all in this area. A good local volunteer may be all you need, it really depends on what is available, but an IBCLC is usually going to be your best bet. If you need help figuring out how to find an IBCLC please let me know.

    Two very good paced bottle feeding videos: https://www.youtube.com/watch?v=dxpIzcitLc8 and https://www.youtube.com/watch?v=ykdFuEOIdeE

    Alternative feeding methods: https://www.youtube.com/watch?v=vrrrC5NyNnQ

    Cup feeding newborn: https://www.youtube.com/watch?v=fCyWvcsdYOE

    Nancy Morhbacher has many videos and articles on laid back (reclined, or "natural" breastfeeding positioning.) Here is her blog, you can explore from there: http://www.nancymohrbacher.com/

    good article that covers the basics of many latch and positioning ideas: http://feedthebabyllc.com/latch-and-positioning/

    What to expect at a lactation consult: http://www.cwgenna.com/lconsult.html

  3. #3
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    Default Re: 2 week old- latching problems

    Thanks so much for your helpful tips and resources! After studying the natural position videos, I successfully fed her with both breasts, though i noted the left to be more difficult for her to latch, and I had a sharp nipple pain with her latch. Despite having gravity assist and no hand expression beforehand, she still did the immediate re-latch with the left breast, though overall this was a successful feed in my opinion.

    During her next feed however, she was inconsloably fussy, squirmy and was not able to stay on either of my breasts past a few minutes. She would latch and then cry and try to suck for a few seconds then again lift her head and cry. I cannot figure out why- milk seemed to be coming out fine, her position was the same as it was the first time it worked. I then moved to bottlefeed and she was perfectly fine so i know she was hungry. Could it be that this position was uncomfortable for her this time despite it working for her the first time? I was so disappointed because I was finally happy that it had worked just a few hours ago and now she seems to hate it.

  4. #4
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    Default Re: 2 week old- latching problems

    Hi lpetix, I am sorry you are feeling disappointed after an initial bit of success. Here are some more suggestions, again take what makes sense to you.

    Why was one feeding successful and the next not? No way to know for sure. But one thing to consider is that this is how it works when trying to get a baby back to the breast. A step or two forward then a step back. Again, both you and baby are learning something you have not done much of yet. For nine months baby was fed through your umbilical cord and for the last two weeks baby was primarily bottle fed. So nursing is all new. Yes, WANTING to nurse is instinctual. There are many ways to key into that instinct that may help baby latch and nurse, you can see that discussed in some of Nancy M.s videos on "natural" breastfeeding. But nursing is still also learned behavior. Baby is learning and so are you. There are bound to be setbacks. It does not mean she hates nursing, please take that idea right out of your head! Think of it this way...in a year or so when your baby starts to walk, which is also instinctual and natural for her to do, at first she is going to fall a lot and probably cry. This does not mean she hates to walk. In fact she will need to fall so she can learn how to not fall.

    Remember I suggested this?:
    Try different latch and positioning ideas until you find those that work best for you and baby.
    You and your baby are a unique nursing pair. All the videos, explanations and pictures are there only to give you ideas. Then you have to take those ideas and see how to use them just to start to find what works for you...more important is to listen to your own body. Are you comfortable? If not, make the needed adjustments. Watch baby. Is baby settling in or is baby squirming, unlatching, crying etc? Again, make the adjustments that make sense to you at that moment. It may take several tries to get baby latched well, then once baby is latched, you can make whatever further adjustments that seem to help while baby remains latched.

    If you were able to go watch a mom who had been nursing for a while, whose baby is nursing "perfectly" you would often notice she adjusts herself and her baby repeatedly. If you asked her about it, she might not even be aware it is happening. It has become instinctual. But no mom starts out that way. Every mom has to learn what works best for her and her baby and this takes time and practice.

    If baby is super fussy and you think baby is just too frustrated to continue trying to nurse, (or you are) then of course go ahead and give baby a little supplement in a bottle or alternative device if you believe the problem is that she is hungry (remember baby will usually drink whatever is in a bottle whether they need it or not, sometimes baby may just be tired and fussing due to that or some other reason.) Just give enough so you both calm down. Maybe an ounce or so at most. Then try nursing again. If one feeding goes by with no nursing, that is a feeding where it will be very important that you pump to make up for that. Then try nursing again at the next nursing session. This is not an issue that is going to resolve completely overnight, but you want things moving in the direction of baby nursing more and being supplemented at least a little less each day.

    Also - this is important- give up the idea that every nursing session should be of a certain length with a blissful baby who nurses peacefully to sleep or stops nursing and acts "playful" and "content." That will come later although never all the time...all babies act unhappy at the breast sometimes no matter what age. At two weeks? No way. Even very healthy newborn babies who are doing very well can appear pretty miserable much of the time! Please know that even the baby who is breastfeeding perfectly and happily will cry a lot, cries at the breast, fusses while nursing, fusses as soon as they are done, squirms, pulls away, latches and unlatches, wants to be held most of the time, and seems to be constantly hungry and wanting to nurse minutes after mom thought baby was "done," wanting to nurse right after spitting up all over the place etc etc....That behavior and much more is all entirely normal, and is especially intense right at this age when most babies shake off the sleepiness of the first couple weeks and suddenly realize they are ravenously hungry.

    At this point, getting baby to the breast asap when baby cues, and also offering to nurse, helps a lot, because babies normally become so hungry so quickly at this age. If there is any delay in getting baby to the breast, this can make baby upset and that makes baby very disorganized and uncoordinated when trying to latch. This is a good time for mom to be getting lots of help because she may find she needs to be holding baby almost all of the time. So at this point, holding baby skin to skin or with very easy access to the breasts is a good idea at this age.

    Watch out for nipple pain! I know from personal experience that when in this type of situation, if baby manages to latch it can be such a relief you try to put the pain aside. And actually to some degree this is ok, because again, you and baby are learning and one thing you have to learn is how to adjust things so nursing does not hurt, and you cannot learn this if you never let baby stay latched when it hurts. On the other hand, latch pain or nipple injury that is ongoing and not getting better is potentially a very serious problem and if that is happening again probably best to get in person assistance from a competent IBCLC.
    Last edited by @llli*maddieb; July 16th, 2017 at 11:23 AM.

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