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Thread: supplementing since Birth is it too late to just breastfeed?

  1. #1

    Default supplementing since Birth is it too late to just breastfeed?

    HELP!
    My baby is 5 weeks old and that evening she was born I had to supplement with 5cc's of formula because she kept crying and wasn't satisfied with just nursing. The nurse told me to give her formula so I did and since then I have been relying on formula to get my daughter through her feedings. My nipples and breasts are always sore and I find myself stopping her feedings and just pumping because I can't take the pain anymore. Even after she nurses both sides until I think they are empty she still cries and sucks on her hands for more so I give her an ounce ortwo of formula which I hate to do. I was told to increase my milk supply to pump every 3 hours and that my supply should increase but I'm still only able to pump 1 ounce every 2-3 hours and I have been doing this weeks. She is eating 3-4oz every 33 hours and in the evening she is eating up to 6oz. Will I ever be able to keep up??? I am starting to feel hopeless about her breast feeding at all. When it comes to her latching I have beed trying to get her mouth around the whole areola but her bottom lip alway curls in and when I try to flip it out shd pulls away. She also tends to chomp down a lot and it brusies my nipple.

    This is my first baby and I want to exclusively breast feed more then anything. Please, any advice would be appreciated
    Last edited by @llli*ke128; July 7th, 2012 at 09:13 AM.

  2. #2
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    Default Re: supplementing since Birth is it too late to just breastf

    Welcome to the forum and congratulations on the new baby! I am so sorry the nurse at the hospital sabotaged you right from the outset. When a mom has trouble nursing, the solution is NOT to hand her a bottle! Unless the is something so wrong that a pediatrician concurs that supplementation is medically necessary, a lactation consultant should be called in to assist a mom with nursing. But even though you got tripped at the starting gate, it is definitely not too late to breastfeed exclusively! Milk supply can be increased at any time, if you have the right tools and are willing to do the work.

    Here's what I think you need:
    1. A visit with a lactation consultant, preferably an IBCLC. Nothing beats hands-on help when you are struggling to nurse a newborn!
    2. A good pump. A hospital-grade pump would be ideal. A very good double electric pump, like a Medela Pump in Style would be second best, and a consumer model double electric pump would be third best. Anything less than that is unlikely to get good results.
    3. Correctly-sized breast shields. These will allow you to maximize stimulation and milk removal when pumping.
    4. A professional scale. This one is optional, but I found it to be extremely useful when I was in a similar situation. By weighing your baby before and after nursing, and subtracting the before from the after, you can get a very accurate picture of baby's intake during a nursing session, and know whether or not you need to supplement.
    5. A regimen of frequent post-nursing pumping sessions. I personally recommend pumping every 2 hours during the day and every 3 at night, which is a lot of work but NOTHING- not herbs, not Rx drugs- increases milk supply as effectively as frequent milk removal. It is better for supply to pump 1 oz every 1 hour than 3 oz every 3 hours, because the frequency of demand is as if not more important than the quantity of milk removed.
    6. Herbs: also not strictly necessary but potentially helpful. Fenugreek, blessed thistle, and ordinary oatmeal are all good for increasing supply. Your LC can help you with the dosage for the first 2.
    7. Drugs: as a last resort, Reglan and Domperidone are Rx drugs which are used off-label to increase serum prolactin levels and improve milk supply. Both have additional side-effects and are not for all moms, so talk to your midwife, ob, or family doctor before taking either one.
    8. The right birth control method. I assume you're headed in for your six week postpartum checkup soon, at which point your care provider will go over birth control methods. Since you are not exclusively breastfeeding, you cannot rely on breastfeeding to prevent pregnancy (and even EBF moms cannot rely on it for more than 6 months, at the outside). Hormonal contraception is unlikely to be a good choice for you right now, since ALL hormonal methods (including the so-called "safe for breastfeeding" methods like Mirena or the mini-pill) have the potential to negatively impact milk supply. If you want advice on birth control, just let us know and we'll happily chat about methods and help you find one that may be right for you.

    All of what you describe is very typical when bottles and supplements are introduced right from the beginning. When a baby is used to being supplemented, she will often act hungry even after nursing because she expects every feeding to conclude with a bottle and with the stuffed feeling it gives her. Generally the best thing a mom can do is to shelve the bottles and simply nurse, nurse, nurse, but I would not advise you to do that without guidance from a lactation consultant. Supplementing so much and from so early on could have resulted in you having low milk supply, and the fact that nursing is so painful for you also suggests that your baby's latch could be sub-optimal, which can also lead to lowered supply. However I do think that you should strive to nurse as often as possible, keep the supplemental bottles small (1-2 oz MAXIMUM, with 1 oz being preferable), and pump like it's your new religion. Once you can fill all baby's supplemental bottles with breastmilk, you will know you have enough milk to transition to exclusive breastfeeding. I also suggest that you work to finish feedings at the breast, to remind baby to associate comfort, pleasure, and satiation with the breast, not the bottle.

    Can you tell us more about the pain you are experiencing? Does it occur at the beginning of a feeding, throughout the feeding, at the end of the feeding, or after the conclusion of the feeding? Would you describe it more as a stabbing or pinching pain, or more of a burning? Are you cracked or blistered at all? When baby unlatches, are your nipples misshapen/creased/wedged/asymmetrical/shaped like new lipsticks?
    Last edited by @llli*mommal; July 7th, 2012 at 12:25 PM.
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    Default Re: supplementing since Birth is it too late to just breastf

    Edit: my post went up before I saw mommals. So excuse any repetition.
    I think you are feeling hopeless because you have gotten very wrong and incorrect breastfeeding information somewhere. Yes, there is hope, I assure you. But you need to educate yourself and get qualified hands on help if you can.

    My baby is 5 weeks old and that evening she was born I had to supplement with 5cc's of formula because she kept crying and wasn't satisfied with just nursing.
    Brand newborns cry a ton and no, they usually do not act 'satisfied" mere hours after they are born, that means nothing, I suspect you never needed to supplement, your baby was doing just what baby needed to do at that point-insist on nursing lots and lots.

    OK, so now:
    Milk supply increases based on milk being extracted from the breasts frequently. Usually, a baby is better at doing this than a pump. Extra pumping can help, or course, if there truly is a supply issue, or baby does not nurse well. But nursing frequently is the best way to get milk supply where it needs to be as long as baby can nurse effectively. If you cannot nurse due to the pain, then pump. But you need to be using a hospital grade rental pump in such a situation if you can.

    How often (how many times a day) does baby nurse? Do you let baby nurse as long as baby likes and how long is that? I understand your breasts are sore-what exactly is happening while nursing? How does the latch feel? Is your nipple misshapen after nursing? Do you hear or see any swallowing? Is the soreness from a painful latch, pumping, what?

    If baby is nursing all day, you are not going to pump much milk. Why? Because baby got the milk when nursing! Anything you pump is extra. If baby is nursing frequently, stop worrying about how much you pump. In fact, just stop worrying about how much you pump no matter what-pump output tells us very little. Pump if you need (if baby does not nurse or does not nurse well) and save/give to baby what you get, (if needed) but stop stressing over how much you pump. You want to nurse at the breast, so making that happen is what you want to be concentrating on.

    Even after she nurses both sides until I think they are empty she still cries and sucks on her hands for more so I give her an ounce o rtwo of formula which I hate to do.
    So don't give her formula. Nurse again. Your body is alwasy making milk. Your breasts are never empty no matter how they feel. If supplements are needed, (and you can figure that out based on baby not gaining or pooping without them,) try supplementing (an ounce or two at most per feeding) BEFORE nursing, and let baby finish at the breast.

    3-4oz every 33 hours and in the evening she is eating up to 6oz.
    ? I am unclear what you mean here. But 6 ounces at once would be a tremendous amount for a baby to this age to eat in one feeding. Twice or more the norm. Babies overfeed on bottles and take what is in a bottle even after nursing fine as they cannot help but take what is in a bottle. How much a baby takes in a bottle, after nursing or not, means nothing.

    Whether at the breast or bottle, or a combo, baby should be being fed a minimum of 10 times a day. That is the minimum. A baby this age typically needs about 25-30 ounces of breastmilk a DAY. (Some sources day more like 20-25 ounces.) So nursing 10 times a day, that averages out to 2-3 ounces per feeding. And many babies nurse more frequently than that to get what they need. So feedings should be small and frequent.

    When it comes to her latching I have been trying to get her mouth around the whole areola but her bottom lip alway curls in and when I try to flip it out shd pulls away. She also tends to chomp down a lot and it brusies my nipple.
    Good you are working on latch but I suggest working on different postioins as well...In a laid back positon, many babies can latch better even if they have a hard time gaping wide etc.

    Many babies are never going to be able to take in the whole areola! It depends on the size of the areola and babies mouth. This is not needed for a comfortably latch.

    Since latch is still painful for you after all this time, I strongly urge you to get hands on help. Find an IBCLC who is experienced in helping babies this age with latch issues. If she is or once was a LLL Leader, all the better. You need someone who will sit wiht you and work on latch, your main problem at this point is that breastfeeding is painful for you.

    Also, contact your local LLL if you have one.

    Whether you ever needed to supplement or need supplements now is unclear, imo.

  4. #4
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    Default Re: supplementing since Birth is it too late to just breastf

    Some articles that may help you:

    There is no one “right’ way to latch a baby. Latch is good if it is comfortable for mom and baby gets milk. How it looks or how you get there is not important.

    Try: laid back positioning: http://www.biologicalnurturing.com/video/bn3clip.html and http://www.llli.org/docs/00000000000...astfeeding.pdf

    Here is a video about deep latch. http://www.ameda.com/resources/video

    More on latch: http://kellymom.com/ages/newborn/bf-...tch-resources/

    Breast sandwich: http://www.llli.org/llleaderweb/lv/lvfebmar04p3.html

    What is normal and expected in the early weeks with baby: http://kellymom.com/bf/normal/newborn-nursing/

    Feeding the non-latching baby: http://www.llli.org/docs/00000000000...ching_baby.pdf

    And pumping log: http://www.llli.org/docs/00000000000...umpigchart.pdf

    I also strongly suggest the book The Womanly Art of Breastfeeding (8th edition)

  5. #5

    Default Re: supplementing since Birth is it too late to just breastf

    Thank you so much for the advice! I feel better already. I am nursing about 5 times a day and pumping the rest. Like I said I'm pumping every 3 hours or so. My nipples are sore from nursing but my breasts are sore from pumping. When I start the pump it really hurts for about a minute. When she nurses it is a shart burning pain at first and usually gets better except my right side hurts throughout the feeding. She only nurses for 15-20 minutes at a time. When she nurses she gets really excited and latches hard but then pulls away over and over while grunting. She curls in her bottom lip and when I flip it out she pulls away. She falls asleep a lot too. The latch feels like she is chomping more than sucking. I do see her swallowing and hear it at the beginning and then it seems like she sucks a long time before swallowing.

    Thanks again!

  6. #6
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    Default Re: supplementing since Birth is it too late to just breastf

    But 6 ounces at once would be a tremendous amount for a baby to this age to eat in one feeding. Twice or more the norm. Babies overfeed on bottles and take what is in a bottle even after nursing fine as they cannot help but take what is in a bottle. How much a baby takes in a bottle, after nursing or not, means nothing
    Was going to say exactly that!!! If a newborn's stomach only holds 2-3 oz...where do you suspect she is putting the other 3?

    When she nurses she gets really excited and latches hard but then pulls away over and over while grunting
    Overactive letdown, maybe?
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  7. #7
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    Default Re: supplementing since Birth is it too late to just breastf

    Quote Originally Posted by @llli*ke128 View Post
    Thank you so much for the advice! I feel better already. I am nursing about 5 times a day and pumping the rest. Like I said I'm pumping every 3 hours or so. My nipples are sore from nursing but my breasts are sore from pumping. When I start the pump it really hurts for about a minute. When she nurses it is a shart burning pain at first and usually gets better except my right side hurts throughout the feeding. She only nurses for 15-20 minutes at a time. When she nurses she gets really excited and latches hard but then pulls away over and over while grunting. She curls in her bottom lip and when I flip it out she pulls away. She falls asleep a lot too. The latch feels like she is chomping more than sucking. I do see her swallowing and hear it at the beginning and then it seems like she sucks a long time before swallowing.

    Thanks again!
    Try to nurse more often. The main reason to be pumping at this point is due to nursing being painful-so if pumping is painful as well, that defeats the purpose. If you do need to pump, (because baby has not nursed well or the pain of nursing is too much) start on a very low setting and dial up but stay at a setting that is comfortable. Make sure the breast shells are the right fit, your nipple should move freely in and out of the tunnel. Some moms lube up the shell with olive oil but that is just a temporary measure until you can get a properly fitted shell.

    I just met with a mom today who had nipple injury and that pain right at the start of nursing. laid back positioning helped her a ton. Also, I know it is hard because it hurts but nursing WAY MORE often, at the very earliest cues, even before any cue, will very likely help with the pain. A very hungry baby is a frantic baby who will chomp. A calm baby will often nurse more gently.

    Keep working on latch and positioning, nursing more, and start working on healing your nipples. I bet you can turn this around pretty quickly.
    feeding cues: http://www.llli.org/docs/00000000000...eding_cues.pdf

    healing sore nipples: http://kellymom.com/bf/concerns/mother/nipplehealing/

    also I suggest stop fiddling with her lip since she objects. Try gently stuffing more of your breast in after she latches, or better yet, bring her to the breast kind of from below so she naturally tilts her head back and takes in more of the underside of the breast with her lower jaw. (think about how you tilt your head when taking a drink from a water bottle.)
    Last edited by @llli*lllmeg; July 7th, 2012 at 10:01 PM.

  8. #8
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    Default Re: supplementing since Birth is it too late to just breastf

    Overactive letdown, maybe?
    Hmmm. Maybe, but that pulling off could also be from uncomfortable positioning, poor latch, or flow confusion from ther bottles. (baby expects a rapid flow like she gets with the bottles) Pump output and supply concerns would suggest it is not oald. BUT, if it IS oald or taht is part of the picture, again, laid back positioning and nursing much more often would help.

    ke128, here is an article on oald if you want to investigate this for yourself. DO NOT START BLOCK FEEDING but you can try the other iieas if this sounds like what is happening. http://kellymom.com/bf/got-milk/supp.../fast-letdown/

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