Expert: ruth kraft - 11/26/2011

Question
Hi,
I have had lots of problems getting breastfeeding established. I pumped and bottle feed for the first 5 weeks while trying to get him to bf because I couldn't get him to latch, then, he seemed to get better and I have only given him a couple of bottles since then. Things are still not perfect and I don't think the latch is right because my nipples are tender and I have to try several times before I get him on one side and I can't always get him to take the other side ( the nipple is flat on that side) and  he often makes a clucking sound. he also seems to need to feed all the time  although I think he is only drinking for the first  5-10 min the he slows down and nibbles for 30 min and seems much less settled and doesn't sleep much in the day. He will sleep for a 4-5 hr stretch at night. (some days he has only slept 10 hrs in a 24 hr period).
I know there is plenty of milk because I was getting enough when pumping and when he comes off I can still get milk out when I squeeze the nipple.
At the beginning of this week I went to the clinic to get him weight and he had lost weight which really upset me. I had the nursery nurse who had been weighing him in the weeks before weight him the next day using her scales and turns out he had actually put on 160g in the 12 days since she last weighted him. I also got her to observe him feeding as she seemed to think he was doing fine even with the clucking sound but the episode from the day before has me really worried that he is not feeding effectively, is a weight gain of 160g in 12 days ok. He is wetting 5-6 diapers a day and haveing several bowel movements.

Answer
it sounds to me as though  you are correct that there must be a latch issue. you should feel no pain. especially this late after 5 weeks. finding someone local who may be able to help you get him latched better will be helpful. You can view the videos on www.drjacknewman.com to see if those are helpful so you know what you are looking at.  At 6 weeks we would hope that he goes through a growth spurt and will also increase your supply. you can nurse and pump at the same time that will build supply and make it easier for him to get a faster letdown but getting him to nurse efficiently will be your key. Unfortunately that is not something I can fix though email as I need to actually SEE him latching and sucking.
It sounds like you are super close to what he needs to be at for intake. Keep it up and fix the latch and it should get easier from here.