Hi all, I'm new here! I've been pouring over the many threads and links learning lots of great info. However, I still have some questions that I'm hoping some of you can help with. I'll try to give all the pertinent details. Sorry for such a long post.
DS is 5 weeks old and was born a little early at 35w 6d weighing 5lb 10oz. The LC in the hospital recommended a nipple shield when he wouldn't stay latched for long. The shield did help, and he seems to nurse well with it (although I've come to hate it). I think his real issue was very high billiruben causing him to be lethargic (resulting in a 4 day NICU stay under the lights).
He surpassed his birth weight within the first week and has been gaining steadily since (7lb 3oz at last dr apt 2 few weeks ago). He receives only breastmilk. The NICU docs insisted I supplement, so he received some bottles of my milk after nursing in those days, but no bottles since. The only time I ever pumped was in the NICU.
For the last few weeks DS has been very gassy and fussy at all times of day. The only time he isn't upset is when he is nursing or when he falls asleep after nursing. The gas just seems to keep coming out of him non-stop, and he gets visibly frustrated trying to pass it at times. His best times are at night when he nurses beside me and falls asleep from there undisturbed. During the day, I burp him after he nurses, which in turn gets him wide awake and ready to fuss.
My first inclination was to eliminate various foods. I started slow, and eventually come to the full Sears elimination diet for the past 2 days, with the exception of chicken instead of turkey. No real change yet in his behavior. I know its only been two days, but I was hoping for something.
As DH and I have both continued researching possible issues, we have considered oversupply, OALD, or foremilk/hindmilk imbalance. My right breast does have a significantly higher supply that the left. I think I may have created the issue by inadvertently nursing lots more from the right at night due to the side of me that DS normally sleeps on away from DH. Left breast also has some significant cysts (always has), and has been aspirated twice in the past. I've wondered if either the presence of the cysts or the past aspiration procedures could have any effect.
DS has lots of wet and dirty diapers, and poop is yellow and seedy. There has been no green mucousy poops, which further confuses me. Everything I've read on fore/hind imbalance refers to green poop. On my full right breast, I've never observed the milk spraying out unless I am manually expressing. When it leaks on its own, it just drips. DS doesn't seem to choke or sputter, so, I don't think that I have OALD.
I've tried to block feed on the left side to increase supply on the left and let the right just be for a while, and to make sure he's completely emptying at least the left side and getting all the hindmilk. The right will get really full and firm, but not to the point of discomfort, so I am okay there. If DS hasn't been on the left side in a while, I can keep him on that side for a while, but when I try to do subsequent feedings on that side, DS quickly gets fussy on the left side. I assume it is because not much is coming out at that point, or not at a fast enough rate to appease him. I can still get some out when I squeeze. I compress like crazy on the left while he's nursing to try and help him out. I'm not sure if he just prefers the faster flow of the right and therefore is getting frustrated with the left more quickly, or what. If I move him to the right side, he goes to town eating.
I've also tried latching him w/out the nipple shield, and while I can get him on for a while on both sides without it, I know the latch isn't great and still needs a lot of work. The left side hurts much more than the right, and I seem to get what I think are milk blisters when he nurses the left side w/out the shield for any amount of time.
So, to summarize, poops seem normal and he is gaining weight, no green poops..... and I don't seem to have OALD, but I do have OS in the right side.... although the OS isn't a problem for me comfort wise (yet), but could it be causing him not to be able to get to the hindmilk when I use that full side? (visually, breasts are very disproportional, which I can deal with). Elimination diet has not shown any visible results in the short term.
Any suggestions? Am I missing something here? I have questioned whether he might be sucking in a lot of air due to the nipple shield.... could that be part of the issue?
My local LLL meetings aren't for a few weeks (just missed them this month), but I will probably call a leader next week or see a LC soon, both to help with weaning from the shield, and to try to get to the root cause of all the gas and fussing.