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Thread: Going Cold Turkey From Bottle to Breast

  1. #1
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    Aug 2014
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    Default Going Cold Turkey From Bottle to Breast

    Well my ongoing adventure in pumping and breastfeeding continues. My little girl is almost 2 weeks adjusted (15 weeks actual) and I'm getting to the end of my rope as far as pumping goes. I'm just so sick that every two hours I have to put her down to spend 30 minutes pumping. She'll be wide awake and looking around and I have to put her down. I can't delay because that will mess up when I can try to put her to breast next.

    I've read about some mom's who have had success setting aside a couple of days where the baby just breastfeeds, no bottles. Basically a breastfeeding boot camp. I'm debating whether that is something I want to try with my little one.

    I still struggle with low supply, pumping a total of 350mL in addition to 4-5 breastfeeding sessions a day. Her latch is rather lazy, she won't open up wide and once she's on milk is constantly dribbling out the side of her mouth. I managed to get her to latch properly yesterday for the first time, no leakage and a good 5 minutes of good deep swallows. She has an upper lip tie. I was concerned she might also have a posterior tongue tie, but our pediatrician said no. He just went by looks though so I'm not so sure.

    She's still young and has only just started really letting us know if we're late to a feeding. She's also showing nipple preference, if I offer her my breast first she'll chomp and pull and fuss. I have an SNS system but I've only used it a handful of times, it's just so fiddly.

    I'm just reaching a point where I need to evaluate whether its worth the headache of pumping so often. If I just need to put aside my plan to breastfeed her and refocus.

  2. #2
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    Default Re: Going Cold Turkey From Bottle to Breast

    Quote Originally Posted by @llli*liz.g.autry View Post
    Well my ongoing adventure in pumping and breastfeeding continues. My little girl is almost 2 weeks adjusted (15 weeks actual) and I'm getting to the end of my rope as far as pumping goes. I'm just so sick that every two hours I have to put her down to spend 30 minutes pumping. She'll be wide awake and looking around and I have to put her down. I can't delay because that will mess up when I can try to put her to breast next.

    I've read about some mom's who have had success setting aside a couple of days where the baby just breastfeeds, no bottles. Basically a breastfeeding boot camp. I'm debating whether that is something I want to try with my little one.

    I still struggle with low supply, pumping a total of 350mL in addition to 4-5 breastfeeding sessions a day. Her latch is rather lazy, she won't open up wide and once she's on milk is constantly dribbling out the side of her mouth. I managed to get her to latch properly yesterday for the first time, no leakage and a good 5 minutes of good deep swallows. She has an upper lip tie. I was concerned she might also have a posterior tongue tie, but our pediatrician said no. He just went by looks though so I'm not so sure.

    She's still young and has only just started really letting us know if we're late to a feeding. She's also showing nipple preference, if I offer her my breast first she'll chomp and pull and fuss. I have an SNS system but I've only used it a handful of times, it's just so fiddly.

    I'm just reaching a point where I need to evaluate whether its worth the headache of pumping so often. If I just need to put aside my plan to breastfeed her and refocus.
    Can you explain the situation more? Why are you breastfeeding only 4 or 5 times per day? And why does pumping at exactly two hours affect when you can next put baby to the breast? I would think you should be pumping after nursing, and nursing at least 12 times per day.

    Is the lip tie getting cut? Have you sought another opinion on the tongue tie?
    Are the bottles being given via paced bottle feeding? Are they being kept small?
    Premies often have small mouths and latching can be challenging while they are still tiny. Have you sought help from an IBCLC?

  3. #3
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    Default Re: Going Cold Turkey From Bottle to Breast

    My pumping/feeding schedule is as follows:

    3am - breastfeed and bottle-feed, then pump at about 3:30pm
    6am - Daddy gets up and bottle-feeds her
    8am - breastfeed, then hand off to Daddy to bottle-feed while I pump
    9:30am - pump, then bottle-feed at 10am
    Noon - breastfeed and bottle-feed, then pump at 12:30pm
    1:30pm - pump, then bottle-feed at 2pm
    4pm - breastfeed and bottle-feed, then pump at 4:30
    6pm - Daddy bottle-feeds while I pump
    9pm - breastfeed, then hand off to Daddy to bottle-feed while I pump
    11:30pm - pump, then bottle-feed at midnight

    To maximize the amount of time between pumping and breastfeeding, I switch back and forth between pumping before and after feedings. Because of my low supply the goal is to try to have my breasts as full as possible when she breastfeeds, to increase flow, which will hopefully stimulate her to drink more and not just nibble.

    When she was discharged the lactation consultant recommended breastfeeding ever other feeding, since she was still small and the focus was the most amount of calories with the least expenditure of energy. The advice of the lactation consultant was to increase the number of breastfeedings, when she started to empty the breast regularly. That hasn't happened. Whenever we've done a pre- and post- weight she averages about 10 mL transferred from one breast. She'll never really does a consistent job at nursing. I've watched the videos on Dr. Jack Newman's website, and she'll do maybe 3-5 minutes of what the one video says is good drinking and then just nibbles until she falls asleep. I do breast compressions to try and increase my flow, but it doesn't seem to work.

    I try to do the paced bottle feeding, not sure how consistent Daddy is about doing it. As you can see above she eats every 2 hours during the day; this is approximate, I try to feed on demand but she still sleeps most of the time and needs to be woken to eat. She gets 45mL in the bottle, less if she breastfed and I never insist she finish the bottle.

    The lactation consultants I saw while she was in the NICU were wonderful. Very encouraging, but of course the focus in the NICU is different than at home. There the focus was on helping me to increase my supply and pump as much as possible, and to develop good technique on my side of breastfeeding, she was so tiny getting a good latch wasn't a focus. I went back to the hospital's outpatient lactation services and wasn't as impressed. This was a consultant I'd never seen before, and she basically just shrugged and said my daughter was a preemie, keep trying. I found IBCLC who does house visits and plan on calling her tomorrow to set up a consultation. Latching my girl is definitely a challenge, she won't open wide and getting her latched deep seems impossible. I'd like to have the lip tie cut but my pediatrician didn't seem to think it interfered with latching, just that it would be an issue when her teeth started coming in. I plan to seek a second opinion on the tongue tie, and will probably have the same doctor cut the lip tie regardless of whether there's a tongue tie or not. I just only seem to remember in the evening when the doctor's office is closed.

    The whole process of breastfeeding, bottle-feeding, pumping can take up to an hour and a half, which leaves us only a half hour to relax before it starts all over again. And she doesn't seem to be improving in her desire to breastfeed. That's why I wonder if it would work to basically take a nursing vacation. Set aside two or three days where all she and I do is rest and breastfeed on demand, no bottle-feeding.

  4. #4
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    Default Re: Going Cold Turkey From Bottle to Breast

    The whole process of breastfeeding, bottle-feeding, pumping can take up to an hour and a half, which leaves us only a half hour to relax before it starts all over again. And she doesn't seem to be improving in her desire to breastfeed. That's why I wonder if it would work to basically take a nursing vacation. Set aside two or three days where all she and I do is rest and breastfeed on demand, no bottle-feeding.
    I think the problem is the idea of suddenly stopping all bottles (and pumping?) You do not mention how much (ounces) baby is supplemented currently, but based on that schedule it appears baby is at least half supplemented if not more? If this is all with your own breastmilk that you pump in a day, then the nursing vacation ideas MIGHT be fine, assuming baby is capable of nursing normally at this point. But you don't really know that...if you see a lactation consultant and she does a weighted feed (or a couple) and sees nothing wrong with baby's ability to latch and nurse effectively, that would be more reassurance about this.

    Until you can see the IBCLC, maybe take things more gradually, starting with nursing ONLY (no pumping or bottles, just nursing) for some of the feedings. I would also suggest, aside from adding additional meals that are "nursing only" sessions, nurse every time baby feeds even if baby is also getting some milk in a bottle and/or you also pump. Paced bottle feeding with proper positioning and pauses is VITAL as over supplementing is death to breastfeeding success, so go over it again with your husband.

    Also, maybe rather than waiting to fill up before nursing sessions, try breast compressions and switching sides frequently to keep baby more actively nursing. For optimal milk production, you want to have milk extracted from the breasts as frequently as possible.
    Last edited by @llli*maddieb; October 20th, 2014 at 01:11 AM.

  5. #5
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    Default Re: Going Cold Turkey From Bottle to Breast

    I agree with the PP
    Suddenly cutting out all bottles and only breastfeeding seems a bit premature and probably not safe for baby or maybe even you until you can confirm that baby is ABLE to get enough milk by breastfeeding and that your supply is enough.

    I would quit trying to "fill up" before breastfeeding. Nursing at every feeding is going to be better for your supply.
    What pump are you using? how much do you get at each pumping session? How long do you pump at each session? Are you doing massage, compressions and hand expression as well?
    Doing the feed/supplement/pump at most if not all feedings is going to be exhausting so you may not be able to keep it up for long but if you can manage it for three days, you may well see an increase in your supply. And if Daddy can handle the bottles while you pump it will be a little better. Or if you can manage to use the SNS it will save a step.

    Then hopefully if you are able to do the nurse/supplement/pump thing for a while and get to the point where you can pump enough to fill all the bottles, then you might be able to start reducing the amount of bottles and just let baby nurse more while you reduce the pumping sessions.

    The Idea of a nursing vacation to increase supply is generally geared for working moms who are having trouble keeping up with their supply while pumping at work and since baby is generally better at removing milk, having baby nurse lots over a long weekend can often boost supply back up since the body gets the message of demand better when delivered by an effectively nursing baby.

    If your baby isn't able to nurse effectively yet, trying to cut out all bottles and pumping for a weekend could be detrimental to baby's growth AND your supply.

    What Else are you doing to increase your supply? Herbs, foods, water etc? Have your thyroid levels been checked? Have you looked into medications?

  6. #6
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    Default Re: Going Cold Turkey From Bottle to Breast

    I'm using a Medela Symphony. I get anywhere from 20mL (1 hour from last pump) to 90mL (5 hours from last pump). That is after pumping about 30 minutes with massage, compression and heat; I also do hand expression after I pump, but never seem to get more than a few drops. I actually find that if I pay too much attention to my breasts during a pump I produce less, I think I start stressing about how much milk I'm producing and that inhibits let down. I seem to get the best result with massage before, and then constant heat with occasional compression during pumping.

    I feel like I'm an expert in what to do to try and increase supply. Oatmeal everyday, plus fenugreek and blessed thistle 3 capsules each 3x a day, goat's rue tincture 2mL 3x a day, 12 glasses of water and 6 smaller meals. I just ordered Motherlove's More Milk Special Blend tincture and am going to try that in place of everything. I do have tubular breasts, so there is the possibility of insufficient glandular tissue. I've had hypothyroidism since puberty, but had my levels checked about two months after she was born and they were good. I want to get them checked again since fenugreek can lower T3 and I started fenugreek after I had my levels checked the first time. I tried to get a prescription for domperidone, but my doctor was only willing to write one for Reglan. I have a history of depression and anxiety and with what I read about Reglan's side effects I don't think its wise to risk it. I've struggled with finding the right the size flange for the breast pump. I use the 27mm at the moment, they seem like they are too large but if I try using the 24mm I get significantly less milk and more pain.

    I'm just horribly discouraged.

  7. #7
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    Default Re: Going Cold Turkey From Bottle to Breast

    Yep, sounds like you have become expert with the pumping.

    You might want to have the Dr check your prolactin levels too then since Reglain and Domperidone won't do you much good if your prolactin is normal to high. The drugs work by reducing dopamine which inhibits prolactin so they are likely to only be effective if your prolactin levels are really low. Since you have had issues with depression you don't want to just try those drugs unless there is indication they would actually be effective.
    In the US Domperidone is difficult to aquire but compounding pharmacies can do it with a prescription or you may be able to get it online with a script. But again, probably not worth it unless you can get the levels checked with your history of depression.
    If IGT is the case, then figuring out how to use the Lactaid or SNS is probably worth continued efforts since it will save you the separate bottle feeding step. I know they can be a royal pain (I used one for over 5 months) but bottles caused me even more pain because they encouraged a shallow/lazy latch and suck.

    By the Way, YOU are doing an awesome job giving the best you can to your baby! I don't know if anyone mentioned that. If you reach the point where the continuing stress of the feed/supplement/pump treadmill is too much and you have to take a little break or pump vacation to reduce the stress and avoid a total breakdown then just nurse at all feedings in addition to needed supplements for a day then do it. I know there were days in my journey on the treadmill where I had to do that. (I don't seem to have thyroid or IGT, I just didn't respond to pumping well enough for it to bring up my supply much.)

    Do you have a good infant scale to be able to do pre/post feeding weights? It might help you figure out when baby starts to get it when it comes to nursing.

  8. #8
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    Default Re: Going Cold Turkey From Bottle to Breast

    I've struggled with finding the right the size flange for the breast pump. I use the 27mm at the moment, they seem like they are too large but if I try using the 24mm I get significantly less milk and more pain.
    Ugh, it is very frustrating to be in between sizes:

    A couple things to think about - You can switch flanges as needed, and/or use a different flange size for each breast if needed. I am wondering it possibly you find that when you are fuller you need the larger and can use the smaller more comfortably when less full?

    If the smaller flange hurts but is otherwise giving you a better seal and better milk extraction, try lubing it up with olive oil to avoid injury.

    Play around with pump settings. I also used a symphony for a short time and found some of the settings really were too intense for me.

    Have you looked into alternative flanges from pumpin pals? http://www.pumpinpal.com/


    I actually find that if I pay too much attention to my breasts during a pump I produce less, I think I start stressing about how much milk I'm producing and that inhibits let down
    YES! Try covering the pump up with a towel or something so you do not even see the milk coming out and put your mind on something else entirely- a book, TV, conversation, whatever.

    Some moms find visualizations/meditations very helpful. If you have ITunes there is one you can get on there as a free download that was designed by a lactation consultant, you can find others online as well.

    If you are feeling overwhelmed and discouraged, that is a good indication your "plan" needs tweaking. So I think your impulse to take a nursing vacation is very, very valid! For all we know it would work-we just have no way of knowing. But I think there are lots of ways you could tweak your current routine that may make it more manageable for you without going "cold turkey."

    Milk production is increased by frequent removal of milk from the breasts, and newborn babies typically nurse very frequently- 10 to 12 or MORE times in 24 hours.

    But babies do not nurse on some hourly this or that schedule. So I would suggest, maybe try to free yourself and your baby up- and how this will look depends on you and your baby- maybe with finding times to ONLY nurse, (no pumping & no supplements) and by encouraging nursing as much as baby will, and supplementing only as needed, very small amounts at a time, either before or after a nursing session, or "in between" nursing sessions, And pumping when you can fit it in, around your baby's nursing.

    Also, try to keep some time aside so you can get one longer (4 to 5 hour) sleep stretch a day if possible.

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