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Thread: Please help!!

  1. #11
    Join Date
    Mar 2008
    Posts
    2,538

    Default Re: Please help!!

    Quote Originally Posted by @llli*mommal View Post
    Welcome and congratulations on the new baby!

    It sounds like you've been pursuing the correct course of action so far. When you have a small, sleepy, jaundiced baby who isn't peeing of pooping enough, supplementing is probably absolutely necessary. And it's probably temporary!

    Here are some things I suggest doing to increase supply and transition to exclusive nursing:
    1. See a lactation consultant, preferably an IBCLC, for hands-on help.
    2. Use the best possible pump- for most moms, this means a hospital-grade rental with correctly sized shields (the LC should be able to help you with both of those things).
    3. Pump as much as possible. You want to be filling every supplemental bottle with your milk. If you can do that, you will know that your supply is equal to the baby's demand and it will be easier to transition to nursing exclusively.
    4. Consider renting a professional scale, one that is accurate to the 1/10 of an oz. If you weigh baby before and after nursing you can gain a good picture of how much milk she is taking in, and use that information to decide whether or not supplementing after a feeding is necessary.
    5. If/when you feel confident that baby is nursing well, use the technique in this link to wean from supplements: http://www.kellymom.com/bf/supply/decrease-formula.html

    Questions for you:
    - How does nursing feel? Any pain, blistering, cracking?
    - Does baby still fall asleep very rapidly at the breast?
    - How often does baby seem to want to nurse? Is she nursing at least 8-10 times in 24 hours?
    - Has the jaundice gone away yet?

    Quote Originally Posted by @llli*mommal View Post
    Nursing every 2 hours is normal, because breastmilk digests fast and baby tummies are tiny. So if you're supplementing out of fear that baby is not going long enough between feedings unless supplemented, you can relax on that score.


    make yourself wake up for that session (the 4 hour stretch) and pump in the middle of the night if nothing else mama, that milk will get you through the sessions where you doubt yourself or feel like she isn't full.

    and an IRL LLL meeting helped me tremendously when I went through this same scenario with my baby boy.
    Autumn
    Moma to *Silas* 10-30-07

  2. #12
    Join Date
    Jun 2009
    Posts
    5,262

    Default Re: Please help!!

    LLLMeg- If baby seems satisfied after a feeding, I haven't been supplementing with formula. When I'm not supplementing, she seems to want to nurse about every 2 hours. If I do supplement, she is satisfied longer, so I've been pumping if 2 hours have passed. Will this work or should I be doing something else? Generally, its only been one four hour stretch at night after she cluster feeds in the evenings...although the cluster feed usually ends with a formula supplement b/c I'm worried she's not getting enough.
    It's not as if you are doing anything wrong or there is something else you "should" do. Do what works for you. But I am saying that you may have enough milk for baby even now, or close to it, but you just need to nurse more often so baby gets more.

    What can happen is that moms who supplement for a time, even when it was totally appropriate, can get onto this nurse/pump/supplement treadmill and it can be very hard to get off it even when milk supply is fine. It's in large part a confidence thing.

    At this age, nursing every two hours is normal for a healthy baby, in fact even more frequently than that would be completely normal. Most babies do not nurse every such and such hours but on a much more haphazard scedule, like the cluster feeding you are seeing. Remember, the norm at this age is a MINIMUM of 10-12 times a day. Many babies nurse way more frequently than that! All normal.

    You will not really know for absolutely sure you have enough milk for baby until you have weaned off supplementing and begun to exclusively nurse. The good news is that at this age, output (poops) will tell you pretty quickly if all is well or not, and you can always go back to supplementing should that be neccesary.

    Weaning off supplements can be a tricky time. Did you say you were seeing an IBCLC? She should be able to help you with this. kellymom.com has an article about weaning off supplements but it's just one suggested protocol. It will be a very individual process.

    I guess I am saying it cannot hurt & will likely help to begin to increase the frequency of nursing sessions. You can keep pumping as well (as you can) until you feel confident that is no longer neccesary. Think of it this way-after two weeks a baby will take in about 2 ounces per feeding. If baby A is nursing 8 times a day and baby B is nursing 12, baby B is getting about 8 ounces more milk per day than baby A. So it would not be surprising that baby A may end up needing supplements ONLY due to the less frequent nursing.

    As far as decreasing supplementing, you can consider doing this as well while you increase nursing sessions unless you have reason to believe milk TRANSFER is poor. Poops will tell you if baby is getting enough overall. But what about milk transfer at each nursing session? There are a few ways to gage this. Does baby actively suck for several minutes most sessions? (it is normal for a baby to nurse vigorously part of the session and to slow down or even stop and then ramp up again.) Can you see or hear swallowing? This can take practice to learn to see. Jack Newman has a video of "really good drinking" you can look at. Just remember every baby is unique and this can look a bit different on different babies.

    http://www.nbci.ca/index.php?option=...id=6&Itemid=13

    To increase vigourous drinking/milk transfer you could try breast compressions. You many want to talk to your IBCLC or doctor about decreasing supplements but aftter all, that is the whole idea-to up nursing at the breast and decrease supplements.

    Also your IBCLC could help you do some before and after nursing weight checks to measure input per nursing session. It is best to do several of these over a few days to get the most accurate picture. Just one weight check may be falsly alarming or falsly reassuring, as babies do not normally take in the same amount of milk every nursing session.

    I have seen a very slight increase in my supply, although I still don't know if it is enough to EBF. I ordered some More Milk Plus which should be here today. How many ounces is normal for a 3 week old to consume in 24 hours?
    As I said above, how would you gage if you have "enough" until baby is exclusively nursing? You can't-not absolutely, because breasts are not clear with little lines on them! But you can tell in other ways that baby is getting enough.

    By four weeks old (and beyond) the average intake is 25 ounces of milk a 24 hour day. Some babies need more, some less. According to Kellymom the range is 19-30 oz per day. (It would be a bit less at three weeks I suspect but I could only find info on ages a month +. BTW at around a month, milk volume levels off because breastfed babies do not need MORE milk as they grow, because the milk itself changes to meet the needs of a growing baby. Of course if a mom is still struggling with low supply after a month she can usually still increase her supply.)

    Remember, what you PUMP is not a good indicator of what baby can get at the breast. Most babies are much more effective than even very good pumps.

    Hope this answered your questions.
    Last edited by @llli*lllmeg; March 6th, 2012 at 07:05 PM.

  3. #13

    Default Re: Please help!!

    Thank you soo much for ALL the advice! I feel so much better about everything

  4. #14
    Join Date
    Nov 2011
    Posts
    429

    Default Re: Please help!!

    with mommal. Her wanting to nurse every 2 hours is normal and healthy. If she wants to eat every two hours and appears satisfied after nursing when she is every two hours then I'd say you are good to go with EBF. Both my daughters wanted to nurse every 1-2 hours until they were about 4-5 months old. A2 still likes to nurse every 2 hours at least at 6 months. Totally normal.
    Melissa

    Young SAHM of
    Afton (A1) (1/24/09) and
    Autumn (A2) (8/29/11)

    Sealed in the SLC Temple

    and and now CDing!

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