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Thread: I think I've lost my battle :(

  1. #1

    Default I think I've lost my battle :(

    My son was born 4 weeks early and had to go to the NICU for respiratory issues. He is very small. Then he became jaundice. I was pumping and trying for a latch before feeds with no success. Since my milk hadn't come in and he was jaundice, he needed to be started on feeds to help clear it, so they started bottle feeding with formula. I continued to try to latch before feeds and pumped while daddy fed him. Eventually my milk came in, but he still couldn't/wouldn't latch. I got a shield which solved the latch problem, and we breast fed exclusively for a week (no pumping during this time, unless I felt too engorged), it seemed like he wanted to eat constantly. I chalked it up to a growth spurt. At our2 week check up the bad news: he lost another 4 oz, for a total of 8 oz loss since we brought him home. (wet diapers were good, poopy were few). I came home and pumped, to see how my supply was; I only pumped a total of 35 mL between 2 breasts... So we went back to trying to nurse then formula feed (after given what little breast milk i had saved), while i pumped. I have continued to steadily decrease the amount i get when I pump... Last pump I only got a total of 20mL between 2 breasts. it has consistently dropped.

    Let's not forget how bad my nipples hurt, they are flat and are severely cracked and sore from pumping pulling them out, despite using lanolin. So nursing/pumping is painful even with the shield. As I mentioned, he is small so getting a good latch is tough.

    I called the LCD at my hospital, suggestions were to increase fluid intake, pump, and try to wean from the shield.... I've tried weaning, every time, and we seriously can not get a latch... Maybe his mouth is too small, or my nipples are too flat. I've even tried pumping first then latching when my nipples are pulled out.

    I'm not sure what I'm looking for here. I am devastated and feel like I'm failing. any advice is welcome. Please don't make me feel bad that I can't. Don't tell me to "hang in there" and it will work out. Obviously it is not. At the rate I'm decreasing I won't have any milk in a few days.... Advice? Anyone with similar experience? I kinda feel like I need someone to just say "it's ok, you tried, hard, and there is no shame in not being able to".

    At the very least thanks for letting me vent.

  2. #2
    Join Date
    May 2006
    Posts
    20,603

    Default Re: I think I've lost my battle :(

    Hey mama. You're not failing. You're succeeding at giving your baby as much of your milk as possible, despite some very trying circumstances.

    It sounds like there is a lot going on, and all of it is difficult stuff, but it all sounds fixable if you have the time, dedication, and energy to persist and make it happen. Most of all, you have to want to make it happen, and that desire can only come from within. That's not me telling you to "hang in there". I'm just saying that there is hope. If letting go of nursing will leave you feeling guilty and give you a broken heart, don't feel like you have to let it go. But if letting go will release you from severe distress and shame and allow you to move forward as a better mommy, no one will criticize you for that!

    Okay, so here's what I think is going on: first, a rough start. Your baby spent time in the NICU and ended up with jaundice, and because of that formula and bottles were introduced very early. That delayed your milk production, but it sounds like it was unavoidable since baby was unable to latch and you were unable to produce enough milk in the early days. Because baby was difficult to latch and used to the bottles, you started using the shield, which enabled baby to latch but also may have hindered his ability to transfer milk and caused him to feed constantly (it's common for babies who are having trouble getting enough milk to make up for poor milk transfer by nursing non-stop). And because milk transfer was impeded by the use of the shield, you ended up with low supply.

    Low supply is typically very fixable, even if baby is have trouble nursing. What you need is:
    1. A good pump. Hospital-grade rental is best, an excellent double electric pump is second-best. Don't try to squeak by with a cheap electric or manual pump- they won't do the job and will only frustrate you.
    2. Correctly sized shields. The pump should not be causing cracking, and if it and not the baby is responsible for cracking, that suggests that the shields are improperly sized.
    3. A rigorous pumping schedule. When I needed to increase supply, I pumped every 2 hours during the day and every 3 at night.
    4. Olive oil. If lanolin is not lubing your nipples enough, olive oil might allow them to slide more freely in the collection tube.
    5. Hands-on help from a good LC, preferably one who is an IBCLC.
    6. Herbs: fenugreek, blessed thistle, and ordinary oatmeal are all said to be good for supply.
    7. Drugs: as a last resort, there are Rx drugs (Reglan and Domperidone) which can increase supply. They have side-effects in addition to increased supply, and are not for all women, so speak to your health care provider before taking either one.

    You also need to deals with the cracks, and the pain from cracking, and here are some suggestions which may help:
    1. Moist healing. Use lanolin, hydrogel pads (like Soothies), and keep the humidity in your house high.
    2. Immerse your nipples in a shot glass of warm water before nursing/pumping. If the scabs are moist, they will not tear open as painfully.
    3. Try a combination of 1% hydrocortisone cream and Bacitracin antibiotic ointment on the cracks to fight infection and inflammation. Use a ea-sized amount, mixed and applied using a clean finger.

    I know this is that hardest thing to believe, but even though you're in a really tough spot right now, things can improve. I had terrible cracks, was using a shield, needed to pump and supplement, and thought I would never enjoy nursing. But I ultimately did- the baby grew and her latch improved as she got older, and with time and effort I was able to ditch the pump and bottles and just nurse.
    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!"

  3. #3

    Default Re: I think I've lost my battle :(

    Mommal, thank you for your reply. It was very heartfelt and helped lift my spirits. I will muscle through and continue to try. I really want to succeed in BF'ing but feel like the odds are stacked against me. I hate pumping, not only because it's uncomfortable (but has improved since I got smaller flanges for my Medela pump) its heartbreaking to sit for 20 mins and have only 15 mL total. Trying to nurse is so disheartening too, it's a battle and he gets frustrated and cries hard which breaks my heart. There is very few successes to help keep my motivation up. I have decided to try and contact a IBCLC for more guidance.

    Any more input is greatly appreciated!! Prayers are too

  4. #4
    Join Date
    Dec 2011
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    The Armpit of the Universe
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    248

    Default Re: I think I've lost my battle :(

    Have you tried doing breast compressions while pumping? http://newborns.stanford.edu/Breastf...roduction.html
    Also, I'm not sure how nipple shields work exactly, or if you'd need to or even could do this with one, but have you tried the nipple sandwich technique to cram more breast tissue deeper into baby's mouth? I found this kinda helped for my flat nipple.
    I hope you are able to see the IBCLC and that she is able to help you out. For me, in the beginning, even just the in-person moral support was helpful (because my son was being a stinker and latching perfectly with her watching, even though at home he was traumatizing my nipples.) She also pointed me to laid-back breastfeeding, which I found immensely helpful for a number of things, especially with getting a better latch. In the early days, I had to latch him sitting more upright, almost forward, but then I'd lean back and it helped him not slip off over the course of the feeding.
    Good luck!

  5. #5
    Join Date
    May 2006
    Posts
    20,603

    Default Re: I think I've lost my battle :(

    My thought is that right now you don't want to get hung up on success or failure. Those are such absolute terms. Sometimes a mom has to redefine success. Your baby doesn't have to be 100% breastfed for you to be succeeding at breastfeeding.

    I am so glad you're going to talk to an IBCLC. So many issues with new babies resolve best when a mom gets hands-on help. The internet is nice, but when the IBCLC is working with you in person she may pick up on something that just doesn't come through in writing.

    One technique that seems to help a lot of moms when they are in your shoes is something called "finish at the breast". You nurse or attempt to nurse, then give the baby a small bottle, and then, when he's mostly full and pretty calm, you switch him back to the breast, allowing him to do his comfort sucking there. That way baby learns to associate the breast with feeling relaxed and satisfied, and those positive associations can help him latch on more willingly the next time.

    This link has some good suggestions for dealing with babies who are reluctant to latch: http://kellymom.com/bf/concerns/child/back-to-breast/

    I will certainly say a prayer for you and your LO tonight.
    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!"

  6. #6
    Join Date
    Feb 2010
    Posts
    504

    Default Re: I think I've lost my battle :(

    . I completely AGREE with mommal's suggest of the "finish at the breast" method. It sounds appropriate to me in this case. Here is the information about it:

    http://www.lowmilksupply.org/finishatthebreast.shtml

    Also - the book associated with the above website "The Breastfeeding Mother's Guide to Making More Milk" is an excellent and informational book - not just about improving your supply but just about breastfeeding in general. I highly recommend it.

    Be kind and gentle to yourself. You're doing the best you can and that is all you can do!
    Blessed with DS - born 9/2/09 - nursed/pumped for 12 months
    Blessed with DD - born 3/27/12 my dreamfeeder

    903 ounces donated.
    http://www.wakemed.org/landing.cfm?id=135

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