Going Insane!

[@llli*studio687]

Hey guys, I'm new. I've been trying to get on this website for a while, but I can't access the forum by phone and this is the first time I could get to an actual computer with a newborn.

Anyway, I am in need of some help or support or insight or piece of mind! This is my first kid. He is 3 weeks today and our breastfeeding journey has been less Breastfeeding is/was so important to me, yet it was the only thing I never looked into while pregnant. I figured, if you do it, you do it, its supposed to happen naturally, right?

So at the hospital, I never really talked to anyone about breastfeeding, I just did it. And he latched on, but he never really communicated well that he was hungry, or I didn't know what I was looking for, and then he would fall asleep almost immediately after latching, so I thought that perhaps he didn't need that much to eat... that's when it went downhill.

So here are the numbers:

8/2- 8lbs 14oz, 19 inches
8/4- 8lbs 6oz
8/7- 8lbs 5oz, 20.75 inches
8/9- 8lbs 7.5oz
8/12- 8lbs 8oz
8/15- 8lbs 8oz, 21.5 inches *he only gained .9 oz during a 40 minute nursing session, ped. started supplementation*
8/16- *day that he was supposed to reach his birth weight*
8/19- 9lbs 1.9oz *gained 1.7 oz during a 30 minute nursing*
8/23- 9lbs 10oz

So, there was constantly periods of time in the beginning where he would suck and sleep on my breast, like for 3-5 hours a few times a day, but he'd fall asleep so quickly on my breast, in about 3 minutes, and it would take me hours to wake him up at night. And it sucks for sleep, or lack there of, but I didn't mind. He always seemed like he was starving though. And then after the meconium cleared out, he didn't have a dirty diaper for 3-5 days at a time, but wet ones regularly, maybe even more so. But I only fed him on demand, with the exception of night, because he wouldn't wake up.

The rn at my ped's office put me on a schedule, because of the lack of weight gain. She said I should feed him every two hours for only 20 minutes, then stop him, because he is only burning more calories than he is taking in. I did that one day, but he seemed starving, so I gave up the next and continued to feed him as much as possible.

On 8/15, my pediatrician had me start to supplement him after every other breastfeeding, she said 1-3 oz, but he didn't seem to know when to stop eating formula, so I just did 2 oz, because otherwise he would spit up A LOT. She had me start the 20 minute feedings again. I also started pumping 30 minutes after every breastfeeding, so even less sleep for me, yay... I was only getting about .25 oz total of breastmilk each pumping (10 minutes), which has been terribly depressing, but I supplemented that as well. I am using nutramigen, because I have celiac (Im also vegan), which is not a cheap formula. The ped told me to use a paci after feedings, because he sleeps for 10 minutes at this point and would wake up and want to suck more. I didn't want to use a paci at all, but I tried it, and (luckily for my sanity) he has rejected them every time.

Yes, he is gaining weight, but he and I are still having stressful breastfeeding sessions, and we are back to nursing whenever he demands it, because he is falling asleep on my breast so quickly and wakes up as soon as I unlatch him, so sometimes in 5 minute stretches over the course of 4 hours. He is a super lazy/passive feeder. Also, the lactation consultant had me go down to 1oz after every other feeding now, and between feedings he won't sleep except for night, but I was told to no longer wake him up, just wait until on demand happens. He didn't wake up for 5 hours last night and then barely fed and fell back asleep for 2 hours. Sometimes he gets frustrated, and I don't know if my milk tastes bad, or its flows fast, or not at all. He super sucks my pinky when I put it in his mouth, but it feels like he is hardly sucking on my breast. He keeps on trying to bottle suck on my nipple now (not every time), and sometimes just latches to my nipple alone and refuses to properly latch, and it is starting to hurt. He barely sleeps now except for night. He hasn't had a bowel movement in over 30 hours, but he has about 15 wet diapers a day. He never seems completely full after a feeding because he always falls asleep, but his stomach is huge when I supplement. I no longer pump, because I had to return it. I'm worried that by next Friday's weigh-in he will have lost weight again.

What am I doing wrong?!?! Are we ok? Am I just crazy? I know this is a long post, but I don't want to depend on formula. And pumping is too depressing and stressful, so I don't want to do it long term. Help!

[@llli*djs.mom]

How much are you supplementing now?

[@llli*studio687]

About every 4 hours 1 oz. But today he acts like he is hungry after that feeding plus supplementation, so im feeling a little stressed and concerned...

[@llli*studio687]

And thats 1oz every other feeding, but hes just been "snacking" constantly today, so for the last week hes been eating about every 2 hours, so i e been doing it around a more wakeful feeding every 4 hours, but today he wants to go back to nursing right after the bottle. Also, i cant tell the difference between comfort feeding and hunger feeding, they both seem the same to me.

[@llli*mommal]

It's actually good for a baby to conclude supplemental feedings with nursing at the breast. Having the baby associate the breast with comfort, satiation, and relaxation helps to combat bottle preference.

When you were pumping, how was that going? And did you ever have a scale for home use? And at this point, would it be possible to get another pump?

[@llli*studio687]

I didnt have a scale for home use. The hospital i delivered at has a weigh station and im less than 10 minutes away, so i use that when i dont go to was.the ped's office that week. I can rent the pump again after the 1st, but with the price of formula at 36.00 a can, i was trying to avoid it. I had some pregnancy complications early on that caused me to lose my job, so money isnt as good as it was.

I do have a dinky hand pump, but with the hospital grade one, i was only getting .25 oz tops, sometimes less. The left was far worse than the right. I tried hand expressing but i suck at it too.

[@llli*vibrantnotions]

Also, i cant tell the difference between comfort feeding and hunger feeding, they both seem the same to me.

Listen for the sound of swallowing. It sounds like "cha".

For the falling asleep right away I have some suggestions. I had a hard to wake, hard to keep awake little guy. I would change his diaper before I fed him to help wake him up, I would feed him in just his diaper (no clothes) so he wasn't so warm and comfy, and I had to constantly touch and interact with him. I would rub his back, tickle his feet, pick up his arm and massage it, stroke his cheek, tickle his ear. Anything to keep him engaged.

Skin to skin contact was also a big help to us for getting him to be willing to nurse/eat. It also helped me just feel better emotionally. Nothing like a good skin to skin cuddle with a newborn.

The "feed only 20 minutes then cut off" thing your RN said... I wouldn't do that. It is normal for a newborn to take 40+ minutes to nurse. If he is nursing don't cut him off, let him keep going!

Sorry you're having a stressful start.

[@llli*mommal]

If you need to supplement, ideally you want to be pumping in order to make up the supplemental bottles. If you can fill any supplemental bottles with breastmilk, then you know your supply is even with the baby's needs and transitioning away from supplementing is going to be easier for you. I know that the rental pump is expensive- I spent a lot of money on my rental pump! But weigh that cost against the cost of formula, and you'll probably discover that renting a pump is at least competitive with the cost of formula, particularly with expensive brands like Nutramigen.

I'd love for you to have not only a good pump but also a professional grade scale. (More $$$, I know!) Scales are great tools for moms who are trying to transition away from supplements. You weigh the baby before and after lots of feedings, as many as you can manage in a day, and this helps you gain an accurate picture of how much milk the baby takes in while nursing. If baby took in 2-4 oz, then there's no need to supplement after that feeding.

I don't like your pediatrician's advice about supplementing. Scheduled feedings and limiting feeding length is generally something you need to do only with very small, very premature babies, who may burn more calories nursing than they are able to take in. Full-term, normal birthweight infants typically do not have this problem!!! It sounds like your baby's issues are more about sleepiness than anything else, and sleepiness is a common problem even with term infants. Some things to do to combat sleepiness:
- Keep the lights dim. New babies often close their eyes in response to bright light.
- Keep your baby cool while nursing. Strip him down to a diaper or onesie when it's time to nurse, and keep a fan blowing in the room where you nurse (not directly on baby, of course!).
- Annoy your baby. Tickle the soles of his feet or rub against the grain of his hair while he nurses, using your hand or a cool, damp washrag. This should keep him from getting too comfy and falling asleep.
- Do breast compressions to speed milk flow to the baby.
- Try switch nursing. If baby starts to drift off, take him off the breast, burp him or change his diaper, and switch him to the other breast. Repeat this process every time the baby starts to fall asleep. Switch nursing is great for increasing intake, and also (hypothetically) teaches baby that nursing is a businesslike endeavor, not one where he can just relax and drift off to sleep. He has to keep nursing actively or you're going to shift him.

[@llli*lllmeg]

Are you under the care of an RN or an IBCLC? (or is she both?)

[@llli*lllmeg]

Did your IBCLC discuss your diet with you? My understanding is that a mom on a vegan diet may need to be supplementing with vitamin B12.

http://kellymom.com/nutrition/mothers-diet/vegetarian/

If your baby is B-12 deficient that can adversely affect appetite and weight gain.

When your baby started gaining, he really started gaining! A pound + in a week? That is twice the average gain rate of about an ounce a day. But this was when you were supplementing how much per day?

8/19- 9lbs 1.9oz *gained 1.7 oz during a 30 minute nursing*

This is OK milk transfer. Not super fantastic, but certainly within a normal range. Before and after nursing weight checks only give you info about that ONE nursing session. It's a clue, not the whole story. Plus milk production inceases for the first several weeks, and baby gets better at nursing. So milk transfer or what you were able to pump a week ago may have no relation to waht your baby can transfer or you could pump today (with the right and properly fitted pump.)

At this point, it appears your baby is gaining very well, so I would suspect now is the time you can start weaning baby off supplements under the guidance of your IBCLC and continue to cue feed, allowing baby to nurse as long and as often as baby wishes, as long as baby nurses a MINIMUM of 10 times a day. (A minimum of 10-12 nursing sessions per 24 hours is normal for the newborn period.) I agree with mommal, as long as you are supplementing it is important to pump as well even if you do not produce much when you pump.

Also, it is normal for a baby to cluster nurse, (Nurse and then want to nurse again just a few minutes later,) take longer to nurse some sessions, fall asleep at the breast etc. that is all normal, as long as weight gain is on track. While it may or may not be needed, there is nothing wrong with waking your baby if you feel this is needed to get in another nursing session.