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Thread: Day 7 postpartum..

  1. #1

    Unhappy Day 7 postpartum..

    My baby girl was born at 33 weeks and 6 days. No NICU stay and only a few trips to the heat lamp.. She was able to room with us the two days of our hospital stay and she's latched on perfectly from the beginning.. All things considered, she is as healthy as an average newborn, excluding her low weight. Because she was born so early, she weighed only 4.7lb. She lost down to 4.1 in the two days we were in the hospital so the pediatrician suggested that we supplement with formula until my milk came in so she wouldn't lose more weight. Despite asking for breastfeeding help from the staff at the hospital, I came home basically with no idea what in the world I'm doing.

    I was told to continue to breast feed for 10 minutes on each breast before allowing her to be supplemented with formula. Then I was instructed to pump for 10 minutes to make sure my breasts were empty.

    My milk has changed from clear colostrum to what now resembles actual milk.. but even after pumping 2 hours after her last feeding, I'm only coming up with 3mL from both breasts.

    I'm about at my wit's end with feeling like I can't feed my child. She does incredibly well when she latches on and I can hear her swallowing at first, but we rarely make it the full 10 minutes on each breast without her getting agitated. When the hubby supplements her with formula, she's never fussy. She eats well and then sleeps very well. We've had no problem with spit ups and she burps fine. Sometimes I even get her to burp between breasts.

    The pediatrician said to continue to provide formula supplementation until she rejects the supplement all together. She said this is the only way I'll know that she's full of breastmilk and no longer needs the supplement. At her one week check up, the baby is up to 4lb 4oz, so she hasn't lost any weight since coming home..

    I'm just incredibly frustrated with the low milk production. Does this mean my milk hasn't actually "come in" yet? There's no noticeable difference in my breasts before I feed as opposed to after I feed. The past two days my nipples have become pretty sore and sometimes I feel a sharp tingle in them, but that's rare.

  2. #2
    Join Date
    Nov 2012
    Location
    Ontario
    Posts
    621

    Default Re: Day 7 postpartum..

    Hi mama, and welcome to the forum!

    The advice you were given sounds very strange to me! Offering formula to make sure the baby is full of breastmilk? huh?

    I don't have any experience with a preemie, but I'll tell you what I would say if your baby was full-term (just to give you something to go on until someone comes along that does have more experience in this area. I think that as long as weight gain and diaper output are ok, they wouldn't be much different). If your baby will latch, put her to the breast. At this point, your baby's tummy is super tiny, and she'll need to eat frequent, small amounts of breastmilk, both to thrive and to establish your milk supply. As long as your baby is able to nurse 10-12 times/day at least, I don't think there's any need to pump at this point. As for the feeding, watch your baby, not the clock. If she's fussy before the 10 minutes are up, burp her, change her, cuddle her, etc., and then offer the other breast. Of course she'll like the supplement better at this point - it's a lot less work to get formula out of a bottle than to eat at the breast till there's a letdown! Giving formula doesn't do any good for your supply either!

    You said you pumped 2 hours after her feeding...are you meaning you pumped 2 hours after she ate, or that you pumped for 2 hours straight? If it's the second one, that might be contributing to the nipple pain. If it's the first one, you should be offering to nurse again at the 2 hour mark, not pumping. Your baby needs very frequent offerings at the breast right now. And yes, it's exhausting, but so worth it to give her the best possible nutrition!

    My last suggestion is to see a lactation consultant if you can. The sore nipples are nothing to ignore, and with a baby that small, I think some hands-on help is warranted to get some help with positioning. You can find a IBCLC here http://www.iblce.org/home

    And of course, feel free to come here with any questions/concerns, and the mamas here do their best to help!

  3. #3

    Default Re: Day 7 postpartum..

    I think I worded that wrong. The pediatrician said that the supplementation is no longer needed once my milk comes in. She said that after each feeding, offer the supplementation. Once she refuses the supplementation, my milk is obviously in and the baby's had enough to eat from me.

    No, I didn't pump for two hours consecutively. I breastfeed her every two hours and pump once she's done when she falls asleep and will no longer latch on, despite any rousing/diaper changing. I never omit feeding her to pump. It's strictly after she's done to make sure my breasts have been emptied.

    My nipples aren't incredibly sore, just slightly a bother.

    Pumping was suggested in hopes of making my milk come in sooner. The nurse explained that it's important for each breast to be emptied completely in order to refill just a little more next time.

  4. #4
    Join Date
    May 2006
    Posts
    21,267

    Default Re: Day 7 postpartum..

    The pediatrician gave you ridiculously incorrect information. Babies LOVE to suck, and because they love to suck they will usually take a bottle even after a completely adequate feeding. And because bottles deliver very easy rewards- milk will come out of the bottle even if the baby has a sloppy latch, and it will come out much more steadily than from the breast- many babies start preferring the bottle. For those 2 reasons, I think that it's very unlikely that your baby will spontaneously start refusing bottles.

    Because it's so easy for babies to get hooked on the bottle, I'd love to see you try a different supplementation method. In particular, an at-the-breast supplementer like the Medela Supplemental Nursing System or Lact-Aid could allow you to forgo bottles altogether. The SNS and Lact-Aid are basically small bags of formula or expressed milk which you wear around your neck. A tube comes from the bag, and you latch the baby onto the breast and tube simultaneously. At-the-breast supplementers are great because your baby will get the idea that ALL her meals come from the breast, and therefore she will be less likely to pop off the breast and fuss in order to get the bottle.

    Some questions for you:
    What sort of pump are you using?
    How does pumping feel?
    How was your birth? Did you have any postpartum hemorrhaging, or any problems related to the delivery of the placenta?
    Do you have any history of PCOS or thyroid problems?
    Are you currently using any form of hormonal contraception?
    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!"

  5. #5

    Default Re: Day 7 postpartum..

    I'm using the First Years miPump double electric pump.
    Pumping is fine. It feels similar to what I feel when she latches on.
    Birth was great. I had no complications at all, aside from the delivery being so early.
    I have no history of PCOS or thyroid problems and I'm using any contraception or taking any medications.

    Today's been even more frustrating for me because she refuses to latch on at all today. She just cries..

  6. #6
    Join Date
    May 2006
    Posts
    21,267

    Default Re: Day 7 postpartum..

    Thanks for answering those questions. The one thing that really jumps out at me is that you are using a light duty pump meant for a mom whose baby nurses well and who therefore does not rely on the pump to maintain/increase supply. You're pumping for a premature baby and trying to increase supply- those 2 things demand a really good pump. Ideally, you'd want to use a hospital-grade rental with correctly sized shields. That should give you a much greater yield and much more stimulation than the First Years.

    Can you see a lactation consultant, preferably an IBCLC? A good LC/IBCLC can rent you the equipment you need (or tell you where to get it), evaluate your baby's nursing, give you tips on positioning, and work with you to handle the special challenges of a small, premature newborn. She should also be able to set you up with a nursing supplementer.

    Keep offering the breast and keep pumping, mama! I know this is horribly frustrating and upsetting, but you're doing something amazing every day that you simply refuse to give up.
    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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