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Thread: Questions about reflux and pumping to up supply

  1. #11
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    Default Re: Questions about reflux and pumping to up supply

    If you go on a reflux forum, I think you're going to find people who see your baby through the reflux lens. Honestly, one of my biggest problems with reflux is that it is over-diagnosed. Yes, there are definitely babies who have real problems with reflux. Babies who are in pain, babies who feed less than they should and gain less weight than they should as a result of that pain. But the symptoms of reflux can be cryptic, and it's very easy to assign every puzzling baby behavior, every fluctuation in weight gain, every spit-up event, to reflux. This is why most babies did just fine before the invention of anti-reflux meds- most of them didn't have reflux. And those that did... Well, they eventually outgrew their reflux and did just fine.

    Your baby seems to be gaining weight just fine. You're not in pain when you nurse. The baby is nursed on demand, spits up but isn't in pain when she does it, and eats a normal amount. She's got fat rolls and the doctor isn't concerned. I'm just not seeing a reflux-y pattern here, YKWIM?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  2. #12
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    Default Re: Questions about reflux and pumping to up supply

    Mommal...thanks foe weighing in. I absolutely agree with everything you are saying. I am very skeptical about this. Yet, the ibclc who gave me this diagnosis is very reputable and experienced so im torn.

    I dont want to put baby on meds and go down that road. I just have a slight concern that this is the turning point where her weight gain is slowing and plateauing, natural or due to what? Combined with my seeming dwindling supply, due to what?

  3. #13
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    Default Re: Questions about reflux and pumping to up supply

    Why do you think your supply is dwindling? It is normal for supply to regulate after the first few months and for breasts to feel soft. In fact as you've noticed that is what has made things BETTER! This does not mean you have a problem with supply. In fact, I could put together the following narrative for you: You started off with quite a bit of oversupply and fast flow, leading to baby having trouble nursing and very rapid weight gain early on. Now your supply is more closely matching what baby needs, your breasts feel better, nursing feels better, baby is happier, and weight gain is proceeding at a more normal pace. ALSO, do keep in mind that the fastest weight gain is at the very beginning. It is normal for weight gain to slow down as baby gets older. See the kelly mom weight gain link I posted originally - you will see that the biggest weekly weight gain is in the beginning.

    I'm with mommal and LLLMeg and YOU - skeptical about the reflux diagnosis. Even reputable and experienced clinicians are not right 100% of the time. Would it be possible to discuss your concerns with the IBCLC and undertake a trial of doing nothing - just nursing as you are, no meds, no pumping, for 2-3 weeks and see what happens? If baby gains well (on the same scale) over that time, you continue as you are. If weight gain is not acceptable, then you start interventions. Because pumping is an intervention and medications are an intervention and ALL medications, even relatively safe ones, have side effects.

  4. #14
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    Default Re: Questions about reflux and pumping to up supply

    I see you keep mentioning your supply dwindling. What is leading you to believe that as opposed to natural regulation?

  5. #15
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    Default Re: Questions about reflux and pumping to up supply

    Quote Originally Posted by @llli*bfwmomof3 View Post
    Why do you think your supply is dwindling? It is normal for supply to regulate after the first few months and for breasts to feel soft. In fact as you've noticed that is what has made things BETTER! This does not mean you have a problem with supply. In fact, I could put together the following narrative for you: You started off with quite a bit of oversupply and fast flow, leading to baby having trouble nursing and very rapid weight gain early on. Now your supply is more closely matching what baby needs, your breasts feel better, nursing feels better, baby is happier, and weight gain is proceeding at a more normal pace. ALSO, do keep in mind that the fastest weight gain is at the very beginning. It is normal for weight gain to slow down as baby gets older. See the kelly mom weight gain link I posted originally - you will see that the biggest weekly weight gain is in the beginning..
    thank you! i love this and pray that this is the case. unfortunately, things have taken a turn for the worse - baby has been nursing for only 2 minutes (lackluster) then falling asleep, sleeping for longer than 90 min (a prob since I need to feed her every 2 hours around the clock to get what she needs), and she has cried at my breast refusing to feed a few times. in last 24 ours she has not fed 10-12 times. and these feeds are just way too short. She doesnt seem too eager to eat at all. She did poo today, and is peeing (how much should a wet diaper weigh to count as soaked?). She has been fussy, sort of a whiny tired cry, looks like she has tummy ache, have seen some things that could be interpreted as silent reflux, though no shrill painful cries. she is not pulling on and off and shes staying on for most of the letdown. its like she comes off to give her self a break. (no spraying, its not forceful). hoping its just an off day...does this sound normal for 11 weeks? Im taking her to ped tomoorrow to get her take on this and weight checked. we can compare to weight that was checked on one of their scales last week.


    Quote Originally Posted by @llli*bfwmomof3 View Post
    I'm with mommal and LLLMeg and YOU - skeptical about the reflux diagnosis. Even reputable and experienced clinicians are not right 100% of the time. Would it be possible to discuss your concerns with the IBCLC and undertake a trial of doing nothing - just nursing as you are, no meds, no pumping, for 2-3 weeks and see what happens? If baby gains well (on the same scale) over that time, you continue as you are. If weight gain is not acceptable, then you start interventions. Because pumping is an intervention and medications are an intervention and ALL medications, even relatively safe ones, have side effects.
    we did this after first visit. then during 2nd visit 2 weeks later, she asked me why i hadnt given baby zantac. I said I just dont see my daughter as a baby who is in pain and needs medication. She doesnt cry. she said well baby not taking in enough milk is a sign of pain. she has a swallowing problem - her milk is coming back up. way things are going now, im starting to wonder if she's right...my heart hurts.

  6. #16
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    Default Re: Questions about reflux and pumping to up supply

    Quote Originally Posted by @llli*zaynethepain View Post
    I see you keep mentioning your supply dwindling. What is leading you to believe that as opposed to natural regulation?

    My supply could be fine, but if my body is producing a certain amount of milk and my baby is not removing it (b/c eating is painful for her???), that would make my supply do down. I could be generating only 16 oz a day. Im going back to work Jan 6...so I worry about having enough (and how to get this baby to accept a bottle!) . can you reach a point of no return where your supply is so low, its really hard to get it back? i want to EBF as I have from birth, its SO important to me. the thought of not making enough milk for her & having to give my baby formula....scary!

    again, i wouldnt be concerned if i had a baby who was staying on breast, eagerly nursing, removing milk every 90-120 minutes. should i be pumping to take remaining milk out of breasts that she doesnt remove after only nursing for 2 minutes? if she takes extra long nap, should i pump while she's sleeping?

  7. #17
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    Default Re: Questions about reflux and pumping to up supply

    ladies, i took fenugreek, could that cause these symptoms?

  8. #18
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    Default Re: Questions about reflux and pumping to up supply

    ladies, i took fenugreek, could that cause these symptoms?
    Do you mean the short feedings? then yes, IF the problem is forceful letdown and the fenugreek made it worse by upping your production beyond normal. If you mean tummy issues, then possibly yes, I know that fenugreek can sometimes cause tummy issues for mom and i think baby as well.

    But the larger question is-why are you taking fenugreek. IF and I stress IF your baby is not removing milk properly then you do need to pump OR hand express and that will keep your milk production fine.

    Now, I have another question. Who diagnosed reflux??? It cannot be your IBCLC, unless your IBCLC is also a medical doctor? Zantac is a prescription medication, is it not? Prescriptions can only be given by doctors. Diagnoses of medical condition like gerd (reflux) -and tongue tie, for that matter- can only be made by MDs. At least in the USA. Yes, of course, an IBCLC can suspect these things and may well be right (even more right than the average doctor as far as breastfeeding related issues.) But technically an IBCLC cannot diagnose anything nor prescribe treatment or medication. At least, that is what the IBCLC’s I know personally have told me. Over and over again.

    One thing to consider is to try the zantac and see if it works. I am not saying this is what you should do, but if the zantac obviously helps or obviously does not help, you will have a clearer picture. I understand wanting to avoid meds but SOMETHING does seem to be wrong if your baby is not wishing to nurse at all.

    I really wonder if there is a latch issue, or a sucking issue, casuing poor milk transfer and/or baby is getting tired out nursing. The slowdown in weight gain post tt procedure is really niggling at me.

  9. #19
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    Default Re: Questions about reflux and pumping to up supply

    Now, about your supply & baby getting enough concerns.

    Baby is being weighed tomorrow, yes? So you will have a better idea of what is going on there so please report back to us and let us know how that goes.

    Try to remember that a baby eats to live, to move, and to grow. A baby this age is not moving all that much so lets leave that aside for a minute.

    A baby might not be taking in enough to GROW entirely normally and that is how we know something may be wrong. This is why a baby is weighed. But a baby is not going to be close to being dangerously underfed and still be growing anywhere close to normally, as your baby has been. So while I think watching output is smart, I suggest not obsessing over it. If a baby this age is pooping ~daily there is little chance baby is not getting at least enough milk to at least live no matter how little baby pees. many babies stop pooping daily or anything like it by this age and are doing just fine.

    Milk production does not disappear overnight, and it does not come back overnight either. But a mother who has established a normal milk production in the first couple of months (as you clearly have, imo) is not going to have all that much trouble bringing milk production back to 'enough' IF it slips below normal due to a poorly nursing baby.

    Hope that helps. It's kind of late here and I am not sure I am making sense!

  10. #20
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    Default Re: Questions about reflux and pumping to up supply

    Quote Originally Posted by @llli*lllmeg View Post
    Do you mean the short feedings? then yes, IF the problem is forceful letdown and the fenugreek made it worse by upping your production beyond normal. If you mean tummy issues, then possibly yes, I know that fenugreek can sometimes cause tummy issues for mom and i think baby as well.

    But the larger question is-why are you taking fenugreek. IF and I stress IF your baby is not removing milk properly then you do need to pump OR hand express and that will keep your milk production fine.

    Now, I have another question. Who diagnosed reflux??? It cannot be your IBCLC, unless your IBCLC is also a medical doctor? Zantac is a prescription medication, is it not? Prescriptions can only be given by doctors. Diagnoses of medical condition like gerd (reflux) -and tongue tie, for that matter- can only be made by MDs. At least in the USA. Yes, of course, an IBCLC can suspect these things and may well be right (even more right than the average doctor as far as breastfeeding related issues.) But technically an IBCLC cannot diagnose anything nor prescribe treatment or medication. At least, that is what the IBCLC’s I know personally have told me. Over and over again.

    One thing to consider is to try the zantac and see if it works. I am not saying this is what you should do, but if the zantac obviously helps or obviously does not help, you will have a clearer picture. I understand wanting to avoid meds but SOMETHING does seem to be wrong if your baby is not wishing to nurse at all.

    I really wonder if there is a latch issue, or a sucking issue, casuing poor milk transfer and/or baby is getting tired out nursing. The slowdown in weight gain post tt procedure is really niggling at me.
    well, at 2 or 3 weeks she was crying, arching when breast feeding and overnight. i showed video of her behavior and he said could be colic or reflux. ped said they dont test for reflux but gave rx for zantac so we could see iff it would help. we gave it to her, she drooled most of it out then spit up the rest. we never gave it again. the arching and crying stopped i think with block feeding. she still writhed at night but would pass gas or have a bm and be fine so we thought this is just gas. so there was no diagnosis by dr. peds give out zantac very easily.

    the tt issue is hard for me to talk about. my heart aches as im not sure if i did the right thing. my baby was gaining great, she brought in my milk abundantly, she could hold a pacifier in her mouth, suck on a finger, i had no pain. not your typical tt baby as i have come to learn. the ibclc said she saw a tie. she kept telling me that my baby's suck should feel like the pump and if it didnt, when my supply regulated she wouldnt be able to remove milk effectively and i could lose my supply. she said it looked like my baby was chomping. (now that i think of it, im not sure how a baby gains a lb a week by chomping without damaging moms nipples.) so i took her to a local ent who said the tie was not significant. 2 weeks later i saw the ibclc, baby only intaked 2.5 oz (she told me she shoulld takke 3-5 at her age) and she told me there was a problem with all the local ents not being able to recognize tt and many of her clients had to go to albany ny to see kotlow, who magically solved all their breast feeding problems. so we drove up there, he did the revision (ptt and ult) and we suffered 2 weeks of agony as my poor babies latch got worse and she clicked and gulped air with every swallow. we couldnt bring ourselves to do the stretches / exercises as she didnt like it. it looks like maybe it reattached but i see her sticking her tongue way out and ridging it. dont remember seeing that before but maybe cos of her age? also i think her tongue used to look square edged now its more pointed. i took her for cst and chiro but still her suck didnt feel like the pump. now i know it doesnt need to feel like pump.

    the new ibclc says her tongue looks fine. i asked if maybe it reattached and she''s getting tired sucking or it hurts to suck*. she said no its reflux. most ppl say revision made a huge difference, for some it is instant. i honestly cannot tell. she definitely now has a deeper latch at times (esp when im "empty"), and seems less gaggy about pulling nipple deep into her mouth. my nipple is getting pulled long, rather than coming out like lipstick shape. her suck blisters are much better. her suck swallow breathe is much more coordinated. again maybe baby just needed time to work out these issues and maybe they were result of over supply/ fast letdown. i just have to tell myself i did the right thing and she needed it b/c i start to feel despondent thinking otherwise. id like to thiink kotlow is professional and wouldnt revise a baby who did not need it.

    *she will occasionally comfort suck for quite a while so prob not

    ladies when i let down sometimes it sounds like something hard (air, milk?) is hitting my baby's tummy. does anyone know what thats about.

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