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Thread: Trying everything, exhausted with little results

  1. #1

    Default Trying everything, exhausted with little results

    I am a new mom and my little girl is 16 days old. I really want to breastfeed however we are running into many roadblocks. We are really struggling and it is wearing me out.

    She was born at 7.5 and left the hospital at 6.10. In the hospital, her latch was immediately good. The nurses seemed ok with how everything was going. A lactation consultant came in and we began discussing more....we realized my milk never really came in. I had a C-Section and after speaking with my mom, her milk was always in a lower supply as well. They started me on the syringe and tube feeding - while pumping after. (I am now using fengugreek as a supplement and drinking mother's milk and my supply is very good). After most feedings, I pump close to 1 oz on one breast and 1/2 oz on the other. Sidenote: my left breast always seems fuller and I pump more...why?

    My husband and I did the syringe, however, it was extremely exhausting and hard to get the tube in the right place. We went in to have her weighed right after we left the hospital and she was down to 6.8 (10 1/2 % of birth weight). I was immediately concerned. One lactation consultant said she was undernourished and I about lost it.

    After that, we started feeding 30 min at the breast, pumping 20 minutes and bottle feeding 1 oz with mostly breastmilk and some supplement. I thought surely she would gain weight with all of that...

    We went in a week later and she only gained an ounce. You can't imagine my disappointment.

    The lactation consultant watched a feeding and believes that my girl is not transferring any milk from me. She will suck but is not really swallowing. She definitely swallows with the bottle. Now they have me breastfeeding for 30 min, pumping for 20 and bottle feeding 1 1/2 oz - mostly breastmilk. This is a lot and it is definitely draining.

    I need suggestions for the following issues:

    • transferring milk from my breast to her (swallowing). I have read that it could be due to engrogement, or a slow let down.
    • keeping her awake at the breast


    I have tried pumping for a minute or so before she comes to the breast to help with let down. This seems to help a bit but she gets sleepy soon after and stops sucking. I try everything to keep her awake. Cold washcloth, pumping her arm, talking to her, etc.

    Please help!

  2. #2
    Join Date
    Aug 2012
    Location
    Nashville, TN
    Posts
    513

    Default Re: Trying everything, exhausted with little results

    I know you will get some great advice from the experts here. I just wanted to send a note of support. It's such hard work feeding a baby. I had no concept till I gave birth last year. You sound very determined. Hang in there and here's hoping some of the amazing moms on this forum chime in soon.
    1st time mom over 40 to Alex(andra) b: 7/14/12

  3. #3
    Join Date
    Apr 2013
    Posts
    11

    Default Re: Trying everything, exhausted with little results

    First things first do not beat yourself about this ,as having a c section is hard enough and I know because I've had 3.to try to wake the baby enough to feed maybe wrapping him up well and taking him outside for a few minutes I found that the fresh air helps wake them and sometimes gives them an appetite.Make sure you put as much of the breastin the mouth as possible.also I would DEFINATELY start putting plenty of nipple cream on the breasts because you do not want to develop sore nipple as that will only make the whole situation worse, mine were actually bleeding during feeds.it is not a problem to feed the baby a bottle of formula if you have to for these very good reasons:it will nourish and satisfy baby and when she is less stressed is more likely to feed.second it gives you a break at least knowing she is satisfied,you can keep pumping.i has to give my baby some bottles due to sore nipples and generally being exhausted as she is my sixth child.although I wanted to exclusively breastfeed it stressed me out so I had to deal with the situation as best I could.good luck and get professional help.

  4. #4

    Default Re: Trying everything, exhausted with little results

    Don't give up hope mamma! If you are producing enough milk now, that is half the batle won already. NOw it's time to concentrate on getting that good milk into baby in a way that works for you.

    Has your IBCLC talked to you about trying the at the breast supplementer again? I know it was hard in the hospital but everything is hard when you have just given birth and just had abdominal surgery! Hopefully you are starting to heal and are more mobile now. An at the breast supplementer (and there are a few different kinds) would allow you to supplement at the same time as baby is nursing, which would cut down on that total feed time you are struggling with. Here is a nice article on why these can be helpful when mom is struggling with the nurse-pump-supplement grind, and it also explains how different kinds might work better for different situations http://cwgenna.com/smartnothard.html

    If you make enough milk, there is some reason your baby is unable to transfer it. Why does your IBCLC think this is happening? Is there any possibility there is a tongue tie or lip tie that needs addressing, or that suck training might help?

    The following is just for general info, since many moms and expecting moms read these forums- I am confused about how anyone determined that “your milk had not come in” while you were still in the hospital? Did I understand that correctly? It is entirely normal for milk to not become abundant until about day 3, before that, mothers makes the special ‘first milk’ called colostrum and it is very scant and yet all a newborn needs.

    it is pretty typical for it to take a day or two longer for the more abundant milk to arrive after a c-section. As long as baby is nursing frequently and getting colustrum, supplements are not usually needed even when there is this slight delay.

    Also more than typical weight loss is common in the first few days after a c-section or any birth where mom received lots of IV fluid. These days, 'typical' or normal weight loss in the few days post birth is considered to be up to 7% of birth weight, and just a few years ago up to 10% was considered not all that alarming. So a baby losing 10.5% after a c-section is not all that unusual. What is very unusual is that even with all the interventions your baby did not start gaining after those easrly days.

  5. #5

    Default Re: Trying everything, exhausted with little results

    Sorry I did not mean to ignore your final questions, I got called away. Ok, so,

    transferring milk from my breast to her (swallowing). I have read that it could be due to engorgement, or a slow let down.
    As far as I am aware, baby not being able to extract milk well is much more usually a baby centered issue than a mom or breast centered issue. Baby cannot get a good latch or cannot suckle effectively for some physical reason, some of which can be ‘treated’ with practice and training, others may need treatment. I touched on some of those concerns above, and your IBCLC should be looking for signs of such issues.

    Are you engorged? This would mean your breasts feel very hard and full between feedings/pumping and, sometimes, don’t soften well after nursing or pumping Yes extreme engorgement can make it difficult for a baby to latch well and can cause the breasts to get so congested it impedes milk extraction, and engorgement also causes other issues. But it’s an obvious issue-your breasts would feel tight and full, even hard-and this would also probably affect pump output.

    Slow letdown would also typically present when pumping as well. Relaxation techniques can often help with this, I think there are herbs as well that address slow let down specifically. But slow let down would have to be pretty extreme to cause a baby to never get enough milk, unless baby is not nursing long enough-in the newborn period, nursing sessions of 30-60 minutes are not unusual.


    keeping her awake at the breast
    switch nursing (switching sides at least once or several times during a feeding) DO NOT do this if you are engorged, it also increases milk production.

    Breast compressions? http://www.breastfeedinginc.ca/conte...agename=doc-BC

    Also I would think suggest you think about it less as keeping baby awake as keeping baby actively sucking. Most babies can nurse effectively while asleep.

    Stroking baby’s back and legs, gently squeezing hands and feet, particularly ‘pumping’ (repeatedly squeezing) the hands and feet can get baby suckling fast again.

    I used to gently jiggle my sons chin to ‘rev him up’ again.

  6. #6

    Default Re: Trying everything, exhausted with little results

    Thank you for the advice. I have seen some progress in more vigorous eatings. The compression really seems to help her, as well as the switch nursing.

    I do have several more questions:

    1. How much (in general) should i be pumping after a good feed? in reading through some of these forums i feel as though my milk supply is lower. I generally only pump an oz (or under) after a feeding. Always more on left....

    2. If i were to start the syringe again...how do I do it myself while still cradling her? Also, will she still be receiving milk from me? How long would I be on each breast?

    Thank you!

  7. #7

    Default Re: Trying everything, exhausted with little results

    How much should you be able to pump after a good feed. Hmmm. I have no way to answer that. The fact is pump output is a truly terrible way to measure milk production. For one thing, if your baby is nursing well and often at the breast, anything you pump is extra. If you are pumping after feeds in order to stimulate production, then don’t worry about how much you pump, that is not really the point. The point is to make sure the breast is as ‘empty’ as possible in order to stimulate production.

    If the baby has nursed really well, then you would not expect to see much milk available right after baby nurses, right? On the other hand, some mothers have very large breast 'capacity' which is not the same as milk production. And those moms might still pump lots of "extra" milk right after a good feed. On the other hand, other moms just do not produce well for a pump, ever, and how much they get when pumping means nothing.

    Kellymom suggests that when a mom is exclusively nursing, (not separated from baby and nursing around the clock) pumps, then a per session pump output of between 1/2 ounce and 2 ounces is normal. http://kellymom.com/bf/pumpingmoms/p...ping_decrease/

    Also it is normal to get more milk from one side. Totally normal.

    I am not sure about the syringe. I am talking about using an at the breast lactation aid or supplementer, which I guess can be used with a syringe, but I am suggesting using one where the milk is in a bottle or bag, maybe around moms neck, or on a table next to mom, and then a tube brings the milk to the breast when baby suckles. I have never used one personally so I am not sure of the finer points. But yes it takes fiddling and practice to work these things, but the idea certainly is mom and baby can do it without assistance.

    more on using a lactation aid

    http://cwgenna.com/smartnothard.html

    http://www.nbci.ca/index.php?option=...tion&Itemid=17

    a video on this page shows 'home made' one being used, it's about half way down-'inserting a lactation aid' http://www.nbci.ca/index.php?option=...tion&Itemid=17

  8. #8

    Default Re: Trying everything, exhausted with little results


  9. #9

    Default Re: Trying everything, exhausted with little results

    yes theoretically baby would still get milk from you and the lactation aid at the same time. You would switch sides as you and baby prefer.

  10. #10
    Join Date
    Mar 2013
    Location
    DC metro area
    Posts
    7

    Default Re: Trying everything, exhausted with little results

    I also had a sleepy baby who just wouldn't do much on her own. At our first test weighing, where you weigh the baby, feed her, and then weigh again, she hadn't transferred any milk at all. Nothing I tried worked at all, and I tried every single suggestion. I would nudge, poke and manhandle her and still only get a few measly sucks and *maybe* a swallow. I tried giving a half ounce by bottle before each feeding to wake her up, I tried finishing the feeding at the breast, I tried breast compression to try and force her to suck more, I tried pumping first to eliminate the wait for letdown. I can't understand why but even though we tried everything many different times, nothing seemed to work for us. We had to attempt breastfeeding for as long as she would allow, then follow that with a bottle, where she'd eagerly suck down 3 ounces, then pump. We tried other methods other than the bottle once she started to seem like she was refusing to feed at the breast more often, but could not make cup feeding or the supplemental feeding system work for us. The only routine we could work with was the breast-bottle-pump. The only things that have saved me was that my LC got me pumping early and often so that I have a full milk supply to work with in getting her to breastfeed better, and even though she seemed to be refusing and it sometimes seemed like we were worse off that day the the previous day, we still did keep trying to feed at the breast. She's ten weeks old now and we have had a lot of success - not because of any magic advice or because we finally figured it out - just because we kept trying and each day she learned and became a slightly better breastfeeder even though you couldn't tell it was happening. We even had days when she would not latch even once all day, but I still tried every feeding to get her to breastfeed and now, these days, she will transfer 3 ounces and we can just nurse without the bottle top-off most of the day. We follow with a bottle of expressed breastmilk maybe 3 times a day, which is great success for us and I am hopeful we will be able to eliminate those soon too. This is all to say that sometimes even when none of the advice works, sometimes pure perseverance will be enough if you have the time, energy, resources and support to keep at it for what seems like waaay to long (which I know not everyone does have enough of those things.)

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