Grazing baby & slow milk flow - Help!

[@llli*yellowrose]

Breastfeeding has been a struggle for us from the beginning. My breasts never grew, were never engorged when my milk came in (at least, no more than they are after a stretch of a few hours), and my daughter was born with a tongue-tie. She finally figured out how to suck correctly after about a month, but by that time, my supply had already been somewhat stunted, between my own physiological issues and her ineffective suck. I'm taking Motherlove More Milk Special Blend and just started Domperidone. DD is only getting a few oz of formula a day, and I'd like to get away from it entirely.

Our current problem is slow milk flow. DD either falls asleep or drags my nipple around in frustration long before she's satisfied, feedings last between an hour or an hour and a half - and frequently bleed into one another, especially if I give her an oz or two of expressed milk or formula to try and satisfy her before putting her down. DD can't nap more than forty-five minutes at a time, because she wakes up screaming for milk. She's gaining weight properly and having enough dirty diapers, but every waking minute is spent at the breast, on the bottle, or fighting to put an overtired baby down to nap. Besides that, because she wants to nurse so frequently, I can't pump between feedings to boost my supply - she usually wakes up within minutes of a pumping session.

I realized last week that I know nothing about her except her hunger cues, her hungry cry, and when to burp her. Our whole life together has been a struggle to get her fed. I haven't had the presence of mind to figure out what tired or bored or lonely looks like, and rarely have the patience or energy to play with her. I'm so frustrated, and being able to give her a bottle in twenty minutes and have a whole hour or more to spend just enjoying her, teaching her, playing with her, and being able to put her down, confident that she's not still hungry - man, that's looking really attractive.

[@llli*maddieb]

Hi Yellowrose. How old is your baby? Many young babies (and many older babies for that matter) do not like to be put down to sleep. They will not stay alseep this way for long. The theory is that baby wakes frequently (or more frequently) when put down, as an instinctive protection. Babies often sleep better in the arms of/on the chest of/next to mom or another trusted adult.

For getting baby to sleep-Does baby have trouble nursing to sleep? What about walking baby 'down' in a sling or wrap or carrier?

Is nursing comfortable for you now? Comfortable all over?

What physiological issues do you have that affect milk production?

If you read the book Making More Milk, the authiors go into some detail about targeting specific issues that cause low production with specific herbs. I don't have it with me now, but I know the herb fennel is suggested in The Womanly Art of Breastfeeding for milk release problems.

For slow flow, breast compressions and/or switching sides frequently, can help quite a bit?

I realized last week that I know nothing about her except her hunger cues, her hungry cry, and when to burp her. Our whole life together has been a struggle to get her fed. I haven't had the presence of mind to figure out what tired or bored or lonely looks like, and rarely have the patience or energy to play with her. I'm so frustrated, and being able to give her a bottle in twenty minutes and have a whole hour or more to spend just enjoying her, teaching her, playing with her, and being able to put her down, confident that she's not still hungry - man, that's looking really attractive.

I think someone has sold you a false idea about what early baby hood "should" look like. If you have an older child who was bottle fed and this is what life was like, ok. That was that child. Every child is different. But typically, for the first several months of life, baby is growing at an incredible rate. All baby needs or wants or should be doing is eating and sleeping and be in the arms of mama. That is it. Babies this age do not 'get bored.' They only get frustrated if they cannot get enough to eat or cannot get to sleep, and nursing usually solves both issues. They don’t get "lonely" either. They get terrified of being eaten by anything larger than they are if they are not near mom or someone who is subbing for mom.

Will a baby who is overfed a huge bottle of hard to digest formula perhaps sleep longer here and there?Yes. We now have evidence that large, quick bottle feedings are unhealthy, but yes. Sometimes those babies sleep longer than is biologically normal. But that does not mean that child does not have the same needs your baby does. It just means they are easier to ignore.

When baby is held by mama, cared for by mama, nursed by mama and loved by mama (or another trusted adult if mommy cannot be there or needs a break) baby is learning all baby needs to learn at this point.
I suspect you know your baby much much better than you think.

[@llli*yellowrose]

DD is eight weeks old. Nursing isn't perfect; she rarely opens her mouth wide despite all the "suck training" techniques the hospital LC showed us, so it's always a little rough on my nipples trying to get a good, deep latch. But it's a vast improvement over the first month, lol.

The LC was the one who suggested the herbal supplement I'm taking and the Domperidone, and I think it does actually have fennel, along with goat's rue and fenugreek. It has helped, I think, but DD still can't get a good, full feeding in a decent amount of time. Once both breasts are mostly drained, she gets upset, rooting and sucking on any available patch of skin, or arching her back and shaking her head, dragging the nipple (another reason nursing isn't comfortable). Or she falls asleep, only to wake up five or ten minutes later, crying. Sometimes I'll give her a bottle, with two oz of expressed milk or formula when she's tired and upset like that, but by that time we've been nursing for an hour already, and it's not long until she's due for another feeding.

I'm concerned about her sleep because she naps so little through the day, even when she's obviously tired (fussy, yawning, droopy-eyed, etc.). She sleeps well enough at night, if we bedshare - which I really dislike; it scares me to death, but its the only way anyone in the house has been able to sleep this last month. Everything I've read suggests she should be sleeping fifteen or sixteen hours, and she's getting maybe twelve.

[@llli*maddieb]

Since baby sleeps best when next to you, how about napping with baby? Personally I think your baby’s sleep is the least of your worries, because a healthy newborn who is gaining normally will sleep as much as that baby needs unless kept awake by duress. The sleep averages are just that-averages. Not every infant needs to sleep that much and some sleep more.

Have you read about bedsharing? Here is one set of guidelines http://www.askdrsears.com/topics/par...leeping-habits

There are simple commonsense steps to take to greatly decrease any risk, and these risks are mostly caused by western style beds, (or worse, sleeping with baby on a couch or cushy chair in such a way baby might get entrapped) or baby sleeping with an intoxicated or otherwise impaired adult, not the bedsharing itself. For most of history and in most of the world, infants sleep right next to their mothers. But it is not safe in all circumstances, so read about the dos and don’ts.

If your baby is gaining normally on breastmilk at the breast, supplementation is not needed. What you describe-baby fussing after a feeding, wanting to continue to suckle, falling asleep and wanting to nurse again 10 minutes later, is normal newborn behavior. (yes two months old is still a newborn.) Heck, my 11 month old nurses like that especially when she is tired. A baby will keep nursing on a 'drained' breast because this is how a baby comforts to sleep and it also increases milk production.

Has your IBCLC shown you how to do breast compressions? These can help with long feeds.

I think, but DD still can't get a good, full feeding in a decent amount of time.

I get it that this is frustrating, but every baby/mom pair is different and some need to nurse much more than others to get enough milk.

Was the tongue tie ever treated with frenotomy?

have you experimented with different positions and latch ideas other than what your IBCLC has shown you? What works best for you ?

Reading what you have written, I am thinking that the issues that need addressing right away involve your comfort. Nursing should not hurt. When it does, that is very draining to mom. You are unhappy bedsharing which is likely harming your sleep. If you cannot get comfortable with bedsharing, maybe a co-sleeper arrangement would be better for you.

But you have been through a really difficult time, with tt and low production, and your baby is (almost) exclusively breastfed- Do you realize how amazing that is? You are at the fine-tuning stage!