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Thread: if only mother's milk were enough

  1. #1

    Default if only mother's milk were enough

    Hello, please help!

    My baby is full term, but small (5 lb, 5 oz), and has since regained his birthweight after a week... but this was because we had to supplement on formula. My breastmilk simply was not enough to sustain him and he would have starved if we didn't start formula. He initially was unable to latch at the time.

    It's about 2.5 weeks later, he finally learned how to latch, and my baby is still doing breast first, then formula. But as he grows, his demands are more, and my supply doesn't appear to be catching up with him. He needs approximately 60 cc's formula to supplement after trying with the breast for 45 minutes or more in order to appear "satisfied".

    On top of this, he's a sleepy nurser. He starts out strong with a good latch for a minute or two of active nursing, then wanes off to sleep with light suckling every 5 seconds. I would switch nurse to wake him up (sometimes successful for that minute or two of active nursing), but really, this process is taking me almost an hour to nurse. He takes an additional 20 minutes or so to drink the formula from the bottle (which he does wake up to).

    Each nursing session (every 2-4 hours) feels so frustrating and all I want to do is provide my breastmilk versus formula, but it does not seem possible with my little one.

    Any suggestions? thank you.

  2. #2
    Join Date
    May 2006
    Posts
    20,841

    Default Re: if only mother's milk were enough

    Welcome to the forum and congratulations on the new baby! It's wonderful that you got him to latch on and nurse. Non-latching babies are a HUGE challenge and the fact that you were patient and persistent for 2.5 weeks is awesome!

    It's really common for babies to take larger and larger supplements as time goes on, because supplements- even when absolutely necessary!- cause decreased milk supply. Milk is created on a supply = demand basis, so every time the baby gets a bottle instead of nursing more, your body misses the "demand" cue and reduces the supply side of the equation. But the first thing to know about this situation is that it is fixable! Increase demand, and your supply will increase as well.

    When a baby is nursing well, you phase out the bottles and increase the amount the baby nurses. This link from kellymom.com explains how to drop formula supplements a little at a time: http://kellymom.com/bf/got-milk/basi...rease-formula/ Now, it sounds like your baby is a very slow and sleepy nurser, and that complicates things a bit. Babies who aren't yet good nursers sometimes can't demand effectively enough to increase mom's supply all by themselves. But this situation is fixable. Your baby will get bigger and stronger and will become a better nurser. And while he's working on that, you can go get some hands-on help from a lactation consultant, preferably an IBCLC. A good LC will evaluate what's going on and help you improve things. She can also help you get a tool which I think you really need right now, which is a good pump- preferably a hospital- grade rental- with correctly sized shields. If the baby is unable to nurse well enough, you use the pump to mimic the demand the baby would give you if he could. This means pumping every time you give a bottle, or more frequently if possible. Once you are able to use pumped breastmilk for all supplemental feedings, your supply will be matched to baby's needs. The LC may also be able to help you find an alternate way of supplementing your baby. Bottles can sometimes cause babies to be a bit lazy at the breast, since they quickly learn that their need will get met with a bottle even if they don't feed very enthusiastically at the breast.

    Some tips on waking a sleepy baby:
    - A cool baby is a more alert baby. When it's time to nurse, strip baby down to a diaper or onesie or at least dress him rather lightly, and keep a fan blowing in the room where you nurse (but not directly on the baby).
    - An annoyed baby is more alert, so while he's nursing tickle the soles of his feet or rub against the grain of his hair using your hand or a cool damp washcloth.
    - Keep the lights rather dim. Young babies sometimes close their eyes in response to bright light.
    - Use breast compressions to speed milk to the baby when you feel like he's starting to transition to light, fluttery, sleepy sucking
    - Try switch nursing. When baby is drifting off to sleep at the breast, take him off the breast, burp him or change his diaper to wake him up a bit, and switch him to the other breast. Repeat the process as many times as possible, until he will no longer wake.
    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
    Join Date
    Feb 2007
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    1,710

    Default Re: if only mother's milk were enough

    As always, mommal gives awesome advice. I would just add one thing. I know that when I ended up having to feed by baby formula in the first few weeks, my confidence in my own body's ability to feed by baby took a huge hit. This can make it harder to wean off the supplements because of the whole "supply and demand" thing - thinking you can't feed your baby can become a self-fulfilling prophecy. A baby seeming "satisfied" is not a good indicator of whether they need supplementation - most babies will willingly down formula from a bottle even if they are getting enough from the breast. Look for diaper output and whether your baby is growing as the main indicators of whether he is getting enough (and weighings with a special scale before/after a feeding if you need to know more specifically how much milk is getting transferred in a feeding). Hang in there, you can do this!

  4. #4

    Default Re: if only mother's milk were enough

    Thank you so much! I feel so encouraged and hopeful from your responses. I will keep all of this in mind when I consult with the LC and doctor.

  5. #5
    Join Date
    May 2006
    Posts
    20,841

    Default Re: if only mother's milk were enough

    Let us know how it goes!

    One thing you might want to suggest is doing a weigh-feed-weigh test at the LC's office. You weigh the baby, then nurse the baby, and then weigh the baby again- and by subtracting the before weight from the after, you get an accurate measurement of how much milk your LO took in while nursing. Now, the problem with weigh-feed-weigh tests is that a single measurement doesn't tell you much, since a baby may feed well at the LC's office and then not so well at home, or vice versa. But if you learn how to do the measurements and then take a rental scale home, you can use the weigh-feed-weigh method to know when you need to supplement and when you don't.
    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

    Default Re: if only mother's milk were enough

    **Update:

    The LC visited our home to assess the situation. She noticed that DS has what they call "tongue tie" which is what is contributing to the continued pain and poor suction. She also noticed that I have become his pacifier (which has kept me on the couch for an hour and half per session) and that he has been truly relying on the bottle for nutrition. My supply was further reduced after his growth spurt, whilst at the same time having a plugged duct on my left side. It's like I'm starting from square one. Just my luck.

    The current solution from the LC is to work on rebuilding my supply by SNS (to remind him that food comes from my breast), and to pump right after. She also showed me how to get him to better latch on with less pain.

    The pediatrician also very recently discovered the tongue tie, and we will be bringing him in tomorrow for a procedure to get that fixed. (poor little guy, he just had a circumcision yesterday!) The doctor also suggested I take fenugreek 3 times a day.

    I'm relieved to know exactly what is going on now, and to have some work around solutions in the process. I just hope that my baby will change his mind about the bottle and that I'll eventually be able to supply enough milk to discontinue SNS. I had a feeling that I never really ever produced enough in the first place.

    I can't help be continue to feel frustrated though. So far, breastfeeding has not been very enjoyable for me. I hope this procedure helps.

  7. #7
    Join Date
    May 2006
    Posts
    20,841

    Default Re: if only mother's milk were enough

    Thanks for the update! I am so glad that the LC discovered the tongue tie, and that the pediatrician is taking appropriate steps to fix it.

    I hope that nursing soon becomes more enjoyable and easy and that you can ditch the supplements and the SNS and the pump. Nursing a newborn is exhausting enough, even without the extra hassle! It's also kind of unrewarding- at least for a lot of women. Newborns don't give back the way older babies do- they don't smile at you or reach up to give you a gentle touch. And even at the best of times they are difficult to position and keep awake, and they can take forever to get a meal. But all those things change as the baby gets bigger, stronger, and more interactive.

    Let us know how things go as you move forward!
    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!"

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