Breastfeeding failing on day 4 - post-TT and lack of milk?

[toomuchribbon]

Hello all, BF newbie here. Excited to join this board but have an upsetting situation.

I had my DC1 last Thursday, by EMCS after his heart rate dropped during labour. He seemed to feed well at first, filling nappies "ahead" of colour and content schedule - but bfeeding was always painful, with lots of gum chomping and soon enough of course v sore nipples for me. 

On day 2, still in hospital, he went from calm and alert to crying much more and the nappies dried up. After hours of crying we in desperation gave him a formula top-up at paediatrician's suggestion - to me he seemed unwell and while I would have objected to the top-up in theory it seemed the only option. This helped him hugely and to cut a long story short discovered he has a 100% tongue tie which has been stopping him feeding altogether. 

Yesterday we had his TT cut by an amazing lactation consultant (if anyone needs her name just message me though her name already comes up a lot on here!). She said it would have hindered his feeding pretty much entirely.

Since yesterday my breasts have been very full and heavy - engorged I think. I have been expressing for him as much as I can but he is suddenly much less keen to BF.

Two main problems are:

1)Despite my breasts' hugeness I am not able to produced much milk when pumping - from R breast first pump for about 30ml, the next a few hours later about 20ml, and from L breast almost nothing.
Could something be wrong? They are agonisingly tender, there is milk in there - or should I just be more patient?
Considering trying fenugreek. 

2)DS has always been an enthusiastic feeder, latching and attaching well. Since his TT release last night he fed once really well, for 45 mins with the LC there to watch, but since has been reluctant to properly suck. He roots a bit, then just loosely sucks as if kissing it(!) then pulls away. He used to fall asleep on my breast and look so happy .
I don't know if it is just part of the healing from the TT release or if he has just become so used to being fed by syringe with EBM and top-up in the last day or so..?

I am feeling despondent at not being able to nuzzle him to my breast and feed him let alone at not being able to get it established. Feeding just feels all over the place and I have read and read up on it overnight but there is so much conflicting advice e.g. whether pumping encourages milk or the opposite.
Combined with the C section immobility I feel like everyone else is more involved than I am with his care. (Sorry to sound so completely self-pitying...)

I just want to take him to bed, have skin to skin and feed him. Please tell me this is still possible?

[RedKites]

Congratulations on your DS! Other people will be along with better advice soon, but I just wanted to encourage you, it's still early days, with the right support you can do this.

Can you call your LC again? I would guess she would provide some follow up to the TT?

If your DS might be having difficulty latching on because you are quite engorged, then reverse pressure softening might help (scroll down for some pictures).

Some women are hardly able to express milk at all, but successfully BF their babies so please don't take the lack of milk pumped as an indication of your supply - I think 20-30ml from one side is pretty good going for your first few attempts! Nevertheless, if your DS is not feeding from you directly, expressing 8-12 times in 24 hours with at least one time over night is recommended to build up your supply. Some women get more milk out by hand expressing - there is some information on the second page of this leaflet if you've not tried it before.

Lastly, skin to skin contact is really good for both you and baby, even if it doesn't immediately lead to him feeding, so if you'd like to, then certainly go for it!

[BigPigLittlePig]

Congratulations on your LO firstly.
I am no expert but have had my fair share of problems feeding dd.

In your position, I would get in a hot bath and try to hand express, with hot flannels etc to get the milk flowing. As you say, you are engorged so there is milk there. I didn't get on, at all, with manual/electric pumps initially and if you are stressed out, that's all the more reason for them to seemingly not work.

If you can express off a bit, and relieve some of the engorgement (not sure this is a real word) then take yourself and LO to bed, and enjoy some skin to skin time. When he's hungry, but not starving and upset, try him again. You know he can feed, although he's unlikely to be an expert at it, as he has already done so.

I have no experience of fenugreek but from what others have said, I would avoid it for now, as him feeding and sucking will be the best thing for milk supply.

It is entirely still possible for you to feed him yourself, but if he needs some formula in the meantime, then don't beat yourself up. You will get there, even if it takes time. The other thing to do will be to speak to your mw or a local bf counsellor and get them to observe you feeding him. Good luck

[iloveholidays]

Congratulations!

I'm no expert but all three of my DDs were tongue tied. Both DD1&2 fed really well once it was snipped but DD3 (now 14 weeks) took about 36 hours to properly latch on afterwards (although first feed instantly after was perfect). The midwife suggested that maybe she was sore but the paediatrician hadn't mentioned this. He did say after DD1 that it could take a few days to settle into it and not to expect instant results.

I found with DD3 I had to kind of pull my areola back so it was tought then flick as much in as possible it helped.

I would second giving the lactation consultant a call see what they say, but keep going... I'm sure things will settle soon enough.

Good luck

[zoobaby]

Congrats Toomuch. Welcome to your first dose of conflicting BF advice. Strap in and enjoy the ride cos you'll come across endless different opinions. It's enough to do your head in. Sorry I can't needs advise re tongue tie but please do keep asking questions until you find answers that work for you and your LO. Are you still in hospital? I have heard of people demanding (rightly) to remain in hospital until feeding is established. I know it's not as nice as home, but there is a lot more support available. Also, asking advice/assistance from different MWs will sometimes lead you to a magic lightbulb switching on moment when you least expect it.

[zoobaby]

One thing I'd add... based on your description of day 2, please do keep an eye out for jaundice. Day 2 for my DS was the same and he ended up with it. I thought it was the end of the world, but really quite common.