14 w/old doesnt get fat milk due to the nipple shields use/tongue tie?

[Mariellamom]

Hello,
My 14 weeks old DD started behaving really strange or better to say almost never finished after the 6/8 weeks growth spurt. It seems like a week ago we had a 3 months growth spurt that was not that intense ( she was waking up one night every hour to eat). After that the day/schedule got really messed up. She would eat just a little after her nap, have an activity time and would cry searching for food right before her next nap. Most naps started lasting 45 min and she would get up hungry in 45 min, eat again a little and again hungry right before the next nap. The last 3-4 nights she is up every two hours. Sometimes belly issues but mostly acts like she is hungry. At this point I am thinking I should probably supplement with something.
She has a tongue tie and we snipped it but her latch never improved and I constantly use the nipple shields. Now I wonder if with her tongue tie she can get any of that fat back milk...? Maybe this is the reason she is not having enough ? How do I know if she gets fatty milk ?
I was feeding her from one breast at a feeding during the day ( like Tracey suggests) and two during the night. But it doesn't seem to make a difference. I try to nurse her at least 20 min so that she gets that back milk ( Tracey says it comes in after 15 min into a  feed....). But sometimes she would stop eating at a 10 min mark or just suck my breast for 30 min on and off every couple of seconds.
Because of her nights and short naps during the day I am overtired also and cry every morning from no strength/patience.... I've been in a survival mode since birth and it never seems to get better. Only one week out of all 3 months was  a miracle when she was getting  up to eat only once.
I know it is not about me and the baby is about sleepless nights. But I can't survive on a short naps at night and no naps during the day. That is why started thinking about supplementing. Maybe it will give her some fat and longer stretches of sleep in the night?
Thank you for help!

[MasynSpencerElliotte]

Regarding the short naps, how long is her A time?  Could she possibly be undertired?

A lot of the bf info from the BW books is quite outdated now so I am not sure of the accuracy of the 15 min timing for hind milk. Though my oldest DD fed in 5-10 min from birth so I imagine it is probably not the case. Supplementing unfotunately will not necessarily lead to better sleep, some babies wake anyways (my DD2 was mix fed and still had 3 nf's until 5/6 months of age).

[*Ali*]

Have you had her re-checked to see if the tongue tie has reattached? If that was the issue it really shouldn't still be causing problems after being snipped.

If you are worried you could also try expressing a bit before you latch her on to help her get to the fattier hindmilk quicker.

[Mariellamom]

Thanks Ladies. I also was thinking that most babies don't eat for that long but get a hind milk anyways.
We've had several nights in a row where she gets up every 2 hrs. I try to feed her from 'three breasts'. (1, 2, 1). It takes me one hour to feed her because she is falling asleep once she feels full I guess. Once we finished she is up in an hour. We try to delay it but she just acts hungry again so soon. I wonder if it is normal. Kids at her age suppose to last longer in between feeds. Twice in the last week her first two naps were unusually long and I woke her up to eat 3,5 hrs after the last feed. So it seems like sometimes she is ok in the morning and lasts more than 2 hrs.

Regarding her tongue tie, it is not easy to get a good opinion here. We are in Israel. Two doctors said she didn't need to get the procedure, the third one does it for everyone, even offers to do it for adults. We snipped hers and had to stretch her wound after that for 2 weeks twice a day so that it won't be reattached again. Of course it was painful experience for us to see bloody mouth of our DD twice a day and to wonder if it was needed at all... I am concerned that  if we go back to that doc he will snip it anyways and who knows if not just to get more cash in his pocket......
So it might be that she gets tired from sucking soon because she can't latch on properly because of TT.
My pediatrician says that I made a 'game' for DD by feeding her every 2 hrs and I need to stretch the feeds until 3 hrs by offering water.....I wish it was easy to delay the feedings especially in the night.... But it is impossible...
Maybe I just need to 'suck it up' and wait a couple of months until things go better....)

[Mariellamom]

Ok. So I am looking for the solution and decided to stop feeding her to sleep. She goes to sleep independently during the day but I was too tired to deal with her falling asleep independently during the bed time. But now I think maybe she got used to sucking to sleep so much that she gets up to sooth herself...? Who knows. Last night I put her down at 7. Fed and burped her and she was awake in her crib but fell asleep. Woke up at 9 and 11:30! I tried to distract her and delay the feeding but she was crying, was falling asleep but again started crying and rooting...
I don't know how long should I wait to see if she is really hungry. After 11:30 she woke up at 3 and at 6. The last feed was short.  I think she just was gassy.
So at least it was kind of a 3 hrs break! Will see how it will be changing when I will continue not to nurse her to sleep.
Do I need to keep her awaken after each night feed also? Or let her fall asleep at the end if the meal?

[*Ali*]

IMO night feeds are fine to feed to sleep.
The WHO don't recommend giving water to EBF babies under 6mo so I wouldn't offer water to delay feeds personally.

[Mariellamom]

Thanks! About the water I read that it can be dangerous. My pediatrician is from post soviet block countries where are kids just had to be on a schedule no matter what...
Good to know about the night feeds;) thanks !