I'm currently struggling a bit with breastfeeding my son. He's now 7 weeks and 3 days old. Unfortunately, I'm not able to breastfeed exclusively at this point in time. We just finished our first can of formula last night. =\ I desperately want to continue with breastfeeding (and hopefully someday go back to exclusive breastfeeding), but I've been told several aspects of my lifestyle - which I cannot immediately change - may cause problems with supply. In addition, we're supplementing a feeding before bed with a bottle of formula and rice. His pediatrician recommended this and I'm only using formula because after the first few weeks of his life, I've been unable to pump more than one half oz - and usually not even that much.
My son had a little bit of a rough start due to Neonatal Abstinence Syndrome caused by medication I took throughout pregnancy and will continue taking for the next 3 months, if not longer. I'm only going into this because I feel it is relevant. While my son's NAS was relatively mild, he still suffered from several of the more common symptoms, the most worrisome has been poor feeding. We are completely past this now, but it presented complications during the first weeks of his life. I put him on the breast within a half hour after delivery. We were discharged because he seemed to be doing very well. However, after a quick check-up two days later, it was determined that he had lost too much weight. He weighed 8 pounds 1 ounce when he was born, and had lost around 9 ounces within the first three or four days. This worried his doctors due to NAS babies being notoriously poor feeders. He was admitted into the hospital and given IV fluids and supplemental formula. After about 24 hours, I had my mother bring in a pump and was able to give him expressed milk instead of the formula. After he was discharged, five terrible days later, I continued pumping but had given up on nursing because he just didn't seem to be able to latch on correctly. (He was still quite uncomfortable, as if the shock of being born isn't enough in and of itself.) I was terribly sore and just couldn't cope with it anymore. (It should be noted that I tried to breastfeed my first two babies, but only managed to stick to with it for about two weeks with each of them. With the first, I was very young. The second was quite sick and so was I.) After more than a week of giving him only bottles, I decided to try again because I had been forced to give him more and more formula as the amount I was able to pump decreased. I tried very hard to pump every two hours, but being a single mother with a toddler and an 8 year old, it was extremely difficult. By this time I had done loads of research about latching on, and with some practice, we managed to get it down pretty good. The hospital I delivered at does not have a lactation consultant, but I was able to track one down a few days after my first attempts to begin nursing again. She told me his latch was good and that he was gaining an adequate amount of weight. So although I felt apprehensive about weight gain, I continued exclusively breastfeeding. Everything seemed to be going well, until I took him to see his pediatrician about two weeks ago. He wasn't overly concerned, but recommended supplementing. So, I'm now very concerned about supply and nipple confusion. He has only one bottle at night, before we go to bed - but his latch isn't as deep as it was before so I'm somewhat sore. I've always been told there should be no soreness if baby is latching on correctly. Yet the lactation consultant I have met with insisted his latch was appropriate - despite the fact that I was feeling intense pain up until two weeks ago. Right around the time his pediatrician recommended supplementing! I was thrilled when the pain faded away, but now it seems we're having issues with latching on yet again and I'm becoming more sore with each feeding. I have noticed a clicking sound, which I read about but hadn't had to deal with up until these past few days. I break suction and have him latch on again, but the clicking usually continues. My main concern with his latch is poor milk transfer, which I worry will lead to low supply and then drying up completely. Two others concerns regarding supply: I'm trying to quit smoking and I'm tapering off of Subutex (for opiod dependence) after many years in treatment. I only smoke five to ten cigarettes a day, but I'm having real difficulty with reducing my intake further. I'm tapering off of Subutex, but this is not something that can be done quickly. I can't just stop taking it or I'll have terrible withdrawal, and he might have some mild symptoms himself - though I doubt it. The amount reaching him is said to be miniscule. So, I'm not really sure what to do. I don't really have time to research these things as much as I'd like to, so I joined this community. I live in a very backward area. People here generally react to breastfeeding somewhat negatively. There is only one lactation consultant nearby, that I know of, and while she's quite nice and very supportive, I'm not too thrilled with her. Aside from family, I have very little support. Even most doctors seem to feel like it's no big deal whether or not I'm able to continue with breastfeeding. I disagree. It's very upsetting. I'm far more committed to it this time around. Any advice anyone has to offer will be greatly appreciated!
A few more questions...
I've used Fenugreek to boost my supply and it has worked wonderfully! Yet now I'm wanting to stop taking it because I'm concerned my body will build up tolerance and quit responding to it altogether. Is this likely? It may just be paranoia, but I feel without the Fenugreek, I'm not producing enough. I stopped taking it for a few days, and he began kicking and tugging at the breast (without removing his mouth from the nipple). I read this was likely due to the milk not flowing quickly enough, that he was becoming irritated with the slow flow. With the Fenugreek, I have oversupply. But... I can't help but feel oversupply is better than no supply. I'm wondering, what are some other signs that milk supply is low and beginning to dry up? I know the more often baby nurses, the more milk my body produces. Which brings me to my other big concern... How long and how often should he be nursing?? Sometimes he seems to be satisfied after only five minutes! But I was told in the hospital he should nurse for 10 minutes on each side every two to three hours?? I've come to the conclusion that the nurses I encountered were wellmeaning, but completely clueless about breastfeeding. It's a very small hospital. At first, I tried timing every feeding and writing it down. It sounds silly, but this just added to the stress I was already feeling. So now I'm not as intent upon the clock. I just glance at the time at the beginning of most feedings, and within 10 minutes he often falls asleep or loses interest. I'm just so frustrated by this. My mom has insisted that he is just very efficient, but I'm not convinced. He doesn't poop as often as he should, though he seems happy and healthy. I'm not sure if this pooping issue has to do with the fact that he's drinking formula also, or if it means he's not getting enough breastmilk. Plenty of wet diapers... But still, I'm concerned he isn't taking in as much milk as he should, which will affect supply, and so on. I'm very confused about how to tell when the breast is completely drained because unless I'm taking Fenugreek, my breasts never feel hard. Also, if I'm not taking Fenugreek, I stop feeling letdown reflex.
I have many, many other questions, but for now, just one more. When I started putting him to the breast again, I used a shield. I thought it was wonderful! The pain was not nearly as intense! Then I did some research and realized it wasn't such a wonderful thing after all. So, the next feeding, I didn't use the shield and it was unbelievable how much his latch had improved! Suddenly he was latching on deeply, more so than ever before. The soreness lingered a while longer, but faded soon enough. I use NUK nipples, which are supposed to be more like mother's breast and so reduce chances of nipple confusion. But like I said, his latch isn't as deep as it was before we began supplementing this second time. I'm wondering if maybe it might be okay to use the shield just once in a while? I used it only two days, and when I quit using it, the improvement in his latch was almost miraculous. The shield is also NUK - BarelyThere Nipple Shield. Yet it is there, and I know it's going to affect milk transfer if I use it. I can't quite bring myself to drop the supplemental feeding simply because he is thriving now and he while he wasn't doing poorly, he wasn't quite thriving before.
I'm sorry this is so long! I've never been very good at getting straight to the point. I felt like sharing our history might give anyone wanting to offer advice a better idea of why we're struggling right now. I never dreamed breastfeeding would be so stressful. So complicated! Maybe it's just me, but it's been an endless stream of questions and googling for the past 7 weeks!