4 week old and poor latch--what do i do now?

[moodymaximus]

when i had DS and his latch was "poor", the midwife said if it didn't bother my nipples and he seemed happy, everything was fine. but at that time i had a very actively nursing toddler as well.

now with DD, i didn't work as hard on the latch, remembering not having any problems with a slightly lazy latch with DS. but right my toddler nurses only once a day, and i think my milk supply is lower.

i'm a bit worried. in the last days i got a bit engorged, and i'm not sure whether this is because of her nursing less or more. she's also developed a different type of cry--whinier, higher pitched, but also quieter in volume. AND she threw up last night, and is not nursing much today. her latch is very lazy today, and my nipples ARE sore, though after 6 years of nursing they are made of steal .

how do i make sure she establishes a good latch? is it even possible at 4 weeks?

right now i do what i should've done with her as a newborn--i wait for her mouth to be wide open and bring her to the breast. but she often slips off...

so in a nutshell, i'm a bit worried that my production got reduced and her latch is not conductive to good nursing...

[PatioGardener]

Perhaps there are 2 issues here: Latch and supply

1) How is her weight gain, how many heavy pees a day? poops? If she is gaining well and pooping and peeing well (see kellymom: http://kellymom.com/bf/supply/enough-milk.html) then your supply is fine.

2) latch: can you do breast compressions at the start of a feed to make sure that she is getting milk right away and stays interested? That's all I've got right now, but I'll think and see if I can come up with any thing else useful.

Oh - and if you are worried about her change in cry, activity level, vomitting or nursing less, then perhaps consider a trip to the midwife or doctor to make sure everything is OK. (Nursing less can sometimes be the first sign of an illness in a little baby.)

[moodymaximus]

Originally Posted by PatioGardener

Perhaps there are 2 issues here: Latch and supply

1) How is her weight gain, how many heavy pees a day? poops? If she is gaining well and pooping and peeing well (see kellymom: http://kellymom.com/bf/supply/enough-milk.html) then your supply is fine.

2) latch: can you do breast compressions at the start of a feed to make sure that she is getting milk right away and stays interested? That's all I've got right now, but I'll think and see if I can come up with any thing else useful.

Oh - and if you are worried about her change in cry, activity level, vomitting or nursing less, then perhaps consider a trip to the midwife or doctor to make sure everything is OK. (Nursing less can sometimes be the first sign of an illness in a little baby.)

thanks! the poops are fine, and i'm counting pees today. and doing compressions before nursing.

she hasn't vomited since, only her usual infrequent spitting up. but her cry is still different. she seems to be more alert when she's alert, and sleeps a lot in between. she's so different from my other two, and my brain is so fried, i feel like a first time mom!

[PatioGardener]

Good to hear that things are going OK. Are your nipples feeling any better?

[moodymaximus]

Originally Posted by PatioGardener

Good to hear that things are going OK. Are your nipples feeling any better?

my nipples are fine, thanks. i'm not sure she's peeing enough, though. today, from noon until 8pm she had 3 biggish poops, and only 3 tiny pees! this doesn't look good

[PatioGardener]

It sounds like you are doing the right thing by counting her pees then. Between noon today and noon tomorrow she should have 6 heavy (like 3 tablespoons of water in whatever diaper you use) pees.

Do you have an LC you can see quickly? They can usually get a good weight for you and see how baby is transfering milk.

If you are worried that she isn't taking in enough milk, moms are often advised to wake the baby to nurse every 2 hours during the day and every 3 hours at night. You say she is sleeping a lot - how often is she nursing? Can you see her transferring milk? There are some great latch, breast compression and milk transfer videos here: http://www.beyondbirth.ca/ContentPag...Downloads.html

If she isn't peeing enough, I would encourage you to get medical help asap from a breastfeeding friendly health care provider - someone who can evaluate your latch and help you to increase your supply.

But hopefully she'll have some really good nursing sessions tonight and put out some great wet diapers!

[eirual]

Have you payed attention to her 'suck/swallow' pattern. Is she swallowing lots?

Have you tried different positions, they might stimulate other milk ducts?

Is she fully alert when you initially nurse her? Can you keep her alert while nursing? (stroking feet, belly, back, etc.)

If you need to know she's getting liquid, what are your thoughts on expressing, then spoon feeding?

I haven't thought about nursing a newborn in a while, that's all that comes to mind.

[moodymaximus]

Originally Posted by PatioGardener

It sounds like you are doing the right thing by counting her pees then. Between noon today and noon tomorrow she should have 6 heavy (like 3 tablespoons of water in whatever diaper you use) pees.

so she had 7 pees, but some smaller, but all clear, not dark / stinky. but she didn't poop since this morning, which is unusual. she usually poops after waking up.

Do you have an LC you can see quickly? They can usually get a good weight for you and see how baby is transfering milk.

no. and i'm not at all certain any of the drs i will see will be enough supportive or knowleadgeable of breastfeeding to work with it.

If you are worried that she isn't taking in enough milk, moms are often advised to wake the baby to nurse every 2 hours during the day and every 3 hours at night. You say she is sleeping a lot - how often is she nursing? Can you see her transferring milk?
There are some great latch, breast compression and milk transfer videos here: http://www.beyondbirth.ca/ContentPag...Downloads.html

i keep forgetting to time her nursing sessions, as i don't wear a watch. i think she nurses every 3-4 hours, probably closer to 3. but if she's sleepy she won't nurse. she's nursing when she's alert. i wasn't able to see the vidoes, i will try again. what do you mean by transfering milk?

If she isn't peeing enough, I would encourage you to get medical help asap from a breastfeeding friendly health care provider - someone who can evaluate your latch and help you to increase your supply.

i'm afraid this might not happen. i can't choose who i see, and i also don't know enough about the drs here to even try to choose. she did pee enough, but barely. i'm still keeping a close eye. she doesn't have any obvious dehydration sympromts.

But hopefully she'll have some really good nursing sessions tonight and put out some great wet diapers!

thanks. hoping to see some poops now!

[moodymaximus]

Originally Posted by eirual

Have you payed attention to her 'suck/swallow' pattern. Is she swallowing lots?

it depends. sometimes lots,sometimes not.

Have you tried different positions, they might stimulate other milk ducts?

she won't nurse at all at other the cradle hold and lying down.

Is she fully alert when you initially nurse her? Can you keep her alert while nursing? (stroking feet, belly, back, etc.)

she's alert while nursing. she isn't sleepy in this way. she stays alert, then unlatches, stays content for a bit, then fusses a but won't nurse, and then falls asleep.

If you need to know she's getting liquid, what are your thoughts on expressing, then spoon feeding?

i might try this. i'm not very good and hand expressing,a nd when i had a pump with dd1 i couldn't express more than 1oz, and i had much more "obvious" milk then--more leaking etc.

I haven't thought about nursing a newborn in a while, that's all that comes to mind.

thanks for your thoughts!