Nipple Confusion

[pgfairy]

I dunno about lo but I'm seriously confused. Our tongue tie release has made a world of difference and he is now no longer giving me blood blisters and my nipples have 'healed' so we are back on both sides.

However nursing is far from pain free and this child WILL NOT deep latch. When he finger feeds his technique is flawless. He has no problems having my finger way back in his throat, he sucks beautifully and doesn't try to push my finger out with his tongue at all. But when. He is on the breast one of two things happens. He either gets on good and after two or three sucks he forces my nipple forward with his tongue so he's got me against the high roof of his mouth and pinches. Or he flat out refuses to latch and just cries at me.

Our routine has been try the breast whichever side we didn't try the precvious feed. We try until either it hurts too much or mom loses her mind whichever comes first and then we give the rest from a bottle and once he goes to sleep I pump both sides for the next feed

Do I just continue how I am till he 'gets it'? Or am I just reinforcing that if he doesn't get his way at the boob he can have the bottle? Should I finger feed instead of bottle feed? He is on low flow nipples and takes about 20 minutes to get 4 ounces, I'm pretty sure he's more efficient than that on the breast. But his bottle technique doesn't seem to be impacting on his finger feeding technique so what is his problem with the boob? Ps we have tried getting the milk flowing and softening the breast. No impact. We do occasionally get a good feed I think, but when hes done he pinches really badly so it's tough to tell what shape my nipple would have been before he got lazy and pinched it so it might just be that I'm building a tolerance? i am so frustrated. Help.

 

[pinkpassion]

I had this with dd , I eventually got a nipple shield and then slowly weaned off that by taking it off after she got a little milk to satisfy her hunger up front then when she calmed down I'd remove it and make her latch over and over until she got it right, I know a lot of people say don't do the shield but it helped us.. I had the exact same problem you are describing. .. and sometimes I'd give her expressed milk with a bottle until she calmed down and then nurse her!

 

[noon_child]

Could you have a forceful letdown? This might cause him to pull back on your nipple, or push it out, or clamp down in order to slow the flow. Side or reclined feeding (where he kinda lies on your chest) could help if it is this.

Also you say you are only trying one breast per feed then topping him up. Can I ask why you don't try both? With my LO the only way I stayed sane was switching her to the other breast when (like you said) I thought I would go mad from the pain, or switching to a different position so the pain moved somewhere else! Offering both breasts will help keep up your supply while he learns how to feed from you, he'll need smaller top ups and you won't have to pump for as long. Plus if you do have forceful letdowns short feeds, frequently from both breasts should help it feel more manageable to him.

Sounds like you are doing great with it all, well done for all your hard work. Do you have a support group you could go to, or anyone who could come to support you in your home (like LLL)?

 

[pgfairy]

Thanks both for your replies. We are pretty proud we have gotten this far, I'm still holding out hope that at some point in the next 4 weeks he's just going to get it, either cos his mouth gets bigger or he gets more able to handle my let down, which does seem to be quite forceful so we do sit back as much as we can.

As far as giving both sides goes I think I have an issue with oversupply from all the pumping we did early on, and I could easily give up the breast and exclusively pump. As a result if I offer him the other breast before he has drained the first he gets way too much foremilk which makes him much more fussy (and turns his poos green) so we try to drain one boob and not switch around too much.

Fingers crossed we have more success over the coming weeks.

Oh and we don't have an LLL locally which really sucks. There is a local run support group but to be honest they haven't been very helpful, they seem pretty new and inexperienced with some of the less common pitfalls of breastfeeding and I'm fairly certain that after 3 home visits I've heard most of all they have learned in their training. They also dont have any meetings.

 

[noon_child]

Thanks both for your replies. We are pretty proud we have gotten this far, I'm still holding out hope that at some point in the next 4 weeks he's just going to get it, either cos his mouth gets bigger or he gets more able to handle my let down, which does seem to be quite forceful so we do sit back as much as we can.

My Lo did suddenly get it - even though we'd been told no TT, she still fed as if she had one, but at 10 weeks it suddenly felt less painful and by 11 weeks was pain free!!!

As far as giving both sides goes I think I have an issue with oversupply from all the pumping we did early on, and I could easily give up the breast and exclusively pump. As a result if I offer him the other breast before he has drained the first he gets way too much foremilk which makes him much more fussy (and turns his poos green) so we try to drain one boob and not switch around too much.

Oh absolutely I wouldn't take him off if he hasn't finished one side, I just thought if he was still hungry enough to take a bottle he could take your second side instead.

It seems like oversupply might be causing a lot of issues, have you considered cutting down the pumping or stopping altogether? I know the fear associated with this: "what if I have no pumped milk and he's screaming and so I have to put him on the breast but I just cant because it is so painful", but what if your pain could be stopped by reducing the oversupply??

I know when I had pain and was being told that putting LO to the breast frequently would help her weight gain and my supply I just wanted to punch someone - but if you could move towards more frequent feeds on emptier breasts it might mean less pain, less green poo and discomfort and less time spent pumping and cleaning bottles etc.

Oh and we don't have an LLL locally which really sucks.

Have you tried NCT? If there are no LLL counsellors who are near enough to visit there might be NCT (0300 330 0700) ones instead (I had both visit me!). The national breastfeeding helpline is here toohttp://www.nationalbreastfeedinghelpline.org.uk/ and they might be able to offer support too.

 

[pgfairy]

My Lo did suddenly get it - even though we'd been told no TT, she still fed as if she had one, but at 10 weeks it suddenly felt less painful and by 11 weeks was pain free!!!

That helps keep me going, I can tell myself at least that in just one more week maybe....

Oh absolutely I wouldn't take him off if he hasn't finished one side, I just thought if he was still hungry enough to take a bottle he could take your second side instead.

It seems like oversupply might be causing a lot of issues, have you considered cutting down the pumping or stopping altogether? I know the fear associated with this: "what if I have no pumped milk and he's screaming and so I have to put him on the breast but I just cant because it is so painful", but what if your pain could be stopped by reducing the oversupply??

I know when I had pain and was being told that putting LO to the breast frequently would help her weight gain and my supply I just wanted to punch someone - but if you could move towards more frequent feeds on emptier breasts it might mean less pain, less green poo and discomfort and less time spent pumping and cleaning bottles etc.

Yeah, this all did cross my mind but as you say, it's scary and we've had to supplement with formula in the past. I'm fairly certain on more than one occasions we've over fed him when he's 'done' with the breast and we've still given him supplemented bm or formula to keep his weight up. I know he can get a full feed out of one breast if he's not ravenous so oversupply might be the cause of some of our issues.

I need to be brave and exclusively breast feed for a few days, but we are just coming out of a month of well intentioned house guests and other insanity, so haven't gotten up the guts just yet. My husband is home again in a little over a week, so we were planning a breastfeeding vacation when he's here to take care of me while I take care of LO. I'll work on my courage and try to get off the pumping by then.

 

[noon_child]

Good luck!

 

[pgfairy]

I had this with dd , I eventually got a nipple shield and then slowly weaned off that by taking it off after she got a little milk to satisfy her hunger up front then when she calmed down I'd remove it and make her latch over and over until she got it right, I know a lot of people say don't do the shield but it helped us.. I had the exact same problem you are describing. .. and sometimes I'd give her expressed milk with a bottle until she calmed down and then nurse her!

We gave the nipple shields a try, thank you so much for the suggestion. My LO won't drink through them. At all. Go figure,

My Lo did suddenly get it - even though we'd been told no TT, she still fed as if she had one, but at 10 weeks it suddenly felt less painful and by 11 weeks was pain free!!!

Oh absolutely I wouldn't take him off if he hasn't finished one side, I just thought if he was still hungry enough to take a bottle he could take your second side instead.

It seems like oversupply might be causing a lot of issues, have you considered cutting down the pumping or stopping altogether? I know the fear associated with this: "what if I have no pumped milk and he's screaming and so I have to put him on the breast but I just cant because it is so painful", but what if your pain could be stopped by reducing the oversupply??

I know when I had pain and was being told that putting LO to the breast frequently would help her weight gain and my supply I just wanted to punch someone - but if you could move towards more frequent feeds on emptier breasts it might mean less pain, less green poo and discomfort and less time spent pumping and cleaning bottles etc.

Ok I have another question. HOW did you manage to keep nursing without pumping and topping up your little one?

We've gone to a policy of only pumping when we have to top him off with the EBM from the fridge, and breastfeeding the rest of the time but most of the time one of two things happens

1) We latch. And remove him and relatch because he's pinching. And remove him and relatch because he's pinching, and remove him and relatch because he's pinching....and we do this until I want to throw him out the window (mostly kidding with that comment at which point we stop and I give him the rest of his feed from the bottle in the fridge and pump.

OR

2) He latches and does ok for a little while (like 5 minutes) and then I suffer through as much of him pinching as I possibly can before I have to remove him. Then either he is not hungry any more (occasionally) or we go back to scenario 1, or we just go straight to the bottle, depending on how tired I am.

Did you just nurse through the pain till your LO got the hang of it at 10 weeks noon_child? And if so....any hints tricks and tips for dealing with the pain while nursing would be very much appreciated!

 

[noon_child]

oh I pumped and topped up but only because I knew she wasn't getting enough from me (really slow weight gain!). I was just thinking that now you have the tongue tie clipped you have almost got to go back to day 1 and start again trusting your body to make enough milk for him based on his demands. If he is able to put on weight and have plenty of dirty nappies you know then that you don't need to pump.

How did I keep feeding, d'you know I'm not even sure. I know I cried a lot. I know I did combinations of continuous unlatching and just feeding through it. I changed positions so that different parts of my breasts got pinched and I swapped sides a lot when I couldn't stand it. I also fed more from the side that seemed to get a better latch.

A LC I saw said she could see me pulling back at the moment of latching in anticipation of the pain and that was making it worse. She advised I make sure I don't rush to latch before I'm ready, to take a deep breath and prepare myself not to flinch. Also to try to always have a firm backing of pillows of chair backs so that it was physically harder for me to flinch. You can also take a painkiller 20mins or so before a feed.

Dr jay Gordon suggests rather than unlatching all the way, that we break the vacuum as if we are going to unlatch and then as the baby opens its gape in panic at being unlatched, we push the chin down with our thumb (opening the gape further) and press the child further on to the breast to get a deeper latch. Dunno if that makes sense, I didnt k ow about it back then so dunno ifit works.

Laid back feeding can also help (especially if oversupply might be an issue).

Oh and depending where you live,visits from LLL, NCT and trips to local breastfeeding support groups!

 

[pgfairy]

Well, we are nine weeks old today and I think we're starting to get the hang of it.

We're better on one nipple than the other but we're feeding exclusively off one breast and pumping the other (which has some issues all it's own and we still don't quite have the hang of it yet) but we're getting there! Pinching is reducing dramatically every day.

I told myself at 7 weeks that if we got to 10 weeks and he was still failing so miserably we were going to bite the bullet, buy a double pump and a bunch of pumping bras and he would just be an exclusively expressed breast milk baby. Looks like he won't be banished from the breast after all.

We didn't make any changes either, to the latch or anything. He really is just 'getting it'. How STRANGE. Persevere momma's, sometimes you just have to push through!!