can I get her to nurse?

[rugbymom]

Hi!  I just had my second little girl 5 days ago.  She hasn't nursed yet.  I've been pumping and feeding her bottles.  My supply and anatomy are not the problem.  She bites and doesn't move her tongue forward to suck.  I saw the LC in the hospital and was told to do finger sucking, worked on proper bottle latch and we figured she'd get it once my milk came in.  Well, now my milk is IN (I get 6oz every 2 hrs!!), and she still hasn't figured it out.  I can leak milk in her mouth, but she seems less and less interested in even trying.  She just bites the bottle too but that is enough to get milk out.  I would love hints, advice, anything.  I just want her to breastfeed- pumping sucks.  Should I bite the bullet and pay $65 to go to an LC?  I'm doubtful that they can do much, really- you can't explain and draw diagrams to a 1 week old.

Oh, and she is not tongue tied.  We thought she might be, but she isn't.

[tibeca]

Contact a la leche league leader. They are free and may be able to get you on the right track!

[homemademom]

Everyone, including two LCs told me my baby wasn't tongue tied either. Despite the fact that he didn't "look" tt'd, he was doing everything a tongue tied baby does. That led me to this forum and some very helpful posters who told me about posterior tongue tie.  Posterior tongue tie is where the tongue is tied down toward the center of the tongue and not the tip. The only way to diagnose it is to observe what the tongue does functionally, not just looking for an obvious frenulum.  Check out these links and see if any might relate to your situation.  

http://www.llli.org/llleaderweb/lv/lvaprmay02p27.html

http://www.cwgenna.com/quickhelp.html

http://www.lunalactation.com/KnoxTT.pdf

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

Also wanted to say congrats on the awesome milk supply. Pumping is a drag, I know! Even with all of our issues, ds finally started nursing at 2 1/2 months. That was a looooong 10 weeks, but I'm so glad we're finally able to nurse. 

[rugbymom]

Duh- LLL- how did I forget that option?!    I even went to meetings with my first. 

I'll ask the doc about posterior tongue tie, but she can be observed sticking her tongue out past her gums/lips.

[gemasita]

Maybe someone will post the link to some pictures...I only have a second...but I wanted to say that posterior tongue tie is more about lifting their tongue than sticking it out, I think.  They can have a divit in the middle of their tongue when they try to lift it to the top of their mouth and it also won't reach the top of their mouth.

I just wanted to give you some encouragement too...DS had a hard time nursing and I had supply issues so ended up pumping more than nursing until about 8 weeks.  But he remembered how to nurse and we are doing fine now (except that I have to supplement with donor breastmilk).  Babies do seem to remember how to nurse - it's instinctive to them, even if it's not to their mothers!  ;-)

[Heba]

Article here might be of use?

http://www.llli.org/llleaderweb/lv/lvjulaug94p53.html

[rugbymom]

Thanks for the encouragement that she might actually figure it out.  She latched on the other day and I think she actually swallowed a few times.  I usually can't get her to do much more than initial latch.  And, that clampdown article was very helpful.  We actually have to pry her mouth open to go around the bottle nipple so she doesn't just collapse it.  She isn't hypertonic, though.  She is super cuddly.  :) 

I've been trying to look in her mouth for posterior tongue tie.  I haven't been able to tell anything yet, though.  And, I forgot to ask the doctor when we were there.

[Heba]

Have you tried laid-back nursing?  It can sometimes be helpful in getting the tongue to come forward.

www.biologicalnurturing.com (has description and a video).

Hope things get better fast!  If not, I would say it's definitely worth the $$$ for an IBCLC consult if you can swing it.  If they are board-certified, then they will have lots of experience and should have several "tricks" up their sleeve for you to try.  Good luck!

xx

[homemademom]

Just curious, does she flange her upper lip out when she's feeding and clamping down?

[Marissamom]

Originally Posted by rugbymom 

I'll ask the doc about posterior tongue tie, but she can be observed sticking her tongue out past her gums/lips.

so can I, and I have a posterior tongue tie. same for my two tongue tied sisters and my two tongue tied children. posterior tongue ties are incredibly difficult to diagnose by the means used to check for 'classic presentation' tongue ties, but with such sever issues it could be very worth finding someone skilled in diagnosing and treating them. 

[rugbymom]

She does not flange her lips out on the bottle at all.  We have to do it for her.  Getting her into the proper sucking position is a 3-handed job. 

On my breast, she isn't doing much of anything anymore.  :(  I guess I better get some more help real soon...

[Marissamom]

have you checked to see if she has a lip tie? they often aren't a problem, but can be tight enough that the baby isn't able to flange their lips themself

[rugbymom]

She does have a lip tie.  I'm not sure that it's that tight that she couldn't flange her lips, though.  But, I am not an expert at all.  Who is an expert?  Who should I ask about these things?

Good news:  Yesterday morning, she nursed for 5-10 minutes!!  I heard her swallowing!  She still took a bottle after that and drank a lot, so I'm not sure how much she got, but that was cool.  I couldn't get her to nurse the rest of the day, but oh well.

How do you go about getting her to nurse more?  She gets so angry after a while- I don't know how much to push her.  She also gets angry for me having her try.  I've tried letting her have some of a bottle first, doing it when she's not really hungry yet, doing it when she's super hungry, etc.  But, if she doesn't feel like it, she just screams and won't try. 

[Taryn237]

This link has pictures: http://www.cwgenna.com/qhcontent.html

You can check just by feeling under her tongue as well.  http://bfmed.wordpress.com/2010/11/04/clinical-pearl-the-murphy-maneuver-for-diagnosing-tongue-tie/

If baby is having trouble breastfeeding and you are not sure if he is tongue-tied, San-Diego pediatrician Dr. James Murphy suggests pushing your little finger to the base of the tongue on one side and sweeping it across the other side to see what you can feel. If you feel little or no resistance more than a small “speed bump,” the most likely there is no problem.

Should you feel a large speed bump that you can get past with a little more effort, it is most likely a “tree trunk” frenulum, a short, wide band of tissue buried in the floor of the mouth and attached to the base of the tongue. It usually, though not always, restricts tongue movements and causes latch problems even though it looks like there isn’t enough there to be a problem.

When you can’t sweep your finger across without pulling it back to “jump over a fence,” the frenulum is a fibrous band attached closer to the front of the tongue. It may be buried underneath the floor of the mouth or visible as an external web. If you see a narrow white streak running down the middle of the floor of the mouth that feels like a wire, it usually extends to the front of the tongue like a string. Pushing your finger into this “piano wire” frenulum will often cause the tip of the tongue to tilt downward and the center if the tongue to pill down and crease along the middle. “Tree trunk, “fence,” and “piano wire” frenulums are red flags for significant tongue function impairment.

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