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Thread: Newbie Question

  1. #1
    Join Date
    Mar 2012
    Location
    Santa Fe, NM
    Posts
    8

    Default Newbie Question

    So, long story for a short question. On December 13th I was sent to the hospital from my perinatologists' office because my cervical length was down to 2.2 cm. By the next morning, that length was down to 0.3 cm, so I was admitted for bed rest for the remainder of my pregnancy. 11 weeks and a few days later, my water broke (I was 34w5d) and was induced. My DS, Isak, was born early the next morning (Feb 28). Because he was earlier than 36 weeks, he was automatically admitted to the NICU. He was only there for 24 hours and then spent the next 2.5 weeks in the special care nursery. So here's the deal: he nursed the first day a few times. After that day, his bilirubin level shot up, so he became very sleepy and had to go under the lights (the nursing is obviously not related to this, LOL!). He was allowed 30 minutes out of the lights, eight times a day to eat. Because he was slightly premature, he also didn't have the whole "suck, swallow, breathe" thing down. We live an hour away from the hospital, so I would pump as much as I could and bring it in every day. Apparently pumping and I don't get along, because I never pump more than a teaspoon at a time (at MOST). Because of that, he had to be supplemented with formula. After he finished the lights, he was allowed to nurse again, but it was never entirely productive (also, I couldn't be there all day every day, so I was missing a lot of time). We just brought him home last Friday, so he is now three weeks and a few days old. He came home on oxygen, so he constantly had a canula stuck to his face (only reason for the oxygen was the elevation difference...he was born at 5500 ft and we live at 7500 ft). I tried to nurse him for the first few days he was home, but both of us would end up frustrated, and it usually ended with crying on my part and screaming on his. He was frustrated with the tubes in his nose, and because of that would spend the whole time flailing around and ripping at the tubes on his face. I was frustrated because I didn't know how to help him. Well, as of yesterday, the tubes are off (YAY!), but now I'm not sure where to start. He can't really get a good latch, and because of that he ends up screaming and smacking my breasts. He opens his mouth and everything, but I don't know how to help him after that. I think he also gets frustrated because when he gets a bottle, formula immediately comes out without him having to work for it.

    Any ideas on what I can do? I don't want to give up this soon, but I don't even know how much milk I have, as the pumping amounts lead me to think it's not much (I have hypothyroidism and PCOS...so yay for the double whammy of low milk supply issues).

    Thanks!

  2. #2

    Default Re: Newbie Question

    Wow. What an ordeal for you both! So happy to hear baby is doing well.

    Where to start in such situations is entirely up to you. Due to your hormonal issues and this looooong ordeal, it is possible you will never make enough to exclusively nurse. It's impossible to say but there is that possibility. So, I would suggest start by asking your self how you would define "success" in this situation. Would you like to be able to nurse baby at the breast, even if you are also continuing to supplement? Would you like to ensure baby gets as much breastmilk as possible, no matter how baby gets it? Would some combo be best for you? Etc. There is no right answer, and of course the answers may change as the situation evolves.

    For nursing AND supplementing at the breast-have you tried an at the breast supplementer (lactation aid?) There are two primary brands, the Lact-aid and the Medela SNS. I have heard more moms say they like the lact-aid best, but it’s going to be individual. These devices allow you to give baby supplements while nursing. Many moms with low supply and moms who are nursing adopted babies find these devices very helpful, but of course some moms and babies don't enjoy using them.

    For milk production-are you doing everything you can in that department? Using a hospital grade pump and pumping very frequently, 8-10 times a day? Have you looked into what galactagogues might be appropriate in your situation? The book Making More Milk covers milk supply issues extremely well and is written for the mom, not the professional, with real world ideas and tips and a ton of accurate, evidence based info. There is also the website www.lowmilksupply.org

    Any local support? Local LLL and/or a lactation consultants?

    For bringing baby back to the breast, this is the best article I know of. Your baby has had a long history of bottle feeding so it is no surprise nursing is a stretch for him. he may never latch, he may, again, impossible to know. Certainly some babies have learned to nurse after many months of bottle feeding, but there are no guarantees. A lactation aid is only going to really work if baby will latch, although a lactation aid can sometimes help give baby the 'instant reward" that helps baby want to try to latch.
    http://kellymom.com/bf/concerns/child/back-to-breast/

  3. #3
    Join Date
    Mar 2012
    Location
    Santa Fe, NM
    Posts
    8

    Default Re: Newbie Question

    Thank you! I will look at the website, article, and book you mentioned. To be honest, I'm only pumping five or six times a day--mostly because (a) it's REALLY uncomfortable for some reason (to the point of pain), even though an LC has checked to make sure I'm using the right size of everything and doing it correctly, and (b) it's really disheartening to pump all those times and only get a teaspoon of milk. One of my friends today suggested that I try hand expression, so I'm going to try that after I take a shower here in a few minutes. I'm okay with him getting breastmilk in whatever way he gets it. I'm also okay with supplementing formula if I have to. I just want to try everything I can because I know how much better breastmilk is for him.

    Thanks!

  4. #4

    Default Re: Newbie Question

    Thank you! I will look at the website, article, and book you mentioned. To be honest, I'm only pumping five or six times a day--mostly because (a) it's REALLY uncomfortable for some reason (to the point of pain), even though an LC has checked to make sure I'm using the right size of everything and doing it correctly, and
    Well, just like nursing should not hurt, pumping should not hurt. And how it looks only tells part of the story-if it hurts, something is wrong. Wrong Flange size in one thing that could make it hurt, and some moms need different sizes for each breast. Are you starting on the lowest setting possible? And how LONG are you pumping for? Some moms, desperate to produce more when they pump, pump too long and injure themselves that way. About 15 minutes a side would be a reasonable time. When trying to build milk supply, more FREQUENT pumping is more important than how long you pump each time.
    Pain inhibits letdown and of course would make pumping somethign you dread, not good. It is really important you get to the bottom of what is causing it to be painful when you pump.

  5. #5
    Join Date
    Mar 2012
    Location
    Santa Fe, NM
    Posts
    8

    Default Re: Newbie Question

    I generally pump for about 15 minutes (I have a double-electric). The LC told me that by this time, I should be using one of the highest settings, so that is part of the problem. Does the strength of the suction being higher get more milk, or should it not matter as much?

  6. #6

    Default Re: Newbie Question

    The LC told me that by this time, I should be using one of the highest settings, so that is part of the problem.
    Sorry, I do not understand this reccomendation. Maybe a mom who knows more about pumping can chime in here?

    Yes, of course a higher level of suction would theoretically produce more milk, but, if it is HURTING you to pump, so you do not pump frequently enough and your letdown may be inhibited and you may even have nipple injury, that is clearly counterproductive. I would suggest starting on the lowest setting, and then, while you pump, slowly dial it up to the highest setting that you can COMFORTABLY pump at.

    You have a double electric, great-but is it a rental aka hospital grade pump, like the Medela Lactina? Or a personal use pump, like a Medela Pump N Style? For a mom with low supply who is only pumping, and thus needs to be pumping around the clock, the best pump is usually the rental grade. (Which, as the name suggests, you rent, they are far to expensive to buy.) Personal use pumps are designed for moms with already established milk supply who are pumping 2 or 3 times a day, due to working for example.

  7. #7
    Join Date
    Mar 2012
    Location
    Maryland
    Posts
    142

    Default Re: Newbie Question

    I think using such high settings is a big part of the problem. I was advised to use the lowest setting that gets milk going, and I definitely notice a point at which it hurts if I turn it up too much. You may need to experiment a little bit to find the settings that are most comfortable for you while also being efficient. I think if it's hurting you and you're anticipating that, it can have an effect on how much you are able to produce at that time - anxiety is the enemy. Do your best to relax, and empty your mind of any worry about how much you're getting, and such.

    It sounds like you've been through the wringer with all this, so no matter what happens don't beat yourself up.

    Also, is the LC you talked to associated with the hospital or did you find someone to come to you? It may be you need some better hands on help than you've already gotten?

  8. #8
    Join Date
    May 2006
    Posts
    19,895

    Default Re: Newbie Question

    If pumping at the highest setting is hurting you, don't use the highest setting. Better to use a lower setting and pump more often!

    Can you describe the pain you're in? Does it come on after the pumping session or during it? Is it a burning pain? Any sensations of itching or tingling? Any cracking of the nipple skin? Does the nipple appear white or pale after using the pump?
    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!"

  9. #9
    Join Date
    Dec 2011
    Location
    The Armpit of the Universe
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    248

    Default Re: Newbie Question

    with pps. Sounds like you've been through so much on top of the normal new-baby adjustments, but I just wanted to chime in on encouragement.

    Are you seeing an endocrinologist for the hypothroidism? Levothyroxine is totally safe while BF, since it's basically just replacing what your body would be making anyway, if your thyroid was working normally. Being on the meds (and at the right dose--it may take some bloodwork and trial-and-error to figure that all out) will make the difference between night and day on your energy levels. I'm on levothyroxine and fortunately have had ok thyroid levels since being pg, and bf, but before that, I was on and off the synthroid, and my life was wack-o. So I don't have any personal experience with low milk supply problems, but I just thought I'd throw that out there in case you didn't know about the safety of thyroid-replacement medications.

  10. #10
    Join Date
    Mar 2012
    Location
    Santa Fe, NM
    Posts
    8

    Default Re: Newbie Question

    It's a Pump'n'Style, but I have an appointment with WIC next week and they're going to give me one of the rental ones to see if that helps :-) I'll try starting on the lower setting tonight. Also, today I tried hand expression, and for the first time doing it, I think I did pretty good...I got about an ounce and a half. Maybe that'll be the route that works best for me? At least it seems like a step forward!

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