What is next step?

[rybka13]

Well, over 3 weeks of reading every possible information related to breastfeeding and how well informed I am..Still not wiser though. My storry is so typical that I feel emberassed for starting that thread. Hundreds before, here on mumsnet and many other sites. I assume I would be good source of advice for somebody in my position now providing me not being in deep sh..ugar myself currently. Ds2 is 3.5 week old and we struggling with bf. I had problems with bf dd1 but that was different story. Unplanned baby, Pregnancy Induced Hypertension, lot of medication during pregnancy, stress as we just moved to UK and I wasn't even able to communicate in english, no work,no friends, no family around, stiches after labour, then infection and fever, mastitis, low milk or no milk and PND. So i quited after 2 weeks.PND for 2 years as an effect. Second child completely opposite, planned, nice pregnancy, SMP as low as it is but always ;-), quick and uneventfull delivery of 4.26kg baby (9pounds 6oz)-next day no more pain than after long bike ride haha. Baby strong, willing to suck and me full of optimism. All HP happy with position and latch, pediatrician check perfect. Only blisters on nipples after 24hrs should alarm me but I have been told it is normal! I carried on feeding despite of pain and baby getting more jaundiced and dehydrated. Midwives coming and going and although very nice and helpful every one having different views at problem.Meanwhile Domperidon prescription. Finally we lost 8% bw and were so jaundiced we landed in hospital.Tong could be a reason, I sort of wondered why it looks so snake tounge alike. Pediatrician checked and decided there could be tongue tie involved although minor-not a surprise she could not say anything else as the first doctor from the ward was sitting next bay. We were referred to specialist and received calculation of formula we should give. Hubby in pieces because baby is starving...persevered with latching on 7-8 times a day 20-30 minutes on each side every time, or longer if we fall asleep.We started supplementing or rather just ff as i don't think ds was getting much milk. 10 days later ds has tongue tie released. It took 3 attempts, blood bath and so much screaming that if we weren't last other mothers would run with their babies. Apparently it was total, very thick one, preventing any movements. Next 24 hrs-nightmare, poor latch (as if before was better), baby drooling, snorring and choking on it's tongue. Have to say I regreted decision and felt selfish for my breastfeeding dedication. 7 days later things settled down, ds latching but still painfull, milk supply seems to be low and my feeling is getting lower-less proper drinking from breast moments more comfort sucking even when extremaly hungry. I drink hectolitres, eat like a horse, take domperidon and fenugreek plus drink nursing tea twicedaily,take multivitamin, not to mention porridge every mornig. I tried to bf as often as possible in 24 hours-nearly every hour or two during day and every 3 during night, tried to cut down formula and bf more, tried to pump between feeds-best achievment 1 oz from both breast together. No formula top up means bf 24 hrs, from one breast to another. After day of feeding and pumping my breast looked like dried raisins and i didn't fill through the night. My boobs hurt and nipples are so sensitive that even protection pads feel like fire burning. I do not think it is trush as pain isn't deep. More likely just sucking, pumping and general mashing.
Midwives and hv advise not directly of course to quit. "It is your decision blahblah but you have to think what is best blah blah you tried everything".
So to the point. Tried domperidon, fenugreek, herbal tea, galactagogue foods.Still on all of them. Tongue tie released. Nursing on demand.
Halfhearted tried pupming and not very keen on persevering-making boobs even more painful. Same with shields-baby not happy to latch on with shield and all together will it make difference to milk supply?
In reality feeding 7-8 times a day at nearly 4weeks with 90 mls(3oz) formula every time. Feeding both breasts at a time, 20-30 mins each.
What is next step? See consultant? Should it be done before? I asked my HV is there any around but she has no idea. Tried to google but results are nearly none for mid Wales. I guess emailing LLL may yield same resultats as posting thread here with so many folks being so experienced and educated on that subject. I found breastfeeding group about 15 miles away but only twice a month so need to wait till next month. Another one 25 miles away, twice a month. Is there any point to go? I would if i knew there will be somebody knowledgable there but how can i know that.
If it is true that 98% women can bf providing given support then obviously there is smth im doing wrong but being tired and involved protects me from seeing it. Latch? Seems to look ok from outside and all HPs were happy about it but maybe worth to check?

[tiktok]

What a story :( really sorry to read about the horrible tt snip, especially :(

(It's very difficult to read - prob why not many replies! Any chance of reposting, with more paragraphs and typos corrected?!)

I am having a problem picking out the facts of where you are now: is this right?

• baby is 4 weeks
  feeding 7-8 x 90 mls in 24 hours and* bf both sides at each time
  
• HV has 'no idea' if there is any further bf help in your area (honestly? She has not offered even to find out?)
  
• you are in a rural area with no near bf groups
  
• you are on domperidone, fenugree and the works
  
• pumping is not productive
  
  Can I ask: baby's weight and growth; has anyone seen you feed whose judgement you trust; are you using a shield or not?; have you tried hand expressing?

[rybka13]

Thank you tiktok, as always reliable...You got it to the point. I can just add not using shields, tried hand expressing but found it too painful-worse than manual pump. HV gave me leaflet with breastfeeding groups-as mention one 15 miles away twice a month, already missed both sessions for this month, second 25 miles away and a few in similar distance. A few midwives checked me feeding and they were pleased with how it looks like from outisde. Do I trust it? I wouldn't write my post here.
Baby weight born 4.26 Kg, then 3.98 firs check (5 days?), then 3.92 twice and started formula, since then 4.10 3 days later and 4.38 anothe 6 days later. HV coming to check again this Wednsday

[tiktok]

Sorry, still can't make out exactly what weight and growth has been - how old was your baby at these points (don't make me do mental arithmetic :) ) ?

[tiktok]

OK, even without precise ages and weights at these ages, I can understand the concern - your baby is growing slowly enough to justify the frequent weighing and the observations. He is having a lot of formula....it's about the amount he would have if he was fully ff. You are also expressing at times, and also breastfeeding each feeding session. This is the hardest and most time consuming way to feed a baby :(

I imagine you know that :)

The risk is real to your milk supply, because he is just not going to have 'room' for much breastmilk. I would wonder if he is getting much breastmilk during the 40-60 min breastfeeds.

Yes, you need someone who knows about untangling complicated breastfeeding issues, who can see you feed. You don't need them in person. Some bf specialists will Skype and can observe a feed that way. You can find a private lactation consultant, or call any of the breastfeeding helplines and see if you can arrange something like this. Details on the mumsnet bf pages. Your HV should be able to track down a bf specialist for you. I really hope you get good help.

My guess is that you will need to discuss really radical action - a decent double pump which should not be painful in use, used intensively over a period of time, plus lots of skin to skin to keep your baby interested in the breast. Medication and herbs and vitamins are frills - without the basics, they are not going to help much.

[rybka13]

Thank you for your time and knowledge tiktok. I managed to be seen by lactation consultant yesterday and she confirmed that latch is poor means too shallow hence emptying/supply affected plus extremly painful nipples. We tried to establish good latch-not painful but i have to say nothing works at the moment. We talked about positioning, latch, pumping to increase supply and menawhile working on better latch. I was more optimistic yesterday but it is so hard that I feel things are getting worse instead of improving.
In your opinion how quickly can baby re-learn latch, is it possible tongue is still nor right after tongue tie cut? It looks healed well but I mean despite procedure not functioning ok.

[tiktok]

Rybca, glad you saw someone. Your situation is outside my experience and knowledge. Tongue tie aftercare is not my thing in that I have little experience of post-snip problems. Stick with the lc!

[McBaby]

Tongue tie can heal and scar tissue can form whih will still restrict the tongue function. It might we worth getting reassessed for tongue tie again or the procedure may not have been effective in the firsts place if there was an anterior and posterior tie behind. With dd1 we had both of these happen and have to have four cuts in total for her tongue to function fully and enough to feed without me being in pain.

We also had cranial sacral osteopath whih was amazing I could see her tongue function improving after each session.

[returnvisit]

I really admire your perserverance, i would carry on with the LC. Best of luck.

[ClearlyMoo]

Didn't want to read and run. Your story is not dissimilar to mine. Although TTD sounds horrid and traumatic.

We went from baby feeding 400ml formula a day at two weeks back to just 80ml formula (one bedtime feed) at 9 weeks old.

I want to encourage you

Triple feeding (expressing/formula feeding and BF) is exhausting and time consuming but it can get better.

Keep putting baby to breast first.

At the moment I'm feeding 12 times a day approx 30 mins at a time...

I think you need to be realistic that your baby may be a slower feeder. Especially after relearning latch post TTD.

You need to decide if you can cope with gradually reducing formula over time, or if you want to reduce breast milk.

Hope the lactation consultant was helpful. There is a Facebook group called "Infant Tongue Tie UK, Ireland & Europe" where you could share your story and get some relevant help.