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Thread: PLEASE HELP!!-Want to move from supplementing to EBF

  1. #1

    Unhappy PLEASE HELP!!-Want to move from supplementing to EBF

    Hi,

    I am a new mom of a 4 week old baby. He was born at 38 weeks and I put him to breast almost immediately he was born. He became good at latching instantaneously. I nursed him for the 2 days while we were in the hospital. At the end of day 2, when we were about to leave the hospital, his pediatrician came for check-up and mentioned that he is very hungry and has lost considerable weight in the two days, so give him formula. (His birth weight was 6lbs,6oz and 2 days later it came down to 5lbs,7oz). So we had to give him a bottle.

    She said that when my milk comes in, I can stop the bottle. But, I never felt any engorgement in my breasts, so I never knew when my milk came in. But I kept on nursing him on demand. Four days after birth during his first visit, his weight came back up to 6lbs,3oz (3oz short of the birth weight). After a week, I started nursing him exclusively and stopped formula completely, including at night. I checked his urine diapers, since I thought that is an indication of how much is he getting. He had a good count throughout the day but the diapers were not soaking wet. 3 weeks later, we went for his visit again and his weight was 6lbs,4oz. He had gained only an ounce of weight in the past 2 1/2 weeks. This concerned the ped. and she advised to start bottle again. I was very upset over this but everyone in my family thought I was starving him, and so asked me to give the bottle, saying if he is happy, then what's the problem.

    Since day 3 after birth, whenever I pump, I get only around 20-25 ml of milk. When I breastfed my baby for 2 weeks, he used to seem hungry ALL the time, never satisfied. So, I nursed him on-demand.

    Now, I want to EBF him and want to wean him from formula. I am still nursing him every 2-3 hours before giving him a bottle. If I try to nurse him on demand now, without giving him a bottle, he seems frustrated and cries after I nurse him, and nothing comforts him except a bottle.

    He is eating 3oz at a time. Please tell me how can I wean him to EBF? I want to do it sooner rather than later as I am scared that I will lose time, and then it will be even more difficult. I am very very desperate on EBF him, as I was unable to do it for my older daughter due to post-delivery complications that lasted for several months.

    Please, please HELP ME!!!!

  2. #2
    Join Date
    Jun 2009
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    5,633

    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Hi mom2rish! Welcome. I am so very sorry you are having these problems. Please take heart in the fact that many mothers struggle with breastfeeding issues early on and go on to ebf very happily. Other mothers who find they simple cannot make enough breastmilk are able to have a breastfeedign relationship wiht thier baby while alos supplementing as needed. So there are many paths to take in this journey.

    Is there any way you can see a board certified lactation consultant? (an IBCLC) You want someone who cna help you not only make sure baby is capable of nursing effectively but who can work with you on increasing your milk production if needed and help you wean off supplements. We can give you suggestions and support but it can really be helpful to get hands on help. Also contact any local breastfeeding support you may have.

    I have a few questions
    How long has it been since you restarted the formula supplements?
    Since you started the formula supplements again, has baby been weighed again?
    How often do you pump each day and what kind of pump?
    how many times a day does baby nurse each day?
    how often is baby given a bottle of formula each day and how much each time?
    during the 2 weeks of exclusive nursing, how many times a day did baby poop?
    were the 4 day check and the next weight check (showing baby gained only an ounce) done on the same scale with baby naked or in a dry diaper?
    Last edited by @llli*lllmeg; May 5th, 2013 at 07:50 PM.

  3. #3
    Join Date
    Apr 2013
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    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    I just wanted to say that my son always seemed hungry the first few months (he's now 3 months), especially during the 3 and 6 week growth spurts. I basically just hung around topless because he was ALWAYS at my breast. While it's gotten better, I'm still feeding him every 2-3 hours (previously it was more like every 1-2 hours. Feedings often lasted 45-60 mins so yes, always.at.my.breast. He may really need more feedings than every 2-3 hours. If he seems hungry, don't wait, feed him! It's normal! Temporary but normal.

  4. #4

    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Thanks for all your responses.

    I have a toddler at home and no help from outside, so not sure if I will be able to go and see a lactation consultant. But I will try.

    Meanwhile, here are my answers to your questions:
    How long has it been since you restarted the formula supplements?
    - Its been 10 days since I started formula again

    Since you started the formula supplements again, has baby been weighed again?
    - Yes. He was weighed back in 4 days, and he gained 9oz

    How often do you pump each day and what kind of pump?
    - I am able to pump only couple of times as I have read that putting baby to breast is most effective rather than pumping. I sometimes hand-express after feedings to drain out the breasts. When pumping, I use the medela electric double pump (pump-in-style)

    how many times a day does baby nurse each day?
    - 8-10 times a day

    how often is baby given a bottle of formula each day and how much each time?
    - 3oz mostly, but if I nurse him longer, then 2oz, sometimes he even takes just an ounce. He is given formula every 3-4 hours

    during the 2 weeks of exclusive nursing, how many times a day did baby poop?
    - baby pooped almost everyday

    were the 4 day check and the next weight check (showing baby gained only an ounce) done on the same scale with baby naked or in a dry diaper?
    - yes same scale with naked baby and dry diaper

    Also, since he is on formula, he sleeps mostly, and he does not wake up if I want to nurse him.

    Could his fussiness be due to slow let-down? How can I work on that?

    Sorry for so many questions, but I am really desperate on EBF'ing him.

    Thank you again.

  5. #5
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    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Your baby gained 9 ounces in 4 days? You know that is double average gain.
    Yes it is true that nursing usually is more effective than the pump in helping milk production. But that is not the case if baby is being supplemented with formula, because the formula supplement interfears with normal nursing. In that case, mom is usually instructed to pump for each time baby gets any formula. And for best results, pumping in this circumstance needs to be done with a hospital grade rental pump.
    Many private practice Ibclc's do home visits. Others will likely be ok with your toddler coming as well, depending on your toddler. Some have very flexible hours. You have no family, friend, sitter you could get to come with you and watch your toddler for a couple hours? If not, try you local LLL. I once watched moms toddler so she could go to a free lactation clinic.
    Ok, if you are on your own, you need to figure out why your baby was not getting enough milk when exclusively bf. Is it low supply only? Is baby able to transfer milk well?
    I would also suggest considering different options for how baby is supplemented. There is another thread here I just talked about this....
    Good resources -kellymom.com good info on low milk production and weaning of formula Supplements. The book Making More Milk is excellent.

  6. #6
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    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Oh and stop worrying about fussiness. As pp suggested, wanting to nurse constantly and being fussy is normal. Slow let down? Not something to worry about yet. You have to finish painting the car before you add the pinstripes.

    Btw the poop output suggests baby was getting milk, and the weight gain suggests it was enough to maintain weight at least. Yes of course you want baby getting enough to gain but it's clear you do make milk, probably pretty close to enough.
    The extremely fast gain in the last four days suggest to me that baby is probably getting more formula than baby needs. I am guessing here but it sounds like you baby is getting about 18 ounces of formula a day???
    A 4 week old baby needs at most 25 ounces breastmilk or formula per day. So is it possible you are going way overboard on the formula? Just because baby will take a bottle does not mean baby needs it.

  7. #7
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    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    OK here are some ideas to help keep supplementing supplemantal and to not take over baby's entire diet.

    1) 3 ounces is not a supplement. That would be an entire feeding for a one month old, a good one. Babies this age would normally get anywhere from 1 to 4 ounces per feeding at the breast, and the amount would normally vary over the day. So a supplemental top off after nursing would be one to two ounces. Because a baby will take more ounces in the bottle does not mean baby needs it!
    So make sure supplemental bottles are being given in a breastfeeding supportive way, which means slowly, carefully following baby's cues. This may help prevent baby getting used to very fast, large bottle feedings and slow down the tendency toward breast refusal. See http://www.llli.org/docs/00000000000...astfedbaby.pdf
    2) instead of supplementing after nursing, you can try supplementing a small amount (an ounce) prior to nursing so baby can finish at the breast, thus associating the breast with satiety and comfort.
    3) A lactation aid (at the breast supplementer) could be considered. This type of device is helpful for many reasons. See http://cwgenna.com/smartnothard.html
    4) nurse very frequently. A 4 week old infant normally needs to nurse at least 10-12 times in 24 hours. That is the minimum. When a baby starts getting larger bottle feedings, nursing sessions can become less frequent, as you have already seen happening. You don't want that. You want everything to stay as close to 'breastfeeding normal' as possible. This means, very frequent, small feedings, (whether from breast or bottle) and offering the breast at the earliest cue, or even at no cue-just when you feel like it. Calm babies nurse better.

  8. #8

    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Thank you for your response.

    I am giving around 15-18oz of formula to my baby, and he needs 25oz per day, is it? Am I giving the right amount?

    Also, the pediatrician really scared me about his no weight gain (once in the hospital and once at office visit).

    I will check kellymom website for more info and try contacting LC or breasfeeding support group.

    Thanks again.

  9. #9
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    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    OK, to be very clear. It is estimated that 25 ounces per day is about what a typical 4 week old will normally take in when breastfeeding. I do not know how much your specific baby needs. It could be more or less.

    But using 25 ounces as a ball park, if you are giving your baby 15-18 ounces of formula a day, that means well over half of your infants daily nutrition is coming from the formula. I am only suggesting that that may be too much. I cannot tell you for sure if it is too much or too little or just right. You would have to discuss that with your pediatrician and/or an IBCLC. But going only by your baby's great gain over the last 4 days, baby is gaining almost as if he is being 'double fed' because he is gaining double what is average. Of course, he has some cathing up to do, so that is something to consider.

    Yes the no weight gain in that period of exclusive breastfeeding is concerning. But your baby appariently maintaned his weight, he was not losing. So baby was getting somethign at the breast. So you can make milk. This means it is very likely you can increase your production but the sooner you get to work on that the better. The first 6 weeks are considered very important in establishing normal milk production.

  10. #10

    Default Re: PLEASE HELP!!-Want to move from supplementing to EBF

    Thanks for your clarification.

    Just one last question since I want to establish breastfeeding before his 6 weeks-

    What should be the nursing/pumping/formula feeding pattern (time interval between each) in order to totally wean off from formula?

    Thanks for all your help.

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