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  • @llli*maddieb's Avatar
    Today, 12:17 PM
    Hello and welcome. If you pump 30 or more ounces a day, that indicates milk production is likely normal at this point. That is amazing and a testament to the incredible work you have done so far. This is also going to make getting baby to the breast much easier. Also very good news. This indicates baby is capable of normal milk transfer as far as I know. Baby took about another 1/2 ounce from the bottle but that does not mean baby needed that, or that baby would not have gotten that at the breast if baby had nursed a bit longer. Right? And baby has been gaining well, right? So overall baby is getting enough eating 2 and a 3rd ounces 10 times a day? But a breastfed baby is more likely to nurse 12 or MORE times a day. So, meals may be smaller, but more frequent. Not that 2 and a 3rd ounces is an overly large meal, it is not. But when a baby is nursing, meal size normally varies from less than an ounce to 3-4 ounces. So a breastfeeding baby does not need to eat the same amount every time and is not likely to.
    1 replies | 101 view(s)
  • @llli*ramatae's Avatar
    Today, 12:12 PM
    Hello, all! I'm hoping someone might be able to provide some suggestions for our situation outlined below. My son is four months (20 weeks) old and has been exclusively breastfed since birth (born 7lbs, 7oz). He had been gaining weight steadily (an ounce per day) for the first 10 weeks, the next 6 weeks his growth slowed (2-3 ounces per week), there was no gain for the three weeks, and now this week he's losing weight (he started daycare and is refusing bottles). He has weighed 14lbs, 9oz for the past 4 weeks. When my son’s growth slowed, I began to wonder about milk transfer. What I’ve found through weight checks with an IBCLC and at home, is that he gets about a half of an ounce of milk each time my milk lets down. My milk tends to let down every five minutes after the initial let down when nursing. Swallowing during the initial let down lasts 30 seconds to a minute. In between let-downs, there is rarely swallowing going on. On the other hand, when I pump while away from baby, once I let down milk will spray for ten minutes and I can get one to three ounces per side in ten minutes, so I know I have enough supply. Consequently to the above, to get him 2 ounces at the breast, he must stay at the breast for at least 30 minutes (15 on each side), that is about how long it takes for me to let down four times. And of course, if he's hungrier than that, or if there are interruptions or he's distracted (often the case), the nursing “session” takes an hour or...
    0 replies | 4 view(s)
  • @llli*maddieb's Avatar
    Today, 11:39 AM
    I agree with mommal. If this has anything to do with the domperidone, it would be that the plug is a possible indication the dom or something else you are doing to increase production is starting to work. The most common cause of plugs is that milk is not being removed from the breast frequently or effectively enough. Yes there are other causes but that is the biggy, and usually the most important thing to correct if plugs start occurring. Of course frequent and effective milk removal is also the key to adequate milk production. Plugs are a common issue with breastfeeding. Much more common and usually much less problematic than low production, so I would suggest do not get too upset about the plug. There is no need to be desperate about clearing the plug. Yes, you want to clear it.. but sometimes that takes several days. It is ok. If pumping is hurting you, you might want to try other methods for clearing the plug and also troubleshooting your pump. You say one side (the one with the plug) was producing 'normally." This sounds like you are taking the dom to increase production in one breast? But of course, if it works, the dom will act to increase production in both breasts. Nothing against domperidone but it is usually possible and preferable to increase production using various methods of increasing the frequency and effectiveness of milk removal. I assume you are under the care of a lactation consultant for low production and they suggested the use of dom...
    2 replies | 83 view(s)
  • @llli*maddieb's Avatar
    Today, 11:21 AM
    Yay for poops! Always a good sign. That poop is coming from somewhere! Also great you are going to see an IBCLC. I suggest, read the appointment info I linked above. If you are feeling there is more milk in there after baby nurses and baby will not nurse more, then hand expression may help and cannot hurt. I do not think you have to do it after every feed, however. Do what you can, what feels right. You do not want to exhaust yourself and do not worry if there is not much. The best and most direct method for increasing milk volume into baby is encouraging lots of nursing. If you are not going to give your baby what you express, then yes there is no need to try to collect it. But if you did want to collect it, a sterile container just means something that has been sterilized. You could boil a glass or bowl or something, (make sure it is something that can be safely boiled, I am pretty sure any container that can safely go in a dishwasher and microwave can be boiled but not positive.) If you do manage to get some milk into a container, cover it with plastic wrap or a sterilized lid and put it in the fridge, where it will stay fine for several days. If you decide supplementing is needed, and you do not have a syringe, baby can be fed what you express with a spoon or small open cup- either something that has also been sterilized or just a plastic spoon or cup that came wrapped. A small glass like a shot glass would make an excellent vessel for both milk storage and...
    4 replies | 146 view(s)
  • @llli*venerye's Avatar
    Today, 11:00 AM
    He finally pooped! It took over 2.5 days. One blowout and another large bowel movement back-to-back. I have him dressed down to a diaper to keep him more awake & hopefully skin to skin will help, also doing the breast compressions. I am going to set up something with the hospital lactation consultant on Monday and maybe rent a hospital-grade pump as well. Should I hand express after every feed, just to empty the breast more? I don't have anything sterile here at the moment to catch the milk for baby's use. I don't generally respond well to pumping/expression, but I can get some out...
    4 replies | 146 view(s)
  • @llli*mommal's Avatar
    Today, 07:59 AM
    :ita Couldn't say it better myself. I will only add that if supplements become necessary- which seems like a big if at this point- don't let it throw you. I had to supplement one of my kids and there is a way back to exclusive breastfeeding. YOu're doing great, hang in there!
    4 replies | 146 view(s)
  • @llli*mommal's Avatar
    Today, 07:53 AM
    As far as I know, Domperidone does not cause plugged ducts. It does increase supply, and higher supply can be associated with a higher risk for plugs. You know that old medical adage "When you hear hoofbeats, think horses, not zebras"? It means that when you're trying to diagnose a medical problem, the most likely suspect is probably the correct one. So for plugged ducts, the horses are things like sleep position, poor pump fit, nipple blister or bleb, poorly fitted bra... Don't go for the zebra (Domperidone causing plugged ducts).
    2 replies | 83 view(s)
  • @llli*mommal's Avatar
    Today, 07:48 AM
    I have no idea which bottle is best- I think it varies a lot from baby to baby. What can make a big difference is whether or not paced feeding is being used- that is, baby sitting very upright, bottle held horizontal rather than vertical, feeding being paused at appropriate intervals.
    1 replies | 108 view(s)
  • @llli*mommal's Avatar
    Today, 07:45 AM
    A daily multivitamin is generally a better way to give an older baby- who isn't eating much or any solids- iron and other micronutrients. Just give it in the tub, as vitamin drops tend to stain clothing. Why vitamin drops and not formula? First, because it's usually easier to give a baby a vitamin drop, since most babies who are breastfed are reluctant to chug a bottle of formula. Vitamin drops don't taste super great, but neither does formula, and the amount of vitamins in a dropper is just a few cc's. Second, if you give formula and the baby takes it, that is cutting down on her intake of breastmilk. That's a high price to pay for a little extra iron. Remember that when you're talking about micronutrients, you're playing a statistics game. The reason additional iron from solids or vitamins is recommended for ALL breastfed infants >6 months is not because ALL breastfed infants >6 months will become iron deficient if not supplemented. Only SOME of them will, and that fraction is great enough and the effects are potentially severe enough to justify the blanket recommendation, especially considering that a baby with normal iron status will not be injured by getting a little additional iron. So if you have a baby who won't eat solids or take vitamins, you probably do not need to worry that much. You want to try to give the baby some additional iron via solids or vitamins, but you don't need to freak out if it isn't working that well.
    13 replies | 430 view(s)
  • @llli*novila's Avatar
    Today, 01:29 AM
    I just started domperidone on the recommended dosage of 3 tabs 3x daily, and woke up in the middle of the night all of a sudden with a huge plug in one breast! Of course it is the breast that produces the most normally, and the milk there just gathered in this plugged area that I am desperately and v painfully trying to pump out now. It's like when I lay down, gravity has forced all the milk in the left breast to stop up at the very top of the breast near the collar bone. So is this because of the domP? I haven't actually noticed any increase in my supply yet, being on it for only a few days. I really don't want to stop taking it yet but wonder if something is wrong, since this specific problem has never happened where the milk gets plugged at the very TOP OF THE BREAST! Are domP users more prone to clogging, even when supply has not changed??
    2 replies | 83 view(s)
  • @llli*maddieb's Avatar
    Yesterday, 08:28 PM
    What makes you concerned you do not make enough milk? Is your baby gaining weight normally, or not? If you did not make enough milk, or if your baby needed something that was only available in solids, wouldn't your baby be hungry and consequently eating more solids? If you think your baby is lacking in appetite, that is one thing. Poor appetite is potentially caused by anemia. So if your baby were not gaining and not nursing or eating much, that would be a sign something was wrong. But if baby is gaining normally, then there is probably not anything wrong. As far as whether all babies need additional nutrition aside what is in breastmilk after 6 or 8 months, I am going to again refer to the book My Child Won't Eat. This is a book that was originally published by LLL and was often recommended by LLL Leaders, at least back when I was one. In other words, as far as I know it is an approved source of information according to LLL. The concerns about whether or not breastmilk alone is adequate nutritionally after 6 months is addressed on pages 106 and 107 and 117-119 of the current edition of this book. I cannot quote it all but basically he is saying that it is NOT universally true that breastfed babies need additional sources of any nutrients in the first year. He makes the case that it depends on the baby. He is not advocating for withholding solids, he says it makes sense to introduce them at 6 months. He is just saying it can be normal and usually entirely fine if...
    13 replies | 430 view(s)
  • @llli*mackeroo2013's Avatar
    Yesterday, 06:59 PM
    Yes, I'm concerned about volume and adequacy, both.
    13 replies | 430 view(s)
  • @llli*maddieb's Avatar
    Yesterday, 05:53 PM
    Well I am going to have to research what Karen said. That is not my understanding but I certainly could be wrong. Mackeroo, if your baby is low in any nutrient, or you fear they are, baby can be given a vitamin/iron supplement. Your breastfed baby would not need formula unless baby is not getting enough milk to gain and grow normally. Such supplements are added to formula so formula fed babies get them, but can be given to a breastfed baby directly if needed. As far as baby seeming fussy at the breast and content after a bottle, that could be any number of things. Babies get fussy and refuse to nurse all the time. This does not mean they need to be fed with a bottle, and satiation after a bottle is also not necessarily meaningful. Is it possible baby simply would have nursed a bit later and been content? Are you concerned you are not making enough milk for your baby? That is a different concern than whether your milk is nutritionally adequate.
    13 replies | 430 view(s)
  • @llli*maddieb's Avatar
    Yesterday, 05:30 PM
    Hi venerye. I think it is important to know why we look at poops, and that is because it is a more immediate daily sign a newborn is getting enough to eat without weighing baby constantly. If a baby is gaining normally, than a day or two without poops may not be a problem at all. Here is what I see in weight check history: Baby born a healthy weight Baby lost very little weight after being born, less than might be expected. So in fact my guess is that it is very possible baby lost more weight in there between checks and was back on the upward trend by the weight check on the 19th when baby was 7 days old. By the 26th, when baby was 16 days old, baby had surpassed birth weight by more than 2 ounces. So, all that points to entirely normal gain. Back to birth weight by 2 weeks. But since we do not know for sure what was happening due to different scales and not knowing for sure what happened between checks, and since baby has not pooped in a couple days, I think it makes sense to look further. Let's look at the two most relevant numbers for now. Those are the last two checks, done on the same scale. So we can assume the most accuracy from those.
    4 replies | 146 view(s)
  • @llli*djs.mom's Avatar
    Yesterday, 03:45 PM
    actually as long as you and your LO are nursing 3-5 times in a 24hour period you don't need to replace anything. That's still enough breastmilk-which is higher and fat and calorie content than cows milk that it doesn't need to be replaced.
    7 replies | 337 view(s)
  • @llli*bhacket4's Avatar
    Yesterday, 03:15 PM
    I need a bottle that I could use with my son occasionally that is best for switching breast and bottle. Ideally a bottle that he has to work really hard at getting the milk, and it won't flow into his mouth. I've tried several and spent upwards of $100, and all these bottles stink. Any advice is appreciated!
    1 replies | 108 view(s)
  • @llli*mobaby's Avatar
    Yesterday, 02:49 PM
    This is kind of long and I am sorry!! My DS was born via c section at 36 weeks on aug 3rd. He had some breathing issues which landed him into the NICU for 8 days. Meanwhile he had cpap, oxygen, a feeding tube and IV. Slowly weaned off everything and I was providing expressed milk (pumping 10 x in 24 hours). He finally started taking all by bottle and not spitting up. I expressed a desire to breastfeed several times but the response I got was you can do it 1-2 feeding per day only but he has to get the bottle afterwards so we can know how much he is getting. I was extremely frustrated because once he was discharged we had no breastfeeding established, only bottle. No one even to help me figure things out. I know he can drink from the bottle well and he actually has always latches very well. (which I am sick of the bottle because others think it is a game to see who can feed the fastest and they don't understand the faster he takes the bottle the more of a hinderance it is for me to BF). He is not an efficient eater yet and is still very lazy and it takes a long time to feed. And I am still having to pump after every feeding and supplement with expressed milk. We saw lactation consultant (not sure is IBCLC) a few days after discharge and basically I was told when he was closer to his full term age he would be able to do better and I could go "cold turkey." I wasn't comfortable with that so yesterday I went to IBCLC appt (90 minutes) and he nursed, 15 mins per side, and...
    1 replies | 101 view(s)
  • @llli*venerye's Avatar
    Yesterday, 01:41 PM
    My baby is 2 weeks old today. He passed his meconium pretty quickly and has been having yellow, seedy stools since day 4/5. He was having 3-4 quarter-size stools a day, then he had one day of a quarter size stool and one enormous blowout, and now it has been nearly 48 hours with no bowel movement at all. Plenty of wet diapers throughout all that time. I took him in for a weight check today to make sure he is gaining. 8/12 birth weight 8lb 2 oz 8/13 discharged 8lb 1 oz 8/15 ped office #1 8lb 0 oz 8/19 ped office #2 (different scale) 8lb 0 oz 8/26 ped office #1 (same scale as 8/15) 8lb 4.5 oz Two peds have seen him and commented that he has slight jaundice but not enough to warrant testing. All of my kids have had jaundice.
    4 replies | 146 view(s)
  • @llli*mackeroo2013's Avatar
    Yesterday, 12:28 PM
    Thanks for the reply. I'm just a tad confused. So, my daughter is 8 months old and not eating solids because she refuses, so if she needs more iron, should I be giving her some formula?
    13 replies | 430 view(s)
  • @llli*lllkaren's Avatar
    Yesterday, 11:47 AM
    A creased nipple is a pretty good indication that the problem is something that's going on in the baby's mouth. :huh Latching/positioning help from an IBCLC would be a good place to start.
    5 replies | 256 view(s)
  • @llli*lllkaren's Avatar
    Yesterday, 11:40 AM
    A bit of a clarification -- while a mom's milk supply won't necessarily decrease as baby gets older and is still nursing consistently, and milk continues to be an excellent source of nutrition throughout the second year and beyond, milk alone can not provide all the nutrition a toddler needs. After 6-8 months, babies do need additional sources of iron and zinc, at least.
    13 replies | 430 view(s)
  • @llli*zambomommy's Avatar
    Yesterday, 11:13 AM
    I agree with PP. If you have a 30 oz freezer supply, I would send him with the 6 oz you pump the previous day +2 oz from freezer stash. Assuming he is at daycare 5 days a week, that 30 oz should last you 3 weeks. In addition maybe you can pump once on saturday and sunday and freeze it. This will definitely take you through one month. I plan on doing this starting next week, DD will be 11 months in 9 days! We still nurse 5 times a day (she night weaned a week ago, on her own, and I miss it terribly!) Once your son hits 11 months, you can send him with 6 oz and maybe 2-3 oz of yogurt to satiate his dairy demand. At 12 months, you can switch to cows milk and kiss that pump goodbye!
    7 replies | 337 view(s)
  • @llli*mackeroo2013's Avatar
    Yesterday, 10:37 AM
    I should add that she seems content now that she had that extra bottle of milk and the nipple on the bottle is still a stage 1.
    13 replies | 430 view(s)
  • @llli*mackeroo2013's Avatar
    Yesterday, 10:36 AM
    Thanks for the replies.. something just happened that I would love your feedback on. Again you know my daughter doesn't eat solids so I fed her at her normal time and she was pulling on my nipples and she started to cry like she seemed frustrated I didn't understand why I thought it could be that she was teething but then figured I could try giving her a bottle of my breast milk to see if maybe she was still hungry and was frustrated because she wasn't getting anything from me. So I warmed up a bottle of my breast milk and she drink it so fast within 2 minutes. So what does that mean? I'm trying not to get discouraged because I want to continue to exclusively nurse her way past a year.
    13 replies | 430 view(s)
  • @llli*djs.mom's Avatar
    Yesterday, 08:05 AM
    If you only get 4-6oz you supplement with 2 oz from your freezer supply. When your freezer supply is exhausted you can tell them to try to up the solids and see if he is OK with only 6 oz, solids and water and if not have them supplement with 2 oz of formula. After 10 months my son wouldn't take pumped milk at all. So he would drink only water and eat solids while away from me and we nursed on demand while together. He never ended up needing any formula. It's only 8 more weeks! You are so close. And then you can pump wean all together!!!
    7 replies | 337 view(s)
  • @llli*mommal's Avatar
    Yesterday, 05:52 AM
    :ita with MaddieB. Any chance that you could pick up a better pump? I used the Ameda Purely Yours and while it's a fine pump for a mom who responds well to pumping and only relies on it part time, I don't think it's a good machine for a mom who is trying to maintain or increase supply by pumping. It just doesn't have enough power, in my experience. If you go and see an IBCLC, she may be able to set you up with a better machine. Any chance of seeing a different pediatrician? I don't like the dismissive treatment or the advice you received from yours.
    5 replies | 300 view(s)
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