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Thread: Low confidence nursing my 4 week old advice! (kinda long)

  1. #1

    Default Low confidence nursing my 4 week old advice! (kinda long)

    At my LO 2 day check up she lost a lot of weight (7lbs 1.5 oz to 6lbs 2oz) and ended up with high jaundice and put on phototheraphy. From there they had me supplement with a SNS after each feeding because they said she was only getting a fourth of an ounce during nursing. The following week we went back in for another LC appointment and she had gained to 7lbs 2 oz. During a nursing session there, they said that she took in a quarter on an ounce. She then recommended that I take supplements (more milk plus) and let her nurse and if she still was hungry to nurse again and if she was still hungry to give her a minimum of an ounce of expressed milk.

    So, I have been nursing both breast then giving her 2oz of expressed milk and then pumping after each feeding. I am pumping around 1.5oz to 2oz (total from both breast) each time. I want to start EBF and stop giving her expressed milk but I do not have enough confidence to do that yet as I don't want her to "starve". I always start the day wanting to try but by mid-day I start worrying that she's not getting enough and end up pumping after a session and giving her expressed milk again. When she nurses I hardly hear her gulping or swallowing, if I do, it is for a short period and it stops so that worries me that she isn't getting enough.

    To point out, I do have breast augmentation and the LC said that might be causing me to have a slow let-down. I am also taking More Milk Plus and Moringa.

    I know to tell is by checking for wet diapers but I haven't gone long enough without giving her expressed milk to do that..

    Any advice in what I should do? I feel like she's getting use to the SNS as the flow is faster because during some feeds she is extremely fussy and yanks off or pushes the nipple out until I put the straw in which is making me want to start her on bottles instead of the SNS.

  2. #2
    Join Date
    Mar 2013
    Location
    Illinois
    Posts
    102

    Default Re: Low confidence nursing my 4 week old advice! (kinda long

    My LO had high jaundice too and it was the worst experience ever....At least your were given the option to give your baby expressed milk...they just pushed formula on my baby which made me angry and I think was the culprit for so many problems at the beginning tyring to BF. I feel for you mama!! I have heard some of the leaders comment about going on a BF vacation were you kick back and EBF all day for a couple of days...maybe that would be a good way to start...
    Happy Mama of 4 beautiful boys ages 14, 10, 7 and the newest member of the family:
    Damian Gabriel 2/13/13 , , twice a day at work, and finally successfully. We never gave up and we are as happy as can be !!

  3. #3
    Join Date
    Aug 2012
    Location
    Nashville, TN
    Posts
    525

    Default Re: Low confidence nursing my 4 week old advice! (kinda long

    I can't tell if your LO is still getting phototherapy or what the biliruben level is but I insisted my Ped give me a biliblanket to do therapy at home. The biliblanket is portable and has a chargeable battery -I could carry DD and it everywhere. And nurse with it too.
    1st time mom over 40 to Alex(andra) b: 7/14/12

  4. #4
    Join Date
    Jun 2009
    Posts
    5,420

    Default Re: Low confidence nursing my 4 week old advice! (kinda long

    have you had a weight check since two weeks of age?
    Is the jaundice a concern any longer?
    If baby is gaining well and no longer jaundiced, I agree it is definitely time to start working on weaning off the supplements and the pumping. But your IBCLC should be counseling you on how to do this safely and with confidence. Were you given some way to follow up with her? I cannot stress how important it is to keep checking back with your helper when working on breastfeeding issues especially in the early weeks. Things change so rapidly during this time-milk production, babies nursing ability, baby’s wakefullness, etc, all should be improving, often dramatically. So what is relevant advice one week may be totally unneeded the next.

    Your baby taking in a quarter of an ounce at two days old is entirely normal. If your baby was only getting a quarter of an ounce at age two weeks, (by which time you want to see per nursing session intake of about 2 ounces or more) then the question is WHY. Slow letdown would not completely explain such a small intake imo. There are many other possibilities. Maybe this was just a not great nursing session. Maybe you and/or your baby were tense. Maybe there is/was something going on with baby's latch and sucking ability. If your letdown is slow, then encouraging baby to nurse longer or more vigorously would probably help, right? but instead you say you were told to supplement after nursing. Yes it is important to supplement if your baby is not gaining, but must it be AFTER a nursing session? Why not before? why not during? I don't get it. I am not saying that advice was wrong then, I am saying it may no longer be relevant NOW.

    You cannot really tell if a month old baby is getting enough via wet diapers. New studies show that is not an accurate indicator of baby getting enough milk to grow as needed. Certainly it is a good sign if baby is wetting lots of diapers, and it is an even better sign if baby is pooping with normal frequency (at least three 50 cent piece sized poops a day-poops with some volume, not just streaks.) But it is now thought that weight gain is the best indicator of baby getting enough milk. So perhaps more frequent weight checks always done correctly and on the same scale would be helpful to give you confidence. Not daily, that is too frequent. But maybe weekly? And know what you want to see. Almost an ounce a day or, more accurately, 6 ounces a week (or more) is good weight gain. Don't worry about your baby’s birth weight and the big drop anymore. For one thing, that tremendous drop was almost certainly at least in part due to the typical inaccuracy/inflation of birth weights. I suggest, look at how much baby has gained since her last weight check as your best indicator of how things are going now. And remember the rules of weight checks-baby naked (or in same type of dry diaper) and on the same scale EVERY time, and YOU double check the numbers and ask for a re-weigh if there is any question.

    IF your issue is low milk production, the book Making More Milk is a fantastic resource. Kellymom.com has the best online information on low production and galactagogues in my opinion.

    You cannot tell if what your milk production is by how much you pump. If you are pumping in order to stimulate production, then there is no reason to worry about how much you pump. If needed, supplement with what you get but try not to stress about how much you pump. What you are able to pump sounds like normal pump output for a mom who is also nursing. If baby is extracting milk frequently and well and you make enough milk for baby, anything you can pump is "extra."

    How often do you nurse? If it's not at least 10 times a day, I would suggest upping the frequency of NURSING. I am not suggesting you pump or supplement more, that is only needed if you are not producing enough milk/baby is not gaining well now and I have no idea about that. But nursing with normal frequency (10-12 times a day or more for this age) will help your baby get enough milk.

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