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Thread: A Host of Breastfeeding Issues / Concerns

  1. #1

    Default A Host of Breastfeeding Issues / Concerns

    My baby boy is 15 weeks old and at his last doctor's visit (about a month ago) weighed 11.4 pounds and was about 24 inches long.

    He breastfeeds exclusively while I am home with him and feeds about 6 times in a 24 hour period. He has at least one dirty/poop diaper a day and at least 5 wet ones. Because of low pumping output I have had to supplement formula into my pumped breastmilk (with the return to work and him in day care).

    With a bottle he drinks about 5 oz every three hours (that is 4 oz of breastmilk and 1 oz of formula). I never wanted to give him formula but I'm just not pumping enough (using a Medela swing and a manual; I actually have had better luck with the manual. Also used an Ameda Purely Yours and it didn't work any better).

    I pump at work every 2-3 hours but can only get about 2 oz per session (and that's with both breasts pumped). Obviously, I'm not pumping enough on one day to be able to provide him with enough milk for the next day. I have tried watching videos of him, listening to relaxing music, applying warm compresses, drinking Yogi's Nursing Support Tea, etc.) but nothing helps. I know I have the milk in there (I can feel my breasts preparing for feeding even when I'm not with him; a tingling sensation and my bra pad is usually soaked with leaked milk) but when I pump nothing comes out.

    I wanted to breastfeed until at least 6 months but now I don't know if I'll make it to 16 weeks. It is depressing.

    Additionally, my little son is now in the habit of playing with my nipple at feedings. He will place it in his mouth, suck quickly, and then move his head. He'll do this repeatedly until, frustrated, I put him on the other breast. But I'm concerned he's not draining it completely (I can still manually express milk from that breast) and so because he's not draining it, it won't continue to produce.

    I can't remember the last time I was engorged. Or even felt full. And he sleeps a good six hours during the first part of his night. Used to be that I would become engorged after three hours.

    Help!

  2. #2
    Join Date
    May 2012
    Location
    Cincinnati, OH
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    71

    Default Re: A Host of Breastfeeding Issues / Concerns

    Mabye waking him up before 6 hours pass at night for a feed may help. The best way to get your supply up is to nurse, so when you are not working I suggest not to give any formula or bottles and only nusre. I do commend you for going back to work, I wanted to and could have but couldn't bear to leave my DD in childcare. So bravo to you! I use the evenflo SimplyGo Single Electric Breast Pump, I have the same brand manual pump too but I get more out from the electric one. Also make sure you are eating well an extra 500 calories a day and drinking pleanty of fluids too!! When you pump do you let it pump until nothing left comes out and stop or do you let the pump run for a few minutes even after nothing is coming out? Let it run for 3-5 min after nothing comes out if you aren't already. And I don't believe you can drain a breast absolutely dry, I have never experienced that. I can always squeeze some out with my hands. This works for me when I pump, I will raise my are over my head and that usually for some reason helps my let down reflex to kick in and I can see more coming out in the pump at that time too. I also notice when I bend over at the waist, like to tie my shoe helps with my let down reflex. I don't know if this helps you but good luck to you!
    09-28-2011 VB (41 Weeks 1 Day) Breastfeeding 12 months & counting.

  3. #3
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: A Host of Breastfeeding Issues / Concerns

    I would try to nurse more often and pump more too.

    Consider renting a hospital grade pump (BTW, newmom, the evenflow pumps are awful ones. They wear out fast!). Make sure you have the right sized horns. Are you pumping past when you see drops stop by about 5-10 minutes? Are you using breast massage to express all the milk ? A hands free bra is very helpful for pumping. But when a mom says she has milk and cant get it out, it's a pump issue. So you can fix that get sized by an IBCLC and rent a pump.

    But...I'm not sure you have a supply problem in general. Is baby sated by you on your days off? And 5 oz is an EXCESSIVE amount to eat every feeding. A bottle fed baby should get 1 to 1.5 oz per hour of separation. Try a different bottle and use paced bottle feeding.
    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!

  4. #4
    Join Date
    May 2012
    Location
    Cincinnati, OH
    Posts
    71

    Default Re: A Host of Breastfeeding Issues / Concerns

    Thanks for the heads up aprilsmagic! Good thing I don't have to pump too often.
    09-28-2011 VB (41 Weeks 1 Day) Breastfeeding 12 months & counting.

  5. #5
    Join Date
    Jun 2009
    Posts
    5,595

    Default Re: A Host of Breastfeeding Issues / Concerns

    I think that your baby is being fed in a way that is not breastfeeding supportive at daycare, and you may have issues with pump output. But I agree with Susan that neither neccesarily adds up to low supply.

    First off, at daycare, your baby should be being fed smaller amounts at a time and on cue, rather than sceduled, as much as possible. There is also a way to position a baby when bottle feeding that allows them to control the flow and reduces overfeeding. Share this information with your caregiver: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    You have tried several different pumps it sounds like. But are they all new? have you had them tested? Sometimes the motor stops working efficiently and that is the problem. Sometimes the problem is as simple as a worn or torn membrane or loose connection. Also, breast sheild size can make a big difference.

    2 ounces per session is not a terribly low amout to be pumping, it may be your normal. But certainly you can take steps to increase that amount. This article has some ideas. http://kellymom.com/bf/pumpingmoms/p...ping_decrease/

    There is no reason to think you will not be able to nurse until 6 months or longer. Even if baby needs formula supplementation, that does not mean breastfeeding must cease. You can continue to breastfeed and supplement as neccesary. But if your baby can get enough milk when with you, I would agree with pps, nurse as much as you can while with baby-it will not hurt at all and will probably help to increase the frequency of your nursing sessions- and save any supplementation for during separations but only if needed.

  6. #6
    Join Date
    Nov 2011
    Posts
    45

    Default Re: A Host of Breastfeeding Issues / Concerns

    I noticed you said something about letting down and your breastpads would be soaked. Perhaps try finding out the amount of time between those let-downs and pump BEFORE you have a let-down (it's easier to let-down when you haven't done so recently). Also, try pumping once or twice when you are around baby--for me it helped my body get used to letting-down with the pump. I would pump in the early morning (usually after a 5 a.m. feeding) and watch LO sleep while I pumped. I only had one major incidence with pumping since then, but that was entirely due to stress (mid terms were around the corner). Also, since you're taking tea, perhaps also try fenugreek supplements if you fear a low supply. As for engorgement, you're not engorged after 6 hours at night anymore because your body has adjusted to your baby's schedule, which is a great sign (and more comfort for you!).

  7. #7

    Default Re: A Host of Breastfeeding Issues / Concerns

    Thanks, all.

    I tried with pumping when I started to feel the "let down" and that gave me about an extra half of an ounce than I normally get. But that was also with applying some warm compresses to my breasts. Unfortunately, with my job, I can't go to pump more than the every 2-3 hours that I am doing already.

    The pumps are all new and not used. And I have various breast shield sizes. I have tried compressions, massages, relaxation techniques and it's all the same. Tonight I'm planning to record him crying because I can usually feel the let down when I hear him cry. I also pump each side at least 10 minutes but continue to pump after that to see if another let down will occur (for at least another 5 minutes). I also stop and massage or compress for about 2-3 minutes (as this little "break" in the past would produce another let down).

    Additionally, my little one is using the Medela Calma nipple, which simulates breastfeeding as much as possible (meaning he has to create a suction in order to get any milk to pass through). We got to 5 ounces per session while I am away after starting with 3 oz, having the little one cry, increasing that to 4 oz to still have him cry, and then finally to 5 oz where he was content. Using the formula of 1.5 oz per hour of separation, it amounts to 15 oz since I am away from him for 10 hours a day so it doesn't seem excessive.

  8. #8
    Join Date
    Nov 2011
    Posts
    45

    Default Re: A Host of Breastfeeding Issues / Concerns

    wow... um, yeah I'm at a loss of why you can't pump a little more. My recommendation would be to have an IBCLC work with you and the pump to see what's going on. Even though you have tried different size shields perhaps you ended up deciding on the incorrect one? Although, being just 1.5 oz shy per pump isn't that bad because no pump is as good as a baby is when it comes to extracting milk, and if you're like most and have 'just enough' for baby, then that makes sense and I wouldn't worry about it. I know that now that I have just enough for baby, I'm usually about 1 oz shy of whatever amount she actually consumes when we're apart (although that was a couple months ago now). And I know that this doesn't work for all mother's, and it's also not usually recommended, but for me, when I'm gone from LO, I pump as often as she nurses, which your body is still letting you know when she is late for nursing by letting down. Maybe try to keep track of how far apart nursings are when you are home for the day and try to pump at those times/intervals?

  9. #9
    Join Date
    Jun 2009
    Posts
    5,595

    Default Re: A Host of Breastfeeding Issues / Concerns

    You are right, 15 ounces intake for a separation of 10 hours is not excessive at all. But, just to go a tad off topic for a second, 5 ounces per feeding is leaning toward the high side. 3 feedings over 10 hours seems a bit infrequent to me. This won't help with the pumping issue but I still suggest some of the ideas in the bottle feeding the breastfed baby link, Paced bottle feeding can be helpful not only in reducing over feeding but in reducing the "bottle preference" or "nipple confusion" some babies experience. You report some behaviors at the breast in your op that suggest this could possibly be happening a bit with baby.

    Also may there be times your baby drinks almost 5 ounces but not all, but the leftovers are being discarded? Does every bottle contain 5 ounces of the breastmilk/formula combo? If you do not mix the formula with the breastmilk, if baby does not finish the bottle, the breastmilk bottle could be left in the fridge for the next feeding. I believe with formula and formula breastmilk combos, any "leftovers" have to be immediately discarded. Of course if baby refuses formula unless it is mixed with breastmilk that is different...

    OK back to pumping concern- 10 hours is a longish separation, and the longer the separation, often the harder it is to keep up with demand when pumping. Some moms just need to pump more frequently in order to get enough. As pp points out, pumps do not extract milk as well as a baby, so often a mom needs to pump more than once to get enough for one feeding.

    If more pumping sessions at work or during your commute is not doable, again, you can continue to supplement as needed and still breastfeed. As long as you pump enough at work and nurse enough when with baby to maintain your supply, you could do this long term.

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