Help! 4.5 month old latch getting worse...swallowing tons of air, but gags when latched on right!

[demurefemme]

Hi, everyone!  Longtime reader, first time poster :)

Long story short: I think it's about time I stopped thinking my son would grow out of his bad latch...haha. Where to start...

When my son was born, I had been nursing his older sister for almost 3 (completely picture perfect, right from the first latch) years. When he came out, he had a smaller mouth than she had at birth, but I had bigger nipples. I knew from the beginning that he had a shallow latch, but I figured he'd grow into it.

At our 3 day postpartum visit, the midwife assistant took one look and said "oh, he can take in a lot more than that!" During that visit we were able to get a great latch, but he wan't really liking it at all (he was very sleepy during the visit, so he didn't protest much, just struggled and tried to pull off before giving up). The next day, however, he gagged every time I got him latched on "correctly," and then refused to nurse. I didn't want to risk a nursing strike with a 4 day old baby, so I let him use his shallow latch from then on, still thinking he'd grow into it.

Fast forward four and a half months, and he just keeps getting worse. I have a really hard time keeping his lips flared the way they are supposed to, and he still gags with anything more than a fairly shallow latch.  I also have mild OAL (nothing compared to the first time around, but enough that he has a hard time keeping up), so between that and his shallow latch, he takes in a ridiculous amount of air.  Every time I get him on right (with the first suck, not just at letdown), it's the same story: he gags and pulls himself as far back on the nipple as he can.

Has anyone had any success fixing a baby like this? I have read a million threads, and everyone else's baby seems to have outgrown the problem fairly quickly. We can't really afford a lactation consultant, and I didn't have a very good experience at the one LLL group that I can attend (they kinda made me feel like a freak for nursing my daughter, who was only 8.5 months at the time).

Thanks in advance for any help - I really appreciate it :)

ETA: weight gain is great - up from 9lb 2oz at birth to about 16lb 4oz now, nipples aren't sore...but the gas can really make him miserable if it doesn't come out :(

[PatioGardener]

Hmmm... that sounds to me like he may have some sort of a tongue-tie.  The pushing the breast back out/shallow latch can be common with a tongue-tie.  I'd start there, I think, and eliminate that possibility first.

[demurefemme]

I wondered about tongue tie - in fact I spent a long time last night reading up on it! But he doesn't have any of the stereotypical physical signs: he can stick his tongue out, the lingual frenulum doesn't come anywhere near the tip, and he doesn't have that heart-shaped appearance to his tongue. And they definitely checked him for it at the birthing center. For some reason that's my sharpest memory of anything other than the stitches while I was getting stitched up.

After my reading last night, though, I wonder if maybe it could be a lip tie. Would that have the same effects? I can't seem to find any pictures of lip ties, though.

Thanks for the advice! I will definitely look into it more...

[PatioGardener]

Yes - lip tie could have the same effect.  My DS had one (clipped at 2 months). 

A posterior (type 3 or 4?) tongue tie looks very different from an anterior (heart shaped tongue) tie. The tongue can often extend beyond the gums, but can't touch the roof of the mouth or cup around the breast as needed to maintain a good latch.  If you look in the Breastfeeding Resources sticky in the Breastfeeding Challenges section, there are some good tongue-tie resources that may be owrth reading. There is lip tie info in those threads as well.

Good luck!