CST and LC say everything is perfect...but it's not

[homemademom]

Ds is 2 1/2 weeks old.  He's a 5th baby and I nursed my other 4 dcs for two years each.  Baby nursed well at first, though was a little clenchy in his jaw.  My breasts were firm and he latched well.  Then, I started to feel pain and had cracked nipples (about the time my minimal engorgement went away).  My milk supply was tapering as evidenced by lower and lower pee and poop output by the end of his first week.  Weighing before and after feeding showed low milk transfer.  I started pumping but my output was small, which is not normal for me (my last baby had different bfing issues and I ep'd for a month until they resolved. It was nothing for me to pump 4-6 ounces in 10-15 minutes per session).  I'm having to supp with formula for my newest ds, which absolutely breaks my heart, as I'm only providing 50% of the bm he needs. I pump 8-10x a day.

I don't know what to do.  No one can find anything wrong.  He's not tongue tied. The only thing *I*  can figure is that my nipples are very long and flaccid (longer and more flaccid after nursing for the past 8 years) and ds cant pull them back far enough to compress the areola.  Football hold is the least painful (but still awful) position.  I'm hoping to wait this out until his mouth grows some more. I put him to the breast everyday so he doesn't forget how to latch and suck (so far, so good).  My concern is that even if he's eventually able to nurse properly, I wont have the supply to match.  

So, a couple questions.

If you have long nipples, do you have any tips?

Do you think it's still possible for my milk supply to increase after 17 days, with mainly pumping?  (I take herbs, and I'm open to other ideas) 

Any other thoughts? 

[PatioGardener]

Have you had someone really good look for a posterior tongue tie? Tongue-tie leaps out at me from your post.

[homemademom]

Originally Posted by PatioGardener 

Have you had someone really good look for a posterior tongue tie? Tongue-tie leaps out at me from your post.

Well, those I've seen (mw, lc, cst and ped) all say no, but that doesn't necessarily mean anything.   Who  should I have check?  If it's tt, it's got to be posterior because as it is, there is no frenulum to speak of and no heart shaped tip. He can extend his tongue to his lip, but rarely does.  I feel like my memory is so faulty and I can't remember what my other babies did! I'll have to look for some video of normal infant tongue movement.  Thank you so much. I'm going to pursue this. . .

[danipoppins]

I thought posterior TT too. It is commonly missed because the frenulum is not the typical TT presentation. My 3wk old had his posterior TT clipped at 9 days. My midwife missed it but I had an LC look more closely and she picked it up. http://www.cwgenna.com has a great article on TT with pictures.

There are things you can take to increase your supply: goats rue, fenugreek, eating more oats, making sure you're getting TONS of water. What are you using to heal/protect your nipples? Lanolin? Nipple shields?

I'd look up posterior TT and either get a second opinion from a different LC, or share the info you find to your current LC.

Good luck :-)

[homemademom]

Oh my gosh, thank you!!! I'm seriously crying over here. The pictures, especially of the one where the frenulum isn't visible behind the mucus membrane, is EXACTLY how my ds is. I've been manipulating his tongue for the past few minutes. He CAN'T move it hardly at all.  

I'm taking all those herbs and drinking water, but I could be drinking more.  Oh, I wish this wasn't a long weekend. I really want to find someone to help me.  What kind of practitioner do you recommend to help me? Should I contact my ped first? 

Originally Posted by danipoppins 

I thought posterior TT too. It is commonly missed because the frenulum is not the typical TT presentation. My 3wk old had his posterior TT clipped at 9 days. My midwife missed it but I had an LC look more closely and she picked it up. http://www.cwgenna.com has a great article on TT with pictures.

There are things you can take to increase your supply: goats rue, fenugreek, eating more oats, making sure you're getting TONS of water. What are you using to heal/protect your nipples? Lanolin? Nipple shields?

I'd look up posterior TT and either get a second opinion from a different pending the info you find to your current LC.

Good luck :-)

[PatioGardener]

It depends where you are. There is a website with TT friendly docs and dentists - I'll try to find it. Where I live there is a dentist and an ENT who do them and that is it.  If you can post your location it will help. Also, check out the TT FAQ. http://www.mothering.com/community/forum/thread/833815/tongue-and-lip-tie-faq

[danipoppins]

http://www.lowmilksupply.org/frenotomy.shtml

However, the LC I saw gave me a list of 3 local docs who clip and none of them are on that list. So, if there isn't anyone on that list in your area, ask here for recs, call any and every LC near you and first ask if they're familiar with posterior TT and then ask if they know anyone who clips them.

I'm so glad you were able to figure it out. Dealing w/TT can be maddening. This is my second TT babe; first was an anterior tie that never was clipped, but didn't impact nursing after the first 2 mos. Posterior TT seems to be a whole different animal and I don't believe this baby's TT would have ever stretched like my 10 yo sons did.

I should tell you that even though DS's posterior tie was clipped, I still struggle with some nipple pain, clicking, etc, he can only stick his tongue out to his lip (not over), I have to make sure to sandwich my breast and point up towards his palate with every latch, and I'm working to get him to re-learn how to suck properly. If things don't continue to get better in the next couple weeks, I'll look into getting it re-clipped. Make sure you get/do some exercises to keep it from re-attatching (the doc who did ours did not give us any ).

Hang in there, hopefully thing will turn around soon!

[homemademom]

The nearest doctor to me is a couple hours away.  I'm going to call tomorrow and make sure he handles posterior ties. I think my ds has a lip tie, too (he can't flange out his upper lip well either). I want to make sure he can do both.  Thank you both so much.  I really hope this is the answer to our problems.

Edited by homemademom - 2/22/11 at 4:00pm

[danipoppins]

You are welcome - I hope the doctor can help you. My DS has a lip tie too, but I didn't pick it up until after the TT was clipped and he can flange so I think we'll leave it for now. Keep seeing the CST; DS has been adjusted and I think it has helped (even though he didn't have anything major to work on). Keep us posted!

[natural&organicmom]

As far as herbal supplements I used: Motherlove, More Milk Special Blend, Herbal Supplement when my milk supply seem to dip with number 2.  It was tremendous.  It is recommend to consume w/ 1-2 oz pure cranberry to cover the awful flavor.  Wiithin  8 hrs I had a tremendous amount of milk.  Hope that helps.  I believe the website is www.motherlove.com

[homemademom]

Originally Posted by danipoppins 

You are welcome - I hope the doctor can help you. My DS has a lip tie too, but I didn't pick it up until after the TT was clipped and he can flange so I think we'll leave it for now. Keep seeing the CST; DS has been adjusted and I think it has helped (even though he didn't have anything major to work on). Keep us posted!

We have an appt in a week and a half. It feels like forever away :( I'm trying to stay positive though, and I'm grateful the doctor is very experienced and knowledgeable. I'd rather wait for someone who's an expert than a local doctor who isn't.  

Originally Posted by natural&organicmom 

As far as herbal supplements I used: Motherlove, More Milk Special Blend, Herbal Supplement when my milk supply seem to dip with number 2.  It was tremendous.  It is recommend to consume w/ 1-2 oz pure cranberry to cover the awful flavor.  Wiithin  8 hrs I had a tremendous amount of milk.  Hope that helps.  I believe the website is www.motherlove.com

Thank you. I started taking this one yesterday, along with the other herbs my LC recommended.  I hope it improves things quickly.

[bebestar7]

have you considered using a shield?  I know so many people have reservations about these, I pumped exclusively for weeks bc my lo couldn't latch on properly bc of the shape/size of my nipples. after researching pros and cons, I finally gave in and bought a shield and we have been doing great ever since.  I know some mamas have used these for the entire time they breastfeed... which I hope I don't have to do but will if its the only thing that works for us.

[wholewheatchick]

Good luck!  My DD had a posterior TT and a lip tie that was sever; we had to travel 2000 miles to have it taken care of.  You're lucky you caught it early!  Hers wasn't clipped till she was almost 5 weeks old.  We have had to do some pretty major CST to help after the clip though; so keep that in mind.  Posterior TT can be so maddening!

[homemademom]

Originally Posted by bebestar7 

have you considered using a shield?  I know so many people have reservations about these, I pumped exclusively for weeks bc my lo couldn't latch on properly bc of the shape/size of my nipples. after researching pros and cons, I finally gave in and bought a shield and we have been doing great ever since.  I know some mamas have used these for the entire time they breastfeed... which I hope I don't have to do but will if its the only thing that works for us.

I haven't. Can you explain to me how they work? Is it because it simulates a bottle nipple, which is what we're using right now?  His tongue tie is pretty severe, so he's really only able to gum things (he can't get his tongue over his lower gum line for any significant amount of time).

Originally Posted by wholewheatchick 

Good luck!  My DD had a posterior TT and a lip tie that was sever; we had to travel 2000 miles to have it taken care of.  You're lucky you caught it early!  Hers wasn't clipped till she was almost 5 weeks old.  We have had to do some pretty major CST to help after the clip though; so keep that in mind.  Posterior TT can be so maddening!

I remember crashing your ddc when you were having such terrible difficulties because I really felt for you! Yes, this whole thing is SO agonizing.  And having to supplement with formula really, really sucks :(  Fortunately, we only have to travel 300 miles to get to our doctor (yes, a little black humor is all I can muster).

[PatioGardener]

hang in there! are you able to keep pumping with what must be a very full life right now? keeping up your supply should help baby to nurse once the tt is clipped.

i would not recommend the shield in the case of post. tt - especially as it will soon be clipped.

good luck!

nak

[homemademom]

Originally Posted by PatioGardener 

hang in there! are you able to keep pumping with what must be a very full life right now? keeping up your supply should help baby to nurse once the tt is clipped.

i would not recommend the shield in the case of post. tt - especially as it will soon be clipped.

good luck!

nak

Thanks for your support! Yes, I'm pumping around the clock. My supply is slowly increasing. I've been keeping track of my output over the past 3 days and it's gone from 12.5 to 16.5 oz in that time. Hoping that the motherlove I started last night will boost it even more.

[bebestar7]

Originally Posted by homemademom 

I haven't. Can you explain to me how they work? Is it because it simulates a bottle nipple, which is what we're using right now?  His tongue tie is pretty severe, so he's really only able to gum things (he can't get his tongue over his lower gum line for any significant amount of time).

 

I am certainly no expert, but I would imagine that it is more like a bottle nipple than a breast, so its worth a shot.  Only about 7 bucks, I got mine at Target, they're all over online.  My LC never suggested it to me because they said when my LO got bigger he would have an easier time latching on but he didn't... never checked for a tongue tie...

good luck, sorry you're having such difficulties.  :(  

[SomedayMom]

Hey there!  I don't have great advice, but wanted to post b/c I am going through something similar with my 3rd baby.  He had an anterior TT clipped already and we've been seeing a chiropracter too.  My little guy won't latch at all without a nipple sheild and that was while I was supplementing with a finger feeder only.  I went to bottles only after he started latching with the sheild.  I made the decision this week to take him to the doctor that does posterior TT.  We have an appointment tommorrow.  I'm really hoping it helps.  My little guy will latch and sometimes he'll get milk out but not nearly enough.

It's stressful.  You have more children to take care of than I do, but even with 2 older kids I don't know how I could keep up the pumping and supplementing for much longer.  I've set a goal of 8 weeks and then I'll have to decide what to give up...either the pumping has to go or the nursing.  Hopefully he'll get it by then though.  I'm pretty reassured seeing that other people have made it through. 

I can post back how the posterior TT goes...

Good luck!

[homemademom]

Originally Posted by SomedayMom 

Hey there!  I don't have great advice, but wanted to post b/c I am going through something similar with my 3rd baby.  He had an anterior TT clipped already and we've been seeing a chiropracter too.  My little guy won't latch at all without a nipple sheild and that was while I was supplementing with a finger feeder only.  I went to bottles only after he started latching with the sheild.  I made the decision this week to take him to the doctor that does posterior TT.  We have an appointment tommorrow.  I'm really hoping it helps.  My little guy will latch and sometimes he'll get milk out but not nearly enough.

It's stressful.  You have more children to take care of than I do, but even with 2 older kids I don't know how I could keep up the pumping and supplementing for much longer.  I've set a goal of 8 weeks and then I'll have to decide what to give up...either the pumping has to go or the nursing.  Hopefully he'll get it by then though.  I'm pretty reassured seeing that other people have made it through. 

I can post back how the posterior TT goes...

Good luck!

Good luck with your appt. I hope you see an improvement. How old is your baby? 

I hear you on the pumping and supplementing. I'm absolutely committed to breastfeeding. I did it exclusively with my four other babies for two years each. But man, this is hard. And it's so discouraging to put in so much time and work and get just a paltry amount of breastmilk, and then STILL have to give formula.  Fortunately, my dh is such a help.  He does all the feedings at night (3 or 4 of them!) while I pump.  Blah.  Anyway, I'm going to refrain from setting any pumping goals until after we have the procedure done and then, get with our lc and cst again.  I would feel so much more hopeful if my supply hadn't tanked inexplicably. . .

[homemademom]

I'm not sure what to think. . .  

I woke up today feeling really worried about my baby getting a bottle so often (worried about nipple confusion and his forgetting how to latch).  So, today I tried to finger feed him. He did really well with it.  His tendency has always been to pull his tongue up and back when he opens wide (so it forms a hump), and it was another reason I thought he had tongue-tie.  Well, today, he wasn't pulling it up as much AND he kept his tongue down over his lower gum the entire time he fed from my finger (2 oz of bm). I kept peeling his lower lip back to see where his tongue was and it was there.

So now I'm wondering if he has posterior tt after all. Maybe he needs to retrain his tongue?  I seem to recall reading about how to get a baby to do that, but neither the cst or lc acted like that was anything to try.  Any thoughts?

In other news, I moved up to a bigger flange and got a full ounce more with each session!  Oh my gosh, how in the world did I not realize this?? I had to pump for my last baby for several weeks but couldn't remember which ones I'd used (I have about every size thanks to dh buying my pump and not knowing which ones to get, lol).  I hope I'll be meeting ds's milk demands by tomorrow night.