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Thread: 4 weeks and trying to get back to breast-long post

  1. #1
    Join Date
    Jun 2012
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    Winter Park, FL
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    Question 4 weeks and trying to get back to breast-long post

    I am actually writing this on behalf of my wife, as 1) she does not speak much English and 2) she is a little nervous to put these questions out there. Here is a synopsis of what has happened to this point...

    Our baby is 4 weeks old now and has yet to take a full feed at the breast. When she was born, the nurses tried to put her to the breast within 20 min of birth, but she did not take, so they wrote it off as she was not hungry. The whole first night in the hospital she was exclusisvely finger fed as the baby still did not take the breast. Since she was born in the evening, the hospital said they didn't have an LC on staff until the next day and the night nurses were not much help. When LC came in, she said the wife has flat nipples and introduced a nipple shield. The baby still did not feed too well as I think the shield was too big for her mouth (baby is one the small side). We ended up finger feeding the whole next day in the hospital. That evening we tried for over an hr to feed the baby at the breast with no luck and so the hospital gave us formula to use since the baby was very upset.

    We were discharged the following day with the instructions to keep trying and use formula if necessary. We ended up using about 5-10 mL of formula for feedings for 3-4 days out of hospital then we went to see another LC through the hospital. That LC noticed a tongue tie, so we got it clipped. While the baby does have better use of the tongue now, still no luck at the breast. We have been renting a pump for the last three weeks and the baby has been eclusively fed with breast milk, and we have seen the LC every week for the 3 weeks but even she hasn't been able to get a full feed at the breast (have been there for almost 2 hrs at a time). At the last visit the LC basically said, you may want to invest in a pump as she just won't calm down enough to take the breast. She told us to try for 5-10 min at a time and then give her the bottle (so as to not make it a bad experience for both).

    I am assuming that the baby is used to the bottle and therefore refusing the breast but my question is, at 4 weeks, is she a lost cause (which is the impression I got when we left the LC) or should we try approaching this a different way? I am trying to schedule time with a different LC, but I was wondering if there is anything that can be tried in the mean time that may help her get back to the breast. The wife basically loathes trying to put her to the breast as it seems to be a scream fest. The baby has fed via the nipple shield a time or two but even then it wasnt a full feed (still gave the baby 1/2 oz or so of pumped milk. At this point the wife is not sure if it is worth the struggle. She is a stay at home mom and has basically accepted that she will be pumping all the time. Is it possible for the baby to get the hang of it when she gets a little bigger, and has a larger mouth and all? Thanks for any help.
    Last edited by @llli*froo56; June 9th, 2012 at 04:52 PM.

  2. #2
    Join Date
    Jul 2010
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    New York
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    Default Re: 4 weeks and trying to get back to breast-long post

    Your wife is truly a fortunate women to have a husband so concerned for her and their baby's health and well being.
    There is information available on the process called Relactation and infant suck training.
    If you search those two terms you will find helpful tips and suggestions.
    it is never too late to offer the breast, your wife can start right now, after she has bottle fed put the baby to the breast.
    Let the baby come to the breast without being over whelmed by hunger. Offer only 2 ounces of pumped milk per feeding, and then put the baby to the breast to suck for comfort or to finish a feeding. Offer the breast rather than a pacifier.
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  3. #3
    Join Date
    Jun 2009
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    Default Re: 4 weeks and trying to get back to breast-long post

    Ok, so it is NOT a lost cause to bring baby back to the breast at this point, at all! Babies of many, many months old have been brought to the breast. Your wife (with your support-so important) has done amazing to bring in an appropriate milk supply without nursing, just by pumping. That is very hard to do and she has done it, as baby is exclusively fed with her pumped breast milk. So since your wife has enough milk for baby, there is no need to worry about relactation-half the battle in such cases! She will have to keep up the frequent pumping until baby is nursing completely. However, as baby begins to take the breast more and more, she can pump less and less, as the baby nursing replaces the pumping. Nursing a baby is way, way, way easier than pumping, so this is definitely a goal worth working towards.

    This article has many great suggestions for bringing baby back to the breast. http://kellymom.com/bf/concerns/child/back-to-breast/ This is a process and takes time, perseverance, and patience. It is often one step forward two steps back. It is not usually going to happen in a snap at a lactation consulting appt.

    However, the support of a lactation consultant may be very helpful. You have to find the right one for your wife and for this situation. Someone who is experienced with helping mothers with babies this age and in bringing baby back to the breast. Some hospital based LCs are mostly experienced with the babies they see in hospital-ie, very young babies. It makes a difference. It's not that one LC is better than the other, but if you have a beloved Ferrari you do not bring it to the Volkswagon dealership. kwim? You bring it to the Ferrari dealership, or to a great, well recommended all around mechanic who is very experienced with Ferraris.

    If you have a local (or anywhere close-ish) LLL Group or Breastfeeding Coalition, try asking there about local IBCLCs (International Board Certified Lactation Consultants.) If the LC you find is not an IBCLC but comes highly recommended, that is often fine. Call them and talk to them before hiring. You can also find LCs here but they are not all listed: www.ilca.org I am curious if a lactation aid (aka an at the breast supplementer) was ever suggested to your wife?

    What is your wife’s first language? It was hard but I managed to find a breastfeeding helper for my sister in law who is from Vietnam and very new to English. So you may be able to find someone for your wife to talk to directly in her native tongue, again I would suggest contacting your local LLL as a start.

    As pp suggests, babies get frantic because they are hungry. Even when bottle feeding, feed baby very frequently, in small amounts. (see paced bottle feeing info: http://www.llli.org/docs/00000000000...astfedbaby.pdf As suggested in pp, bring baby to the breast whenever-there is not even a need for there to be a cue from baby. Comfort nursing often comes first.

    Encourage your wife to get into a relaxed position and just hold baby with “easy access” to the breast. She can be clothed, just able to get the breast to baby quickly if baby starts to root. The “Laid Back” info below may help as suggestions for relaxed positions that can turn into a nursing position should baby go for it!

    Laid back: http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/

    FYI: lactation aid: http://www.nbci.ca/index.php?option=...tion&Itemid=17

    I also wonder how you & wife know baby is unable to take a “full feed” at the breast. If you are going by baby taking the bottle after nursing, that means nothing. Most babies will do this, hungry or not. Also, if baby can nurse with a shield but not without, use the shield. If baby can nurse without a shield, don’t use the shield.

  4. #4
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    Jun 2012
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    Winter Park, FL
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    Default Re: 4 weeks and trying to get back to breast-long post

    Thank you ladies for the responses. I was a little worried about posting, as I wasn't sure if I was breaking a board rule or anything by posting for my wife. :-) To answer some of the questions, the reason we feel that she is not getting a full feed is that usually in the 10-15 min slug fest, we hear only 4-5 swallows. Also, the one time she that she actually did feed fairly well was at the LC office, and she fed for a combined 45 min, but after being weighed she had only consumed about 1.25 oz, so we figure in a 10-15 min feed she isn't getting much. We are lucky that my wife is able to pump 3-5 oz in a 15 min pump session, so the supply is there. I think we unfortunately got off on the wrong foot due to the tight frenulum. She basically couldn't use her tounge for the first week and a half (until we could get it clipped) and so we were having no luck with getting a decent latch. By the time she got her tongue clipped she was already getting accostumed to the bottle.

    The LC we had been seeing was an IBCLC and an RN. While she was helpful I feel she didn't have too many suggestions on getting her off of the bottle. Also, it was a little difficult since all of the IBCLC's instructions I had to help translate to my wife. I did not think it would be difficult to find an IBCLC thats is fluent in Spanish; however, there seem to be very few in our area. The next IBCLC that we are trying to meet with is fluent in Spanish so hopefully that will help in the process.

    The information you ladies provided on having her work while using the bottle is something we will definitely have to incorporate. While we do have slow flow bottles that she feeds with, we still have been tilting them almost vertical, especially at night when we just want her to feed quickly :-). All that being said, we were able to find a nipple shield by the same manufacturer as the bottles that we have been using, and the baby actually seems to at least be interested in latching with that. We've only had those new shields for half a day, so we will see how it goes. Thanks again for the help, it is very much appreciated.

  5. #5
    Join Date
    May 2012
    Location
    Cincinnati, OH
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    Default Re: 4 weeks and trying to get back to breast-long post

    [QUOTE=@llli*froo56;1271640]Also, the one time she that she actually did feed fairly well was at the LC office, and she fed for a combined 45 min, but after being weighed she had only consumed about 1.25 oz, so we figure in a 10-15 min feed she isn't getting much.QUOTE]
    Just remember that baby is learning just like you and Mom are to breastfeed. The more the breast is offered and taken no matter how long or little of time, the more practice she gets to becoming better at sucking. It is so beautiful to see a Husband and Father so dedicated to his Wife and Daugther. Also offer the breast to the baby when you don't notice any hunger cues, she may take it for comfort as listed above, or may even want a little snack. You and your wife are doing amazing already, your patience and determination are sure to get you the results you want.

  6. #6
    Join Date
    Mar 2006
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    10,440

    Default Re: 4 weeks and trying to get back to breast-long post

    Check out that link.

    And do not get discouraged...there have been older babies who end up nursing after weeks and even months of refusal.

    If you can, get rid of the bottles now though and use another method.

    What about an SNS to give the milk with? I found a Lact-aid easier than the other types.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  7. #7
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    Jun 2009
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    Default Re: 4 weeks and trying to get back to breast-long post

    Well keep doing what you are doing, which is really great, and try the ideas here. It should not be difficult to find a Spanish speaking LLL Leader as well as IBCLC.

    As far as the milk transfer measure from the before and after weight check-these can be very helpful but it is important to not read more into them than what they show. A single before and after nursing weight check tells you what happened milk transfer-wise at that particular nursing session, no more, no less. Babies do NOT always transfer the same amount each feed, by a long shot. So I think it's important to do at least 3 of these over a few days to gain a bigger picture. Also, nursing session length is also very limited in what it can tell you. Also, with before and after weight checks the rule of thumb is, the best sign is to see 2 ounce gain (or more) from one session after 2 weeks of age. Before 2 weeks it is normal to be less. But since your wife can pump so much milk, if baby is still not getting enough, this is a milk transfer issue and not a supply issue, so hopefully your IBCLC can help with that.

    It is important that a baby can transfer milk well when nursing. But babies do normally vary in how much they get each session and, as pp says above, as baby gets a bit bigger and better at nursing this increases pretty quickly. But the other factor is nursing frequency which can vary quite a bit and that is fine. A breastfed baby needs a certain amout of milk per day-I think at 4 weeks and older, babies need between 25 and 35 ounces per day. But some babies will snack 20 times a day to get this much, others will nurse 10 times a day and get this much. (Older babies-over 2 months or so, can often nurse less frequently to get this much.) As long as baby is getting enough overall, all is well.

    If baby appears unsatisfied after nursing, I would suggest nursing more. Supplements, if needed, can also be given before baby nurses, rather than after. This allows baby to "finish at the breast" which may help reduce bottle preference. Of course using a lactation aid instead of a bottle would help the most in avoiding bottle preference.

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