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Thread: 4 month old only transfering 2 oz at breast

  1. #1
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    Default 4 month old only transfering 2 oz at breast

    We have a long history of problems BFing with my 4 month old DS. Low weight gain, painful nipples, long feeds. low supply. We had his PTT and ULT revised at 8 weeks but haven't seen any improvement. We have done suck training, CST and around the clock pumping to get my supply up. Right now I nurse him 7 times a day and supplement 3 oz of EBM via bottle after each feed. I pump 4 times a day.

    At his last visit to the IBCLC, he only transfered 2 oz at the breast. Obviously this is not enough for us to try and wean the supplement. I'm at the end of my rope and am planning to gradually wean my pumping and let my milk dry up. I don't have any hope left that his milk transfer is going to improve.

    I'm so sad that things turned out this way as I wanted to do extended BFing, but I don't know what else I can do.

  2. #2
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    Default Re: 4 month old only transfering 2 oz at breast

    Is there any way you can rent a good scale and do some pre/post feed weights at home? I don't think that one single measurement gives a great indication of how he's doing...he might have just not had that great a feed at the LC's that day. Might be worth doing, even if it turns out he's not doing better. At least that way you'll know.

  3. #3
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    Default Re: 4 month old only transfering 2 oz at breast

    2oz a feed is with in the realm of normal. The problem is that you only feed him 7 times a day. You need to feed a child 10-12 times a day. I am confused by your numbers. Are you getting enough in 4pumping sessions a day for 21 EXTRA oz??? because if you are pumping 21 oz in 4 sessions AND he is transferring 2oz each feed on his own, you definitely have no supply issues. And I disagree that you couldn't wean the supplement. The issue is simply getting the baby to the breast MORE OFTEN and FOR LONGER. So at the point in time when you normally pull out the bottle you should FLIP the baby. Put him to the other breast. Your breast are never out of milk. It's just about needing to demand that they letdown more. I am not saying this transition will be smooth and painless. At 4months depending on how long you have been supplementing with a bottle your child is USED to the bottle and used to only having to do a certain amount of work per session. But your baby is only 4months old. And you are making enough milk to sustain him. So do the work to get him back to the breast rather than feeding him substandard nutrition.
    Do skin to skin time during the feeding when you are NOT going to give the bottle. Like be naked on in panties and diapers only in bed or in the shower for the feed you aren't going to give a bottle AND on that day you also introduce an 8th feed. AND drop one pumping session. So you do this for 3-5 days to get your supply to change to this demand. Then Rinse, lather Repeat until you get have dropped all 4 pumping sessions. Then you will be feeding 11 times a day. Watch diapers the whole time. If at any point it doesn't seem like enough you add in one more nursing session. You CAN do this. And your baby deserves your milk. So don't give up. Not when so many women are struggling to make enough milk and you are in fact doing it. Keep feeding your baby your milk.
    Last edited by @llli*djs.mom; February 2nd, 2013 at 10:45 AM. Reason: NOT

    Way too lazy for formula

  4. #4
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    Default Re: 4 month old only transfering 2 oz at breast

    Thank you so much for your responses!

    I have considered renting a scale to do weighted feeds at home. I agree this would be a good idea.

    I understand exactly what you are saying Djs.mom. My supply was low at around 10 weeks and with pumping I have increased my supply. I do pump around 21 oz a day, I know that supply is not my issue right now. However, if I was to stop pumping, I believe my supply would tank because he is unable to remove the milk from my breast. Our issue is milk transfer so no matter how many times I put him to the breast he cannot transfer enough milk to sustain himself, or to empty my breasts enough to keep up my supply. We are feeding every 2-2.5 hours during the day and he STTN. I get up at night to pump to keep my supply up. There is no way for me to feed him anymore often while maintaining both of our sanities.

    We have tried to switch him back to an SNS but he just screams and refuses to latch. We have been supplementing with a bottle for 2 months because he was FTT and our IBCLC wanted us to get in as much supplement as we could with the least amount of work for him.

  5. #5
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    Default Re: 4 month old only transfering 2 oz at breast

    2 oz. sounds like he is doing an okay job emptying--if he emptied 2 oz every time he fed, 10-11 feeds would get him within the 19-30 oz. a day average most babies eat every day.

    Pumping is a pain, and so time consuming. I can't imagine dealing with it four times a day while actually home with my baby! But pumping counts as a "feed," really, so you are "feeding" 11 times a day already right now. What would happen if you just replaced one pumping session with a feed? Like an hour after one of the usual feeds? Does baby refuse the breast if offered more frequently than every two hours?

  6. #6
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    Default Re: 4 month old only transfering 2 oz at breast

    I like the idea of renting a scale for home use. One "snapshot" measurement at the LC's office doesn't tell you much. For example, when I did a weigh-feed-weigh at the LC's office, my LO took in 1.5 oz. A little low, but not terrible, right? Well, I started taking the measurements at home and only rarely would my daughter take in a single ounce of milk, so it became abundantly clear that I did need to supplement. If I had relied on that measurement at the LC's, I would have gotten a very different impression about what I needed to do.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  7. #7
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    Default Re: 4 month old only transfering 2 oz at breast

    Quote Originally Posted by @llli*sonogirl View Post
    2 oz. sounds like he is doing an okay job emptying--if he emptied 2 oz every time he fed, 10-11 feeds would get him within the 19-30 oz. a day average most babies eat every day.

    Pumping is a pain, and so time consuming. I can't imagine dealing with it four times a day while actually home with my baby! But pumping counts as a "feed," really, so you are "feeding" 11 times a day already right now. What would happen if you just replaced one pumping session with a feed? Like an hour after one of the usual feeds? Does baby refuse the breast if offered more frequently than every two hours?
    19 oz oz below the line. A baby need 24-32oz in a 24hour period. And 32 is on the high side. I guess my point Mrs squeegy is this; You are trying to let go of pumping sessions. Which I would also like to see. But you seem to think that you could let go of pumping sessions and get him to take in more in his 7 feeds. But THAT is not realistic. The amount of times a day you make milk is the amount of time WE ALL needed to make milk in order to maintain supply at that age. So is he was taking in 2oz a day 12 times a day, that WOULD be enough. I think you actually have over supply at this point. Because it sounds like you are making AND FEEDING him 35oz a day. Which is really really HIGH. Now I understand that you probably like that as it's probably gotten you the results you want in terms of weight gain. But I think your supply issues early on were about NOT ENOUGH breast stimulation. You rectified that and lo and behold, you are now making MORE THAN ENOUGH milk. So YES I think that you would make less milk if your baby was weaned back to breast only. But I think you are overfeeding him. Again I appreciate that you probably think it's better to overfeed him than underfeed him and I get that. But at the same time it's not OK that your fear of failing to make enough has you wanting to QUIT ALTOGETHER when you are DOING IT. You ARE making him enough milk and he IS getting 100% breast milk. I think you still need to wrap your mind around the fact that the amount of time you pump/feed is the NORMAL amount of time that most people who exclusively breastfeed FEED. So don't let the light at the end of the tunnel be about less time spent feeding. Your baby is only 4months old. They need to eat around the clock! They just do. That's how it works. So please please do NOT quit. Do NOT give up! The amount of time and investment you are making to your childs overall health for this short period of time is NOTHING in terms of time when looked at over the 18 years you are going to be responsible for keeping him healthy and making sure he is eating healthy nutritious food. You already know that you are, for this very SHORT window of time making him PERFECT food. And that the alternative is substandard. I disagree that you can't feed him more. I think all but one of your pumping sessions could be replaced at the breast. If he is sleeping 8 hours at night you don't want to go longer than 4 without pumping/feeding. So THAT sessions probably can NOT be replaced. (Unless you want to try dream feeding him?) But the rest, rather that pump, FEED HIM. And he will much MORE likely to want to do it MORE OFTEN if you stop feeding him 5oz at every feed. Which is WAY TOO much by any standards.

    Way too lazy for formula

  8. #8

    Default Re: 4 month old only transfering 2 oz at breast

    Hi mrssquegy, does what djsmom is saying make sense to you? Because I really have to agree. It sounds as if you think the norm for a nursing 4 month old is to nurse around 7 times a day and sttn-by which i assume you mean 8 or more hours? But this is not the norm. Very few 4 month olds, even with no milk transfer issues, would get enough nursing that infrequently and it would also cause a mother with normal milk production to see her milk production plummet.

    When a mother has been on the exhausting nurse/pump/supplement treadmill for a while, it can remove all joy from feeding your baby. I think many mothers who have done it will tell you that just nursing-even if you do need to nurse 12 or more times a day, even nursing at night--is less exhausting, much less stress inducing, and more fun.

    I'm at the end of my rope and am planning to gradually wean my pumping and let my milk dry up. I don't have any hope left that his milk transfer is going to improve.
    I would suggest, if you cannot keep pumping AND increase nursing frequency, why not try eliminating pumping pretty much totally and immediately, while increasing nursing frequency, including nursing at night as is the norm for breastfed babies, and see what happens?

  9. #9
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    Default Re: 4 month old only transfering 2 oz at breast

    Thanks again ladies.

    I do understand what djsmom is saying. I understand that 7 times a day is less than average and STTN is not usual for this age. It is however what my baby does at this point. When his weight gain was very low I was waking him at night to eat, but when his weight gain improved we started feeding him on demand. This led to STTN and 7 feeds a day.

    I would be more than happy to decrease my pumping and increase my nursing. I love nursing. I just want to make sure that I can feed him enough and with weight gain issues in the past, it is hard to give up the supplement, both for him and for me. I agree that we are likely overfeeding him which is likely leading to him only demanding 7 times a day.

    If I increase our nursing frequency, decrease the supplement and decrease the pumping, do you think I have a hope of getting back to EBF?

  10. #10

    Default Re: 4 month old only transfering 2 oz at breast

    Just to be clear, I did not suggest stop supplementing. If baby can not get enough via nursing, then you have to supplement. I do think supplementing may not be needed if you nursed more often and, if needed, could be done in a more breastfeeding supportive way. I suggested stop pumping, because the pumping is making you so miserable you are losing hope after working so hard. This is unfortunately pretty common. I wanted to suggest an alternative.

    I agree that we are likely overfeeding him which is likely leading to him only demanding 7 times a day.
    yes, I agree.
    if you are feeding your baby an extra ounce or two every feeding, then you can not call what you are doing cue feeding. You also cannot truly accurately gage milk intake in that case because your baby may have only taken 2 ounces (which is not really all that bad anyway) because he was not very hungry. What a baby takes from a bottle does not mean much in terms of hunger. But a baby will stop nursing when he is done, unless baby wishes to nurse to sleep or something.

    If I increase our nursing frequency, decrease the supplement and decrease the pumping, do you think I have a hope of getting back to EBF?
    I cannot recall your whole history, but unless there is an underlying issue, milk production depends on frequent milk removal. Yes baby being able to reasonably effectively transfer milk is an important part of it, but it does not necessarily primarily depend on baby 'emptying' the breast each time, or being a super efficient nurser. We know milk extraction frequency is the key to upping production in many cases. Think about it. You have upped your production by adding pumping sessions-in other words, by upping milk extraction frequency. Right?

    What is your ibclc saying about all this? And If baby is poor at milk transfer, what is the suspected reason?

    Also, if the baby really is so poor at milk extraction that it will harm your supply because your breasts remain too full after nursing, a little pumping or hand expression right after nursing would be the remedy, more so than pumping at other times. I am not suggesting you do this, really I get it you are over it with pumping and I don't blame you. I am pointing out that you could do this, on occasion, if you wanted, if baby had a particularly poor nursing session and won't take the breast again, and you are thus concerned about production.

    If I increase our nursing frequency, decrease the supplement and decrease the pumping, do you think I have a hope of getting back to EBF?
    yes. Your production is already there! Right? So the next step is getting baby back on the breast exclusively. certainly there is far more of a hope than if you wean off the pump and do not increase nursing frequency.

    And while it is certainly a judgement call you will need to make, I would rather see you supplement with formula (if needed) than prematurely end your nursing relationship with your baby because pumping is making you so miserable.

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