Please help...need serious help nursing my newborn twins, we are having a latch issue

[Ahappymel]

Hello,

I need some serious help from you knowledgeable and experienced lactation consultants/specialists out there.

My twin boys were born via c-section on New Year's Day (after a beautiful progressing homebirth..got to 10 cm and baby A failed to descend after long pushing. He was posterior and in a weird diagonal lie. When he was born,we could see his head had molded off to one side, much like Gumby).

Anyhow, I started breastfeeding my twins in the recovery room and they latched on just fine and seemed to be breastfeeding just fine for two days. We saw good amount of pee and meconium diapers. When we were discharged however, we were told that my  boys had already lost 10 percent of their birth weight. We'd need to come back for evaluation in 2 days. At home I noticed horribly sore nipples and they seemed to be nursing in such a voracious and desperate way. We had pee diapers, but no more poo. Today we took them back in and they've now lost 16% of their birthweight...over a lb each!

After evaluating both boys, the lactation consultant showed me that the boys are sucking UNDER their tongues. It is a very poor latch. They are able to latch onto a finger and bottle, she showed me but they couldn't suck hard enough for that tube feeding device to work. The lactation consultant is recommending that I pump every 2-3 hours, that we supplement with bottles (offering  breastmilk first then formula) immediately to prevent any further weight loss and that we can reintroduce them to the breast in a few days using nipple shields. I talked to a LLL person tonight who said that I might do as the other lady says, but also to continue to offer the breast perhaps after the babies' hunger has been staved off by some bottle first.

I need help desperately. Please, I cannot emotionally deal with losing the nursing relationships with my boys. I am still processing their c-section birth. I want what's best for them...and will do what it takes to continue nursing.

Thanks-Mel.

[carol68]

Hi Mel,

Congratulations on the birth of your beautiful baby boys. I saw your just message when I was searching this website for vegan birthday party ideas for my 5 year old son and I felt I wanted to drop a few words of support to you.

I'm not a lactation consultant, but was lucky enough to be able to breastfeed my two children and was a member of LLL in Ireland at the time. My daughter was a dream feeder from day one and I never had any problems so I luckily knew from the start how easy breast feeding can be. My son however was a bit up and down in the early days and while this wasnt a problem for me it certainly was for the hospital staff caring for me. They were obsessed with his weight, when was he was feeding, how much the nappies weighed etc. In the end I lied and told the staff he had done a poo and I had accidently disposed of it just to get out of the place! Only that I had fed my daughter with no probs and felt confident and not concerned with his loss of weight or lack of poos, these so called professionals  would have turned me into a nervous wreck. All babies lose weight after they are born, this is perfectly normal. Breast fed babies can also go for many days or up to a week in some cases without passing stools. I can't imagine your anxiety with 2 small children, trying to recover from surgery and getting lots of help or unhelp from professionals. 

My advice to you is to to try what you feel is best and to try not get too worked up about what professionals are telling you to do. Easier said than done you may be saying. If you really want to only breast feed without formula then have the confidence in yourself to do that. If you decide to go with formula then don't beat yourself up about that either, giving your child formula is not the worst thing that could happen to them. I don't know what your family, friends are like, but if they are raising your anxiety levels by questioning your desicions then you probably need to get someone to advocate for you and get them to leave you till you are settled into a routine, get them cooking for you or your partner or doing something useful. Make sure that you are eating well and getting plenty of fluids. Find a feeding position that you are comfortable with, lying down on your side is great, give it a try. Once as a nurse I watched a young 19 year old girl do this with her new born baby and was blown away at the ease of it and how totally natural it was. She of course had the benefit of learning from other women in her community, which is something that women in developed communities have lost.

Always remember to aim the nipple towards the roof of your babies mouth to ensure they can get a good seal. If it doesn't feel right then use your small finger to break the seal and relatch. Let them nuzzle and sniff and only bring the breast to them when their mouths are wide open. Also don't be tempted to let professionals shove your baby onto the breast as they may recoil and gag at having the breast forced into their mouth. The bottom lip will curl out when they have a good latch and it will include large areas of your areola (dark part around nipple). Try not to nipple feed as this will hurt and also remove them from breast when awake, don't allow them to fall asleep during a feed. I only ever fed from one breast at a time to ensure that the foremilk (thirst quenchencher) and then the hindmilk ( fatty, rich milk) came. If you change over breasts too quickly,  the babies will only get the thin watery milk that comes at the start and not the nutrient rich milk that they need to keep and put weight on.  You seem to have been given conflicting advice from health professionals regarding this and I'm sure you will get quite tired with 2 hourly expressing etc. If you do successfully express milk (you haven't mentioned a supply problem), then this should be enough for your babies surely without introducing formula? I'm sure they have explained to you that you get much less volume when you express, possibly only 40-50 mls but often less or more, don't stress about figures. If you sit the milk down in the bottle and let it settle, you will see the different layers of watery and thicker milk. Don't be tempted to continue to overfeed the babies with formula, as this may cause them to vomit up all your good milk!  Breast feeding my son was quite painful at times, particularly the let down, but because I knew it hadn't been painful with my first child I was able to push on for those few weeks till the pain ceased. I'm not sure if this has been of any use but I wish you all the very best of luck with your boys. 

Carol    

[Ahappymel]

Thank you so much for the loving and detailed response!

I do believe that my milk has not fully developed yet...but upon waking this morning, my breasts are feeling more full.

I tend not to worry about weight loss and newborns, but I do believe they were losing too much.

My 7 lb 11 oz baby weighed 6 lbs 9 oz yesterday and my 7 lb 4 oz baby was down to 6 lbs 2 oz...and it was pointed out to me that their saggy skin, which when pulled up did not recede right away, was a sign of dehydration.

When she showed me what they were doing with their tongues, it made sense...why they seemed to be getting so frustrated at the breast, why the latches were hurting so much in the last days leaving my nipples swollen, red and raw.

This is the plan we have for now (by the way, I had an "emergency" visit from a local LLL leader late last night).

We are going to give them bottles over the weekend to get their hydration/calories up. By the way, after bottlefeeding yesterday, both of them pooped! Yea!

I will pump every 2 hours and we'll offer them that expressed milk first, formula second. The lactation consultant seemed to believe that being on the bottle might help them train their tongues to stay DOWN when sucking. I will continue to offer the breast, perhaps after I stave off their hunger a bit with a bottle.

And I of course, have to focus on relaxng and healing from this awful week/surgery.

[rinap]

Oh dear. Such a hard situation. But it sounds like you're doing the right things. Getting food into the babies first and foremost. And getting your supply up. It's hard, especially while recovering, but there are a lot of cases here where twins have needed bottles early on but have moved on to breast feeding exclusively when they are a little older.

Good job.

[Spring Lily]

I just stumbled upon this post here, I remember a few weeks ago you were just asking in the multiples section about birth options. Congratulations on your babies! Glad they arrived safely and you had a wonderful home labor experience.

I would continue to offer the breast a few times a day while you give them the bottles. My twins were preemies and we did what they called "recreational" BFing. That sounds like what you are doing with them right now. You know they're getting their nutritional needs from the pumped milk/formula, so that really takes the pressure and stress of the breastfeeding experience for all of you. Instead, it's about exploration for them, getting comfortable with latching, being close, and bonding. In a few days when they are getting better at feeding, you may see their latches begin to improve. I bet that when they get it, they get it, and you'lll be able to ditch the bottles in a matter of days. Also, the recreational BFing will help boost your milk supply.

We had some real breastfeeding challenges and had to rely on bottles for a few months. But we kept up the recreational BFing for weeks, they got better as they matured, and eventually we said goodbye to all formula and bottles. It really does happen, and that was a matter of months, probably very different from what you're dealing with. Hopefully that will give you some reassurance that what you're going through certainly doesn't mean you will lose the BFing relationship. Keep up the good work, mama!

[vforba]

Here is a great site about Tongue Tie, I have never had to deal with this but recently a couple of friends of mine have both had issues with this.

http://www.kiddsteeth.com/dental_topics.html#early_infant_oral_care

I hope that this site will be helpful.

vicky

[abee]

Congratulations on your twins! Sounds like they have a great mom.

I have a friend and her daughter had tongue and lip ties. After clipping, nursing is great. The previous post link has info about both. This link has some great pics of lip ties before teeth. http://thefunnyshapedwoman.blogspot.com/2011/03/introducing-maxillary-labial-frenulum.html

Keep up the good work!

[SFmum]

Congratulations, and keep up the good work! 

THE BEST latch advice I got when my daughter seemed to have forgotten how to nurse on day two after starting like a pro was to start her on my finger, wait until her latch was complete and then quick shove a boob in her mouth. Please forgive me if I'm stating the obvious here (and I know things are probably much different for you with twins than they were for me). I know you've been getting lots of help from LLLers and all. But, you never know who's going to give you what tricks. My daughter was born in the hospital after two sleepless nights of sluggish cervix home labor so I had the great good fortune of having a whole parade of breast feeding coaches come through to lend a hand. Everyone got her latched, left the room, and then I couldn't recreate it until Fritsy (I think her name was!) gave me this trick. 

Anyway, you're doing a great job! And you inspired me to post my first reply on these boards after being a happily lurking member for three years.