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Thread: Previous breast surgery, low weight gain

  1. #1

    Default Previous breast surgery, low weight gain

    My baby is having trouble gaining weight. I can see several possible issues and would appreciate any suggestions.

    I had a breast augmentation in 2002 with the incision over the areola. I can produce milk, but it appears that I'm not producing very much. My baby was okay with nursing for the first few days, but then he began to cry and claw at the breast out of frustration (mainly in the evening). He is also very sleepy and likes to nibble at the breast without really sucking. If I try to put him down, he wakes up and cries then goes back to nibbling sleepily without a strong suck. He sleeps for several hour stretches at night, waking up only a couple of times to nurse.

    I have been pumping several times per day to try to increase milk supply. A couple of times, I have been able to get over an ounce between both breasts. More commonly I can only get 1/2 ounce at a time. After pumping, though, I can still hand express some milk. I rented a hospital grade Medela pump. I didn't get very much milk at first, so I bought larger breast shields and that helped. When I pump, milk starts spraying out but this only lasts about 30 seconds, then only drops come out, then nothing at all. Sometimes if I keep pumping the milk will start to spray again in a few minutes, but usually it doesn't. Also, one side seems to produce more milk than the other. I got a Medela SNS so I can tube-feed my baby the pumped milk while he is nursing. Even with the SNS he does not finish the milk inside.

    Baby was 8 lb, 5 oz. at birth. I was induced, so I had lots of IV fluids. The following day he was 8 lb. 3 oz. At two weeks he was 7 lb. 12 oz--a loss of 9 oz. total from his birth weight. I spoke with a lactation consultant at the place where I rent the pump and she said I should definitely be supplementing as baby should have regained his birth weight by now and I should be pumping 20 oz a day!!

    Baby poops and pees all day long (and has already peed on me several times while I was changing his diaper). His pee is yellow, not clear. Poop is yellow and watery (sorry if this is tmi).

    Any thoughts would be appreciated!

  2. #2
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    Default Re: Previous breast surgery, low weight

    If you are getting 5-6 wets per day your baby is getting enough. I would pay close attention since it is possible you could have either supply problems or issues with milk transfer as a result of your surgery. Docs generally like to see babies regain birth weight by 2 weeks, but it's not set in stone.

    Are you pumping in addition to nursing? How often are you doing each? Can you give us an idea of a typical day as far as feedings/nursing/pumping?

    It's normal to be able to express after pumping, a pump will never completely empty your breast. And your pumping output is not a good indicator of your supply, since your body responds differently to your baby than it does to a pump.
    “We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
    --Anonymous

  3. #3

    Default Re: Previous breast surgery, low weight

    We pretty much nurse all day long. However, most of that time he is not really sucking, just sleeping. If I try to take him away from the breast he wakes up and fusses till I put him back on. Then he'll have a couple of strong sucks before going back to sleep. Whenever I can put him down, I pump--about 6-8 times/day. There's no point in pumping longer than 5-10 min because after that nothing comes out. There have been a couple of days when we had to go somewhere, so we were driving for a couple of hours during the day (like the doctor visit on his 2 week checkup). Otherwise, we spend the whole day--7 am to 10 pm--nursing/pumping/diapering. I really want to breastfeed him and I don't want to give up, but I don't know how much longer I can keep doing this all day long.

  4. #4
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    Default Re: Previous breast surgery, low weight

    Maybe if you could extend those few strong sucks and try to keep him awake it might help as far as not being on the boob all day long. A lot of mamas have good luck using breast compressions to keep baby sucking and interested.

    Here's another article about how to boost baby's weight gain. There might be some tips in there you'd find helpful.

    Do you have a sling or baby carrier? It might help you feel like you're not tied to the couch all day long. You'd at least have your hands free and could move around and with most kinds you can nurse while baby is in there hanging out.
    “We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
    --Anonymous

  5. #5
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    Default Re: Previous breast surgery, low weight

    Good advice from the PP. Just wanted to suggest the bfar.org site, and their forum: http://bfar.org/
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6

    Default Re: Previous breast surgery, low weight

    Thanks for the article and info. I do have a sling that I can use for nursing.

    Another possible issue is that I have relatively large nipples and areola--baby can really only get the nipple into his mouth but not much surrounding skin. I even had to buy larger breast shields for my pump. Could this be part of the problem?

  7. #7

    Default Re: Previous breast surgery, low weight

    Great website--thanks so much!!

  8. #8
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    Default Re: Previous breast surgery, low weight

    Large nipples can cause problems with baby's latch, and latch problems can cause milk transfer problems. Time and growth should help improve those, but in the meantime you can concentrate on getting the best latch possible. Hands-on help is the best way in my experience, but there are good videos on www.drjacknewman.com. You can also try googling "nipple sandwich" and see if something turns up.

    I know it's discouraging not to see milk coming out when you're pumping, but it's not the case that there's no point in continuing to pump. "Pumping dry" as it's called tells your body to produce more milk even if it doesn't yield any in that session. Also, you can encourage further let downs (the point at which you're seeing the milk coming out fast). It takes time. Pumping longer in general does produce more milk, so don't be too ready to dismiss that supply building value of the pump.

    I'm glad to hear that you're supplementing at the breast. I think that's the best way to go, providing that your baby isn't having sucking problems due to the large nipples. If he is, that could explain why he stops prior to draining the SNS rather than fullness. He could be getting exhausted. It really helped me when my baby was having nursing difficulties (large nipples here!) to rent a sensitive scale and weigh him before and after feedings. It was two months before he could successfully extract milk from the breast, and so there was a lot of pumping, SNS finger feeding, and bottle feeding just to keep him going to get to that point. Thankfully, he was almost always willing to be at the breast.

    It's good that you're being alert to things that could be causing problems. Keep working at it, and I hope you'll get them sorted out.
    I breast milk fed my Blossom for fifteen months (after exclusively pumping for thirteen). My Bud (nineteen months) is still nursing directly (after a rough start that included a few months of pumping and supplementing with mommy's milk).

    TwoDewdrops: Nursing Dresses and Tops for Discreet Breastfeeding (and Pumping)

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