Still having latch problems anyone? - Page 2 - Mothering Forums

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#31 of 58 Old 06-10-2010, 07:05 PM
 
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we're now back to exclusively pumping, with the odd nursing session thrown in at night. I guess im just not cut out for breastfeeding. It stressed me out so much that I couldnt eat-I know...control freak much?! I am pumping a ton too. I feel bad now that I put her through getting her tongue clipped and now we're not even nursing really. Im just hoping that it will also save her from any speech issues in the future.

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#32 of 58 Old 06-17-2010, 01:08 AM
 
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Can I crash this party? I was in the May DDC but DD2 came April 14th, so she's 9 weeks old now and we're still having latch issues. Jenfl, I think I've seen you have similar issues, so I thought I'd crash and see if we could all figure this out together.

Our story: DD was born at 37s and was an interested nurser from the get-go, but her latch stunk. She fell off all the time and clicked constantly; but she was gaining weight, so we kept coming up with excuses for the nipple damage and sorry rhythm. I thought things would change when my milk came in, or when she had more practice, or if I pumped some of the extra off, or if I used a nipple shield. But it still didn't feel right.

We got a diagnosis of a posterior tongue-tie and had it clipped; 1.5 weeks later, we still had no improvement. Off we went to a speech language pathologist, who noted that she had a high palate, a flat tongue, poor tongue groove, and zero suck. The reason I didn't have more pain was because she had no suck strength, so she was compressing the milk out of the end of the nipple and that was it. She was gaining weight because I had a good supply, but given time her weight (and my supply) would tank because she was just freeloading.

Insert a "therapy" regimen of pacifier-exercises, bottle feeding, and 100% nipple shield nursing. We confirmed the tongue-tie was clipped correctly (it was), and a week after starting exercises we saw great improvement: excellent tongue groove, good rhythm, and she wasn't pushing the bottle out of her mouth or gagging on the paci hardly at all. But her suck was still weak, and she still clicks even on the nipple shield.

5 weeks of therapy/visits/copays later, we're still in the same place, essentially. Nursing is still a two-handed ordeal, with the shield, still clicking. I met with the SLP again yesterday and we're working now on getting her off of the nipple shield, if that's even possible. I go back to work in 2 weeks, and I'm just crushed that my whole maternity leave has been spent pumping, bottle feeding, and just fighting to get this going and we're still not there. DH was a huge BFing supporter for DD1 but has already mentioned calling it quits... we're dealing with a dairy sensitivity and reflux to boot (which the SLP thinks is related to her feeding issues), and I just don't think he realizes that the benefits really ARE worth all of this trouble.

I know so many women have it harder than I do, so I really shouldn't complain. But nursing DD1 was so wonderful; I was really looking forward to having that relationship again.

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#33 of 58 Old 06-17-2010, 07:47 AM - Thread Starter
 
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I go back to work in 2 weeks, and I'm just crushed that my whole maternity leave has been spent pumping, bottle feeding, and just fighting to get this going and we're still not there.
That's EXACTLY what I am feeling right now.

My latest update- While my vasospasm seems to have subsided it may not have entirely gone. I am back to pumping majority of feeds. I think the pain/soreness comes back because of the side-lyng position at night, but I can't find anything more convenient specially with DS being super sensitive about any kind of movement. He will wake up if I just move a muscle in my neck
I also think my nipples get sore bcoz he likes to nurse to sleep. He is a high need baby and anyting I can do to make him sleep better helps. But he keeps sucking on and on and on.... !!!!! He stopped letting go off the breast since he was 2-3 weeks old. I don't want to use the pacifier with every feed...I am very frustated with the whole BF experience but hoping to make it to atleast 4 month mark!

Thanks for listening mamas

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#34 of 58 Old 06-17-2010, 10:43 AM
 
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Hi, Mosaic! It does sound like we're going through very similar things. It really sucks, huh?

When did you have your LO's tongue clipped? I know that can make a difference in getting function back; I've also heard that it takes as long for things to improve as the baby was tied. Unfortunately, I can vouch that that isn't always true -- DS was clipped at 5.5 weeks, and we hit 11 weeks yesterday.

Can you tell me more about the exercises you're doing? Our LC just has us trying to get DS to stick his tongue out. Which does seem to make a small improvement, as long as we're doing that many, many times a day. When we stopped doing it as much, things fell back again. I'd love to work some more exercises in.

We're not dealing with tongue grooving or suck issues, thank goodness. His suck must be super-strong to overcome the tongue issues. I noticed a significant improvement on the grooving after the clip. I'm pretty sure DS has a high palate; I know that often goes along with tongue tie.

I'm not sure, though, that he was clipped enough. The doc clipped a tie that seemed to be at the base of his mouth, near the front. But I think there might be a more posterior tie, too. When I run my finger under his tongue, I still feel resistance. But it was hard enough to find this doctor, and at the follow-up, he believed that DS is now fine. And he doesn't want to try clipping DS's minor lip tie.

DS won't take a bottle (he doesn't seem to be able to figure out how to drink from it -- it gags him), which I'm torn about. One the one hand, there's no chance of risking losing the little function he has to nipple confusion or bottle preference. On the other hand, I have no option for a break when things get really hard and frustrating. And DH can't take DS on his own for a little while, which he really wants to do (and I want him to do -- I'd love to take DD to some mommy-daughter things!).

So there's really nothing more that I feel I can do. It's either going to get better or it isn't. From what I've heard, if it's going to improve on its own (the palate re-shaping, etc), it'll get better between 3 and 4 months. So I'm going to try to push through the next 1.5 months. (Ouch, that makes it seem like forever.) At 4 months, I figure I definitely can maintain a pumping supply for 2 months (to get to 6 months). After that....

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#35 of 58 Old 06-17-2010, 05:18 PM
 
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DD's tie was clipped at 2.5 weeks, so we seemingly had everything going for us to get nursing back on track. The exercises we did:

1) Let him suck on your finger, nail side up, drawing it into his mouth. Once he gets going, pull back a bit and place a finger under his chin to pull the tongue out over the gumline and keep it there. The finger under the bony part of the chin is to stabilize it.

2) Same as above, but press down and out on the hump in the back of the tongue along with his sucking rhythm. Kinda like when you tell someone to "come hither" with your finger, but upside down. This was to draw the tongue forward more and reduce sensitivity in the back.

3) Bottle: Let him suck the nipple in, then push it in until the whole nipple is in there, with flared lips, and keep a finger under the bony part of the chin to stabilize it. The SLP recommended Evenflo Classic bottles with the old-fashioned brown nipples, size 1, to give enough resistance for training and not sabotage nursing. Start every feeding with 1 oz in the bottle, then nurse with the shield to get good form.

4) Paci: the newborn Soothie brand. The goal is to get him sucking and then pull back slightly on it to increase his sucking strength. FWIW, the LC and I both though DD had great sucking strength, but the SLP showed me that I was mostly feeling compression, not sucking. I felt a lot of pressure on my finger during the exercises, but sure shootin', try to pull the finger out a bit and the suction was lost immediately.

This SLP works at a pediatric dysphagia clinic... you may want to look for one near you. Gagging on the bottle is something DD did early on, but now we've worked through that sensitivity; worst case scenario, I figure I can pump as long as my supply holds out.

As for whether the tie was clipped enough, the SLP commented on the shape of DD's tongue when crying. It should be cupped, not flat. But like you commented, we may both still face issues because of slightly different anatomy, high palate, etc.

Amy, I totally hear you on the paci use. DD LOVES to suck... it's too bad her sucking SUCKS! Sometimes I just need a break, and I pull the paci out but then it just falls out of her mouth all the time so it's not a good break either.

I tell ya', it's a good thing we love these little people because this is a lot of work!

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#36 of 58 Old 06-18-2010, 04:15 PM
 
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Mosaic, thanks for the info on the exercises! That you've found a therapist to work on this with you has pushed me to give that another shot. I've already seen two therapists, both of whom missed Sprout's tongue tie. But one was totally inexperienced, and the other... well, I have no idea. But she came up with this weird theory that the behavior was left over from his rapid breathing in the few days after birth. I'm trying to get in with the pediatric therapists at the other hospital system in the city in hopes of getting the sort of evaluation that you did.

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#37 of 58 Old 06-18-2010, 04:36 PM
 
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DD also 'clicks' when nursing, she even 'clicks' on the bottle - is this related to her high palate? or her supposedly 'fixed' tongue tie?

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#38 of 58 Old 06-18-2010, 08:29 PM
 
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DD also 'clicks' when nursing, she even 'clicks' on the bottle - is this related to her high palate? or her supposedly 'fixed' tongue tie?
When my DS clicks, my nipple comes partially or fully out of his mouth. Is that what happens for you, or is it just clicking in the course of "normal" nursing?

If she's actually losing the latch, I think it could be either. If the tongue doesn't have full function back, it could be causing the loss of suction. If her palate is high, it can be hard for the breast to fill that area and causes suction loss.

Or it could be both. Because, you know, one of those problems isn't hard enough to deal with alone. </sarcasm>

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#39 of 58 Old 06-18-2010, 09:02 PM
 
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Ugh, so something has changed with Cecilia's latch in the last week. She's been nursing more, and now I'm developing swollen "buds" or blisters or whatever you want to call them on my nipples, and one's bled. It hurts to nurse, like it did when she was a newborn. Not happy with this! She's nursing in the same positions and holds as she always has, so I don't understand why the sudden change and pain.

eta: Is there a breast feeding subforum here? Maybe I can ask for help...

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#40 of 58 Old 06-18-2010, 11:09 PM
 
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When my DS clicks, my nipple comes partially or fully out of his mouth. Is that what happens for you, or is it just clicking in the course of "normal" nursing?

If she's actually losing the latch, I think it could be either. If the tongue doesn't have full function back, it could be causing the loss of suction. If her palate is high, it can be hard for the breast to fill that area and causes suction loss.
Huh. My DD does that - the clicking and losing the latch. It doesn't hurt, though, and she's gaining weight well. Usually she does it for 2-3 feedings (out of 8 million) a day.

It isn't normal?

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#41 of 58 Old 06-20-2010, 09:22 PM
 
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I kept meaning to mention this -- if you suspect latch problems due to high palate, try a symetrical latch (as opposed to an asymmetrical latch). This will put more breast tissue up against the roof of the mouth and help fill that empty space.

When I discovered this, it finally explained why, when I would get on a kick of getting Sprout to latch on "properly" to try to fix the clicking, things got worse!

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#42 of 58 Old 06-29-2010, 09:48 PM
 
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Okay, I have a decision to make. Sprout and I have just been chugging along for the past few weeks. His latch is still not great -- sometimes terrible, once in a while decent, mostly mediocre. He's 3 months tomorrow.

I've managed to get an appointment with some pediatric therapists at a local hospital on Thursday. I'm trying to decide if I want to go.

It all just seems like so much effort. So many times now I've dragged the poor boy to some medical professional, and we have nothing to show for it. I have to drive 40 minutes each way with him and try to time our feedings so he's hungry when we get there (last time, I timed it poorly and had to hold a screaming hungry baby in the waiting room for 15 minutes).

I'm not sure that the therapists will know any more than I've learned in all my research. It's not a very breastfeeding friendly place -- will they even know what to do with us?

And if we do go and get exercises, will we keep up with them? So far, our record isn't great. Of course, that has to do with the fact that we've never seen any improvement from ones we've tried.

So I don't know. I'm just in this very resigned sort of place right now, and the effort involved just feels exhausting.

But if I don't try now, I won't be able to try later. The longer I wait, the more ingrained any habits become. So it's not like I can wait a few months, see how things go, and decide to try the therapy then.

Any insights? Mosaic, do you think the therapy has been worth it?

Jen, former sys admin and current geek , wife to DH , SAHM and Montessori homeschool teacher to DD "Nugget" (05/07) and new arrival DS "Sprout" (03/31/10)
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#43 of 58 Old 06-29-2010, 10:31 PM
 
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I'd say don't give up now. But if you're going to give up, pick a point. Maybe go to this next appt and if you don't learn something new, then you could give up. Or if you have other things to try, or other milestones, then make a list of things you can still try, knowing you can give up in peace after that?

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#44 of 58 Old 06-30-2010, 12:45 AM
 
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I'd say try it, because at least then you know you will have tried everything. But that's only because you seem so dedicated and patient with this issue - I myself probably would have given up months ago, and I so admire that you keep trying!
So, either try it, see if you get the impression any exercises/ etc they give you will help, and if you feel confident about the answers you get, great! If not, eh, at least you gave it a shot.
Or, don't try it but don't beat yourself up because you have done SO much work on this! You've done great!
I forget, though - does Sprout take a bottle yet? What are you guys currently doing to get by?

AFM, S's latch on the right side (where one nipple is a little more inverted and the breast is noticeably smaller) suddenly hurts SO badly. I think it's cause our oversupply is finally calming way down, but ouch! I'm worried that it's too late for us, since (like you say Jen) bad habits are pretty ingrained and her latch has been pretty sloppy due to plenty of milk. Now it hurts hurts hurts when she sucks until the letdown happens, and then again ouchie when the milk slows after several minutes.
I'm going to try to go to the lactation clinic in my area soon. In the meantime, ow!
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#45 of 58 Old 06-30-2010, 01:05 AM
 
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That kind of sudden pain was the precursor to the blebs/milk blisters I dealt with a couple of weeks ago, Jess. Be very, very careful. Inspect your nipples after she nurses and make sure there isn't a spot turning white. If there is, try to open it in the shower with hot water pounding down. They feel so much better once opened.

My sister went through this with her kids and she says that she thinks they could be caused by something so small as a change in tongue position-- I don't know about you, but Cecilia's suddenly "found" her tongue recently, so I wouldn't be surprised if that was the case!

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#46 of 58 Old 06-30-2010, 08:05 PM
 
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Well, I guess I'm going tomorrow. I tried to call this morning to push the appointment back a week or two (using his vaccinations as an excuse), but the receptionist told me how hard it is to get these appointments (mine is a cancellation) and the schedule person never called me back. So I guess I'm going by default.

I feel a little better because DH (and DD) are coming along. Part of my exhaustion with all of this is all the appointments I've had to take him to alone. Not for lack of interest or concern from DH -- just logistics. So having them come along is a small happy.

Oh, and I saw that a University of Florida pediatrician just published a paper about tongue tie and how it isn't treated enough. So I'm going to call her. She's about a 2 hour drive away, but... maybe she can point me to some resources? I don't know. Just grasping at straws. I have a feeling Sprout wasn't clipped enough, so I kinda want her to let us come up so she can have a look. But I know it would probably cost big $$$ and that's a long drive with a little one. So....

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#47 of 58 Old 07-01-2010, 05:13 PM
 
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So, I went to the appointment and it was actually pretty useful!

As I had come to suspect, Sprout has limited upper lip mobility (his lip is pretty short from nose to mouth and the frenulum that connects lip to gum is pronounced) and an extremely high palate. Those things often go along with tongue tie.

When he nurses, he uses compression more than suction (like you guys, right, Mosaic?). That's why things hurt and why he can't maintain the latch.

So we've got some exercises to stretch and pull his upper lip and cheeks. We're also supposed to let him suck on our finger and touch the roof of his mouth to desensitize the palate (since his tongue likely doesn't reach up there) and get him to flip out his upper lip when sucking.

She also gave us some tips for attemping to introduce the bottle -- stiffer nipples, smaller base, and how to do cheek and chin support to keep his form.

So, aside from getting some ideas on how to help, it's nice to hear again that I'm not crazy, that he does have significant impediments to nursing correctly. She also told me that there's another doctor who does tongue clipping, so we may go and get a second opinion on whether the initial clipping was far enough. He also does lip clipping, so that might be an option.

And, apparently, it's up in the air whether we'll be able to go back for more therapy -- our insurance has denied therapy claims before for breastfeeding assistance because they think the mom should just go to a bottle.

Give me a second to be frustrated and angry that we're still dealing with this at 3 months....



Okay. Thanks. Better now.

The good is that he's still gaining weight like a champ and my supply is still holding up. He nursed briefly at the appointment and took in nearly 3 ounces! We're both just stubborn, I guess. Or I'm too cheap and lazy to use formula.

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#48 of 58 Old 07-01-2010, 06:12 PM
 
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so glad you are getting answers. dani curls her top lip in too while nursing. it doesn't hurt, but i think that's why she loses her latch a lot. it does seem like a purposeful loss of latch instead of accidental though.

Nursing is a bunch better for us though overall. We still have rough spots in the AM, but things are so much better and not as gassy/burpy.

Only issue now is a stupid milk bleb that caused me a good bit of nipple pain. OW!

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#49 of 58 Old 07-07-2010, 10:18 AM
 
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I love seeing the good news in here! Jenfl, some of the tricks they taught you sound a lot like what we learned (supporting chin, etc.) plus some new ones since your guy is an overachiever and has to get the lip involved, too. If it won't break the bank, I'd recommend going back for at least one follow-up to see if the exercises are helping. I think part of the reason we haven't had much progress is because I was kinda doing one of the exercises wrong.

jsh7809, any luck with the LC? I agree with Cecelia's mama that you want to get that sorted out before it causes any more trouble... I bet your LO can get the hang of it I tend to forget that this is a nursing relationship that naturally develops and changes over time as they get older and stronger, our supply evens out, etc.

As for us, we had our "final" appointment last week because I'm back at work now. She helped me fine-tune my technique on the finger exercises and showed me how to help work on it even if little missy won't suck on the finger (which, since she has suck issues, too, is very helpful). I've been really trying to do that more every day and I think it will help; I hope so anyway, because you can tell that she hates it! She also told me what to expect down the line as we introduce solids, etc... I admit I always thought this was a nursing issue, but now it's clear that we have to get it ironed out or we'll face continued feeding, speech, and dental issues down the road.

Anyway, I just want to give everyone in here major props for fighting through these obstacles!! And I hope to keep hearing more good news from everyone!

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#50 of 58 Old 07-07-2010, 10:52 AM
 
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Hmm, L curls her top lip in, too. Could this have something to do with why she tends to suck in little blips of air? It's mostly right after my milk lets down. It's like the seal just breaks for a split second, but she doesn't lose her latch.

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#51 of 58 Old 07-07-2010, 11:12 AM
 
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My LC and therapist said some babies do curl their upper lip, and can compensate -- but with Sprout's other impedients, it all adds up.

So I did the exercises for 2 days, and things got worse! So I've stopped, and we're back to "maintainable" and "resigned".

Jen, former sys admin and current geek , wife to DH , SAHM and Montessori homeschool teacher to DD "Nugget" (05/07) and new arrival DS "Sprout" (03/31/10)
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#52 of 58 Old 07-08-2010, 09:50 AM
 
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Hmm... do you think you were doing them correctly? Is it possible this is a case where he's a little disorganized while he shifts from old patterns to new ones? How was it worse?

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#53 of 58 Old 07-08-2010, 04:20 PM
 
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He started dropping every suck instead of being able to maintain for a few in a row. I'm pretty sure I was doing them right.... all they were were stretching his upper lip and cheeks, and letting him suck on my finger with upper lip flipped out (touching upper palate and encouraging sucking instead of compression). Plus, the "worse" started right after his appointment, before I'd done the exercises on him myself.

Not sure if it was a rough spot on the way to something new.... he does seem to flip his lip out more often, even after that short period. But it doesn't seem to affect things much.

Got an appointment July 30 with another doc to get a second opinion on whether he was clipped enough.

Jen, former sys admin and current geek , wife to DH , SAHM and Montessori homeschool teacher to DD "Nugget" (05/07) and new arrival DS "Sprout" (03/31/10)
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#54 of 58 Old 07-09-2010, 12:23 PM
 
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Hmm... I agree that it sounds like it got worse, but I don't know what that means. Can you call for advice without having to pay to go back in before the 30th?

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#55 of 58 Old 07-09-2010, 01:32 PM
 
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We are having issues over here. DS has some sort of bump/bubble under his tongue that I noticed at about 1.5 weeks old. I called my doula and she came to look at it and said she hadn't seen something like that before. My MW didn't indicate she knew what it was either, just said that the baby didn't look tongue tied. I asked our dr about it and he said that it was probably a blocked salivary gland/salivary cyst and that it was a "watch and wait" issue. Well, baby is now about 10 weeks old and the bubble is getting larger. I've also noticed his latch doesn't seem very good now and that he holds his tongue differently in his mouth. He holds it more towards the roof of his mouth (like you would if you were making a clucking noise). He's still growing, peeing, pooping, smiling, starting to giggle so he's getting enough milk in, but it's really painful for me. I struggle enough with breastfeeding, I don't need pain to go along with it. I'm going to nurse when I can and pump until I can get him into the dr again. Of course, the dr will probably just refer us to an ENT which will be another wait period.

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#56 of 58 Old 07-09-2010, 04:23 PM
 
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i kinda feel like i'm crashing this thread, since i haven't been part of it all along. s to all of you who are working through more significant challenges!

just in the last few weeks, occasionally charlie only wants to suck my nipple, like he won't take in more breast tissue to get a deep latch. he doesn't do it often, sometimes not for days and then several times in one day. it happens when he's sleepy, but not all the time. if i unlatch him, i can't seem to correct it, or get him to open wide. instead he wants to suck my nipple into his mouth.

as a result, my nips have been sore on and off lately. any tips? he did this when he was first born but i worked him out of it. i'd hate for him to return to his lazy ways .

me+him for 15 yrs, welcomed our little one march 25th, 2010.

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#57 of 58 Old 07-09-2010, 05:06 PM
 
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Quote:
Originally Posted by Peace+Hope View Post
i kinda feel like i'm crashing this thread, since i haven't been part of it all along. s to all of you who are working through more significant challenges!

just in the last few weeks, occasionally charlie only wants to suck my nipple, like he won't take in more breast tissue to get a deep latch. he doesn't do it often, sometimes not for days and then several times in one day. it happens when he's sleepy, but not all the time. if i unlatch him, i can't seem to correct it, or get him to open wide. instead he wants to suck my nipple into his mouth.

as a result, my nips have been sore on and off lately. any tips? he did this when he was first born but i worked him out of it. i'd hate for him to return to his lazy ways .
Somebody told me to let her see me open my mouth really wide and stick my tongue out right before she latches on. That she'd eventually imitate that. Seems even more likely since he's older now.

Who knows if that's true, though.

Hippie sympathizer and mom to L, 4.8.10.
Pet-mom to Squirt with FLUTD & Maya the deaf wonder dog .
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#58 of 58 Old 07-09-2010, 05:16 PM
 
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I've also been told to stimulate the top lip, as that makes them open up wider. Basically they say to wait for that big, open mouth and then try to catch a good latch. If it's not good, break the seal and don't let them cheat!

Is he hungry during those times and actively want to eat or is that only when he wants to comfort nurse? If it's a comfort thing, maybe this is bad but I'd probably not worry about it too much; but if he actually thinks he's going to eat that way, I'd very assertively nip that in the nip.

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