correcting lazy latch in 8 week old?

[trimbler]

Hi,
I just noticed much fussier feeds on the right breast for the last couple of days, when watching more closely this morning (ie not getting so distracted by DS1), I realised she probably has a lazy latch on that side, ie not really wide enough? It works for her at the start of a feed, when I'm spurting anyway, but when the flow slows she gets upset, perhaps because she's not latching properly to extract the milk efficiently? Although I fed from the right for the night feed last night, it was still fuller than the left in the morning, so I offered that one first and tried to encourage a wider latch with nipple to nose. However, she just doesn't seem to want to latch enough to persevere, so just cries and gives up rather than opening wider? I don't think she's full at that point because when I offered the other breast she took that, but I also noticed that she didn't have such a wide latch on that side. I hadn't really been paying attention recently as my nipples are comfortable and I seem to spend more energy trying to stop DS1 from prodding and poking her than on watching what she's doing! With DS1 as a baby, I could easily take him off to correct his latch and he'd be desperate to get back on, and took a full feed. However with DD2 she seems so easily distracted that she doesn't seem motivated enough to work on the latch, she'd rather just give up. Any ideas on how to correct this latch would be appreciated! When I squeeze my breast, especially the right one, after she's given up on it, the milk is still quite watery so I'm worried about maintaining my supply on this side, especially as she doesn't seem to have much time for comfort sucking to stimulate more supply. I haven't had her weighed recently as we've been away a lot but will do tomorrow. She seems to be doing the right number of wet nappies but her poos are quite variable and often very runny and green/brown, they seem yellower, less runny and more 'normal' when she does take longer feeds. Sorry this is all garbled, in a rush! TIA...

[becj86]

Sounds like she could be struggling with the flow a bit. Have a look at over supply and overactive letdown - just google and see what you think, the green poos, shallow latch and fussiness sound a lot like L was when he was little. Re: watery milk, you could try massaging the breast near the chest wall to help loosen the fats off the duct walls and into the milk to give her more fatty milk earlier in the feed. That can help with the greeny poos.

Maybe also have a look into laid back feeding/biological nurturing. This can help with the latch and fussiness. 

[trimbler]

Thanks becj86, my letdown is sometimes a bit too much for DD, although now she'll splutter less frequently, so I think she's more able to handle it, I'm not soaking muslins although the milk will continue to spurt out a little if she does break off at the start, but as I said that doesn't happen so much now. I don't remember DS being like this, his poos were always nice and yellow and he would eat and eat for ages, whereas DD will stop and give up for whatever reason much more quickly. I've been trying different positions as DS was fussy feeding at times which I eventually put down to silent reflux (milder form) as he had difficulties laying down at all; DD doesn't seem to be quite the same but a more upright position sometimes helps. I can never get comfortable with the football hold. I had a look at that oversupply post earlier but will follow up the laid back feeding link now you've recommended it! Interesting tip re massaging the breast, never thought of that, will give it a go! I googled green poo a while back, I'm never quite sure as most articles about foremilk/hindmilk imbalance talk about frothy poo, whereas DD's poo is just runny and/or mucusy. But I'm sure they're more yellow when she does stick at it for longer, so will try the massage to see if it has the same effect - more importantly, to know she's getting what she needs to gain weight! Right, enough waffle from me, I'm off to look into laid back feeding etc!

[becj86]

L's poo was green and mucousy and then became stringy, almost like wet grass, it was terrible. I was advised to stop all dairy but thought I'd try increasing his fat first, with the massage, block feeding and laid back feeding and he was like a different child the following week. He honestly went from putting on 20-30g per week to 500g per week in the space of a fortnight.

L also had strong preference for one side when in a GS and the other normally, one side has one large hole and squirts like a hose where the other is more spray-like, these are things we learn about our LOs as we go along and no two are the same.

Hope you find what works for you and your DD

[*Ali*]

We also have a FAQ worth looking at Oversupply and Overactive (Forceful) Let-Down

[trimbler]

Thanks both of you, yes that's the post I've read, Ali. Interesting, my DD has also expressed stronger interest in each breast at different times, I wonder whether that was also connected with a growth spurt? Can I ask about block feeding, I'm a bit confused about how to make it work? I've been single side feeding since I stopped being engorged early on, so I guess that's like block feeding in 2.5-3h intervals already? If I offer the same breast twice in a row with say a 3h interval, that would be like block feeding over 6h, or not offering the other breast for almost 9h? That seems like too long, could that reduce supply too much? I've tried offering the same side at each of 2cluster feeds as that didn't seem so drastic. This morning I started on the right, then offered the right again at the second feed 3h later until she wouldn't go back on any more, then offered the left, she only took a little then just cried. Should I have just persisted on the right for longer? I really struggle to know when she's really had enough or when she is just uncomfortable, distracted and would rather look around than feed, or frustrated that my flow has slowed or not latching well enough to feed efficiently. She never seems starving though when I next offer a feed, I just feed when she wakes around the right time and doesn't need more sleep, even though she's not really asking for it.

Thanks again, I'm hoping to get some more advice from a friend who's training to be an advisor on a breast feeding helpline but I wanted some ideas from you lovely ladies on how this would fit with EASY too.

[trimbler]

Just been reading things over again, would oversupply only be the case if baby is gaining well? Had her weighed yesterday, she's not a big cause for concern but I've been asked to get her weighed again in 2weeks, they'd normally say once a month. I can tell she's definitely not gaining like her brother did. She was 3.8kg at birth (41w) and now 4.9kg at 8 weeks. But bec, your DS was gaining poorly and you took action for oversupply and then he put it on? How did you encourage him to stick at a feed when fussing? I sometimes try singing to her, but it's so hard when everyone wants to play with her and she would much rather do this than feed... Then of course she's OT so I have to give up and get her to sleep!

[MasynSpencerElliotte]

I block fed DD2 at points, I actually did one side during the day and the other side for nights! She was having a df and 2 nf's at the time so I was getting plenty of feeds from that side. I can't remember how long I did that for or at what age though, sorry.

[*Ali*]

Over supply can cause weight issues because LO may not be getting to the fattier hind milk.
What about offering both sides but staying on the same braest for two feeds in a row?

[becj86]

The fussiness pretty much stopped when I did the laid back feeding because he wasn't being squirted like a fire hose and he was getting milk in a flow he could cope with. I fed in a recliner, so laid back for letdown, sat up if he was getting impatient and laid back when he jumped off with the subsequent letdowns.

If you're worried about losing supply, you could pump the other side and build a stash or do smaller blocks. My blocks were very long (12hr) but I was hand expressing more than 1L/day... The idea of the blocks is partly to reduce the supply but also to increase the fats she's getting. If you think supply is less of an issue, maybe stick with the massage thing and single sided feeding.

I wouldn't necessarily worry too much about trying to get her to keep feeding once she seems like she's done. My flow was such that even at that age, L was done in 5-10 min. 10 min being if distracted. That feed time stayed the same and even get shorter once he was gaining massively, too, so you're not necessarily looking for her to feed for longer.

Oversupply was a major part of L's low weight gain, he got so much watery milk and so little fat. Once the balance was better, he gained much faster.

If you're particularly worried about how much she's taking, you could do a weighed feeding, where you weight her immediately before and after a feed to find out how much she's taken in. You may well be surprised.

[trimbler]

Hi again, I tried to post a couple of days ago but lost connection! Thanks so much for your suggestions, don't think we're quite there yet but I've tried using the same breast twice if we finished up with very watery milk the first time, so kind of flexible block feeding? We've had more yellowy stools although we still get very watery green/brown ones too. Think we're getting more fatty milk at the end of feeds too, most of the time. Still taking a long time to 'finish' a breast, my friend suggested compression to speed up the feeds, which works for the dream feed but just upsets her when she's awake. Previously she had started waking more often at night, but seems to be doing longer stretches again now. My friend was concerned about me block feeding if weight is an issue so I am limiting that now, she recommended I pay more attention to latch and positioning, certainly the better feeds are laid back (thanks!) but I struggle to do this out, also she is still fussy feeding much of the time. But going longer stretches at night, and the better looking poos seem to suggest to me that something is working, will keep you posted and update when she is weighed next week, if not before!

[*Ali*]

When I was out I just sat on a chair and slid my bottom to the very front of the chair then leant back against the seat back.  Having a cushion or nappy bag fill the space behind me also helped.

[trimbler]

Hi just checking back after the weighing! Well, the HV isn't concerned and she has put on weight, but she's steadily moving down the percentiles. She was 75 at birth, maintained that line at 2 weeks but dropped to just above 50 by 4 weeks, just below that by 8 weeks and now at 10 weeks she's nearer 25. Poos still green at times but variable, whenever she feeds well we get more yellow poos but we've had fussy feeds again since her jabs last Friday, maybe some loss of appetite related to that, but also we've been out for some feeds and she really doesn't like feeding out! Only manage to get much into her when I cover her up as she seems distracted by everything that's going on around her, she's happy sitting up and looking, but won't stay at the breast even if it's been a while since the last feed and I know she must be hungry. So we struggle on, thanks for your help, I'm still single side feeding and using the same breast consecutively if it was a poor feed. Not really sure what else I can do, DS actually lost some weight around 4-5 months as he was so distracted during feeds and just wanted to play, but he soared through the charts up until 3 months! Maybe I just had more time to concentrate on him and he didn't have a whirlwind of an older brother to contend with...

[becj86]

Was her birthweight increased at all by IV fluids during labour?

[trimbler]

Oh I had no idea that could happen, yes in did have IV fluids in labour although they didn't go through properly for ages, no one would listen when I kept saying I felt really faint until finally the obstetrician noticed and pushed them through, but I don't think it was all that long before delivery, how long would I need to have had them for it to make any difference?