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Thread: Under 2 weeks, and a host of problems

  1. #1
    Join Date
    Feb 2006
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    11

    Default Under 2 weeks, and a host of problems

    Hi everyone -

    Boy am I glad to have found this website, because first of all I have to say it helps SO MUCH to learn that other people have the same problems I do. I have a number of books on breastfeeding and some days just looking at the illustrations of happy mothers and happy babies peacefully feeding makes me burst into tears. I know it doesn't start out that way, and that it does get better, but it's hard to keep that in mind sometimes.

    Anyway, Dorothy was born by C-section 12 days ago, and breastfeeding has been a struggle from the start. There were so many C-sections that day that the nursery didn't get her to me until about four or five hours after birth, and neither of us knew how to nurse well enough to get very far. She was given formula that night, and several times the next couple of days, but over the next few days she lost close to 11 oz, 10% of her birth weight. I saw the hospital's lactation consultant every day after that, and started pumping my milk and bottle-feeding her after trying to breastfeed, and she gained back 2 oz in a day; her first doctor's appointment was last Wednesday, and she had gone from 6lbs 2.9oz at discharge to 6 lbs 6 oz in the two days since leaving the hospital. I think she's gaining weight alright now, and we're off formula entirely. I'm pumping regularly but trying to limit bottle-feeding to only one or two a day.

    BUT:

    My right breast has an inverted nipple, and Dorothy has never been able to nurse on it (I do most of my pumping on that side);
    Despite all my efforts, we have latch-on problems no matter what position I'm in - she seems to have learned to clamp down. We started with the football hold and that got too painful so I started over with the cross-cradle hold; that started out very well but now she's clamping on that one, too. Is this something she'll grow out of? Is it too late to teach her to stop, and how?
    She seems to be having enough wet diapers, but the past few days the number of wet diapers seems to have gone down in comparison with the number of poopy ones. She poops nearly as much as she pees, and sometimes it seems like more. She also can be rather gassy, despite burping.
    She can be very hard to get onto the breast, and once she's there, I'll get a good few first minutes of sucking and swallowing but then I don't hear swallowing anymore even though she seems to be taking long sucks. She'll stay on for quite a while on her own, just sucking, until she falls asleep and the nipple falls out of her mouth; but when I move her, she is clearly still hungry and usually starts rooting again or chewing her hands.
    She also cluster feeds, usually from about 7 pm until 10 or so, then wakes up about two to three hours later for the first late feeding. Much of the time I have to give her a bottle at least once in the night or she won't go back down.

    That's most of the problems, or the ones I can think of right now; I'm sure my positioning isn't quite right, but I'm most worried about the initial suck-swallow and the lack of it later. I can't really afford regular meetings with a lactation consultant and I'm not sure what to do... I wish I could see what's going on inside her mouth and my breast so I could be sure! Any help is appreciated, and I'm so sorry this is so long - I think I had to get everything out.

  2. #2
    Join Date
    Feb 2006
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    1,168

    Default Re: Under 2 weeks, and a host of problems

    I'm glad you posted here and also that you are finding encouragement just from reading other threads. My initial reaction to your post is that I'm very impressed at how many problems you and your daughter have already overcome. Despite the cesarean birth and delayed start to breastfeeding, she is 100% breastmilk-fed, is nursing almost exclusively, and is growing well. As she is staying on the breast with good swallowing sounds and coming off the breast contented (not crying or fussy), then it seems apparent to me that a lot is going RIGHT in your nursing relationship, and you should give yourself a hearty pat on that back for that.

    About the clamping -- no, it is not too late to teach her to maintain a good latch. When she clamps, worm your pinkie finger in between her gums to break the latch, then relatch. Even a newborn may respond to encouragement to open really wide, especially if you demonstrate what to do.

    Babies often clamp as a response to too much milk. Can you tell if she is clamping once your letdown begins? If this may be the case, try lying back in a recliner or propped slightly on pillows, with baby on top of the breast at whatever angle works for you. Gravity will slow the flow.

    Have you tried the side-lying position? If you can master it, it may make those night feedings easier on everyone and reduce the need for the EBM bottle.

    My most important suggestion, since you are eager to consult someone in person (which is essential for correcting latch/positioning problems) is to call a local LLL Leader. Leaders will often make home visits and their assistance is free of charge. Attending LLL meetings is also a good thing, but may not be something you are ready for just 2 weeks postpartum.

    --Rebecca

  3. #3
    Join Date
    Feb 2006
    Posts
    37

    Default Re: Under 2 weeks, and a host of problems

    {{{{{{{hugs}}}}}}} Sounds like you've been through alot! Kudos to you for your committment!!
    i am sure you will get some good ideas here!

    I also have an inverted nipple and was given breast shells in the hospital. I wore them in between feedings the first few weeks and they worked wonders!! I think the brand is called Ameda.

    i can also say that after a couple minutes I don't hear DD swallowing, but can see it in her neck and can see the long and drawn out sucks.
    If you find you still need to supplement, maybe you can use a SNS. I had one for my son (supplemental nursing system)

    I also agree with the above poster about an LLL meeting when you are up to it! Take care and you are doing a GREAT job

  4. #4
    Join Date
    Jan 2006
    Location
    Charleston SC
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    2,601

    Default Re: Under 2 weeks, and a host of problems

    12 days old! She sounds like such a treasure. You are doing a great job nursing her, I would def get in touch with a LLL group in your area, they will be able to help you in person!

  5. #5
    Join Date
    Feb 2006
    Posts
    11

    Default Re: Under 2 weeks, and a host of problems

    Thanks for the encouragement, ladies. Graciesmom, how long did you have to wear the breast shells before they started to work? I bought some the other day and have been wearing them (though not the entire day, I usually take them off if I'm going outside) without any real result. I also try pumping that breast before a feeding to extend the nipple, but in both cases the flesh around the nipple is pulled out rather than the nipple itself. She tries pretty gamely to nurse on it, but we just don't seem to get anywhere.

    As for the clamping, I have been trying to break her grip if it hurts - the problem is that I'm so sore by now on that side that pretty much EVERYTHING hurts. Once she's actually suckling I'm fine, but there are no latch-ons that aren't painful right now.

    I had my followup post-partum appointment yesterday and discussed a few things with my OB/GYN, and when I told her the amount of time Dorothy tends to spend on the breast for each feeding - often 30 minutes or more - she said that was all wrong, that she was using me as a pacifier, and I had to break that habit. I don't think that's the case, since she only feeds on the one side and therefore needs to stay on longer, but it's certainly not helping the nipple soreness on that side. More and more she seems to constantly want to be feeding, and we've had to go back to giving her more bottles; I'm really concerned she's not eating enough, now, and I'm also worried I'm just not producing enough milk for her anymore despite all the suckling.

    In any case I haven't contacted any LLL leaders yet - I keep meaning to but I guess I just don't really know where to start when it's in person. It's so much easier to just dump information out here. Thanks again for the support; it is so much appreciated.

    -Rebecca

  6. #6
    Join Date
    Feb 2006
    Posts
    1,168

    Default Re: Under 2 weeks, and a host of problems

    Hi Rebecca -- I'm glad to see an update from you, although I'm sorry you're still having a lot of pain and uncertainty.

    In reverse order: To find a local LLL group or Leader, go to this website:

    http://www.lalecheleague.org/WebUS.html

    Click on the appropriate locations until you reach your local area, and then pick up the phone or send an e-mail to the contacts listed for groups near you.

    Information can be outdated, so I encourage you to contact everyone listed in your town or your part of the city -- cast the net widely to maximize the chance that someone will respond to you quickly. You need someone to meet with you in person and evaluate your latch/positioning and your inverted nipple -- we can't do much to help with those matters through cyberspace.

    As for your OB/GYN's advice ... hmm, how can I say this? I'm sure she is a very fine surgeon, for that is her specialty. Breastfeeding (clearly) is not her specialty. For a 2wo infant to spend 30 minutes or more per feeding is perfectly normal. For her to suck for comfort and soothing is also perfectly normal. (Before there were pacifiers, did people tell moms not to let their babies use them as pacifiers? Of course not. Babies need to suck to feel okay.)

    Your daughter will go through -- probably already has gone through -- growth spurts, during which she will want and need to eat almost constantly. Keeping her at the breast for all her feedings will ensure that your milk supply keeps up with her demand. Her frequent feeding is not a sign that you don't have enough milk -- quite the contrary, it is the precise method by which she WILL get enough milk. Does that make sense?

    There is nothing, IME, more toe-curlingly painful than latching onto a sore nipple. The fact that the pain does go away once she settles into sucking is very encouraging. A bad latch will never feel better, while with a good latch, there may be initial pain for a variety of reasons in the early weeks, but the pain will go away within a minute or two.

    I don't have any experience with inverted nipples, so I can't advise you there. For now, I would encourage you to continue wearing the breast shell 24/7 except when pumping or trying to nurse. If she isn't nursing effectively on that breast yet, then I encourage you to pump regularly on that side, to stimulate milk production. Someday the nipple will extend a little further, and the baby will be a little more skilled and coordinated, and she will latch well on that breast -- and it will be lovely if there is ample milk there waiting for her when this happens.

    Have faith in the meantime that your body can meet her needs for nourishment and comfort -- even one-breasted, if need be! Watch her diaper output to be reassured that she is getting enough milk. Stop watching the clock. Keep treating your sore nipples according to the recommended protocol; keep being vigilant about good latch. As soon as you can, meet with an LLL Leader or an IBCLC lactation consultant for hands-on evaluation and guidance. And above all, be proud of how WELL you two are already doing and how much courage and determination you have found within yourself.

    --Rebecca

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