I have been EBFing my 5 wk old daughter and have been starting to have some difficulty the past week or so. I am getting different opinions on what is happening and what to do about it from the two LCs I've been seeing and my ped. I'm confused, worried, and having a hard time emotionally thinking that my daughter and I won't get the hang of this, or that she is not getting enough to eat. Here's what has been happening - apologies for a long post but want to be thorough!
I will start by saying that her weight gain is good (born Sept. 8 at 9.7 lbs and weighed 11.2 lbs on Oct. 11) and she is having plenty of wet and dirty diapers. Dirty diapers have become more orange than yellow, and are mucous-y. She was 8 days overdue.
-At birth, she was given to me immediately and I nursed her. Over the next few days (before milk cam in), my nipples became sore and scabbed. She was either screaming or trying to nurse. The home nurse that visited us recommended a supplementary feeding of formula based on her weight loss (9.7 at birth and 8.3 three days later) and we did this twice out of sheer exasperation - I had a long and difficult labor and was discharged from the hospital just 24 hours after her birth. Neither my husband or I had slept more than an hour or so in days. I also pumped a few times so that if supplements were needed we would not need to use formula.
-Day 4 or 5, my milk came in very strong and I became engorged. In the next few days it became clear that I had a very abundant supply and a forceful letdown. The primary issue now became that my daughter was choking, sputtering and gulping for air at the breast as it was like drinking from a fire hose! Her latch was not textbook - she seemed to clamp down with her gums (I assume to control the fast flow) and thrust her tongue more than actually suck. I tried to work to get her gums to flare, pull chin down, etc. which sometimes helped. She rarely nursed more than 10 minutes per session and on one side only, pulling off frequently to breathe with her mouth. Nipples healed fully and I did not experience any more pain while nursing.
-October 1 (3 wks old) I saw an IBCLC at our peds office to discuss how to manage the oversupply/OALD. She watched us nurse with minimal difficulty. Baby was weighed before and after, and she had taken in 4 oz. on one breast in less than 10 minutes. She gave me some tips about nursing with the OALD - all things I'd already been doing (moderate block feeding, reclined positioning, pull baby off when letdown occurs and catch spray with cloth, etc.). She reassured me that some of these kinks would work themselves out with time as my body adjusted to my daughter's needs. I felt good and we went on our way. Shortly after, assuming that nursing was well established, we did introduce a pacifier to help with my daughter's constant need for non-nutritive sucking (if suckling for comfort at breast and milk came out, she was very mad). She happily sucked the paci and continued to nurse well (or so I thought). It was a godsend for our fussy evenings where she wailed from 4 or 6 pm to 10 or midnight.
-October 10 (5 wks old) I saw another IBCLC independent from my peds office. The newest development in the past few days was that my daughter had begun fussing, bobbing, and clawing at my breast during feedings - particularly at night - although sometimes during the day. I was in tears most feedings seeing how upset my daughter was and worried that she was hungry but not eating. She also began spacing feedings out to about 6x per day from 10-12x previously. I was worried about how long between feedings she was going. The LC was not able to get baby to suck on her finger or latch correctly at my breast for the entire visit. Her assessment was that baby does not know how to suck and just gums the breast. With my oversupply issue beginning to correct itself, baby is having to work to eat and thus the fussing and angry feedings. She recommended suck training with tube and syringe, pumping 8x per day, and nursing when possible. I was devastated and overwhelmed. Here I thought that my issue was *too* much milk and now was being told my baby doesn't know how to eat. I was also told she has a high arched palate. The LC also instructed me to have cranio-sacral work done to help with mild torticolis (sp?) on one side of her neck. I left the appointment and cried and cried. I want desperately to EBF my daughter but knew the regimen was too intensive for me to maintain for any length of time, particularly given my fragile emotional state and lack of sleep.
-October 11, I saw our pediatrician for a weight check and to discuss the advice I had been given by the lactation consultant(s). She was pleased by baby's weight gain pattern. Her assessment was that baby *does* know how to suck, or her weight would be suffering. (Baby was born at and is still above 90th percentile.) She watched me nurse and noted baby was coming off breast frequently, did not have the best latch but was still doing relatively well. She sucked on the ped's finger right away but then started gumming it after a bit. She felt baby is a lazy eater given how easily she was able to get milk due to my OALD, and that as she continues to develop, her suck/swallow will get better and we'll do just fine though it might be a bit fussy in the meantime. She told me to continue nursing my baby when she is hungry, work on practicing sucking with my finger when baby is willing, and to return for a weight check in 10 days. She also told me to not get hung up on how long baby nurses, or how frequently (within reason). We discussed that I might have been upsetting baby by trying to force feedings when she was not truly hungry or during times when she was just simply upset (fussy evenings). Finally, she reminded me that baby is only 5 weeks old and BFing takes time to perfect for both mama and baby so not to get discouraged. I left the appointment feeling much better about my ability and baby's to work through this in a way that is healthy / manageable for both of us.
But....I am still second-guessing myself and confused by all the conflicting advice I've been given. She definitely is NOT a good sucker, though we are getting by. Feedings are hit or miss. I do think there are times she is hungry and gets frustrated because she can't immediately latch. I try to catch her as she wakes up from a nap since she seems to do best then. I'm worried about how much she is actually getting, and what that means for my milk supply. She still does not eat for more than 10 minutes (often less) and I'm already worried about her ability to suck on a bottle when she goes to daycare in 7 weeks. The few bottles she's been offered have taken her an hour to do 1-2 oz.
Has anyone had a similar experience? Did it work itself out? Based on my situation, do you have any advice for me?
Again, sorry for the super long post. I really, really want to BF my daughter but not at the risk of my emotional health. I subscribe to the theory of happy mama, happy family...and BFing is anything but happy for us right now.
Thanks in advance for your words of wisdom!