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Thread: Nursing Problems (?) My 4 Week Old Angel...

  1. #1
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    Default Nursing Problems (?) My 4 Week Old Angel...

    A week and a half ago my little girl (was 2 wks old at the time) saw our Dr. She
    had only put 2 oz on over a 2 week period. Exclusively Breast feeding. When she
    was born she had a lot of mucus and spent her first 24 hours chocking and spitting
    up lots of it. She did well nursing at that point. Since then - she continually
    falls asleep while nursing . . . during the first couple of weeks she would nurse
    enough to 'take the edge off' her hunger - but no more - and never drained the milk. She had grown an inch in 2 weeks, and her head grew a full inch as well - but almost no weight gain. Dr. wanted me to start supplementing her with formula - not what I wanted so we talked about supplementing with breast milk. I bought a pump and
    have been supplementing her 1.5 to 4 oz every feeding. She nurses approximately every 3 hours - last couple of days has been more - but again - she constantly falls
    asleep at the breast. Nothing I do wakes her for more than a few sucks. I do breast compressions while she's nursing to encourage her to drink - and she does swallow - but then stops almost immediately. Needless to say - she drinks the bottle very well . . which worries me because I find that she has gotten even worse
    since we started supplementing - although she does look like she's putting on
    some weight now...
    I worry that she's not latching on properly - although I have no pain now and my milk supply is good. Today - I stretched her feeding to 4 hours instead of the 2 to 3 that she normally goes and she nursed better . . . should I be trying to hold off a little longer before feeding her so she is very hungry? I'm worried that if I do
    this she won't put the weight on that she needs to - Dr will insist that I go to formula if she doesn't show any improvement this Tuesday. I'm confident that she will - but worried that I'll have to pump and supplement continually now... .
    Any thoughts or suggestions would be so appreciated. I've scoured this forum and found lots of great info but need some encouragement right now. Thanks everyone.
    Life is Beautiful.

  2. #2
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Hi kessy and welcome to the forum. Congratulations on your new baby!

    You are working so hard to nurse your baby. Just know lots of moms have issues like this in the early days and go on to happily nurse their babies!

    Have you seen an IBCLC? (Board certified Lactation Consultant) since you were told to supplement? If a baby is not getting enough milk by nursing, it is important to find out why. Supplementing only treats the symptom, not the problem.

    Can you tell us a little about your baby's birth? Was it in a hospital, did you receive IV fluids, etc.

    What was baby's birth weight? What was baby's lowest weight? What was baby's two week weight? What about baby's output-poops, etc. Was that normal-at least 1 for each day of life until about day three, then 3 or more a day?

    It is normal for a hospital born breastfed baby to lose weight in the first few days after birth. The typical rule of thumb that shows all is well is for baby to be back to birth weight by 10-14 days of age. How short of this did baby fall?

    Today - I stretched her feeding to 4 hours instead of the 2 to 3 that she normally goes and she nursed better . . . should I be trying to hold off a little longer before feeding her so she is very hungry? I'm worried that if I do
    A breastfed baby less than about 6 weeks old usually NEEDS to nurse at least 10 to 12 times per 24 hour day. They need to nurse this often to ensure they get enough and to get mom's milk production where it needs to go. So trying to stretch times between feeding baby is not recommended. Nursing frequency is more imprtant, generally, than how long baby nurses each time. And you do not need to worry about baby 'emptying' the breast. This never really happens as your body is always making milk.

    This article explains about nursing frequency http://kellymom.com/bf/normal/newborn-nursing/
    Last edited by @llli*lllmeg; February 22nd, 2013 at 10:41 PM.

  3. #3
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    with LLLMeg. Definitely do NOT stretch out the feedings- when there is a problem with weight gain or milk supply, frequent feedings are ideal. A hungry baby does not necessarily take in more milk or feed better than one who isn't yet all that hungry.

    Tips for waking a sleepy baby:
    - Keep the lights dim. New babies sometimes close their eyes in response to bright light.
    - Keep her cool. When it's time to nurse, strip her down to a single light layer or even just a diaper if your house is very warm, and keep a fan blowing in the room where you nurse (though not directly in the baby).
    - Annoy her. Tickle her feet or rub against the grain of her hair using your hand or a cool, damp washcloth.
    - Do breast compressions as you nurse to keep milk moving to the baby.
    - Try switch nursing. When suckling slows and baby seems to be drifting off to sleep, remove her from the breast, burp her or change her diaper, and put her onto the second breast. Repeat the process as many times as necessary, until the baby will no longer wake.

    ETA: what sort of pump do you have and how often are you using it every day?
    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!"

  4. #4
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Thanks for your responses . . .

    Baby was 8lb 8oz at birth and dropped to 8.1. At her two week appointment with the doctor she weighed 8.3 but had grown an inch longer and her head had also grown a full inch. Dr. was a little confused at her lack of weight gain and said that she did not look malnourished at all. He figured it was a lack of supply . . . although she had more than enough wet and dirty diapers right from the start - which is why I thought she was doing okay. I was really upset to find that she had gained almost no weight at that point.

    She was born in a hospital and at the last 1/2 hour they did put an IV into me. I was induced via a gel put onto my cervix and had my water broke 3 hours later by the Dr. Baby came 1.5 hours after that.

    I have a Philips Avent pump (electric) and use it every time I nurse except sometimes at the mid night feeding. I pump off anywhere between 1.5 to 4 oz each time and 'top her up' with the bottle when she has spent a good amount of time at the breast. I have seen improvement from time to time with her nursing - like yesterday with that one four hour stretch (that only happened the one time btw . . . I think I may have given the impression that I was forcing her to wait - which isn't the case - I feed her every 3 hours, except for the occasional 4 hour stretch through the night but was wondering if extending her nursing sessions would help . . . ). Lots of times we cluster feed - which seems to me like it's mostly for her comfort. If I don't actually hear her swallowing - does that mean that she is not feeding properly? Or is she actually still getting some milk when I don't hear the swallowing sound?

    Since I've started supplementing with the bottle - she's definitely more satisfied. Happy also as she's started to make eye contact and smile. I am just so worried that she'll be reliant on me pumping for the duration of breastfeeding - or that something else is wrong... (the doctor did check her out thoroughly - including her tongue to make sure she was not tongue tied..) She has lots and lots of very wet and dirty diapers each day.

    I will be seeing a LLL consultant (or at the very least talking to) on Monday. I just don't know if this is something she'll grow out of or not...

    I should mention that last night she slept for almost 6 hours...she'd had a couple of very fussy days prior and slept no longer than 2 hours round the clock... we were both exhausted . . . thing was...when she woke up this morning I expected her to be really really hungry. I felt awful that we'd both slept so long. But as she started nursing . . . she stopped sucking and started falling asleep again . . . I did breast compressions to get her sucking again . . . moved her around . . . changed her . . . but she would at best only suckle a few times then stop again. I pumped 4 oz of milk and fed her via bottle after an hour of trying to wake her up and keep her nursing. THIS is what worries me most . . . shouldn't she need and want to nurse after such a long night? If I didn't have the pump . . . how would we deal with this??
    Life is Beautiful.

  5. #5
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Your four week old is smiling? Wow! Sweet baby!

    Based on your pump output, it does not sound like low milk production. My guess is the weight was off due to use of different scales. I am sorry your doctor saw a happy, healthy, growing baby and diagnosed low production based on one weight check. However, if it was low production, it sounds like you have solved that issue by pumping as your production now sounds good.

    Speaking very briefly and generally, a typical feeding at the breast when a baby is under three weeks of age is 1-2 ounces each feeding. After two weeks, it's 2-3 ounces, and after a month, it's 3-4 ounces. But this can vary quite a bit and still be normal and fine, as long as baby is getting enough milk OVERALL, which by about one month is approximately 30 ounces a day. (And it stays that much from now on-a baby does not reqire more breastmilk per day as baby grows.) If a baby is being fed every 3 hours, that is 9 times a day and may not be enough for some babies. So I think we were suggesting to just go ahead and cluster nurse etc. as you have been doing. Cue feed as long as baby is nursing often enough-at least 10-12 times a 24 hour day. This is normal and healthy newborn behavior. We were just encouraging you to keep doing what you were doing and not try to space out feedings because, as you said you suspected, that is generally not a good idea for several reasons but especially if baby is not gaining well.

    Anyway, to your questions- If you are nursing and then feeding your baby what you pump via bottle, it's possible baby is getting more than baby needs each feeding. This would explain long stretches of sleep. There is also the possibility baby is getting used to the flow from the bottle and this can make it more difficult for baby to nurse, which would explain baby not being as interested in nursing. (This is why bottle introduction this early is so often problematic.) I understand this is what your doctor told you to do! But it may be time now to do a weight check ON THE SAME SCALE and see where you are. Average weight gain after about the first week is about one ounce a day. If your baby is now gaining about that since the last weight check, maybe you and your doctor can agree to stop the pumping and bottles and just nurse again.

    The other thing that might be causing overt sleepiness and/or slow weight gain is if baby cannot extract the milk well. Milk is there but baby can't get it out efficiently. You are already doing breast compressions so that is good. Now having someone who is trained or at least experienced with nursing watch a feeding would probably be helpful. A before and after nursing weight check would give you more information as well.

    I will be seeing a LLL consultant (or at the very least talking to) on Monday.
    Are you planning to see an LLL Leader? Or a Board certified lactation consultant? (IBCLC) Or someone who is both (some are.) BTW did you make an appointment to talk to someone on Monday? Or is this at a clinic that is only open on weekdays? If not and you just think you have to wait until Monday to call, that is not typically the case with either LLL Leaders or IBCLCs. Usually they can be reached or at least left a message on weekends. Personally I prefer weekend calls. I am a Leader only not a lactation consultant btw!

  6. #6
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    btw i forgot tp add-
    I am just so worried that she'll be reliant on me pumping for the duration of breastfeeding
    This is very unlikely. I see every indication you will be able to get back to exclusively nursing and soon.

  7. #7
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Quote Originally Posted by @llli*lllmeg View Post
    btw i forgot tp add- This is very unlikely. I see every indication you will be able to get back to exclusively nursing and soon.
    Likewise. Your pump output is terrific and I don't see any reason to think that you'll be stuck doing this forever.
    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!"

  8. #8
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    I feel a lot better about things today. Baby has had a good nursing day and I've pumped enough off to 'top her up' PLUS store about 7 oz extra for a busy day we have coming up tomorrow.

    I was planning on making contact with a lactation consultant from a list that was provided to me from the hospital. I believe they work through and for the city health unit and are associated with the hospital.

    I'm so thankful for this site - and for your help and thoughts. What a learning curve this is! We have our doctors appointment tomorrow - so I'll let you both know how baby is doing weight wise. Keeping my fingers crossed for a good result. I'm in a much better frame of mind today - and much more hopeful. There is such a connection between body and mind - even (and probably especially) in regards to nursing and what baby picks up from mom.

    I just finished nursing babes ... while we were nursing - hubby brought up a load of laundry freshly warm from the dryer and put a large towel over the both of us . . . I thought it might make baby want to sleep - but it relaxed her and me to where she was sucking brilliantly and getting lots of milk. (Can't TELL you how happy this made me!)

    Thank you both for your words, advice - and knowledge. It's really helped me to get a better grasp on things mentally and not worry so much...
    Life is Beautiful.

  9. #9
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Quote Originally Posted by @llli*kessy24 View Post
    I just finished nursing babes ... while we were nursing - hubby brought up a load of laundry freshly warm from the dryer and put a large towel over the both of us . . . I thought it might make baby want to sleep - but it relaxed her and me to where she was sucking brilliantly and getting lots of milk. (Can't TELL you how happy this made me!)
    What a neat trick! I'm going to remember that one!

    Was it dark under the towel? Sometimes new babies will close their eyes in response to bright light.

    Looking forward to your next update.
    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!"

  10. #10
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    Default Re: Nursing Problems (?) My 4 Week Old Angel...

    Great news! Babes is now 9lbs 8oz! Dr. was shocked! (((smiles))) He thought it was amazing that I haven't been using formula! I am SO thrilled!!!

    Soo . . . now it's just a matter of keeping up with it all and encouraging baby to nurse often and well. Her sucking (when she is actively nursing) has improved a lot . . . it seems to be since more milk has come in . . . that and with my milk supply being much more ample - she's getting the milk easier to begin with and it appears to encourage her. She still falls asleep VERY easily - but we're working on that. Yesterday was a VERY busy day and hard on her. We're taking it easy today . . . lots of nursing / cuddle time, sleep and soft music.
    Life is Beautiful.

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