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Thread: Running out of options

  1. #1
    Join Date
    May 2013
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    12

    Default Running out of options

    My LO is almost 2 months old and we've been struggling with breastfeeding from day 1. She is almost 4 weeks post tongue tie and also struggles with my overactive letdown and flat nipples. We have literally been sitting on the couch struggling for 2 full months now and I'm at the end of my rope. Sometimes she'll start to do really well--improved deeper latch, draining the breast, etc, and continue to improve for several days, and then BAM, suddenly one day we're back at square 1--with a latch so shallow she can't transfer milk if my breast is even a little bit soft. I try to pump but for some reason I just can't seem to pump efficiently--the pump doesn't elicit my letdown and I never get more than an ounce or two. She hates bottles anyway--I've tried 3 different kinds. Today and yesterday she has been extremely sleepy, waking up to root a little, then when I try to latch her on she either falls asleep again before I can get her to get a decent latch or falls asleep trying to transfer milk from the shallow latch. I'm so worried that my baby isn't getting enough--why does she keep backsliding like this?? Need encouragement!! I can't stand the thought of weaning after all we've been through but I can't take much more of this.

  2. #2
    Join Date
    Nov 2012
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    Ontario
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    Default Re: Running out of options

    Hang in there, mama! I know it seems so hard right now, and discouraging when you think things are finally starting to look up, and then it all seems to go to heck in a handbasket! And there's that prevailing misconception out there that things magically start getting better at the 6 week mark. That was NOT the case for me, and for a lot of people on here. It took about 4 months for me to be able to say that I felt really good about breastfeeding. My LO had a small mouth and a shallow latch, and she just needed to get bigger. We also dealt with tongue/lip tie and thrush. Have you tried gently massaging her jaws? I felt sometimes that my DD had a tight latch, and that she was just tense. I also would run my finger along the inside of her mouth, along the gums, to get her tongue moving and loosened. I can't give you any scientific evidence to say that it for sure helped, but it made me feel like I was doing something, YKWIM?

    How has her weight gain been? How are her diapers the past few days when you said she's been sleepy? Please don't give up. You've put in 2 of the hardest months already, every day you stick with it (hopefully) gets you closer to an easy-going, satisfying breastfeeding relationship.

  3. #3
    Join Date
    Jun 2009
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    5,920

    Default Re: Running out of options

    Hi! Welcome, I am so sorry you are having so much difficulty!

    improved deeper latch, draining the breast, etc, and continue to improve for several days, and then BAM, suddenly one day we're back at square 1--with a latch so shallow she can't transfer milk if my breast is even a little bit soft.
    Your right, this does not really make sense. If baby can latch and nurse well SOME of the time, why not all of the time?

    Well, in part the answer may be that no baby nurses the same every time. Some sessions are going to be short. Some sessions are going to be long. Some sessions are going to be fussy. Some sessions are going to be what I call "latch on latch off turn yourself around." Etc. This is just normal breastfeeding. As long as baby is nursing with good frequency and gaining weight, these variances are just life as normal and not typically a problem.

    If your baby's nursing efficiency is so erratic it IS a problem, then there are many things to look at.

    I try to pump but for some reason I just can't seem to pump efficiently--the pump doesn't elicit my letdown and I never get more than an ounce or two.
    This would be within the range of normal pump output for a mother who is pumping occasionally while also nursing around the clock.

    So I have a few questions-
    How has baby's weight gain been
    Is baby only breastfed or also getting supplements, formula or expressed breast milk, and if there are supplemntal feedings, how much/often?
    How many times in 24 hours does baby typically nurse, and is nursing always when baby cues, or do you also offer, or is there a scedule or ??
    How often do you pump and with what kind of pump? Why do you pump?
    Are you working with an IBCLC?
    Any improvement in latch and nursing since the frenotomy?
    Are you using nipple sheilds or did you ever?
    What positions seem to work best?
    Have you noticed any differences in generally 'good' sessions from generally 'bad' (time of day, baby more awake, baby more sleepy, nursing position etc. ?

    You mention forceful letdown. Do you have overproduction?
    Last edited by @llli*lllmeg; June 16th, 2013 at 04:11 PM.

  4. #4
    Join Date
    May 2013
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    12

    Default Re: Running out of options

    Baby's weight gain has been erratic. She gained her birth weight back by 2 weeks, then stalled until her tongue tie was cut at 4 weeks; then she gained very very quickly for several days as she filled up on my suddenly-increased milk and forceful letdown. Then the letdown caught up with her and her gain faltered. Then an LC helped me with her position and she started gaining very quickly again (I started block feeding, detaching during letdown, etc. Her latch improved for a time.)

    Baby is getting no supplements at this time. This AM I pumped because I was having a hard time getting her to take from the breast, but she wouldn't take the bottle.

    I nurse on demand. She gives me cues to eat pretty much all the time while she is awake. I feed her many, many times during the day, twice at night.

    I hardly ever pump; when I do I use a hospital grade medela pump.

    I have seen an IBCLC multiple times.

    There have been sporadic improvements in latch since her frenotomy. Sometimes she gets a really good latch but it's just luck of the draw. There doesn't seem to be anything that I'm doing that changes the latch for the better.

    I have never used nipple shields.

    I used to do laid-back nursing but I don't find that it works for us anymore. Now we do cross-cradle, which worked for awhile.

    Sometimes I get a really good session in the AM when my breasts are fuller. The worst latches are in the evening.

    I did have overproduction but since I've been block-feeding my supply has gotten under control. I still have forceful letdown though.

    She is still having wet diapers but not soaking. She still has lots of poopy diapers. It's confusing to me, because everyone says that as long as she has wet and poopy diapers she must be gaining. But she was having full diapers even when she wasn't gaining.

  5. #5
    Join Date
    Jun 2009
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    Default Re: Running out of options

    I forgot to ask- When baby does not latch well, does it hurt you? Because if weight gain is appropriate when baby is exclusively nursing and nursing is comfortable for mom, then there really is not a breastfeeding problem. If baby is not gaining normally or nursing hurts mom, then there is a problem.

    As far as weight gain goes, it can certainly be normal for weight gain to come in fits and starts. But it is also true that output, especially wet diapers, do not always tell the complete story either. If a baby is pooping several times a day, with some actual volume (not just streaks) there is no reason to worry about wets. And a baby who is pooping a lot is probably getting enough unless baby has an absorption issue due to an underlying health condition or severe allergy.

    I do hope baby was gaining very, very well if you were/are block feeding. Block feeding of course reduces milk production and generally should be approached very cautiously when a baby has or had milk extraction difficulties (such as tongue tie) and also be attempted only when a newborn is gaining very well-at least 8 ounces per week. See this for more- http://cwgenna.com/blockfeeding.html

    What breastfeeding issues were you experiencing due to the overproduction that made you decide to block nurse? Baby not liking the fast flow? Engorgement, plugs, etc?

    If baby is generally happier at the breast when your breasts are fuller, do you think there could be a vacuum issue? Basically, the fuller breast perhaps allows for a better seal? Or do you think your baby is happier with the faster flow? I would suggest that if baby likes a fast flow and nurses better when your production is higher, maybe it is time to stop block nursing. Block nursing is certainly very helpful for lowering milk production, but sometimes it works too well, iykwim.

    Do you have any desire to try a nipple shield? From what you have said I don’t think you need it, but they are designed to facilitate a better latch and work for many moms who cannot get baby to latch or latch effectively. There are drawbacks and issues to consider, but the drawbacks to no longer nursing baby are far worse. So a nipple sheild could possibly be appropriate in your case.
    Last edited by @llli*lllmeg; June 16th, 2013 at 05:14 PM.

  6. #6
    Join Date
    May 2013
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    12

    Default Re: Running out of options

    Quote Originally Posted by @llli*lllmeg View Post


    What breastfeeding issues were you experiencing due to the overproduction that made you decide to block nurse? Baby not liking the fast flow? Engorgement, plugs, etc?

    If baby is generally happier at the breast when your breasts are fuller, do you think there could be a vacuum issue? Basically, the fuller breast perhaps allows for a better seal? Or do you think your baby is happier with the faster flow? I would suggest that if baby likes a fast flow and nurses better when your production is higher, maybe it is time to stop block nursing. Block nursing is certainly very helpful for lowering milk production, but sometimes it works too well, iykwim.

    I was pretty much in a state of constant engorgement and sometimes when I let down the "spray" would last a full 2 minutes. The reason I started block nursing was because she would just sort of chew on my breast, not latching with any efficiency, and let the milk flow just kind of pour into her mouth. She wasn't gaining well and was having 10+ green, foamy (sometimes bloody) poops daily. My milk never seemed to be white, only clear or vaguely eggy looking. So the LC had me start block nursing so she could start getting the fattier milk. This worked for several days--her latch improved, she started draining my breasts (which had NEVER happened before) and she gained 6 oz in a week. Then her latch backslid and even though I still have plenty of milk she just can't seem to get at it without a colossal struggle.

    I do think a lot of the problem is a vacuum issue. She sometimes starts out with an OK latch, then as my breast "deflates" part of her lip comes detached from the breast and I can hear air rush in. Other times, especially if I latch her on when my breasts are less full, she'll seem to get a nice wide latch but then if I detach her I see that the only thing in her wide mouth was my nipple and air. More often she just clamps down on the nipple, even if her mouth opens very wide. Sometimes this hurts and sometimes it doesn't.

    She seems to does like the faster flow, so I haven't been block nursing for the whole 3 hours anymore (especially now that my supply is more normal and I don't generally have engorgement anymore.) This has helped a little. I've also been "pinching" my breast in the u-hold like the LC showed me; sometimes she gets some more in that way.

    In general, she seems to be acting fine and not like a worried, dehydrated baby. This is encouraging to me, but it's still very frustrating to have her root and root or fuss and then not be able to latch her so that she gets all she can/wants, especially if I know the milk is there!

  7. #7
    Join Date
    Jun 2009
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    Default Re: Running out of options

    OK, if you were block feeding under the care of an IBCLC, then it may be helpful to go back to her now for some fine tuning on latch to improve the seal issue.

    It does sound as if you had overproduction. But, just fyi, Usually when there is overproduction (and baby can get enough milk out) baby gains very fast, even if baby is getting mostly foremilk and having the green poops and discomfort from too much lactose. Baby still gains, typically. Because all breastmilk is nutritious and has fat and calories.

    Block feeding lowers milk production. All milk, fore and hind milk. Yes, this is turn may lead to baby getting LESS foremilk and consequently, more hindmilk at a feeding, but if your baby was not gaining well despite you having overproduction, the issue was also that your baby was not getting ENOUGH milk, due to not being able to latch well, probably related to the tongue tie(?) And of course, baby not being able to latch well would also make engorgement worse. Does that make sense in your situation? If it does, I would again suggest talking to your IBCLC, you may want to stop block feeding altogether, as it sounds as if it has done its job.

    Also, I am not sure what you mean by baby ‘draining’ the breast. The breasts always make milk so they can never be drained. Typically, a young baby prefers very small feedings, and feeding very very frequently. Baby may not super soften or drain the breast especially if the breast is very full, but that is usually ok as baby will be nursing again very soon. Or by “drained” do you just mean, baby getting enough milk out so you are not engorged?


    I've also been "pinching" my breast in the u-hold like the LC showed me; sometimes she gets some more in that way.
    I assume you mean the 'breast sandwich" technique which can really help baby get a better latch. Doing this and being really careful with latch saved my bacon with my baby who could not latch well at all on one side at first. I had to remember that if I positioned baby differently, then I would hold the breast differently to get the same effect. So, a "u" hold worked if baby is in cross cradle or in any way approaching the breast from the side, but a "C" hold would be better if baby is in football or the classic laid back position and approaching the breast from below. -is this your experience as well?

    I don't think you are out of options at all! I think it sounds as if you and baby are doing really well despite these early challenges. Fine tuning latch is usually pretty simple and it sounds as if you have good help for that, or you can keep working on the positioning and latch techniques you know about already to find what works best for you. What works best typically evolves and changes over time anyway.
    Last edited by @llli*lllmeg; June 17th, 2013 at 10:33 PM. Reason: can't spell

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