possible weak latch - sorry, bit long

[howiwonder]

hi
i think my 11 week old has a bit of a weak latch, i know the most helpful thing would be for me to go to a bfing group but i cant make one this week and next week the local ones arent running as its half term so just wondered if anyone could answer a couple of questions in the meantime...

bit of a back story - we have had a terrible time over the past few months. ds2 was born mid nov, i felt he was quite a fussy feeder but thought all would come good in time and it was just early days, learning how to feed. however, at 11 days old the mw asked us to take him into hospital as she had concerns about his colour and to cut a long story short, he was diagnosed with a serious heart defect and had open heart surgery at 16 days old.
he was tube fed my ebf after the op in tiny amounts which was slowly built up, then the breast was reintroduced and we alternated tube and breast until finally removing tube. when he went back on to full time breast feeding, he didnt gain weight well in hospital, actually lost in tiny amounts over the days but i fought to get us discharged as i knew when we got home, off the busy hospital ward, we could really relax and have skin to skin and establish feeding better. we were allowed home and the feeding really picked up, he has steadily gained weight and went from the 2nd centile after surgery to now sitting just above 50th.

however, i still feel feeding isnt quite 'perfect'. i dont know if this is just something i have to expect as i always read about heart babies struggling to feed - i suppose that will be a question for the doctors at our next appt.
he seems to have a weak latch IMO, never feels completely solidly latched on the breast. milk often leaks out of his mouth during feeding - am i right in thinking this is a sign of weak latch? if it is a weak latch are there certain positions better for this?

also i have to get really comfy to feed him and position him, feeding out and about can lead to us both getting a bit hot and bothered if we are on a little chair at a dining table for example. i actually dread feeding him out and kind of avoid it tbh. i think i also have strong letdown and he can get very spluttery at the start of a feed.

but if hes consistently gaining weight do i actually need to worry about this? i would just love it all to feel a bit easier and pop him on in the way i did my ds1. fought really hard to keep feeding through all this trauma so would just love it to be a bit easier and less frantic for us both.

[Noodled]

Tbh your strong let down can make it more comfy for him to keep the latch a little less secure. His gain is great, each baby feels and feeds a bit differently.

Some real life hflp with positioning could help, his latch could be weakened by something like a tongue or lip tie BUT he is obviously doing brilliantly and not all babies do velcro on.

[CelticPromise]

Wow. You have done an amazing job to keep going through such a tough time.

I'm a BF peer supporter but not an expert. I've never heard the description ' weak latch' but I have seen babies that slip down while feeding, is it that? If you feel you have a lot of milk and you see it leaking out it sounds like you have plenty.

I think that with latching, if it ain't broke don't fix it. I see babies without a textbook latch, and if they are gaining weight, weeing and pooing and mum has no soreness or discomfort then that's fine.

When you say about getting comfy do you mean you have to concentrate quite hard on getting a good latch? Maybe as your baby gets bigger and stronger this will get easier for both of you. Perhaps he finds feeding tiring? I don't know anything specific about babies with heart problems but I do work with NICU mums and lots of those babies get very tired feeding.

Lastly, are your groups definitely not running at half term? The ones in my area don't close in the holidays.

Best of luck, and well done on your amazing job so far

[BertieBotts]

Tongue/lip tie can contribute to babies "slipping" from a good latch to a bad one - this can also cause milk to leak from the mouth as they find it hard to get a good seal.

Lip tie pictures and positions

Lots of pictures of tongue tie - sorry this page looks a bit grim - lots of mouths! There's quite a lot of info on tongue tie (analytical armadillo/milk matters is great) but lip tie is harder.

I might be totally wrong here but worth checking out. :)

[howiwonder]

thanks for those speedy replies! celtic i thought i had heard the expression weak latch somewhere, thought it sort of describes how it feels - like i dont get that strong suctioned on feeling, he can come off quite easily and i find myself supporting the breast with my hand which i dont think ive done before
. come to think of it though the spluttering and leakage is usually at letdown so maybe it is all linked to that, as you say noodled. its just that never seemed to bother ds1, but all babies are indeed different!

when i talk about getting comfy, i mean being in my nice big chair at home with all my pillows and the like, lots of space to manoeuvre him around. his breastbone is still 'broken' after the op as they have to cut through it , so i have to be careful how i hold him until it heals which doesnt help.

he definitely did find feeding tiring before and immediately after the op, but i hope that isnt the case any more - in theory they have 'corrected' what was wrong with his heart, so it shouldnt be an issue unless there has been a post surgery complication. this is probably why i am slightly stressed at anything that isnt perfectly normal - i worry that it means something is up. lots of wees and poos, and as i said weight gain good.

i asked HV about possible tongue tie but she thought not after looking.

ive just had coffee with a friend whose baby is the same age and sat feeding serenely, barely moving throughout and my ds thrashed about and cried so i suppose i felt a bit

will double check about the bfing groups, i thought as they were in schools they would be closed but maybe not...

[howiwonder]

thanks bertie - crossed post with you - i became convinced he had tongue tie (he makes clicking noise on letdown too) but then the hv said no. but the symptoms with fast letdown are very similar so its hard to know

[BertieBotts]

Tongue tie is quite often missed by professionals - it might be worth having a look yourself with reference to the pictures. See this thread for lots of posters who were told their baby didn't have TT when actually he/she did!

I think overall if weight gain/nappy output etc is good and you don't have pain while feeding, then not overly a worry, but if it can be sorted, then you may as well get it sorted. As an aside my friend whose baby was lip tied found that the biological nurturing position worked the best for her - just not v practical for out and about.

One of the BF groups I used to go to closed over half term and the other didn't. It seems to be related to whether or not the organisers have school age DCs :)

[howiwonder]

thanks - will go to a group and ask again about tongue tie just to get another opinion. no pain for me which is good.

dont think biological nuturing position could happen for us just yet, if it is what i think it is - (with baby on their front on chest?) - hes not allowed to be on his front until alls healed. i never really experiment with different holds though, maybe i should - its just it seems to get him more frustrated and worked out if i move us around too much.

im hopeful as he gets older, bigger and stronger we will get our feeding mojo a bit better. fed ds1 until he self weaned shortly after his second birthday so would love to do the same again. bit anxious about every little thing at the moment, hopefully that will pass too...

[BertieBotts]

Ah okay. Yes BN is baby on your chest with you lying back.

[CelticPromise]

Hi again. In my experience there aren't that many people really competent to diagnose tongue tie but lots happy to say there isn't one! Would it be an option to see someone privately to check and snip if necessary?

[Iggly]

It's either a tongue tie or you've got oversupply so he doesn't need to latch on as the milk just flows very easily.

As Bertie says, get him checked for TT by a professional - not a HV. Even a BF counsellor might miss it so ask them about their experience.

Your milk supply will settle down soon so there's a risk that your milk won't flow as fast or as easily so he might struggle even more.

[howiwonder]

As in a lactation consultant? I suppose it depends how much it costs. I will look into it. Will see what they say at a local group first I suppose.
Looking at the pictures I find it really hard to tell, can hardly get a good look in his mouth to compare.
Saying all this , he's feeding really nicely as I type so he does have his moments. This could imply its letdown related maybe as this has been a long on and off feed...

[Iggly]

If you've got a strong over active letdown, it usually means over supply too.

It cost me ~£100 for a LC to come over (London).

[Iggly]

I meant to add - even then she wasn't an expert so I had to pay another one who was!

[howiwonder]

God the old tongue tie is a bit of a minefield isn't it?! Two private consultants to visit, yikes!

I thought supply would have settled by now, is that wrong?

What I read about oversupply rings true aswell. When i had to exclusively express during the tube feeding days, i had loads and loads of milk. My freezer is completely full of the stuff. If he comes off during feed, my milk will squirt across room, happened recently narrowly missing BIL!!

[CelticPromise]

Hmmm it sounds like oversupply, and if you think that's the problem there are things you can try to regulate it. One breast each feed or block feeding. But if he is struggling to latch the oversupply might be helping him get enough so that's the flip side. I'd get your latch checked as soon as you can.

Is there a local BF line you can call? Don't start forking out for experts until you've tried there. in the group I help at the BF counsellor does not officially diagnose TT but she has a good idea of what to look for and can refer to specialist clinic at hospital for formal diagnosis and snip on the spot if appropriate. Often there is a 3 week wait which is eternity for a mum with non feeding newborn, mastitis, shredded nipples etc but might be acceptable to you. BFC also gives out list of private TT people for those who don't want to wait. I believe they're in the region of £100-150. Perhaps your local BF support can put you in touch with one if you feel that is the problem.

[howiwonder]

Yep sounds like I need someone to look at latch, wouldn't surprise me if we aren't doing it brilliantly. I'm a bit nervous handling him after his surgery, they say this wont be an issue in a month or so time when all has healed so I will feel more confident soon.
I pretty much only ever feed from one side as it is, he has one and is rarely that interested in the other. Figured as he was gaining weight it wasn't too much of an issue. Seem to remember ds1 only ever having one side at a time as well. He usually doesn't feed for massive lengths of time either, I've noticed. Maybe 10 or 15 mins one side and that's it, probably every 2 hrs on average.
If I can't get to a local group I know there will be one somewhere else in the city I can go to. So I will definitely go and get someone to have a look next wk. they can at least give an idea about possible TT aswell.
Thanks a lot for the input, very interesting

[beginnings]

I have no good advice as I've not had the issues you've described OP, and have only breastfed one baby so am no expert, but just wanted to say that I think you're absolutely fabulous and I wish you and your little one very well. He's an incredibly lucky boy to have you.

[howiwonder]

That's such a lovely thing to say, thank you very much. The mission to bf was actually helpful for me, it gave me something to focus in in hospital, something very practical that I could do to help him when I was otherwise feeling helpless.
Fingers crossed he will continue to recover well. It's a bit sad but I'm kind of wishing these newborn days away, can't wait til he's a robust big baby that I can lug about on my hip. He's totally lovely though, I'm trying to remind myself to enjoy him and not get so caught up in worrying all the time!

[CelticPromise]

Ah you wouldn't be human if you didn't worry, especially after what you went through! I can totally relate to what you say about the expressing, my own DS was extremely premature and it was good to be able to express for him when I couldn't do anything else.

Wishing you all the best.

[CelticPromise]

I just looked at your OP again, forgot to say about public feeding- could you set up a dining chair in front of a mirror at home and practise different positions? you might find one that works better for you and it might help your confidence to know how little can be seen?

[howiwonder]

Thanks - its not really how much can be seen, im past caring after feeding so long with ds1! its more that neither of us seem to get comfortable and he starts crying and it all gets a bit fussy and stressful. but i think its also maybe me forgetting what its like feeding a newborn and how fiddly it can be at times!

[BertieBotts]

If you do have oversupply then it typically takes much longer for supply to settle - ref think 6-9 months rather than the usual 3-4.