Persistance Pays

[@llli*allmykids]

My daughter is 12 weeks old today and I thought all hopes of BF was gone. She weighed 8.5oz at birth but her weight was slowly decreasing (she got down to 6.12 after a week) so I knew something was wrong with BF. She seemed to latch fine but it wasnt until after I met with my first LC that we discovered she wasnt transferring the milk. By then my milk had dried up...I mean I could pump for 20min and get 1/2 oz. I started on Domperidone to get my supply back up and I was pumping around the clock. Eventually I had enough to exclusively bottle feed (with very little formula). I went to see another LC (of course all these visits got expensive) and I started renting the hospital grade pump, and she told me my DD displayed symptoms of tongue tie and referred me to an ENT. I was hesitant and didnt go right away because I didnt want her to endure the pain only for me to BF. Reading up on it made me see that she could have issues with speech in the future so I decided to go. I waited until this past week to take her and sure enough, she had a posterior tongue tie and a tight labial lip which were both clipped right away. The ptt wasnt obvious to any of the LC and the ENT said only a professional could have found it, but I immediately saw a difference in her nursing (I nursed b4 leaving the ENT).

Now we are 4 days off the ptt and I have been pretty much nursing on demand. I plan to go weigh then nurse to confirm if she's transferring an adequate amount of milk this week, so in the interim, I'm still pumping afterwards so I can ensure my supply maintains. I'm sharing this because after reading a lot of posts and reading as many sites as I can, I was literally a day off of giving up on pumping exclusively and vowed if nothing changed visiting the ENT I would stop bc it was wearing me down.

I hope this is encouragement for anyone who may be experiencing any challenges...just hang in there. This is my 3rd child and I nursed my other two so of course I was determined to figure out WHY I couldnt nurse my last.

Its been years since I nursed so I have a few questions. Should I let my DD nurse for as long as she wants or time sessions? How will I know when she's content? How long should I wait between feeds? I'm back at work but fortunately I work from home 100% so it helped in trying to overcome these obstacles, I cant say I would have made it had I had to go in the office and try to pump every 2hrs. I'm praying the worst is over and we are finally off to good BF. YES only after 12 weeks!

[@llli*auderey]

wow, mama, congratulations! it sounds like you've done an awesome job.

some thoughts on your questions:

you should nurse on demand - at earliest demand - until she's done. lots of babies fall asleep at the breast or pop off contentedly. you can offer the other side if she's still awake. don't plan to wait a particular amount of time bmetween feeds - watch for her early cues (like chewing on her hand, pushing her tongue out, that sort of thing) and frequently offer even when she's not cueing. sometimes this means she'll eat every hour, but that's ok. especially as she's new back to the breast and you're not certain about your supply, let her nurse whenever she wants for as long as she wants - that will get your supply up like nothing else.

now that she's nursing on demand, it's time to change your thinking about how much she takes in. this is usually better measured through output. for normal no problem breastfed babies, they should have 6-8 wet diapers in 24 hours. since she wasn't transferring well at first, you want to additionally make sure that she is transferring well now, so a couple of before & after weighs on the LC's sensitive scale is probably worth it. but after you confirm that, if she has 6-8 wets in 24 hours, she's getting enough, and you can quit pumping.

just want to confirm - you are not supplementing (with milk or formula) her for the past 4 days, just nursing at the breast?

good for you!

[@llli*allmykids]

Thanks so much for the kudos. She definitely seems content after nursing now, and I'm pretty much on demand. I was concerned if she's only nursing (snacking) for like 5-10min at a time but maybe every hour, is that ok for my supply? I guess I'm basing it on the fact that I would feed her 3-3.5oz every 2hrs and my pumping sessions were at least 15min long and I would typically get about 4oz. I know I cant relate a bottle feed from a breast feed and I also understand that the more often I nurse the more hindmilk she may be getting thus she may get full quicker. I'm just extra paranoid right now and a few before/after weighs will help ease my mind. She hasnt had any formula in a few weeks, and I was told by my LC to offer her a bottle of expressed milk once a day (so she stays familiar with the bottle). Other than that 1 bottle a day she's just nursing at the breast. Will there ever come a time where she doesnt fall asleep at the breast? When she initially was doing that, early on, it was a sign that she was not transferring milk so of course still being paranoid, I'm relating her sleeping now the same way. I definitely think once I weigh I will feel more comfortable. In terms of the wet diapers, curious b/c obviously when she was taking the bottle the diapers would be soaked (very heavy). Now they are wet (not heavy) but its obvious that she's wet them. Does this matter at all, and it should still be counted as a wet diaper. I cant really count stools right now b/c she hasnt been going very often...she went the other day and it had been 9 days (this is off eating expressed milk every 2hrs so I know she was getting enough). I've taken her to the pedi twice and have been told it's not unusual for BF babies to go several days...I'm keeping my eye on this.

For the person who asked about my work, I'm a contractor for BoA...I do mainly audit work. I was truly blessed, I found the job after getting laid off and just before I found out I was pg, so I was happy to not have to go in the office during the 1st trimester...they took me back after my ML so I just started back this past week, and trying to keep my DD home with me as long as I can. She's the last one, so trying to relish the time we have as much as I can.

[@llli*auderey]

nursing 5-10 mins every hour is GREAT for your supply. the more often she nurses, the more BALANCED the milk is (fore/hind). breastfed babies can't eat too much. basically, now that you have her back to the breast - just RELAX

do you need to have her on bottles? i'm asking b ecause if you're not planning to go back to work away from her or anything, what's the "need" for her to stay familiar with the bottle? sounds like a pain to me because it also means you have to keep pumping. i, personallyl, would stop that as soon as i could.

falling asleep at the breast is one of the best things about nursing. it's how MANY mamas on here put their toddlers to sleep. as long as she's gaining, it's a great trick to keep up your sleeve. i imagine it would be hard to shift, mentally, from that being a bad thing to that being a good thing!

a diaper doesn't need to be soaked to count as wet, particluarly if you're talkiing disposables - those can hold gallons it seems like! i was just looking at this earlier today but "wet" = 2 - 4 [tablespoons, i am pretty sure, from the Breastfeeding Answer Book]. i'll try to check it and update tomorrow. you can test a new diaper to see what that feels like.

ETA: up to 6 weeks old, baby's wet diapers should have 2-4 Tablespoons (30-60 ml) - you can test this out on a dry diaper to see how it feels. after milk comes in, there should be 6-8 of htese per 24 hours. after 6 weeks, it might drop to 5-6 wet diapers per day but they'll be 4 or more oz (120 ml) because baby's bladder is growing.

breastfed babies don't get constipated so you really don't need to worry abo ut their poos - 9 days is totally normal. glad to hear your pedi knows this! even up to 2 weeks is normal.

[@llli*lintrax]

Thanks for posting this! My DS (my 3rd child also) has been having trouble with weight gain and with nursing in general. It's been very frustrating and a bit of a fight to keep going this time. You've given me inspiration!

Best wishes to you!!

[@llli*aprilsmagic]

YAY. Gald you are nursing and not EPing!

[@llli*allmykids]

hey auderey, you are absolutely right, I need to relax. I am going to nurse and weigh before/after tomorrow so I will know how much she's getting in. I think I will be able to relax more then only because I had so many challenges efore. It's good to know 5-10min every hour is great because that's about what she's doing. Some feeds are a little longer and when she's done, she either falls asleep, or SNATCHES off. The only reason I have been pumping to have a bottle on hand is really because like today, I had my neighbor come down to help out while I was on a conference call. I was afraid she would cry and distract me, so I had a bottle on hand for my neighbor to feed her. I havent nursed in restaurants yet either, so if we go out to eat, I give her a bottle. It's mainly for those situations when I 'need' a bottle, but I try to limit my pumping to maybe 3 times a day (which is great coming from every 2hrs)....and I'm mainly storing the milk in the freezer for long term use.

Thanks for the note on soaked diapers. It's 5pm and she's had 4-5 obviously wet diapers so far today, so I'm sure I will change her at least 2-3 more times before going to bed. I will be sure to post tomorrow after my weighs and let you know how it went. She's never taken in more than a few mL in the past so I'm excited to see how much she'll take in.

[@llli*allmykids]

lintrax, i know for a fact my challenge with 3DD is that I was able to successfully nurse my last 2 kids and I knew there had to be a REASON I was having challenges with the 3rd. I kept trying and when she was consistently losing weight I knew there was a problem. I saw two different LC and I heard high pallet, short tongue, small mouth, etc...and I kept trying but she kept losing weight. The last LC said she displayed symptoms (not that she saw the tongue tie) and I took to ENT to confirm.

Obviously we know that babies naturally WANT to nurse and if they cant there is a reason...a legitimate reason. I guess it's in my personality to always want to know WHY...I can accept just about anything if I know the reason and it was unsettling to me that I didnt know the reason she wouldnt nurse. My husband called me obsessed and my friends said I was old and she didnt want it. So in spite of all the negativity I was getting I still pushed on, so I would definitely encourage you to at least find out the WHY. I didnt plan to continue EPing for too much longer if clipping the PTT didnt work, but I knew this was my last baby and for the sake of wanting to have that bond with her I pushed forward....

Best wishes to you as well!

[@llli*auderey]

dang, i couldn't get back to update today and i forgot to look up the numbers. but it sounds like she's on track. how exciting!

3 pumps a day is still a lot ... have you made sure to check your milk for lipase before you go storing all that?

[@llli*auderey]

here's my update: ETA: up to 6 weeks old, baby's wet diapers should have 2-4 Tablespoons (30-60 ml) - you can test this out on a dry diaper to see how it feels. after milk comes in, there should be 6-8 of htese per 24 hours. after 6 weeks, it might drop to 5-6 wet diapers per day but they'll be 4 or more oz (120 ml) because baby's bladder is growing. (from the 1997 Breastfeeding Answers Book).