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Thread: Getting back on the breast at 12 weeks - need help / advice!

  1. #1
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    Default Getting back on the breast at 12 weeks - need help / advice!

    Hi everyone,

    I am now just about 40 hours into almost pump-free BFing with my 12 week old son after almost two moths of EPing and I really need help.

    The trouble all started with severe breast / nipple pain and sores for the first few minutes every time he began BFing, and it made me very reluctant, but I was told the pain would subside in 6 weeks. So I persevered. At home - things were rough for us because he seemed to have colic, which meant lots of crying (both of us) and rather expensive homeopathic attempts to settle him and extreme, heartbreaking gas pain episodes. At about 5 weeks I went in to see the LC, and it turned out that he had a sucking problem, and was therefore not getting enough milk from BFing and also had not yet regained his birth weight (which was a hospital record 10.5 pounds). For the colic she recommended that I stop eating cow dairy. For the sucking he had to go and see a special chiropractor. She recommended that I EP to get my supply back up (I was down to about 35% of what it should have been) and not BF directly to manage the pain I was still experiencing.

    Of course, the chiro was on holidays for the next 3 weeks... but we finally went to see him and after two sessions the sucking difficulties were greatly improved and I was told to go see the LC to get him back on the breast. Then, she was on holidays for 2 weeks. However, with the sucking resolved, I started trying to BF during the day and pump at night. My baby was extremely fussy at the breast, pulling off, screaming, etc, and it was making things difficult and painful for me. Also, in doing this, I noticed my supply was starting to drop again, and I had to provide my baby with a bottle of formula every two days or so. Better formula than hungry screaming baby although that stuff is pretty nasty and smells so horrible.

    When I finally saw the LC she told me that I had forceful let-down and that's why he was pulling back and fighting against the breast. She assured me I did not have supply issues and recommended that I pump a bit before giving the baby the breast. After this, I kept pumping every 3 hours night and day and would give my baby the breast at least once a day, sometimes up to 4-5 times, when I wasn't super-full. However, getting him 'full' with only the breast seems to take hours, and is more often than not a bit of a struggle. Then, family and friends came to visit one after the other and I started EPing (but still offering the breast once a day). I started easting dairy again and haven't noticed any real change in gas issues, and I think it's a foremilk / hindmilk imbalance.

    I'd noticed in the last week that when pumping I didn't seem to have the forceful let-down flow, and after reading threads on this forum have decided to break up with the pump and try to BF exclusively. Since he's 12 weeks, I feel like it's now or never. I'm 'block feeding' - 3 hours each breast on demand. I'm block feeding to make sure he gets the hindmilk and not just the foremilk, which I think is why he has so much gas.

    The main problem seems to be latch, I think he's not taking in enough of the areola in, and when he does, he throws his head back and repositions so he doesn't have as much in his mouth. I think that he's also pinching, and when he comes off I notice the nipple looks pinched. This is probably also contributing to him not getting enough out, which is probably why I am feeling engorged. Also, one side's nipple is now in searing pain because of the bad latch. OUCH.

    The engorgement is just that I feel excessively / heavily full and start dripping all over the place, even when he's not nursing the other side. Last night I had to pump because he fell asleep and I was leaking all over the place. He woke up half an hour later and I fed him the pumped milk and then nursed him on the breast every 2-3 hours until 8 AM this morning when the pain was just too much (so I pumped again and fed him).

    My questions are:
    1. How can I get him to open up his little mouth, especially at night, so he isn't taking just a bit more than the nipple? How do I retrain him in this sense?
    2. Am I doing everything I can to get him on the breast / am I doing this right??
    3. How long does it take to realistically break up with my breastpump? Is it OK if I still use it when I'm dripping everywhere and feeling over-full and he's being super-fussy (last feeding before bedtime, for example?)

    Any help, wisdom, advice, or encouragement would be greatly appreciated!!! This is my first baby and I had no idea the breastfeeding learning curve was so endless. I'm extremely motivated and even willing to EP but absolutely hate being tethered to the pump on a 3-hour time clock. It truly does get in the way of living life at times.

    Thanks so much again!
    Etienne's mom
    Last edited by @llli*kjmf; September 10th, 2012 at 03:57 AM. Reason: clarification

  2. #2
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    Default Re: Getting back on the breast at 12 weeks - need help / adv

    Reply from llli*racoonz: (to a post I made yesterday that is hidden deep in a thread that's somewhat related) - http://forums.llli.org/showthread.ph...ng-established


    Why are you block feeding? Are you sure you have oversupply? forceful letdown is often accompanied by oversupply but isn't always, and since it seems like you thought your supply was low at some point, it would behoove you to not push it too far back if you don't have significant problems with oversupply. I would be hesitant to cut straight to block feeding if you're just starting to nurse at the breast. A better bet for controlling forceful letdown would be nursing "uphill" by doing laid back positioning or other positioning changes so your baby isn't choking when you letdown. These coping techniques will not reduce your supply.

    try not to stress about foremilk/hindmilk imbalance. gassiness and fussiness about it is really normal for babies who don't quite know how to deal with their own digestive systems. burping, bicycling legs, warm baths, being held in a squatting position, tummy massage can help baby pass the gas/ poop.

    to answer your specific questions:
    - sometimes babies will mimic you if you demonstrate a big wide mouth. i found striking baby's upper lip with my nipple helped sometimes, the nipple sandwich technique helped,
    - How bad is your engorgement? Causing you plugged ducts? or just hard for latching? or what? if it's making latching difficult you could try reverse pressure softening, there's a link to how to do this under the "resources for common concerns" section of this forum. for me, feeding the baby was always the quickest way to relieve engorgement. I had/have ffld and very frequent feedings were key in helping keep the letdown manageable.
    - you've made it 24 hours without supplementing? that's a good sign. you may have up and down days, which will be hard but you have good chances of luring baby back to the breast if you keep sticking with it. many babies who refuse the breast will nurse while asleep/drowsy, so take advantage of those times when you can. have you checked out the kellymom page on getting your baby back to the breast for more tips? here: http://kellymom.com/bf/concerns/child/back-to-breast/

  3. #3
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    Default Re: Getting back on the breast at 12 weeks - need help / adv

    Still trying, but my baby has had no poops for 48 hours... making me very nervous. Is this normal?

  4. #4

    Default Re: Getting back on the breast at 12 weeks - need help / adv

    I'm in a similar situation. Trying to EB but it has been a challenge. I wanted to Eb but at the hospital that I conceived at they were not helpful in helping me and baby learn to latch properly and basically forced me to bottle feed my LO. When I got home I tried to BF but baby wouldn't latch finally I saw a lactation consultant (she was wonderful). Things got better but I felt like baby was not getting enough milk and started to take a perscription to help increase milk supply. Then I guess I got overwhelmed or lazy (and it was hard to EBF since I constantly have visitors and family who I'm not comfortable BF'ing in front of ie. my dad) and just decided that BF'ing wasn't a nice and peaceful experience for my LO or me so I would pump and supp. with formula. Now I regret it and would like to EBF but baby is not latching again. I feel at a loss. I wish I hadn't stopped in the first place. Sorry it was so long. had to vent.
    I wish you luck!!! Don't give up!

  5. #5
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    Default Re: Getting back on the breast at 12 weeks - need help / adv

    First off, it sounds like racoonz gave absolutely great advice, listen to her! Also, great kellymom article.

    OK pooping- so several days- even up to a week or longer-between poops at this age-at any age past 6 weeks-can be entirely normal. However, since you are trying to transition to bfding from pumping/bottles, you may need to look at weight gain and other signs of milk intake closely for a bit to make sure all is well. This would mean watching pees closely and weighing baby ON THE SAME ACCURATE INFANT SCALE about once a week. Do not weigh baby every day.

    Did your LC ever work with you on latch techniques? breast sandwich, nipple flip? What about different positioning ideas? Side lying, laid back, foot ball hold, etc? Sometimes finding out what works for you and your baby takes lots of experimenting. Also since you continue to have latch pain at such an age, tongue tie must be ruled out. Yes, part of the problem may be the bottles and baby needs to 'unlearn' poor feeding techniques. But since you are still having problems with a painful latch, I suggest seeing the LC again or finding a new breastfeeding helper who is experienced with "older" babies and latch issues. Just ask her what her experience is! Many LCs rarely work with 12 week old babies because so many moms with issues (and even without) quit nursing by then. Your LC can also help you figure out weaning off the pump, but basically, every time your baby nurses reasonably effectively, you can eliminate that pumping session. Sometimes you just have to put down the pump and nurse only for a day or two to psychologically get over the hump. Even if baby cannot nurse entirely effectively, a few days of not pumping should not harm a well established milk supply at this age. However, try to avoid true engorgement by pumping just 'to comfort' or hand expressing as needed. Or, as suggested by racoonz, nurse!

    Again-when mom is engorged, it is harder for baby to latch. To avoid being engorged when baby latches, I suggest you nurse very frequently. Very frequent nursing also helps with forceful letdown and oversupply issues.

    Stop timing nursing sessions, this is totally unnecessary. I would also suggest you stop block feeding for a bit and see what happens. Instead, nurse VERY frequently and let baby 'finish the first breast first" even if that means baby takes only one breast per nursing session.

    So called Foremilk/hindmilk "imbalance" (actually, the issue if it is an issue, is just too much foremilk all at once) is only a problem SOMETIMES when a mom has extreme forceful letdown and is waiting too long between nursing sessions. And it is not improved by timing feedings. Short feedings, long feedings, as long as baby decides how long and baby is gaining, all are fine and will result in baby getting plenty of ‘fatty’ milk overall.

    I would suggest not pumping unless you need to for comfort. If you have normal supply and baby is nursing well enough, you do not need to pump. If you really do have oversupply and baby is nursing well/frequently enough, pumping makes it worse. Pump only to comfort to avoid engorgement if needed. Better, try to get baby to nurse again if you feel full.

    A baby popping on and off during nursing sessions and being fussy etc are normal newborn behaviors. A baby struggling a bit & having frustration when latching esp. when they are used to bottles is normal. Concentrate on what is not normal-pain to you when nursing is not normal, that needs to be fixed. And If baby stopped gaining, that would be a concern. Otherwise, try to relax and spend as much time as you can with baby snuggling and cuddling and experimenting, relaxing, and figuring things out. Clear your calendar and throw out visitors as needed!
    Last edited by @llli*lllmeg; September 11th, 2012 at 09:33 AM.

  6. #6
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    Default Re: Getting back on the breast at 12 weeks - need help / adv

    Thanks for all of this advice and support. He did end up pooping a few times yesterday, and I take your point about weighing him regularly on a scale to monitor weekly weight gain as a main indicator of success. I'll see if I can arrange a scale this week.

    We're now into day 4... I feel like we have about two successful nursing sessions in a 24-hour period and a regular marathon feeding session that lasts from 3-7 PM. I've been watching and re-watching the sandwich / deep latch videos on pumpstation and seem to be having the best luck when in the cross-cradle position. I so wish the lying down position would work for me, but it's only possible on the right side, and it seems overall like he doesn't get enough meat in his mouth with this position. He's big and strong, and wrestling him into position sometimes gets difficult for us both. I've also noticed that when he gulps air in when he's fussing just before he takes the breast, he only gets a few sucks and then starts screaming again. It seems to work best when he's not yet in hysterics from hunger and frustration (seems logical, right??!) I've not been timing so much as just encouraging him to latch on anytime he shows the inclination.

    Because my left side is being high-maintenance, I've tried a nipple shield. This way the nipple isn't coming out pinched & slanted, and it hurts a bit less. i think he chomps down on this side strongly because it's the side that produces a lot more and has a more forceful let down. I'm going to start alternating with using the nipple shield and not using it on this side as the latch improves.

    Also, the lactation consultant for my rural, rather remote area has gone MIA due to personal issues this week... talk about timing!! I am really REALLY grateful for this forum to get advice and support.

    Thank you thank you thank you. I am keeping at it, and hopefully 2 good feeds will turn into three and then four until we're noticing the times it isn't working instead of the times it is. I feel very fortunate that my husband has been emotionally supportive. I've gotten the "we don't live in the middle ages anymore, just give him formula" input more than a few times through these past months, so all encouragement is greatly appreciated. I suspect there's a strong psychological element to getting over this hurdle.

    ok, he's stirring; time to put him back on!

  7. #7
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    Default Re: Getting back on the breast at 12 weeks - need help / adv

    OK, we are coming up on a full week now and good nursing sessions are becoming the norm. I just want to let others know that it IS possible!!! I really had given up hope for awhile there... You can break up with your breastpump I have been pumping once a day, just before I go to sleep, and using that milk when feeds aren't successful. When we get to the point that all feeds are successful I will build a freezer stash. At the moment, 100ml or so of breastmilk pumped and the rest fed directly is a huge success. My little boy even slept for 6 hours straight last night, which for me is brilliant on so many levels: he's not hungry & I get a massive chunk of rest.

    I've also stopped using the nipple plastic shield thing!! YAY!! I really hope that my (thus far) success can encourage others. As I said before, it was another thread in this forum that encouraged me and I am so grateful for the support of this network. Love and gratitude to you all.

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