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Thread: Feeling desperate

  1. #11
    Join Date
    Feb 2014
    Location
    Clifton, VA
    Posts
    8

    Default Re: Feeling desperate

    The LC is board certified and works at the hospital where I gave birth. They were more helpful than the girl at the pediatrician's office. They were still concerned about his weight gain, though.

    Our problem seems to be the following:
    1. I have very large, very soft breasts - he is having trouble latching. Thus we have the nipple shield.
    2. He has a "disorganized suck" where he will stick his tongue out the corners of his mouth rather than keeping it centered. This means he will sometime spit out the nipple/shield by accident. We're doing finger feeding, and the LC said even a pacifier will help train that action. I'm nervous about the pacifier, but my husband is all for it.
    3. He is not doing the long, controlled sucks, just little fluttery ones, and he swallows maybe once every 10 or 12 sucks.
    4. He is not getting very much when he nurses... the LC said less than an ounce, and that was after a while.
    5. He will not wake for feedings, or stay awake during them. He'll be sleeping peacefully, but then when I wake him up, he seems to get frustrated very quickly once he's on the breast.

    The LC said I should try to feed him as much as I can over the weekend - to try nursing and then to give him whatever I pump. She said it's impossible to give a baby too much breast milk and this way he could get his weight up. She was OK with the 8 times feeding (which is good, because usually the whole process takes 2-2.5 hours by the time I've attempted nursing, fed him with the syringe, and pumped).

    The other LC told me not to let him nurse too much since nursing burns a lot of calories and he might end up losing weight because of that. This has kind of made me too scared to do much of anything!

    We just bought a scale today... hoping for some good news. And my pumping output is increasing... I can get a reliable 2-3oz each time.

  2. #12

    Default Re: Feeling desperate

    Okay my understanding is that the idea that a healthy term or near-term newborn burns too many calories or becomes unduly stressed by nursing has been disproven. What I suppose could happen is that a baby sucks and sucks without getting enough milk and the suckling will put the baby to sleep, in around about way that could lead to slower weight gain. However the same is true of pacifiers of course from which a baby gets nothing. And yes it is the opinion of many that pacifiers, finger feeding and even bottles can help with suck training you just have to be careful with it all.
    If you're feeling confident and as if you can go forward with the new plan, then I suggest keep closely in touch with the new lactation consultant and continue to tweak your situation as needed. Things change very rapidly in the newborn period, usually for the better as baby gets stronger and mom's milk production increases as is normal for the first 4 to 6 weeks
    I guess I forgot you were using a nipple shield. Of course nipple shields can reduce the amount of milk that goes into baby, and that in turn can cause issues with milk production. So when a mother is using nipple shields when nursing baby pumping as well as nursing is the typical recommendation, at least until milk production is clearly well-established. Of course by that time you may have be able to wean off the shields anyway.

    Since the issue appears to be babies suck, that gives you something to work on. If you would like to look at that situation more, I would suggest the website of Catherine Watson Genna. She is a lactation consultant who literally wrote the book on supporting sucking skills and breast-fed infants.
    Another excellent website of course is Kelly mom.com. And the books the womanly Art of breast-feeding and making more milk are helpful.
    Last edited by @llli*lllmeg; February 22nd, 2014 at 10:35 PM.

  3. #13

    Default Re: Feeling desperate

    Also did either lactation consultant discuss breast compressions to keep baby actively sucking? And what about using a lactation aid for supplements?

  4. #14
    Join Date
    Feb 2014
    Location
    Clifton, VA
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    8

    Default Re: Feeling desperate

    Things have gotten much better - he's doesn't always swallow every suck, but he's definitely getting something. After he spit up post-feeding a few times, I've eliminated the pumped breastmilk and am just doing demand feeding (he has been cluster feeding at night... I'm trying to be appreciative about it).

    My only complaint now is that I've been waking up with uncomfortably full breasts, which I suspect is because of the pumping. My husband gave me a hug and it soaked our bedsheets.

    The only other weird thing is he seems to cluster feed twice in a day, and both are followed by long naps (4 hours) that he is impossible to wake from. Is this OK?

  5. #15
    Join Date
    May 2006
    Posts
    20,621

    Default Re: Feeling desperate

    A couple of longer sleep stretches are okay, as long as baby is feeding frequently enough overall.
    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!"

  6. #16
    Join Date
    Nov 2012
    Location
    Ontario
    Posts
    614

    Default Re: Feeling desperate

    Glad to hear that things are improving

  7. #17
    Join Date
    Feb 2014
    Location
    Clifton, VA
    Posts
    8

    Default Re: Feeling desperate

    One step forward... two steps back. He only gained 3 ounces in the 6 days since his last weighing, and the pediatrician put me back on an every-3-hours force feeding plan. I'm just feeling really defeated and freaked out at this point.

    I thought Tuesday was a good day. He was nursing every hour, but he looked satisfied after the feedings. It was only late in the evening when he was then hungry constantly... my husband wanted to give him a bottle but I said it is normal. And the baby even slept a good 4 hour stretch. I finally felt like things were going right.

    Then my pediatrician said that with him nursing every hour, it means he's not getting enough sleep and that's inhibiting his growing. She said I'm probably not making enough milk. It's starting to feel true, because with the feeding/supplementing/pumping cycle, my breasts feel soft all the time and I'm only getting ~1-2oz combined when I pump. She also said to ditch the nipple shield, but he won't latch without it, so what can I do??

    It feels like this is never going to work out. I feel like such a failure.

  8. #18
    Join Date
    May 2006
    Posts
    20,621

    Default Re: Feeling desperate

    Oh, mama, I am sorry you had such a dispiriting visit with the pediatrician! And also that she gave you a bunch of misinformation. First, I have never once heard that a baby's growth could be inhibited by lack of sleep. It's totally normal for a newborn to feed 12 or more times a day, which means there are no long sleep stretches! Besides, your baby is willing to sleep 4 hour stretches- that's a lot for a young baby! Second, you cannot tell just by looking at a baby that mom isn't making enough milk. When there is concern about growth and milk supply, the mom should be referred to a lactation consultant, preferably an IBCLC. And because you're using a shield, you should be referred to the IBCLC anyway. Telling a mom to simply "ditch" the shield isn't helpful if the mom doesn't know how to get her baby to latch without it.

    It's not necessary for you to have full breasts in order to make enough milk. When a mom is pumping and nursing all the time, it's quite normal for her breasts to feel soft. Every time you make milk, your baby or the pump is removing it. Which is great, because that's what builds supply.

    ETA: In addition to seeing the LC/IBCLC , I'd love for you to get a hospital-grade rental pump with correctly sized shields. That will make pumping easier and more productive. I'd also like to make sure your health is good- call your ob or midwife and ask about your placenta. Retained placenta fragments can have a negative impact on milk production, and if you had a difficult birth or your placenta didn't come out in one nice piece, that could be a possibility. I'd also want to get your thyroid tested, since thyroid issues can also cause problems with supply.
    Last edited by @llli*mommal; February 27th, 2014 at 12:21 PM.
    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!"

  9. #19
    Join Date
    Sep 2012
    Location
    rockford,il
    Posts
    537

    Default Re: Feeling desperate

    Find a different pediatrician if possible. That really sounds key. If you Google the aap protocol for slow weight gain in breastfed babies, you find they suggest providing breastfeeding help (improving latch etc) and increasing the frequency and duration of feedings. Also to do before and after weigh feeds. The sleep comment really is utter BS. I often only got 1-2 oz combined even while pumping at work and not feeding for several hours. It's a totally normal amount.

  10. #20

    Default Re: Feeling desperate

    I not sure you can draw a ton of conclusions from one 6 day period of time weight check. What was babies output during this time? How frequently overall was baby nursing? Were weight checks done properly and on the same scale both times remember we are talking ounces and the slightest variation can make a difference. Baby should always be in either nothing or a dry diaper, and the weight on the scale should always be double checked by mom. In fact I would suggest that when gain is on question, request a second check at the same appointment just to be sure there was no human error. Even if the baby has just nursed or if baby has just had a large pee or poop that will affect the numbers. That is why it is overall weight gain over a period of time that tells us more about if baby is gaining normally.
    I guess I'm confused about the every three hours force-feeding idea. So your baby's doctor saying that even if baby nurses 10 times from 12 noon to midnight, if baby then sleeps for three hours, you have to wake him up and feed him? Or is he suggesting that you stretch out the time between feedings to make sure baby never nurses more often than every three hours?
    Frankly if it's the former, if it were me I would just do it. Wake baby up after three hours instead of waiting for four. I am not sure it would be necessary but hopefully that would Get your baby gaining well enough to satisfy your baby's pediatrician. If after following this advice baby gains no better, perhaps it's time to look for other reasons baby may not be gaining.
    If the doctor is saying that you must never nursed any more often than every three hours in other words baby should be nursed eight times a day and no more, then that is incorrect. The facts are very clear that newborns typically need to nurse a MINIMUM of eight times a day that's the bare minimum that allows some babies to gain normally. Many babies nurse much more often, 12 or more Times a day, in order to get enough milk to gain well.
    What did your board-certified lactation consultant say about the pediatricians suggestions? An LC cannot advise the mother to go against medical advice. However she may be able to help you and the pediatrician all come together with a plan that works for everyone.
    As far as how your breasts feel. If a mom is making a normal amount of milk, she will feel overly full after a longer stretch of neither nursing or pumping and she will not feel as full if milk is being removed very frequently. Also Mothers vary in their milk capacity, so some mothers will not feel very full when there is actually quite a lot of milk in the breasts and other mothers feel full when there isn't all that much. In other words feeling full while it does tell us something is not always the best indicator of milk production.

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