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  • @llli*maddieb's Avatar
    Yesterday, 11:16 PM
    Oh for the severe engorgement you might try cold (or very cool) compresses directly on the breasts, and heat only on your back and shoulders if you are finding heat helpful. If you had IV fluids that can cause edema and that can make the breasts even harder and more swollen. As I am sure you know edema like this will pass in a few days. Here is more info on hand expression: http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/06_hand_expression.pdf and video http://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html Engorgement: http://kellymom.com/bf/concerns/mother/engorgement/ If baby cannot latch well or at all due to the engorgement, a nipple shield may help as a temporary measure. More: http://kellymom.com/ages/newborn/nb-challenges/wean-shield/
    2 replies | 91 view(s)
  • @llli*maddieb's Avatar
    Yesterday, 07:06 PM
    Hi jollycat. In that case, you are probably pumping the perfect amount. Here is a situation where the problem is the numbers. Every mom is going to have different numbers. And they are probably going to be at least a little different each time for each mom as well.So, rather than thinking about pumping for X amount of time or until you get Z amount of milk, it is better to think about how your breast feels. After all the reason you are pumping at all is because you are uncomfortable. Right? So pump until you feel more comfortable- not until you are "empty," and not all the time. Only when baby is not nursing enough to get you to where you feel ok. You are not creating a situation where you will always have to pump by only pumping a little when you feel you really need to in order to be comfortable. Many moms make more than enough at this stage of the game. It might help to encourage baby to nurse more often, this is the best course as there are no potential drawbacks- but it does not always do the trick. So when it does not, some moms hand express as needed, some pump as needed, and some just allow the breast to feel full for a while, or some combination of these. All of these are entirely fine, it is all a matter of degree. Over the next couple weeks, your baby may want more at a time and will probably be taking more overall, although that will only be up until about 5 or 6 weeks. At that point, babies do not need more each day, (a one month old and a 6...
    1 replies | 35 view(s)
  • @llli*jollycat's Avatar
    Yesterday, 06:29 PM
    Hi, I have an 9 day old who is nursing very well. 8 or more poopy diapers per day and he was back at birth weight at day 7. I saw an IBCLC on day 7 because of engorgement even though he nurses all the time. She suggested I pump 5 minutes when feeling very engorged, with a manual pump, just to relieve discomfort. I've actually only been pumping for 3 minutes, twice per day at the times I feel uncomfortable. I've been getting over 2 ounces with 3 mins so I was nervous to do 5 minutes as she suggested. So in other words, I'm pumping about 4 ounces a day above what baby needs. Is this too much? Will his appetite eventually increase so he wants these four ounces, or am I just creating a situation where I'll always have to pump? I'm not trying to create an oversupply. I will be returning to work in an office one day per week but I'll be pumping there, so I'm not trying to stockpile a freezer stash. I would say it takes me about that much to feel comfortable but maybe it's because he's so young. What do you think? Thank you!
    1 replies | 35 view(s)
  • @llli*maddieb's Avatar
    Yesterday, 12:37 PM
    Hi mindylane, I am sorry you have been having a difficult time. So, of course breastfeeding is still possible! Oh my gosh, baby is only 4 days? Many newborns who do not nurse at this point nurse fine later. Some babies take many weeks before they are able to latch and nurse. However there is no reason to think that will be the case here. I think you are set to get baby nursing just fine in the next few days because baby has shown they can latch and nurse and you are making milk. First I would suggest see the appropriate professional for the issue you are having. Your baby is refusing to nurse, or for some reason cannot nurse effectively. The professional trained to help in that circumstance is not a doctor but a board certified lactation consultant (IBCLC.) Here is an article about what to expect at an appointment with an IBCLC: http://www.cwgenna.com/lconsult.html As long as baby is not nursing, it is imperative that you pump at least 8 times in 24 hours. Some moms find hand expression works better, or you can alternate. It does not matter as long as the milk is being removed effectively and frequently somehow. Please, I beg you, try not to worry about how much you get out when you pump. It is never much at this age, it is not supposed to be! Also pumps are not babies, they are a substitute and even the best ones may not do what a baby can. And what a baby takes in a bottle is totally irrelevant. OK, let's talk about weight gain. Typical weight loss shortly...
    2 replies | 91 view(s)
  • @llli*mindylane's Avatar
    Yesterday, 09:46 AM
    Hi. I just had my baby 4 days ago on the 19th. I really wanted to exclusively breastfeed and as a NICU nurse, I felt pretty confident that I'd be able to. However, it has been nothing but frustration. I thought he started out ok; he'd latch and suck but would get frustrated. I saw lactation at the hospital and she made some suggestions so I thought we'd be good. He ended up losing 8% of his weight by day 2, but they were fine with that. He started getting more and more frustrated with every feed, even though I was feeding him pretty much on demand... usually every 2 hours. We assumed he was cluster feeding. By the time he saw the pediatrician, he had lost 13% of his weight and it turns out I was just literally starving him. The pediatrician suggested supplementing with formula until my milk came in. I was really against it but also didn't want him to lose more weight. My husband fed him maybe 3 bottles over the course of 24 hours and I started pumping. I first pumped .7mL, then 4, then 12. But he would still take 35-60mL from the formula each time. I woke up this morning and my breasts are wildly engorged. They are so incredibly painful and I guess that's why he was getting so frustrated. The milk is there but it isn't making its way out. I'm trying hot compresses, massage, pumping every 2 hours... I'm barely getting anything out and they're rock hard and painful. We saw the pediatrician again this morning. Of course he gained a ton of weight. Thanks to...
    2 replies | 91 view(s)
  • @llli*teach48's Avatar
    July 22nd, 2017, 04:24 PM
    Thank you so much! I appreciate the resources you included and in the depth information you provided! Makes me feel a little better about it all! :)
    2 replies | 105 view(s)
  • @llli*maddieb's Avatar
    July 22nd, 2017, 11:39 AM
    Hi teach48! So there are many things to consider when a mom is pumping part of the day and baby is getting bottles at that time due to separations. Having a good understanding of how milk production works and how bottle feeding can be done to minimize overfeeding will help you meet your goals of providing your milk for your child and protecting your milk production after you return to work. The lactating breasts are making milk all the time, 24 hours a day. Longer periods of 5-6 hours of no milk removal tend to happen around this age, in particular overnight, without it being any problem for milk production, as long as milk removal is still happening frequently and effectively enough overall. And milk can be removed from the breasts at any time. So there is really no such thing as a "missed" pumping session. If pumping break time at work is not optimal, if needed and if you choose, you could pump when you are home, or encourage your baby to nurse more often overnight/weekends in order to protect your milk production, or pump some other time during your work day even if that means two pump sessions are close together, or some combination of these. (If you are uncomfortable going that long without pumping, you may need to find a way to at least quickly hand express to relieve pressure, which will protect your health and your milk production, even if you are not able to save that milk.) My first suggestion is to make sure breastfeeding is going very well before...
    2 replies | 105 view(s)
  • @llli*teach48's Avatar
    July 22nd, 2017, 10:39 AM
    I will be going back to work in the next few weeks. As a teacher, I won't be able to pump as often as my 5 (then 6 month) daughter nurses. It looks like I will be skipping one feeding session, going about 5 hours. If I skip a pumping session, supplementing with frozen breastmilk, and then formula, as needed, will my supply hold when I pump or breastfeed other times of the day? I know it's not ideal, but I think it's what I have to work with. Will I be able to nurse on the weekends still? I am also concerned because when I pump I don't generally produce as much as she eats, so I am concerned in general about pumping. I have been pumping at night to build up a stash, but a few ounces a day will go quickly. What's been your experience? I am trying not to freak out about it all.
    2 replies | 105 view(s)
  • @llli*maddieb's Avatar
    July 21st, 2017, 05:04 PM
    Reflux: Our experience with reflux is that my son had frequent and large spitups, painful "burps" and also that he hated being laid on his back and was generally quite fussy lots of the time. We tried reclining where he slept too- we had a "wedge" under him when he slept in our bed, put books under one side of the legs of his crib and basinet- none of that did much. He just slid down! By far what helped the most was holding him pretty much upright most of the time, in particular for a while after nursing, but really as much as possible. When he was about 3 or 4 months I finally got a sling and that helped tremendously, both husband and I "wore" him most of the time. The spitting up etc. etc. was going on for a long time before doctor said it was reflux and we should try meds. That was when he was about 4 months old. We discontinued the meds after about 2 months, so he was then about 6 months. Somewhere around when he could start to stay sitting up on his own and crawl the symptoms began to alleviate, which makes sense if you think about it. So, maybe 8 months or so? The issues tapered off slowly, so it is hard to remember exactly, but it was certainly well before he was a year old. He still spit up at times and had some occasional painful burps, but it was much less. Also he was a "short" sleeper (nursed lots overnight) until well after his second birthday. But that is just the way some babies are and does not mean baby has reflux or anything else wrong. One...
    6 replies | 535 view(s)
  • @llli*mandra's Avatar
    July 21st, 2017, 03:12 PM
    Thank you for your prompt response! No, I don't understand the "value" of thickeners. The only reason I said I was willing to try it was because the GI told us it will help with the chocking. That's the scariest thing about my baby's reflux. Today we were driving and I had to pull over because she was choking so bad, out of nowhere. That happens at night too, and I am so worried that I don't get much sleep, for fear she will choke. She sleeps in a co-sleeper in our bed, in between our pillows, and we elevated her a little to help with the reflux but she still grunts very often and does't sleep for more than 1.5-2 hours at a time, and the choking is the worst. So when I heard that the thickener would help with that of course I was excited. But the more research I do about it, the more worried I am and will not probably not use it, at least for now. I will try the new medicine, and be dairy and soy free and see if there are any changes. Baby is gaining good and there are no other serious health problems, other than the pain (I can tell she is in a lot of pain sometimes, she is a very happy, chatty baby otherwise), the choking, and the spitting up. When did your little one outgrow his reflux, if you don't mind me asking? The GI told us that it will get worse and she will vomit a lot more, and it won't get better until 12-18 months. I forgot to mention, we also give our baby vitamin D (pediatrician said all breastfed babies should take 1ml/day) and Gerber probiotic drops...
    6 replies | 535 view(s)
  • @llli*maddieb's Avatar
    July 21st, 2017, 12:58 PM
    Hi, thanks for the update! I am sorry you are having this reflux concern. Maybe you understand the value of thickener but I am not sure I do...is your baby gaining very poorly or for some other reason risking serious health issues due to the reflux, and is there any proof the thickener will help? Also why are so many interventions being given at once? If you are fine to give up dairy and soy, that is one intervention. Meds are another. Shouldn't those be tried (perhaps consecutively) for a while before taking the extreme step of no longer breastfeeding? I would suggest not giving up breastfeeding or even going 50/50. There are so many drawbacks to pumping/bottles even 50% of the time as far as longevity of breastfeeding and milk production that it should only be done when there are no other options. How much have you researched this on your own? This seems like a very extreme intervention to me for reflux. My oldest was also diagnosed with reflux, meds did not really help (we tried zantac, then prevacid) The upshot is we kept exclusively breastfeeding on cue and he simply outgrew the reflux. In the meantime we held him upright as much as possible, and he nursed very frequently. Frequent meals helped a great deal. Also he usually nursed one side at a time. What happens if you just let baby nurse one side at a time?
    6 replies | 535 view(s)
  • @llli*mandra's Avatar
    July 21st, 2017, 09:22 AM
    Thank you both for your feedback, it has helped A LOT!!! We made it to 2 months! :) My baby will be 2 months tomorrow, but it turns out she does have reflux. After not getting any real answers or help from our pediatrician (other than suggesting to give formula - not sure why so many doctors do that), we decided to go see a pediatric GI. We just came back from seeing her. I like how she explained everything to us, but I still have concerns. Baby will be put on a different medicine (the one the pediatrician gave us didn't help at all), and although I am not very happy about giving her any medication at this age, I can't see her in pain anymore so I am willing to try it. GI also told me to stop eating dairy and soy, not a problem, I will do it. My big concern is that she wanted me to pump 100% so I can add a thickener to the milk. This I kind of have a problem with because my baby and I both enjoy the time we have together, breastfeeding, and I don't want to give that up. It's good for both of us, and it's not just the milk, it's everything else, the cuddling, the comfort, the looking into each other's eyes etc. I understand why the GI wants me to do it. Baby has been nursing fine, but recently I can see she is in pain, especially after she eats on one breast and I move her to the second one, she sometimes pulls away and cries. I have tried different nursing positions but when she's in pain, none of them work. Any suggestions here? I told the GI I will not stop breastfeeding...
    6 replies | 535 view(s)
  • @llli*maddieb's Avatar
    July 21st, 2017, 08:58 AM
    There are many reasons why expressing milk while away from baby might become harder as baby gets older. In other words it might be related to the plug or it might not. First it would help to know how much you were typically able to express before, and what you are expressing now, and how that differs from the other breast? By this age many moms see a natural reduction in the amount they can express at once. Are you seeing no change at all in your ability to express milk in the other breast? Do you feel as though there is milk, but you are just not able to get it out when expressing? Did you try pumping as well? A few ideas that may have caused this- The plug led to overfullness and your body got the message to reduce production in that breast. In that case, your child nursing lots should increase production and help the issue. There are still plugs or inflammation (swelling) in the breast causing poor milk removal. That side has for a while not been 'stimulated" enough with frequent/effective enough milk removal, which would lead to both the plug AND a reduction in production. Your milk production is reducing a bit naturally (perhaps you had more than enough before) and where that is obvious is in the amount you are able to express. Since babies are better at milk removal than anything else, some mom find they need to actually be making more than enough milk to express much milk.
    1 replies | 237 view(s)
  • @llli*gilismom's Avatar
    July 20th, 2017, 11:11 PM
    Hi KNowledgeable Mamas! I have a five month old (my 4th child), EBF. I had a plugged duct for five or six days this week and got rid of it with lots of breastfeeding. I tried to go back to work yesterday and hand express there - which usually goes very well for me - and from that side, nearly nothing came out. I had to run home to BF her! Is this a result of the plugged duct? Will this resolve after a few more days of BF'ing my daughter? I need to be able to go back to work and pump/hand express and in gen'l be able to be away from my baby for a few hours..... Thanks so much!
    1 replies | 237 view(s)
  • @llli*maddieb's Avatar
    July 20th, 2017, 12:34 AM
    :ita of course! I hate that they put a number on nursing sessions, as it so often leads to moms worrying when baby wants to nurse more and clearly confuses health care providers who do not understand that the often stated number (10-12) or time line (every 2 to 3 hours) are MINIMUMS and that most babies nurse more often and in cluster patterns and in many cases much more often! Enjoy your dear new baby and how much easier it will be this time around. Sounds like you are both doing great.
    4 replies | 255 view(s)
  • @llli*maddieb's Avatar
    July 20th, 2017, 12:24 AM
    Hi dcs123. I would suggest figure out about how much you will need to leave and then work backwards from there. For example. The average daily intake for a breastfed baby of 1 month or older is 25-35 ounces per 24 hour day. So if the separation is for 3 entire days - 72 hours, baby can be presumed to need between about 70 and 100 ounces total. So, in that case, say you have 2 months (60 days) to pump the 100 ounces. If you have op, then when you pump you probably get at least 2-3 ounces, right? In that case, you could plan to pump once a day and have enough in 35-50 days. But it is also possible that pump output will decrease as your milk production reduces to more accurately meet your baby's need. So I think pumping once a day about 2-3 ounces each day would make sense for those numbers and increase if necessary. You want to avoid pumping too much to avoid making your overproduction problematic. This way you are leaving some cushion in time so that when there are days you cannot pump etc. there will still be enough milk for you to go on your trip. Even if you did not have quite 100 ounces it would probably be fine- remember that would represent the max baby might need.
    1 replies | 139 view(s)
  • @llli*maddieb's Avatar
    July 19th, 2017, 08:48 PM
    So baby has never wanted to nurse more often than every 3-4 hours, even when offered? Has weight gain been normal? As a baby gets better at transferring milk and moms milk production increases over the first several weeks, babies do tend to nurse shorter periods, and even 8-10 minutes for a whole nursing session could be entirely normal. But I agree that nursing every 6 hours is much too little for a 6 week old baby. More common at this age is more like 10 times in 24 hours or more. I would suggest do not worry at all about fat content or anything else about the 'quality' of your milk, and I know of no reason to be worried about 'foamy' poop that other wise looks entirely normal. There is a wide range of normal look for infant poop, if a poop is truly problematic, it is very obvious. Also fussiness at the breast is rarely anything to worry about. The only thing you report that sounds unusual to me is the low nursing frequency. But that could be normal too (as long as baby nurses at least 6-8 times in 24 hours.) If your baby is gaining well, probably no worries. But often a baby will nurse more often overall if they are offered. No need to wait for cues. Also it does not have to be every such and such hours but rather when you feel like it, with baby nursing more often some parts of the day. Encouraging baby to nurse overall more often certainly cannot hurt.
    1 replies | 148 view(s)
  • @llli*maddieb's Avatar
    July 19th, 2017, 08:37 PM
    Block feeding reduces milk production- but while it is being done it may worsen the issue of fast letdown, at least at first. This is because fast letdown increases the longer milk sits in the breast and you have to let milk sit in the breasts for longer in order to "block" a breast. So if for example baby is nursing every 2 hours, and you are blocking each breast for 4 hours, every time you switch, baby may be getting the same or even more flow than they did before- even if your milk production is beginning to reduce. About 6 weeks is the typical peak of milk production and after that, assuming mom makes more than enough, her production will begin to reduce on its own. So one strategy would be the forget block nursing, nurse more frequently or as frequently as baby will but maybe one side at a time, and see if that helps with the flow while your milk production naturally reduces over time. If you want to keep block nursing, you can still encourage baby to nurse frequently, so that only when baby switches to the "blocked" side will the flow be fast. The issues you are seeing are temporary and not hurting your baby. It is normal for babies to spit up and some spit up a great deal. it is very normal for newborn babies to have lots of gas, even some painful gas, explosive poop- none of this is unusual for this age and it will reduce overtime even if you do nothing. It is important to understand that there are cautions one should take when block nursing. Here is a...
    1 replies | 151 view(s)
  • @llli*dcs123's Avatar
    July 19th, 2017, 05:42 PM
    Hello! I'm EBF my 7 week old. I have an oversupply, so I only pump when the baby gets a bottle (so she can get used to it). I am going on a trip in a couple months over a long weekend. When/how much should I pump so that the baby has enough to eat during my time away from her? TIA!
    1 replies | 139 view(s)
  • @llli*megkl15's Avatar
    July 19th, 2017, 05:32 PM
    I talked to a lactation specialist that told me to block feed (my baby eats every 2 hrs) to help with my oversupply and forceful letdown. My baby is almost 7 weeks and has gained almost 1lb per week, recently he's been spitting up a lot when he feeds, just opens his mouth and milk pours out. He seems fussier than usual and I have been giving him gas relief. His bms are very explosive, runny and yellow. I'm just wondering if block feeding will help my issues, so far it's been 4 days and I have seen a little improvement but not too much
    1 replies | 151 view(s)
  • @llli*jollycat's Avatar
    July 19th, 2017, 12:42 PM
    Thank you for your reply, and that all makes a lot of sense. I switched back to the pampers with blue strip they gave me at the hospital and now I see he's peeing a lot so I wonder if I was missing the pee due to the poops like you said. Yes, I had to do all that weighing, waking, etc. with my twins. Plus pumping after every feeding etc. It was so much work and while it was worth it, I'm so glad not to have to do that this time. This time, the hospital staff seemed to think it strange that I wasn't going by "feed him every three hours" or whatever but this baby was cuing to eat a lot more than that--more than the "12 times per day" rule even. So they thought I was feeding him a lot but were also happy with his output. Of course the two go hand in hand! I just want to establish a good milk supply so I'm not worried about him eating so frequently right now. Still way easier than what took place with the twins! :)
    4 replies | 255 view(s)
  • @llli*amelia428's Avatar
    July 19th, 2017, 11:00 AM
    Thanks. Yeah I definitely don't want to go under. But apparently draining it can just lead it to fill up and again and again. I hope I can just leave it as is and deal without it getting bigger :/
    2 replies | 173 view(s)
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