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Thread: Reflux... Hours of nursing... Going back to work...

  1. #1

    Default Reflux... Hours of nursing... Going back to work...

    I apologize for any typos... I am writing this on an iPad.

    My baby is 9 weeks old tomorrow. He was 8lbs 1oz at birth. He lost almost a pound in the hospital. However... I held out with EBFing and 5 days after his birth... When we were released (section)... He had gained and was 7lbs 4oz.

    His gain since has been slow. 8lbs 8oz at one month and 10lbs 3oz at 2 (immediately after taking a 3oz bottle). His has plenty of wet diapers and several dirty ones a day.

    However... He has been diagnosed with reflux. It was silent at first but now it's the more text book variety. He nurses all day but doesn't eat. My supply was dropping so I started pumping and eating oatmeal. So I nurse him on demand all day (9 to 10 sessions) and I pump and get about 9oz a day.

    Nursing is tough. We have never had a problem with latch. During the day it goes OK. Sometimes we will have a great session (20 to 40minutes... He pulls off full). But In the evenings especially it's the worst bc it's like he is frustrated that my let down is not faster. Add to that the reflux and evening nursing is just awful. He's either arching and in pain.... Or he's feeling up to eating finally and he just gets mad at the breast. Tonight I nursed him from 10:30 to 11:30... When he would actually calm down and suckle...he did great... But it was like 5 minutes of the whole hour and so now he is still starving. I don't want to supplement (even with expressed milk) bc I feel like my body should be responding to his needs... But I got desperate and gave him a 4oz bottle. He drank almost 2oz before trying to just comfort nurse the bottle. He's now back on the breast at 12:15... Just comfort sucking and wide awake despite hardly sleeping today. ( up at 9am...took 2 one hour naps and then slept from 8 to 10:30)

    I should be returning to work next week... But it's completely impossible so I am taking a few more weeks despite the financial pain to do so. He doesn't sleep... So I don't sleep. The medications ( Zantac and Prevacid ) are not helping. Is my only option sensitive tummy formula? I need to get something working in the coming weeks bc I cannot afford to not go back to work.

    I have cut dairy, chocolate and caffeine from my diet. My pediatrician does not feel it is a milk protein allergy. I'm thinking about cutting bad carbs / gluten next....

    Help :-(

  2. #2

    Default Re: Reflux... Hours of nursing... Going back to work...

    Oh, I wanted to add a few things (now that I have a few hours of sleep and can think a little more clearly).

    1. Should I consider exclusively pumping? How does anyone accomplish this when they are the sole caregiver of a baby? If I go this route, is there a way to get my body to respond better to the pump (I can only seem to get an ounce out of each breast unless I go like 12 hours without pumping).

    2. I am block nursing now, or rather I am during the day. At night we switch back and forth a lot b/c he gets so frustrated. Again, though, I am not sure if he is frustrated with the breast or if it's just his discomfort. He seems to have gas pain as well.

    3. A friend mentioned that her cousin had the same problem and they switched the baby to sensitive tummy formula. I do not have a problem with formula feeding (I FF my now 7 year old), but I'd like to keep breastfeeding. I've made it so far And my DH's family has like 9,000 allergies and weird rare conditions that I'd like my baby to get the benefits of being breastfed at least a year

  3. #3
    Join Date
    May 2006
    Posts
    19,889

    Default Re: Reflux... Hours of nursing... Going back to work...

    Welcome to the forum and congratulations on the baby and on making it to 9 weeks of nursing!

    When there's a concern about weight gain, the first thing we like to do is to asks some questions. So:
    - Did you have IV fluids during your birth, and if so, for how long did you have them?
    - Has baby always been weighed nude, using the same scale?
    - What was the baby's lowest weight? Were there any other weight checks aside from the ones you mentioned, and if so, what numbers did you get?
    - Was baby premature, sleepy, or jaundiced at all?
    - Did baby at any time nurse less often than 8 times a day?
    - Are you currently on any form of hormonal contraception? (Including Mirena IUD)
    - You say you're block nursing- what is your motivation for doing that? Do you have oversupply? Also, are you feeding from one breast at a time for one feeding, or for several feedings in a row?

    Based on what you've posted, I don't see any reason for you to consider either formula or exclusive pumping. First of all, if there's a problem with supply, that can probably be fixed. Second, except in very rare cases, formula is not easier on a baby's tummy than breastmilk, no matter what the marketers call it. "Sensitive tummy" formula might be better than regular formula, but it's not better than your milk, no matter how hard the marketing department at the formula company tries to convince you otherwise. Third, if supplementation does become necessary, that can be combined with nursing. Ideally you'd supplement with expressed breastmilk, not formula- but let's cross that bridge when and if we come to it! Fourth, exclusive pumping is much, much, much harder than nursing or combining nursing and pumping. It's hard to maintain and/or increase supply, it's immensely time-consuming, it's logistically challenging (think about storing, warming, and transporting large quantities of expressed milk, maintaining a pumping schedule, pumping in public, etc.). I would only pump exclusively if there were no other recourse- for example, if the baby was unable to nurse.
    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!"

  4. #4

    Default Re: Reflux... Hours of nursing... Going back to work...

    Thank you thank you thank you for your response!!!!!!!!!


    - Did you have IV fluids during your birth, and if so, for how long did you have them? I was a c-section and had pre-eclampsia, so I was on a bag of mag for 24hours post-op. I was allowed ice... but I imagine I may have been on IV fluids since I wasn't allowed to eat / drink for 24 hours. I was on fluids briefly before the section while they were monitoring me as well.

    - Has baby always been weighed nude, using the same scale? Yes. I should also add that the Dr. has not expressed concern over his weight, since he has reflux they are happy to see him gaining at all.

    - What was the baby's lowest weight? Were there any other weight checks aside from the ones you mentioned, and if so, what numbers did you get? Lowest weight was at 7lbs 3.6oz I believe, just before leaving the hospital. Other weights are:

    10/9 - 8lb 1oz
    10/13 - 7lb 4oz
    10/15 - 7lb 6oz
    10/18 - 7lb 9.7oz
    10/23 - 7lb 14.1oz
    11/6 - 8lb 8oz
    11/20 - 9lb 1.3oz <---- diagnosed with reflux
    12/9 - 10lb 9oz <---- weighed immediately after eating 3oz bottle

    - Was baby premature, sleepy, or jaundiced at all? He was born at 37 weeks. The only time he was sleepy was the 24 hours after his circumcision.

    - Did baby at any time nurse less often than 8 times a day? No.

    - Are you currently on any form of hormonal contraception? (Including Mirena IUD) No medication of any kind, aside from a prenatal, vitamin D & C

    - You say you're block nursing- what is your motivation for doing that? Do you have oversupply? Also, are you feeding from one breast at a time for one feeding, or for several feedings in a row? He was developing frothy green explosive poo diapers, so after researching on the site here, I saw this was often a fore/hind milk imbalance. So I started block nursing (one breast over the course of 2 hours before switching to the other breast). I still do that though we *usually* have 2 hours between feedings, so it's more like I just alternate breasts. IE: Left at 1:00, Right at 3:00, Left at 5:00, etc. The only time I go back and forth is around 8pm at his bedtime feed. This is his worst of the day. He's almost always in pain or discomfort so even trying to get him to nurse is like wrestling a bag of snakes. I swaddle him now, but he still arches, pulls away, etc. It takes about 60 - 90 minutes for him to get his belly full enough / fall asleep. He then will sleep for 3 hours and be up for another three (until about 2am) ... during which I nurse him almost the entire time, switching back and forth as he gets upset.


    Quote Originally Posted by @llli*mommal View Post

    Based on what you've posted, I don't see any reason for you to consider either formula or exclusive pumping. First of all, if there's a problem with supply, that can probably be fixed. Second, except in very rare cases, formula is not easier on a baby's tummy than breastmilk, no matter what the marketers call it. "Sensitive tummy" formula might be better than regular formula, but it's not better than your milk, no matter how hard the marketing department at the formula company tries to convince you otherwise. Third, if supplementation does become necessary, that can be combined with nursing. Ideally you'd supplement with expressed breastmilk, not formula- but let's cross that bridge when and if we come to it! Fourth, exclusive pumping is much, much, much harder than nursing or combining nursing and pumping. It's hard to maintain and/or increase supply, it's immensely time-consuming, it's logistically challenging (think about storing, warming, and transporting large quantities of expressed milk, maintaining a pumping schedule, pumping in public, etc.). I would only pump exclusively if there were no other recourse- for example, if the baby was unable to nurse.
    My gut was telling me that formula would be a mistake... so I am glad to have some backup for that (well meaning friends try to push it). I had an oversupply during the first couple weeks that I was able to correct (and now have a freezer of milk), but I pump at least 8 to 9 oz a day of excess... when I *can* pump. Some days I just am not able to b/c I cant put him down. He is in my arms about 14 to 18 hours a day. I was really engorged on the left this morning, so I fed him on the right while pumping the left and got 3 1/2 oz.

    Speaking of... I put him in a basinette/cosleeper. For two nights he's slept in the basinette from 8 until 11 and then 2am until about 6... so then I bring him into bed with me and he just side nurses on demand for 3 hours until I get up. So that is probably why my left was engorged and my right was fine.

  5. #5
    Join Date
    May 2013
    Location
    Oregon
    Posts
    94

    Default Re: Reflux... Hours of nursing... Going back to work...

    [QUOTE=@llli*mrsb0427;1327509]My supply was dropping so I started pumping and eating oatmeal. So I nurse him on demand all day (9 to 10 sessions) and I pump and get about 9oz a day. QUOTE]

    Did I read that right? You nurse 9-10 times per day AND can pump 9 oz??? That is not indicative of low supply. Talk about major oversupply!!! If I was EBF (which I am on weekends when I am with DS - I work full time) there is no way I would ever get that much milk AND be feeding him from my breasts on demand.

    Am I wrong here? Anyone disagree?
    We , , , and with my little monkey, born 9/30/2012.

  6. #6
    Join Date
    May 2006
    Posts
    19,889

    Default Re: Reflux... Hours of nursing... Going back to work...

    Thanks for the additional information. Based on what you've provided, I don't know that I see any major red flags. The baby's weight gain has been a bit slow, but it's also been pretty steady. It is normal for babies to wander around on the charts- growth isn't always happening at the same rate. And your doctor isn't concerned- that's another terrific sign that things are going better than you think.

    Since weight gain is okay and the doc isn't concerned, my guess is that the fussiness you're seeing has little or nothing to do with supply or flow speed, and is simply a developmental stage that a lot of babies go through. It can be pretty extreme, so much so that it's sometimes called evenings-only colic. You might want to read through this link on evening fussiness, and try the tips at the end: http://kellymom.com/parenting/parent...fussy-evening/

    If this were my baby, I would want to talk to the pediatrician again, and discuss the reflux meds. Maybe your baby is on too small of a dose, especially since he's grown a couple of pounds. I would also nix the block feeding. When there is a concern about weight gain, what matters is not about milk quality (i.e. how much so-called foremilk or hindmilk the baby gets), but rather about quantity. All milk- both hindmilk and foremilk- contains everything a baby needs to grow and thrive, and a baby would do quite well on a diet of foremilk alone provided he got enough of it. Block nursing is designed to reduce the quantity of milk you make, so it's something you want to do only if you are absolutely sure that you have a problematic oversupply. It sounds like you might have some degree of oversupply- as the PP said, getting 9 extra oz per day is pretty significant- but I don't know that I'd be working quite so hard to reduce supply at this point.
    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

    Default Re: Reflux... Hours of nursing... Going back to work...

    your baby has gained 3 pounds in 2 months. This does not strike me as terribly slow gain. On the other hand, it is not fast gain either, and block nursing should only be done when there is very fast gain. (more than 8 ounces per week.)

    article(s) on this website said to block nurse due to green poops? can you please tell me which article(s) that was? That is not the current thinking on block nursing and so that will need a correction.

    What nursing positions have you tried? What works best for you?

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