Confused! Desperate! Overwhelmed!

[@llli*momofeee]

Please Ladies I am in desperate need of answers. I'm so confused. I have a 4 week old...at her 2 week appt the doctor said she hadn't gained enough weight. She was born 7lbs 6oz, was 7lbs 4 oz at her 2 week appt. He told me I needed to start supplementing her. He had me give her a couple bottles a day. After one week she was at 7lbs 12 oz. I'd like to work my way back to breastfeeding exclusively. Here is where my confusion and frustration come in. I thought I was finally latching on right after getting help (as in no pain) but after reading website after website and watching video after video I am confused as to whether I am doing it right. Does no pain = a good latch? Her mouth doesn't seem to be open as wide as some of the babies in the videos and diagrams. My areolas are not as big as the women in the videos, so here is another question...does the babies mouth just need to be taking in my areola? or does the babies mout need to take in more and have a full open gape like the women in the video/diagram? Another question...if she has had a bad latch all this time, is my milk supply low? Also, I just had a milk blister, is this because I have bad latches? And did the fact that I gave her a bottle mean she has nipple confusion and can it be corrected? I am so on the verge of giving up and crying, but I want to make it. I am desperate to make it! Please help me!!!!

[@llli*mommal]

Welcome mama, and congratulations on the new baby! I'm sorry you've had such a tough time so far, but don't freak out. Everything you mention sounds correctable.

First of all, yes, a painless latch is almost always a good latch. Don't get hung up on what the latch looks like on the outside, because it's how it feels on the inside that counts. You can have a great latch that looks bad, or vice versa. Also, don't get hung up on the differences between your breasts/nipples/areolas and other women's. Women of all dimensions can nurse successfully.

I honestly think your doc urged you to supplement a bit too soon. Babies are supposed to regain their birth weight by 2 weeks postpartum, and your baby was just 2 oz shy, something which can be attributed to a slow start or to differences between calibration of scales. In that situation, the ideal thing for a doc to do is to refer you to a lactation consultant, preferably an IBCLC, and urge you to consider pumping and supplementing with your own milk via something other than a bottle (cup, syringe, supplemental nursing system, etc.). At this point, that is what I suggest you do. First, see the IBCLC, and have her help you with latching, and second, determine via that consult whether or not you need to be supplementing at all. If you do, get a good pump and supplement with your own milk.

Can you tell us a bit more about your baby, your birth, and your nursing experience so far? For example:
- How was your birth? Was labor induced, did you have IV fluids (and if you did, how long did you have the IV), did you end up with a c-section or other traumatic birth experience, did you lose a lot of blood, did the placenta come out all in one piece?
- When did your milk come in? Did you notice a distinct episode of milk arriving?
- Has baby been jaundiced at all, or perhaps just very sleepy at the breast?
- Have you been nursing on demand, or trying to schedule feedings?
- How many times does your baby nurse in a 24 hour period?
- How was diaper output before you began supplementing?
- How does nursing feel, in general?
- When baby unlatches, do your nipples come out symmetrical, like pencil erasers, or asymmetrical/wedged/creased, like new lipsticks?

[@llli*lllmeg]

momofeee, I am so sorry you have been scared this way. Try to relax, from what you have posted I think you and baby will do fine breastfeeding, you unfortunately have had your confidence messed with by a few different circumstances.

How a latch feels is MUCH, much more important than how it looks. As long as it does not hurt mom, and baby is getting enough milk, then you can be sure the latch is good. I agree with mommal it is possible that other factors made the 2 week weight just slightly off, so I don't know if you needed to supplement in the first place and, even if you did, there are other factors that could cause a baby to not get quite enough besides a poor latch. Even if the issue is poor latch, that is solvable. Most breastfeeding issues are very solvable!

Mommal has great suggestions and questions for you.

[@llli*momofeee]

Thank you so much for helping me. My confidence was shot when the doctor told me she needed to gain more weight. She is my 3rd child and I gave up early breastfeeding my sons. With my first we moved out of our house when he was 1 week old and traveled in transition to a move to Japan when he was 6 weeks old. They had me on Reglan and it was a horrible experience. With my second, again I attempted to breast feed and only made it a few weeks before we got swine flu. I had a hard time and gave up. I am determined to make it this time and I thought it was going well, then had my hopes dashed. We are moving to Hawaii in a month so I want to be feeling more confident by then. To answer your questions...

-How was your birth? Was labor induced, did you have IV fluids (and if you did, how long did you have the IV), did you end up with a c-section or other traumatic birth experience, did you lose a lot of blood, did the placenta come out all in one piece?
My birth was a great experience. I was induced after going past my due date by 3 days. I had IV fluids, I had the IV for about 7 hours before giving birth (both saline solution and pitocin), I had irregular contractions for about 6 1/2 of those hours and then went from 7cm to complete and having my baby out in half and hour. I don't think i lost a lot of blood, I did have a 2nd degree laceration. The placenta came out all in one piece. I had an epidural, it took on one side and not the other, I couldn't walk for quite a while and had to have a catheter to empty my bladder because I couldn't move one of my legs for a long time.
- When did your milk come in? Did you notice a distinct episode of milk arriving? I gave birth on a friday afternoon and my milk came in on Tuesday morning, I did notice because that morning I actually dripped milk and I was surprised.
- Has baby been jaundiced at all, or perhaps just very sleepy at the breast? My baby was slightly jaundiced but not enough to require any special treatments, I just put her in the sunlight coming through the window. She had a little yellowing mostly of her eyes, her skin wasn't bad at all. She is VERY sleepy at the breast. She usually falls asleep almost immediately.
- Have you been nursing on demand, or trying to schedule feedings? I've been nursing on demand. Sometimes I will go 3 hours of sitting and switching side to side, side to side as she never seemed satisfied (and she was falling asleep). She started sleeping more at night after the supplements (when I gave them). I breastfed first then offered the supplement. I made sure she never went over 4 hours (my breasts would usually hurt and I'd wake up and wake her up to eat before that point). She was getting 3 bottles a night from about 8pm through to her 12 or 1 feeding then again about 3 or 4, the last 2 nights I've been trying to cut them back and was able to cut the amount of formula given in half.
- How many times does your baby nurse in a 24 hour period? I don't really know how to answer this. Some times it feels like she is nursing most of my waking day to every hour to 3 hours.
- How was diaper output before you began supplementing? Before supplementing she pooped in the hospital about 3 or 4 times and once we left, she didn't poop for a week. She had pee diapers probably about 7.
- How does nursing feel, in general? Nursing for me has gone from extreme pain (mostly on the right side, I do better putting her on my left breast). At one week I had a lactation consultant help me with the latch (football hold to put her on the right breast, it got better, the cracks disappeared and pain disappeared) then I got hung up on the latch and I started having pain again. Last night I developed a milk blister. I stuck it with a sanitized needle and fed and now its better. Other than the nipples, nursing is feeling overwhelming and confusing but I have great support in my husband who is good at keeping me positive. My determinations thus far is outweighing my frustration...I am hoping to hang on to that.
- When baby unlatches, do your nipples come out symmetrical, like pencil erasers, or asymmetrical/wedged/creased, like new lipsticks? My nipples come out symmetrical, like pencil erasers.

Another issue I'm experiencing is that at times she will seem to get mad or frustrated with my breasts. They feel empty and she will like spit them out and immediately root around like she wants it back, I'll give it back and she'll spit it out and cry and root. I don't know what this means. I fear I don't have milk for her. She also seems to want to use me as a pacifier at times. If I remove my nipple, even though she is sleeping and like flickering my nipple with her tongue (that's what it feels like anyway), she will wake up and cry and root for it. My sleep is almost non existent during the nights sometimes. I am terrified of co-sleeping with her in the bed, I have read some websites saying to do that , but I wouldn't be able to sleep anyway out of fear. She has a bassinet next to my bed, but she often wakes up when I put her in it even if she seems satisfied and sleeping...the moment I put her down, she wakes up and cries and wants the breast again. Nights feel very lonely and are my hardest time other than the evening when she is fussing and spitting out/wanting back the breast.

This afternoon, I got about 1 1/2 hour nap and woke up with my breasts feeling full, she was hungry, she ate and my breasts did feel empty afterward (does this mean she is getting the milk out effectively, even if I can't hear her swallowing?)

Ladies, THANK YOU so much! I already feel renewed in my determination thanks to your help!

[@llli*mommal]

Thanks for answering all those questions! Here's what I am thinking:
1. You had 7 hours of IV fluids. Sometimes when mom is on fluids for a long time, both mom and baby can become bloated (for lack of a better word) with fluids. Baby's artificially therefore artificially inflated, and this can make neonatal weight loss appear more severe than it really is because the fluids are quickly excreted. It can also make a baby appear to be slow to regain birthweight, because the baby's "real" birthweight was somewhat lower than what was recorded.
2. Your milk came in on day 4 postpartum. Anywhere from 2-5 days is normal, but the fact that yours came in on the later side of average could easily make a 2 oz difference in your baby's weight at 2 weeks.
3. Your baby was both jaundiced and sleepy, two things that can contribute to slow weight gain.
4. Your baby's latch was painful, and a painful latch is often also an inefficient one, in terms of transferring milk.

Those 4 things are the ones that stick out to me as things that were or may have been problem areas. And it does sound like you got off to a kind of slow start- when a newborn goes 7 days without pooping, it is reason for concern. But it sounds like you have handled all these problems really well, and I especially applaud you for waking your baby to feed so frequently and working so hard to fix the latch! Because you have done those things, I think you have gotten things on track and can probably phase out the supplements, faster if you pump to make up whatever supplemental bottles you do give.

Here are some tips on keeping a baby alert at the breast:
- Annoy her. Tickle her feet or rub against the grain of her hair using your hand or a damp washrag.
- Keep her cool. When it's time to nurse, strip her down to a onesie or keep a fan blowing in the room you are in. Warm babies fall asleep more easily than cool ones.
- Use breast compressions to keep the milk flowing:http://www.kellymom.com/babyconcerns..._increase.html
- Try switch nursing: when suckling slows and baby seems to be getting sleepy, take her off the breast, burp her or change her diaper, and switch her to the other side. Repeat the process as many times as necessary for her to get a goo deal or until she will no longer wake up.

I can understand your reluctance to share a bed with your baby. Co-sleeping is safe when done safely but not everyone wants to take even the slightest chance, However, you can co-sleep without bed-sharing by using a sidecar crib, which allows mom and baby to stay in physical contact without sharing a sleep surface.

[@llli*momofeee]

Thank you so very much! I have so much hope at this point and so much more conviction and feel like I really CAN do this!

[@llli*kst.7399]

Thank you so very much! I have so much hope at this point and so much more conviction and feel like I really CAN do this!

You can do it and confidence is exactly what you need. Trust your body.