urgent help needed- receeded chin and losing milk supply

[reynardm]

hello!  Four years ago I had DD and she nursed very well, i had a ton of milk and we stopped nursing just after she turned 2.   DS is 3 weeks old tomorrow and its been a really difficult road so far, and I cannot make enough milk. 

, here is the situation...

his latch was good, we worked with Lc in hospital, he was born via an unplanned c-section (posterior face presentation) so we were there for 4 days, my milk did not come in until day 5.  He went from 9.9 to 8.10, brought him home and nursed constantly but he stopped all diaper output, became lethargic,etc.  We had to get formula, the poor thing was literally starving.  Dr had us feed him with EBM, from the breast, and formula every 2 hours 24/7 for a few days until he got back on track.  Called in a LC the next day and she felt he had a possible posterior tongue tie and gave me this list of "symptoms" to give to a surgeon/ENT:

weight loss, low diaper output, inadequate swallowing, painful latch (lipstick shaped nipple), receding chin, retracting tongue, test weighs=minimal transfer (only .4 ounce)

Went to a really good pediatric ENT on this Tuesday and he felt he had a veyr slight tie but not enough to interfere with BF or that he wanted to fix. He said he feels the trouble is his chin..it is quite receeded, his lower lip is tucked under his upper.  Much bigger than the avg newborn.  He didnt have any advice on nursing but to keep trying, and I am having a lot of trouble finding info online.

We have had some better nursing sessions, but he is almost never satisfied and we are still supplementing with formula.  Now for my supply- I can hardly pump any from my right breast (no infection or pain though, from the start with this baby its been very low output) and when I have a good pumping session I am getting on avg. 1/2 to 1 ounce from the right, 1.5 to 2 oz from the left.  I dont seem to be refilling at all, or extremely slowly.  I put him on the breast before doing formula, and am pumping  a lot.  I can only get a solid nurse or pumping session (3-5 oz total) if its been about 4 hours, and then its not usually enough for ds.  (no longer on the every 2 hrs schedule, he now weighs 10.9!  so thats great news)

In addition to this I have to say the aforementioned 4 year old stays home with me all day, is starting to act out this week, I am still recovering and I have chronic fatigue syndrome and fibromyalgia- I dont feel I can keep up wiht all of this work and pumping I am losing my mind, and physically its too much.  I have to be very careful with getting too sick due to my illness too..its a fine balancing act.   sometimes now I have to sleep in the night, last night my DH took feedings between 11pm-8am because I just couldnt handle it.   I really want to continue to BF or even pump and feed, but it feels like eveyr day i have less milk.

I know this ended up being long, sorry!!!!  I am just at my wits end I want to keep going but feel like I may not be able to..I am researching herbs, techniques..anything to boost supply and find a possible better position for him to nurse.

thanks for reading this epic post and for any help!!!!

[gemasita]

People commented on my DS's receeded chin when he was born too.  The LC thought he had posterior tt too because of all of the issues you mentioned.  But he didn't have that.  Your story sounds very similar to mine.  No one could identify any specific problems with his latch.  It just got better with a nipple shield and lots of time...

I also had low milk supply.  Maybe you could order some Motherlove More Milk Plus or buy some Fenugreek.  I tried all of those and had to go to Domperidone, which you can order online from Canada or the South Pacific (www.inhousepharmacy.biz is where I ordered from.  It takes a while to come though - 2 to 3 weeks.  Never ordered from Canada but I hear that people do that too.  Hopefully you can talk with your doctor about whether or not Domperidone would be a good option for you and THEN order it online.  My doctor would prescribe it but it was SO expensive to order from the compounding pharmacy that I ended up ordering it online.)

Hope this gets you started so that you don't have to do too much researching.  I know that is time-consuming.  If you really need to focus on staying rested, I would ask an LC if she thinks a nipple shield might help and maybe she could do a before- and after-feeding weight with the shield.  If your DS can transfer milk well with a nipple shield, then you can nurse more and pump less.  I ended up EP'ing for a while and that was exhausting.  So if I were you, I would do whatever helps you with the pain, whether that is pumping or nursing.  Maybe pumping at night and letting your DH continue to help with those feedings and work on bf'ing during the day.  If you work closely with an LC, you can most likely get your DS to breastfeed better over time, as he grows.  My caveat is that my DS switched from bottle-feeding to breast-feeding with ease so we could work on the bf'ing over time and not feel rushed that we had a window of time before he was going to "forget" how to bf.  I know not all babies can switch back and forth so easily.  I suppose you could work with an SNS (although that might hurt you unless you try a nipple shield along with it) or with syringe and finger-feeding but those are very time-comsuming.  I hate to suggest those to you because that might be too overwhelming right now.  If I could do my postpartum period over, I guess I would just focus on the MOST important things and not stress about every little thing that people were telling me to avoid because I just COULDN'T manage everything.  Bottles ended up working fine for us.  Now DS is 6 months old and is a great breast-feeder and we just supplement when we need to.  I don't pump anymore.

Good luck!  Hope things start getting better soon.

[gemasita]

Now that I re-read your post, it doesn't sound like the pain is really the issue...just the supply.  Maybe trying an SNS so that you can cut out some of the pumping would be better after all.  Maybe do that during the day and then pump at night.  You hate to be on that pumping hamster-wheel - it's a drag.  I was thinking if you tried an SNS, you would save time - your DS would stimulate your production (and better than a pump) and get his supplement at the same time.

[womenswisdom]

Have you considered having craniosacral work done on him? I have seen good results with palate problems with only a few craniosacral sessions. I don't know if it would help a recessed chin, but it's not going to hurt anything to give it a try.

[reynardm]

thanks so much for your responses....its nice to know I am not alone in this kind of situation!  We are down to about 50% Bf now,I am really sad but finally getting more milk plus tonight hoping it will help my supply.  I have had a little more success with the football hold but no increase in production.   pain isnt the main issue, its just supply. siiigh....all I can do is keep trying right? thanks again!

[homemademom]

We've struggled with low supply, too. It did seem somewhat related to posterior tongue tie which we had treated (somewhat unsuccessfully) at 1 mth old and again at 6 mths.  During all those months when I tried to increase my supply, I took domperidone. It worked to increase my supply pretty quickly, but it sort of topped out with me providing 2/3 of my baby's bm needs.  I weaned from it and started taking Motherlove Special Blend and it increased my even more to where I was supplementing with 6 to 0 ounces a day.  Since we had the second tongue tie procedure, we haven't needed supplements at all because ds has much better mobility and can access the milk much more easily.

All to say that 1) you might find a second opinion about tongue tie useful and/or 2) it's really okay to supplement and it's awesome that your baby is getting any amount of your breastmilk.  I went from being completely destroyed and devastated that I had to give my baby even 1 oz of formula to feeling very grateful that it exists at all.  Lastly, I second the recommendation to get some cranial-sacral therapy.  My ds had a high arched palate (frequently accompanies posterior tongue ties) and those sessions really helped. We went for about 6 weeks.