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Newborn unable or unwilling to latch

post #1 of 3
Thread Starter 

Our 5 day old newborn is completely healthy and doing great ... except for the fact that she will not latch!

Strangely, in the hospital the first day, she latched successfully several times and was able to breastfeed about 5-15 minutes each time, about 3-4 hours apart. There were definitely some minor issues that came up at this point -- she seemed to have a strong tongue thrust and fussed a lot at the breast, popped on and off, struggled to latch, etc. We worked w/ the nurses and lactation consultants to try different positions, etc. The second day in the hospital, she struggled much more to latch and was only able to do so about half the time. A lactation consultant helped us learn how to hand-express colostrum and spoon feed, which worked well.

When we got home, baby Ada basically stopped latching completely (or maybe she did once or twice the first day home). So we just continued to spoon feed colostrum, figuring that when my wife's milk came in, Ada would have a much easier time latching (as the lactation consultants seemed to think).

Well ... the milk came in and if anything, baby seems LESS interested in even trying to latch. There is a lot of screaming/fussing when we try to get her on -- she almost seems freaked out about latching. We're trying to be really relaxed about it, let her lay at the breast skin-to-skin, find the nipple herself, drip a little expressed breast milk in her mouth or around the nipple to encourage her. The best it gets is that she's now somewhat willing to lay there for a bit with the nipple barely in her mouth -- not sucking or latching, just letting the nipple sit in there.

In the meanwhile, we've had to start pumping around the clock, which is very elaborate, time-consuming, and upsetting for my wife (who really wants baby to feed at the breast). We don't seem to be making a lot of progress, and baby LOVES drinking expressed milk from the bottle, seems totally content to be a bottle fed baby ... which is not what WE want.

Other factors that may be useful to know -- wife's breasts are very large and floppy (sorry, honey ), positioning baby is a nightmare & very time consuming, and the nipples are pretty flat. Second -- We did a fair amount of sort of forcing baby onto the nipple at first (not having any idea of what we were doing) -- maybe that made her averse? Third factor (not sure if it matters) -- wife's delivery went well but her placenta was retained so she was taken to the OR about half an hour after birth. This meant that baby Ada was separated from her for about 45 mins during prime bonding time. Fortunately, baby and I did skin to skin the whole time, but could that have affected their breastfeeding relationship?

We have a lactation clinic appointment later this week and we have a second pediatrician appointment to work on the latch again (we saw the ped a couple of days ago and got a nipple shield and some advice, none of which helped). But we are really feeling defeated. Does anyone have any words of wisdom for us ... will this baby EVER latch? How can we encourage her to do so?

post #2 of 3
Deep breath!!! All is not lost! You basically described my experience with DD two years ago (except we weren't separated and she never latched at first). Before I get much further, let me just say that I exclusively pumped for her for ten weeks, successfully transitioned her to exclusive breastfeeding and today she's still nursing!
I think forcing her to take the breast was the biggest issue. She quickly developed an aversion to it and would SCREAM if I ever lifted my shirt. The biggest advice I can give you is take a break for a few days then start again fresh with a much gentler technique. When I was getting her back to breast, my rule was that each attempt was merely an offer, with no strings or pressure. I'd offer about an hour after the bottle: baby wasn't stuffed but wasn't starving either and was more likely to try. I kept a small bottle handy. I used a nursing pillow religiously at first since it helped positioning a lot. I'd put on the nipple shield, express some milk onto the outside and inside, lay baby down and touch the tip to her lips. Usually the ready milk got her to at least lick the nipple and slowly but steadily she began latching consistently. If she refused, I'd try again but I never let her fuss more than 5-10 seconds before ending the session, offering a little milk in the bottle and cuddling her. It was very hard to see her reject me but I didn't take it personally: she needed to learn a new skill and sometimes wasn't in the mood. The short, no pressure offers were key to our success. We also worked with a wonderful, experienced LC, used nipple shields and I needed a prescription (domperidone) since pumping wasn't enough to maintain my supply. The other important thing was to make bottle feeding as much like nursing as possible. Small bottles, often and given slowly so that baby was used to having to work for the milk. Google "paced bottle feeding for details on that. I'll slap a couple of great link from kellymom on too that explain some of this in more detail:
Nursing strike/resistance:
http://kellymom.com/bf/concerns/child/back-to-breast/
Fussing/crying at the breast:
http://kellymom.com/bf/concerns/child/fussy-while-nursing/
Paced bottle feeding:
http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/
There's a whole lot more on that site about pumping, nursing, troubleshooting, etc. These links should be a good start but explore the site for more valuable info. I hope that helps, please update your progress and ask more questions!
post #3 of 3
Take a good look for a tongue tie, especially a posterior tongue tie. They are missed SO often and can result in a baby who is unable to latch. Check this video for a good technique for checking this out yourself: http://www.youtube.com/watch?v=5opSbXvL7yQ. There should be no "piano wire" or "speed bump" feeling under the baby's tongue. If you are feeling or seeing anything that concerns you, keep looking until to find someone who is familiar with correcting these and can help you. There is a facebook group called "Tongue Tie Babies Support" that has a good list of providers and lots of supportive information if you need it.
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