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Thread: Question vomit. Long, I'm sorry.

  1. #1
    Join Date
    Jul 2013
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    31

    Default Question vomit. Long, I'm sorry.

    I know I've blown up this forum, but I have another set of questions... or just an update with a request for opinion.

    Situation: I noticed that I have frequent blocked ducts/pores (just started getting blocked pores on the left breast instead of just the right breast -- oh joy). I was power pumping and pumping post feeds and was getting engorged. When I would put my daughter to the breast she would get on and fuss, so I would think I was starving her and give her a bottle. However, after posting previously, I took what Meg said about the breast not being drained sufficiently and began putting my daughter to the breast a lot (after all, if my breasts are engorged, she must not be getting it all out). I think the light bulb went on when I was nursing her and she got this pocket of milk out near my armpit that I thought was just a normal lump in my breast because it had been there for so long. Eventually early this morning my breasts were completely floppy for the first time in a long, long time. I was super excited and rented a hospital grade pump (Ameda Platinum since I have a kit for it), hoping it would alleviate any future plugs... but after allowing my daughter to sleep to her heart's content today I found that I again feel like I have plugged ducts in both breasts. I've been nursing her as much as possible, only turning to a bottle if I feel her fussiness is because of drained breasts and she hasn't had enough (completely bendable and floppy breasts, etc.). I've pumped five times today and have nursed her a lot... I kind of stopped counting because I just put her to the breast.

    So, a few questions (I'm sorry I'm not more organized in my thinking... I only have a small clue about all this):
    Do you think that the plugged ducts/pores could be because of a lack of breast emptying still, or could it be candida? I've stopped wearing a bra, and I've asked my OB/GYN to swab my breasts for a yeast infection but she just looked at my breast and said the baby "had her way with it." My nipples are pink, have been pink a long time, and they have hurt since I can remember if something even so much as brushes against it. I was on antibiotics about a week after birth because of a UTI. I asked her ped to swab her mouth for thrush, but he saw no symptoms and said that the tests aren't always accurate, so he didn't do it.

    When do you think it's safe to take her off of formula? Is it strictly determined by diaper output? How should diaper output look for cloth rather than disposable? I found out that my ped wasn't using the WHO chart for her growth, and doesn't think bf babies grow differently. Also, my daughter has grown a total of 3.5" in two months (has generally been more long than chub, and her father and his family are generally lean and lanky people, think professional dancer kind of lanky)... are these things to consider in case my ped begins recommending supplementation again if she stops gaining as much as he thinks when I began ebfing again? On formula supplementation she gained 10oz a week in three weeks rather than 4oz when ebf.

    I read on kellymom.com that the amount you bf during the first six weeks determines how much you can make in the mid/later months of bfing. I'm frightened that I haven't bf her enough in that time, but I can remember constantly having her on the breast for days. She would nurse, sleep, nurse, etc. I would always be sneaking away to feed her (I'm a private nurser right now). What kind of nursing was she talking about when she mentioned not nursing enough?

    Also, should I wake her when she's sleeping? She hasn't slept hardly at all when supplementing with formula, and she got a round of vaccinations yesterday and since then has been sleeping. I felt guilty for not waking her, but I've tried to bf her when she's searching for the breast and groggy during her naps. She does wake up after about 3-4 hours... and I'm wondering if this is normal and I should let her sleep, or because of my possible low supply if I should wake her? I don't know.

    While ebf, how should a baby's softspot feel? Should you be able to feel the softspot or no? Is there another way to determine if she's dehydrated on top of diaper output?
    Last edited by @llli*forecastofrain; August 3rd, 2013 at 07:09 PM.
    - June 1, 2013

  2. #2
    Join Date
    May 2006
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    20,940

    Default Re: Question vomit. Long, I'm sorry.

    Once supply and demand are well matched, feeling soft, empty, or floppy all the time is normal. Feeling full or engorged is a sign of your body making more milk than the baby is taking. If you're nursing frequently and on demand, and baby is gaining sufficient weight and making sufficient diaper output, you shouldn't worry about feeling floppy.

    It's hard to say why you're getting frequent plugged ducts. Here are a few possibilities:
    1. You're making more milk than baby needs. Making extra milk makes plugs more likely.
    2. Your supply is not excessive, but the baby is unable to empty the breast well. Leaving lots of milk in the breast could be contributing to the plugs.
    3. You just happen to be more than usually susceptible to plugs.
    4. There's some sort of physical factor that's contributing to the plugs, e.g. a poorly fitted bra, a weird sleep position, an imperfect latch, etc.

    I don't think that yeast is associated with plugs... But that being said, painful pink nipples does sound yeasty. Is there any cracking or blistering? Is the pain more of a burning or more of a stabbing? Does it intensify at any time, perhaps after a feeding? Do you have a yeast infection anywhere else on your body, or does the baby have a yeast diaper rash? Do you ever see any other color changes in your nipples, e.g. blanching (turning white) or turning purple?

    According to kellymom.com, a sufficiently wet diaper for a baby >6 weeks should contain about 4-6 tablespoons or 60-90 ml of fluid. To feel what that feels like, just pour that amount on a dry cloth diaper. You want to see at least 4-5 wets per day, and the urine should be pale and mild-smelling. Remember that most poop diapers contain urine as well, so they should be part of the total count.

    Taking a baby off of formula depends, in large part, on how much you're using and how much you're nursing. Can you tell us how many times a day you're nursing now and how much formula you're offering?

    When it comes to a pediatrician, you want a doctor who looks at the whole baby, not just the chart. If your pediatrician suggests supplementing based purely on the chart or on how much weight the baby has gained in a given time period, without doing more investigation into the baby's feeding patterns, then you might want to see a different pediatrician and see if that person comes up with the same advice.

    Don't let the kellymom thing about establishing breastfeeding destroy your confidence. I think it's EASIEST to establish milk supply in the first 6 weeks, but that's all. Your body can do amazing things, given the right input!

    A baby who just got some vaccinations can be expected to be sleepy and grumpy for a few days. Letting her sleep is probably okay, but if you can wake her every 2-3 hours during the day, I think that would be beneficial for both of you.

    You should be able to feel the baby's fontanel (soft spot) until it closes around- what, I think it's like a year or so? Dehydration will be evident in a sunken fontanel, a lack of wet/poopy diapers, dark-colored urine, skin which is slow to rebound when pinched up, sunken eyes, dry mouth, cracked lips, lack of tears, and fast pulse and breathing.

    When in doubt, just put that baby to the breast! I bet that's all it's going to take.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Oct 2012
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    2,209

    Default Re: Question vomit. Long, I'm sorry.

    Hi mama, don't have much to add to mommal's comprehensive advice, but according to kelly mom, a yeast infection can be a risk factor for plugged ducts, by causing inflammation: http://kellymom.com/bf/concerns/moth...rent-mastitis/ (see section on: risk factor - nipple problems ). Here's another tip sheet on dealing with plugged ducts: http://www.llli.org/docs/00000000000...plugsblebs.pdf. But really, I agree, the best thing is to put baby to the breast as much as you can. Frequent drainage is key!

  4. #4
    Join Date
    Feb 2012
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    middle of IA
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    Default Re: Question vomit. Long, I'm sorry.

    it sounds pretty likely to me that you might have thrush. but it's easy and cheap to start treating OTC and you should see immediate improvement, if it's that, and little risk if it's not. here's a good protocol: http://www.breastfeedinginc.ca/conte...agename=doc-CP i used GSE, other mamas on here use Gentian Violet.

    did you see the kellymom page on weaning from supplements? it's pretty helpful.
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  5. #5
    Join Date
    Jul 2013
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    31

    Default Re: Question vomit. Long, I'm sorry.

    Is there any cracking or blistering? Is the pain more of a burning or more of a stabbing? Does it intensify at any time, perhaps after a feeding? Do you have a yeast infection anywhere else on your body, or does the baby have a yeast diaper rash? Do you ever see any other color changes in your nipples, e.g. blanching (turning white) or turning purple?
    No cracking that I know of, only blisters with the blocked pores. I had post-feed nipple burn along with burning deep inside the breast... I had it for so long I thought the burn was my milk being made. I did the water/spit test and my saliva has strings, I'm also strongly craving breads and sugar a lot. Baby has gotten recurrent patches of red on her diaper area that are rough, but coconut oil takes it away... so Idk if it's yeast. And yes, I would get deep stabbing pain in my breast accompanied by a white nipple. I think she may have a PTT, because no matter how great I make her latch my nipple is always compressed with as much of a white line as is possible (my nipple's kind of knobby now).

    Can you tell us how many times a day you're nursing now and how much formula you're offering?
    I feed her whenever she's hungry, which can run between every 1.5-3 hours. I nurse before giving a bottle and after because often she will refuse the bottle in order to nurse to sleep. I felt like I was ready to begin ebfing through cluster feeding again yesterday, so I did until about midnight and then gave a 2oz bottle. When I don't give bottles at night (like last night) she'll eat maybe 6-7 times before going into an intense clusterfeeding/fussy time that begins at about 5-6pm and ends with screaming around 1am. (It went a whole lot better than in the past, but I don't know if my supply is up enough to make the clusterfeeding any better.) So, yesterday she took a total of 8oz of formula... we'll see how today goes.

    And thank you, all three of you, for responding.
    - June 1, 2013

  6. #6
    Join Date
    May 2006
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    20,940

    Default Re: Question vomit. Long, I'm sorry.

    Well, that's not too, too much formula, but it's still rather a lot... I'd try cutting those bottles down to 1.5 oz instead of 2, and then down to 1 oz, and finally down to .5 oz- all while watching diaper output and weight gain. Once you're down to .5 oz, start skipping bottles and then eliminate them altogether.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #7
    Join Date
    Jul 2013
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    31

    Default Re: Question vomit. Long, I'm sorry.

    Quote Originally Posted by @llli*mommal View Post
    Well, that's not too, too much formula, but it's still rather a lot... I'd try cutting those bottles down to 1.5 oz instead of 2, and then down to 1 oz, and finally down to .5 oz- all while watching diaper output and weight gain. Once you're down to .5 oz, start skipping bottles and then eliminate them altogether.
    Yea, I know... It's down to 8oz after being at 13oz for a while. I don't give a bottle every feeding, though. I give one when I can tell she's had enough of sucking and is frustrated... giving constant hunger cues and can't nurse herself to sleep because she's already drained the breast. At least, this is how it seems. That's why it's so hard for me to determine how to go about this weaning thing.
    - June 1, 2013

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