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Breastfeeding and slow-to-gain babies

A mama with a newborn with gain issues and possible tongue tie asked for breastfeeding advice. Here’s what I said.

It took us 2 1/2 months to get properly diagnosed and treated for Miles deep posterior tongue tie. I STRONGLY recommend you search for and join the Tongue Tie Babies group on Facebook, ask questions there and go to a practitioner who believes posterior tongue tie exists. It is a stupidly simple thing to fix with a trained practitioner (minutes, literally) but many people simply do not understand it who should. Those who understand it become evangelists about fixing tongue tie.

IN THE MEAN TIME… The first and most important thing to do is to feed the baby. A close second is to get your supply up.

Now, you say baby lost weight precipitously in the first three days. If you have any sort of IV fluids, however, this is VERY NORMAL. Many caregivers do not even recommend counting weight from birth, but from the 3-day-post-birth low. Being told your baby has lost weight on day 3 is like being told the sun came up in the morning. Shiny had lost 1 pound by day 5… but if you look at her birth pictures, she was VERY swollen when born, probably due to her chromosome issue. Miles lost 13 ounces in 3 days and my midwife did not even blink. We did not give formula in either case.

The best thing you can do to get your supply up is empty your breast as often and completely as possible. Get a good pump, your insurance will probably pay for it. If not, there are plenty of ways of getting one, including rental if you can’t pay $200 up front. Pump on one side while nursing on the other. Get a hands-free bra. Whenever you pump, massage the breast, milking toward the nipple. It takes some practice to learn to do this without breaking suction. When you’re nursing, massage. I cant’ stress this enough. All the teas and tinctures and drugs in the world cannot compare to stimulating and emptying the breasts well and thoroughly, often, and at 10 days your supply is in NO WAY a done deed. Right now your milk supply should be hormonally driven, and you’ve got a couple MONTHS to really fix things.

So, what’s a girl to do? As a mom who has dealt with a lot of crappy nursing situations, here’s what I strongly recommend:

1. GET GOOD HELP. You need a lactation consultant who is both experienced with posterior tongue tie and knows where to send you to get it fixed. You need either a chiropractor or a craniosacral therapist to work on the baby, and you need to get any tongue tie addressed.

2. Whenever you feed formula, spend some time pumping. You need to tell your body how much milk to make, and the more empty you keep your breasts, the more milk you will make.

3. Practice hand expression. Find what works best to make the milk squirt the most, and then do that while your baby is nursing. I have successfully fed two babies with bad latches simply by milking my breast into their mouths at every damn feed. It is hell. But in both cases, the babies DID in fact gain sufficiently and learn to nurse despite huge hurdles (neurological in one, tongue tie in the other).

4. Consider getting a scale. Weigh baby, dressed, before a feed. Without changing the diaper, weigh baby after the feed. You’ll get a feel for how much your kiddo is getting, and how much you need to pump (or how much formula you need to give.) MOST caregivers when faced with a baby losing, will say “Give 2 ounces after every feed.” THIS IS WRONG AND WILL KILL YOUR SUPPLY. In no case is it possible to say “Give 2 ounces after every feed” unless baby is continuing to lose weight day after day at a rate of at least an ounce a day. In most cases, a baby will only need about a half ounce or so after each feed.

5. Spend a lot of time skin to skin in bed with baby. Get as much help as you can and expect that you’re going to spend the next couple weeks figuring this out. It may take a month or two. Rearrange your life if you possible can to allow you as much rest and baby time as humanly possible. The more you get now, the easier things will be in the long run.

Published in Breastfeeding

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