4 month old only eating a couple minutes at at time, is that enough?

[AmKree]

Hi there,
I am a mom to a beautiful 4 month old girl. We have been EBF for four months and it has been the hardest thing I have ever done. I am so passionate about breastfeeding and am sad that our experience hasn't been what I thought it would be.

We struggled from day 1 with latch issues. She has had her upper lip tie and posterior tongue tie revised 3 times now
We also had to start with a nipple shield until she could latch normally which took about 4 weeks. I still deal with a lot of pain but am used to it at this point, mostly on the right side.

We initially had weight concerns as her weight after weaning off the shield stalled for a month. That was when we did her second tie revision and the weight then went up. She was born at 9 pounds 12 ounces and at 4 months weighs 15 pounds. She has plenty of wet diapers and seems content between feedings. We have tried a bottle a few times and she won't take it.

She is a fussy and finicky eater. If there are any noises or distractions she won't latch. This makes it very hard to go anywhere so I mostly stay home with her. I feed her in the bedroom on the bed. I was initially able to feed her elsewhere in the house and in the community but haven't been able to for a month or so now. She started kicking the armrest of the rocking chair and couch which is why I started her on the bed, but now I feel we are stuck here... She also won't latch when we go places anymore either.

She used to eat around 5-7 minutes but the last two weeks has went to 2-4 on average. Can she get enough milk in that time? The five minutes had me concerned, I am about to lose my mind with 2! I know I have a fast let down and she seems to chug at first, but that seems super fast to me. She eats every 1.5-2.5 hours during the day and I wake her every 3 hours at night. I have tried having her go longer between feeds and that doesn't seem to increase her time at the breast. She will eat and go right back to sleep at night, so with her previous weight concerns and the fact she'll latch a bit longer at night I continue to do this.

She doesn't comfort nurse at all. She mostly uses the cradle hold and occasionally I use the football. I have tried the laid back, lying down, and other positions to help with my fast let down but she won't latch in them. I have oversupply and OALD. Since her eating time has decreased I have had engorgement and blocked ducts. I have been doing block feeding to help reduce my supply a touch. And hand expressing for comfort as I don't want to pump and keep the cycle of making too much going.

We are also trying reflux meds as we had some back arching during and after feeds to see if that will help any.

Anyone else have a similar experience or any suggestions? The LC we've seen haven't been very helpful unfortunately.

[ENMS]

Lots of (((hugs))) and congrats for keeping at it for so long! I'm also a survivor of 2 babies with major posterior tongue ties so I know how you feel.

I think some babies are super efficient and can get enough milk in just a few minutes, but it is hard to tell. in your case, I would look into the weight gain / wet diapers to check if she is getting enough.  It could possibly be reflux as you have already pointed out.

Do you think the reflux meds are helping? Sometimes it can take more than one trial, or you may need to up the dose. We have wonderful ladies on the Colic, reflux & crying board who can help you with that.

Have you done any chiro / osteopath body work with her? TT babies have a lot of tension in their little bodies and these have helped us tremendously with my DD2. We needed multiple appointments but it has clearly made a difference.

I'm sorry you have to stay at home to feed her, this must be difficult for you. I have no experience with this, but I know someone who does so I will ask her to pop on here.

Also, just wanted to add - in a few months she'll be starting solids and once she does eat a little bit, it will ease your worries since she's getting more calories to complement the breast milk. It has made a world of difference for us.

[weaver]

She has plenty of wet diapers and seems content between feedings.

There's your answer, hun.  Look at your baby and feel confidence in your mother instinct.  You can do this, you are doing this already and you're doing an amazing job.  A hungry baby will let you know ALL about it.   Sounds like you have lots and lots of great milk and she's getting it into her tummy very efficiently.

[zissi]

hi there,

your baby sounds exactly like mine and its all down to the TT. as ENMS pointed out, have you tried osteo or any kind of body work? for some babies the revision alone isn't enough and they need a lot of work to learn how to drink properly.
my DD is the same. she only feeds for a couple of minutes, only in the dark bedroom lying down. it started for us very early, as a 2 week old baby she would only feed 10 mins which I thought was odd and then she decreased the time more and more. she was super fussy the first 3 months, back arching, fighting the breast. like you Im so passionate about BF that I kept going. we had our TT revised twice but TBH never really saw a major improvement despite bodywork. I just made my peace with it. the issue really is that the baby can't get at the milk that comes after the initial letdown, most young babies fall asleep in that case, but some babies become fussy and fight the breast. I read somewhere that some TT babies survive on the letdown as they don't have to work hard to get the milk. that can work if you have a lot of milk. so I would strongly suggest not to reduce your supply. I actually take meds to increase /keep up my supply because I know that my DD isn't draining the breast properly. I also fed my DD in the first 5 months every hour or so during the day and at night time not much better, on average every 2 hours. that way I could ensure that she continues to gain weight. supplementing for me just was never an option as I told myself that I will feed her 6 months exclusively. she is now nearly 8 months and with the solids we are doing much better. I still offer the breast every 2 hours during the day at least and she eats whatever she eats, some days quite well others not so much. we do BLW. so she decides how much she eats.
and its so hard when you feel that you cannot go anywhere. have you tried feeding in a sling? thats the only other option that works for us outside the bed. I guess its because she can't see anything there and isn't distracted as a result. and it only works when tired and before a sleep or right after.
well done for getting this far, you are doing all the right things, feeding frequently and facilitate feeding when possible. maybe do see an osteo for body work, it may make a difference for you...

[AmKree]

We did several sessions of cst after her second revision. But it is an hour away (three hours round trip with apt) and insurance doesn't cover it. So it was 160 dollars a week and we could only do it a few weeks. I have alo taken her to a regular chiro who doesn't do cst but has exp with infants. We haven't really noticed much difference after all of those appts. Now that the eating is even lower I hate to leave the house honestly to start any of that back up.

I worry about solids though because don't most foods have less calories than my milk? Plus with learning to move more she will be burning more energy than she does now. Any ideas on that?

Thanks for sharing your own stories, so glad I'm not alone!

I didn't think about the "surviving on the let down" but that does make sense... I just want to be comfortable not engorged and at risk for clogged ducts.. I think I may be at that point now as the last couple days I have been more comfortable.

Her weight seems ok, probably on the lower end, but maintaining... She usually has between 7-9 wets a day and 1 dirty diaper.

[AmKree]

We also met with a speech therapist, again didn't do much other than take her history and watch her move her tongue around. She said everything looked good. I tried to feed her there so she could watch that, but of course my little one wouldn't latch....

A sling, I haven't tried but sure can. I'm guessing that wouldn't work well as she is so picky. We call her nosy rosy as she like to always know what is going on, LOL.

Again LC aren't much help either as I can't really get her to latch elsewhere. I have messaged some from our local county about the clogged ducts and they weren't that helpful unfortunately.

[becj86]

Mine would be distracted by every noise as well - worth showing her the source of the noise and how its controlled. Once he knew what the noise was, he would happily latch while hearing it, just that it was new that he had trouble.

Have you read about baby led weaning? That will give her the developmental benefits of solids without taking much from her milk intake as she likely won't swallow much for a few months.

Have you got clogged ducts or are you concerned you may get them?

[AmKree]

I have recently had the clogged ducts as I was really engorged from when her eating went down the last couple weeks.

[becj86]

Sometimes just after a growth spurt, your body increases supply beyond demand and it can take a few days to a week or so for supply to settle back down again. Could just be that...

[weaver]

I want to just give you a massive hug, you sound stressed about just about every aspect of feeding your baby.  And you've had a tough time so it's normal enough that you would feel on edge.  But take time to look at her and to see how contented she is.  She will tell you if she's hungry!

Totally anecdotally, a close friend had OALD and oversupply and also basically produced astronaut food, the richest milk you could imagine.  Her babas grew really well with what might seem like short feeds to others.

If you're concerned about clogged ducts, gently massage the area in the shower, or bath, or try feeding in the bath perhaps?  Check also that your clothes aren't slightly tight around the breast, that pressure can encourage clogging.

Is there a La Leche League group anywhere near you? Just for some company for you   And can you take a break over the weekend? When my LOs were that small, just sitting on my bed in the daytime *on my own* with a cup of tea and a book felt like a holiday.  Remember to take care of yourself too.

[ENMS]

I worry about solids though because don't most foods have less calories than my milk? Plus with learning to move more she will be burning more energy than she does now. Any ideas on that?

Yes, it is true that milk has more calories than solids, but in the case of my baby, she could not get more milk from the breast (even if there was milk left) because of her weak sucking because of her TT. In order for her to gain weight I would need to: BF, then pump, then bottle feed her what I have pumped, and that was exhausting. Now, solids help her get the calories she's missing. So it is really complementing her needs, rather than replacing any milk feeds, you know what I mean? It did take her a while to learn how to eat solids, but now that she has, she is finally gaining weight!

But in your case, she is gaining weight which is good. Some babies are smaller than others, so as long as she is maintaining her curve, there is probably nothing to worry about from that perspective.

I agree with Anne, you sound stressed (understandably!). Tongue ties can really take a toll on mamas who want to breastfeed. I'm sorry the LC was not very helpful. Hopefully you can find someone IRL to support you through this because it is not easy. And we're here for you of course

For the clogged ducts, I've also had more than my share unfortunately Anne's suggestion of massaging in the shower is great. If they keep on coming, you can try lecithin or evening primrose oïl, it changes the milk slightly so that it is less 'sticky' and therefore less likely to clog.

More (((hugs))) for today.

[zissi]

I totally agree with ENMS solids will probably help. they made a difference for us too. we never had major weight gain issues, my LO dropped from the 75% percentile to the 50% between months 3-4 and now since we are on solids she is up again on the 75%. I know it probably feels like a long time till you can start giving solids, I was counting the weeks too but time passes so quickly and before you know it things will get better. we still have short feeds but my LO started even to comfort nurse sometimes and falling asleep on the breast, something she has never done before. I continue to give her frequent feeds, like every 2-3 hrs, I offer at least. in my case there is always the fear in the back of my mind that my supply will drop if I don't feed frequently enough and I don't want LO to wean already. plus she doesn't take a bottle neither, so I don't have any other possibility to get milk into her.
has any of the LC's or other professionals done suck training with her? this gives quite good indication how well your LO is able to suck. in our case we have a weak/disorganised suck, hence the inability to remove milk efficiently. you could look up suck training for tongue tie babies and see if you can do some exercises yourself. also, do you think there is reattachment again? I don't know if another revision would make a difference, I decided after the second release that its enough based on the fact that we never saw any improvements.
I send you hugs as well, I so so hate tongue tie but you are doing a great job despite the obstacles.you will totally get there too!! xx

[AmKree]

Thank you for all of the kind words and encouragement!!!

I have been taking the lethicin for a week or so now. Haven't had any additional clogged ducts so that's nice.

I'm not sure about a disorganized suck, after her tt release I did some suck exercises. She seems to have a strong suck. I think part of her problem is she gets a shallow latch, especially if I'm really full, then the nipple isn't far enough back which causes her to choke with the heavy let down.

I am getting a scale to do weighted feeds to see just how much she gets in those couples minutes. I think if I can verify she is getting a decent amount that will help my anxiety immensely. Then I can focus on the amount verses time nursing, which doesn't really mean much at all.

She just started so big, 9 12, so that's been a hard curve to maintain with all of our issues. She is definitely still doing ok, it just takes all I have to maintain ok if that makes sense.

I think the biggest thing is for her to nurse elsewhere besides home so I can leave, LOL.

[zissi]

I know, our latch is sorta shallow too. I think at this stage its habit too. I was always so afraid that she wouldn't latch at all that I allowed a bad latch and that way she never learned a good latch. It was exactly the same for us, my DD continued to gain well and thrive but at a high cost, hourly feeding etc. looking back Im still so glad and proud that I did it and it will be the same for you. you have done already so well. as I said practise with the sling maybe at home and see if she would feed in there, that would give you a bit more freedom... ?

[AmKree]

Crazy that something that is so natural can be so hard!

Had a rough night of sleeping and her not eating much last night makes one tired mama this morning.

I just feel like bottle feeders don't have all these issues, they can go out and about town easily. I really really want to breastfeed I just had no idea with our circumstances how isolating it would be I hope it gets a bit better over the next couple of months.