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Thread: 10 day old baby and inadequate milk supply

  1. #21
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    Default Re: 10 day old baby and inadequate milk supply

    Got a call back from the WIC lactation consultant. She is looking into seeing if she can arrange a clinic time for me tomorrow where they can not only check on the baby's latch/sucking. He has a good latch, he just gets sleepy at the breast.

    They will also help me out with a supplemental nursing system which will likely still awkward, will likely be a lot better than trying to get comfortable while being close enough to something I can use as a stand for the open top syringe/feeding tube contraption I'm struggling with now.

    They can also help assess the breast pump I have now and they also have parts and breast shields so we can try to get me the right fit.

    There are some other consultants and professionals in the area but I'm on Medicaid for the pregnancy and baby because my old insurance wouldn't cover anything to do with pregnancy and the marketplace wouldn't speak to me because I'm apparently below their income threshold (great, what do I do when the pregnancy medicaid runs out?? FL doesn't have extended medicaid for adults. Sigh will worry about that next month.) But anyway, I'll go with the WIC office if they can fit me in since I am also still restricted to not driving for a few more days, trying to get too far away is not high on my priorities.

  2. #22
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    Default Re: 10 day old baby and inadequate milk supply

    If you can see an IBCLC (Board Certified lactation consultant) through WIC that is really great. Not all WIC's offer this so I did not know what you had locally. But I did not want to imply at all that a WIC LC would not be as good as a private practice LC. my counties' WIC offices have some of the most respected Lactation Consultants around seeing moms. And some WICs have excellent peer counseling programs as well. It's just that the care in general varies so much WIC to WIC.

    If you go to the website for Catherine Watson Genna, she has a nice article about what to expect at an apt with a lactation consultant. Go to her 'clinical corner.'

    Good luck.

  3. #23
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    Default Re: 10 day old baby and inadequate milk supply

    Our problems don't seem to be latch or position related. This baby can latch himself onto my nipples even if they were driving by at speed and normally he gets a good deep latch that is almost soothing after the initial attachment moment.
    It Really seems to have more to do with a deficiency in my let down reflex. He will suck and swallow when the feeding tube is there but when it is just my breast he tends to fall to sleep just nibbling.

    I am hoping that with a few days of pumping to get/keep my milk supply up and the nasal spray we will hopefully get to a point where the supplemental feeding is not going to be necessary anymore.

    Unfortunately, They did not get me into the WIC office today (most of the help I'm looking for from them is really to check my breast pump and help me get the right fit for shields and stuff since the pumping is the painful part right now.)

  4. #24
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    Default Re: 10 day old baby and inadequate milk supply

    Quote Originally Posted by @llli*tclynx View Post
    It Really seems to have more to do with a deficiency in my let down reflex. He will suck and swallow when the feeding tube is there but when it is just my breast he tends to fall to sleep just nibbling.
    This doesn't sound like you have a deficiency. Rather, it sounds like the baby is creating a problem by being sleepy and a not very motivated nurser. My guess is that you would let down just fine if he were a bit more effective at the breast. So please don't feel like there's something wrong with you!
    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!"

  5. #25
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    Default Re: 10 day old baby and inadequate milk supply

    Well how do I get him to be less sleepy and more motivated at nursing?

    I'm still waiting to get an appointment with one of the CLCs through our county WIC offices. They tell me they can help me with a SNS, and checking the breast pump as well as getting me fitted for the right size shields, as well as latch and position coaching as needed but I haven't been able to get an appointment to get in to see anyone. The consultant at the office I normally go to is sick and the other office doesn't answer the phone or return calls.

  6. #26
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    Default Re: 10 day old baby and inadequate milk supply

    I posted this in earlier post but I guess you missed it.
    For sleepy baby at the breast, try breast compressions. You can also try stroking baby, "pumping" babies hand or foot, gently jiggling baby's chin etc. to encourage baby to nurse more vigorously for longer. Look up jack Newman Breastfeeding for info an breast compressions.
    here are tips for waking sleepy newborn- https://www.llli.org/docs/0000000000...py_newborn.pdf

    Have you tried hand expression? that can get the milk flowing so baby is more interested. As I stated before it can also be helpful when added to a pumping routine. https://www.llli.org/docs/0000000000...expression.pdf
    When I went through a similar thing with the newborn sleepiness with my oldest, I made up funny songs about nursing and milk to help keep me relaxed as I encouraged baby to nurse longer. I also used visualization (imagined milk flowing out of me into baby)

    A baby who is being over supplemented might also be less interested in nursing vigorously. of course you want baby to be getting enough, but baby has to be somewhat hungry or baby may not nurse often or well enough.
    Last edited by @llli*lllmeg; March 26th, 2014 at 06:19 PM.

  7. #27
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    Default Re: 10 day old baby and inadequate milk supply

    Quote Originally Posted by @llli*lllmeg View Post
    I posted this in earlier post but I guess you missed it.

    here are tips for waking sleepy newborn- https://www.llli.org/docs/0000000000...py_newborn.pdf

    Have you tried hand expression? that can get the milk flowing so baby is more interested. As I stated before it can also be helpful when added to a pumping routine. https://www.llli.org/docs/0000000000...expression.pdf
    When I went through a similar thing with the newborn sleepiness with my oldest, I made up funny songs about nursing and milk to help keep me relaxed as I encouraged baby to nurse longer. I also used visualization (imagined milk flowing out of me into baby)

    A baby who is being over supplemented might also be less interested in nursing vigorously. of course you want baby to be getting enough, but baby has to be somewhat hungry or baby may not nurse often or well enough.

    I've tried all the little tricks to keep baby nursing, tickling feet, pumping arm, leg, tickling chin, back of neck, reading him a book, talking to him, playing music or sobbing uncontrollably all seem to have about the same effect-occasionally but not always effective at getting him to keep sucking.

    I have tried compressions and hand expression but a few drops is all I've ever been able to really get from it when baby isn't at the breast, it doesn't seem to be enough to trigger him to suck or swallow.

    I sometimes almost feel like I'm force feeding him but he is NOT gaining weight and I'm only getting between 0-3 poopy diapers a day, so I can't see that I'm supplementing enough let alone over supplementing.

    Pumping hurts so pumping for 15 minutes after nursing each time is starting to get really tough. I'm only getting a small amount of pumped breast milk for each session (sometimes as little as an 1/8th teaspoon from both breasts and sometimes as much as half an ounce.)

    I've not seen much effect from using the nasal spray either.

    I'm really tired right now, hopefully I'll feel a bit more optimistic in the morning.

  8. #28
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    Default Re: 10 day old baby and inadequate milk supply

    Ok, I hear you are frustrated. And I am sure very tired. If you can put together 4-6 hours of consecutive sleep, it will probably help.

    Every one who has responded to you wants to help. But we are limited in what we can do over the internet, obviously. So we are going to throw out ideas to you. Some may work for you, some probably won't. Some may not work today but may work tomorrow. Take what works for you and leave the rest. Again I will ask if there is any local breastfeeding support aside from WIC, as you are having difficulty getting quick help from WIC. Again, you can call any LLL Leader any time.

    Lets start with the pumping pain. Pumping should not hurt but it does sometimes. Is your pump turned very high? Is your nipple rubbing against the tube? Pain may inhibit letdown. So if letdown is part of your problem, painful pumping is possibly exacerbating it.
    Hand expression: Hand expression takes practice. A few drops is helpful. Milk production responds to milk being removed from the breasts. So any amount of milk coming out of the breasts is helpful. And presumably hand expression does not hurt, so that is a plus. It does not mean you stop pumping and only hand express, it is just something you could add to your pumping routine.

    Breast compressions may help when pumping but the real purpose is to give baby a little 'shot' of milk to get baby interested in continuing to nurse. It may not help everytime, but done correctly, they are not going to hurt anything so no reason to not try them every time baby nurses. Jack Newman also has a video of breast compressions if you prefer.

    Poops are only part of the story, and again, formula changes normal poop patterns. Weight gain is where you will get a better picture, but weight checks must be done correctly on the same scale or you will not know if they are accurate. The birth weight, the discharge weight, and your first pediatricians visit weight check were (I assume) all done on different scales.

    You may be supplementing just enough, or too little. I have no idea. But when I hear you say you feel as if you are forcefeeding even with bottles, I have to wonder why this is. As I understand it, baby was born after an unmedicated birth, term and of a healthy weight. A healthy newborn baby is usually a very hungry baby. Yes, overt sleepiness and disinterest in eating can be caused if baby is seriously undernourished as well. But that would appear unlikely with the amount you are nursing and supplementing.

    Your baby HAS gained. I am having some difficulty with your numbers, so forgive me if I have gotten this wrong. But while there appears to have been a substantial initial loss from birth weight, since those first three weight checks were (I am guessing) all done on different scales I am not entirely trusting those numbers. After that, your baby appears to have gained 11 ounces (from 7lbs 10 ounces to 8lbs 5 ounces-and I think those two checks were done on the same scale???)
    11 ounces would be in the normal range for gain for a two week old infant. In other words, if your baby was weighed on day 5, and then not again until the check yesterday or the day before when supposedly baby had not gained at all, nothing would have looked abnormal about the gain.
    Last edited by @llli*lllmeg; March 27th, 2014 at 01:03 AM.

  9. #29
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    Default Re: 10 day old baby and inadequate milk supply

    Ok, you are right we did regain to discharge weight with the supplementing

    Hospital Scale (weighed naked)
    Birth weight 8 lb 14 1/2 oz Wed 3/12/2014 7:50 pm
    Discharge weight 8 lb 5 oz (I think this weight was actually taken 3/13/2014 around 8 pm thought I wasn't discharged till eve 3/14/2014)

    Pediatrician's Scale (weighed naked)
    7 lb 10 oz Monday 3/17/2014 Mid Morning
    Told to supplement 1 oz with every feeding -Was getting 8-12 extra ounces a day-(managed to gain back to discharge weight)
    8 lb 5 oz Thursday 3/20/2014 Mid Morning
    Told to cut back supplement to every other feeding for two days and then I could quit the supplement.
    Thursday and Friday I noticed he still seemed very hungry after I would feed without the supplement and didn't seem to be sucking effectively. No Dirty diapers only wet on Friday he only got about 6 supplement ounces that day.
    Saturday when I was supposed to stop the supplement he was at the breast a lot like nearly constantly and when he still screamed he was hungry I gave some supplement through the feeding tube at the breast. He only got like 3 oz of supplement Saturday.
    Sunday I decided to bring the supplementing back up to 8 oz, I did have mom give him a 3 oz bottle and we did get a couple poopy diapers.
    8 lb 4.5 oz Monday Morning. Pediatrician basically told me to do what I think is right when he saw I was NOT going to let the baby starve and that I was determined to not give up on breast feeding. He called in the script for the nasal spray.

    Since then I've been tracking weight on a scale here at the house. I know it won't match either other scales but I am just using it as a marker to make sure he doesn't wind up loosing more weight at least. I tare out the scale with a diaper on it then put the baby on it wearing only a clean diaper.


    Ok done pumping, gotta go back to sleep.
    At only 14 days old can I really let him go 5-6 hours without eating just to let me get 4-6 hours uninterrupted sleep?
    I already feel that letting him go too long between feedings the first weekend home is part of the reason I wound up in this mess in the first place.

  10. #30
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    Default Re: 10 day old baby and inadequate milk supply

    So do I forgo pumping until I can get to see some one who can help me with it?
    I've been afraid to do that because the baby hasn't been extracting milk from me very well and I'm worried about loosing what little supply I have.

    So far compressions have never gotten baby to actually suck/swallow.
    I don't have particularly large breasts, I don't know if that affects how easy/effective it is to use compressions.

    If I switch to trying massage and hand expression instead of pumping to remove milk and stimulate milk production, how much time or how do I know when I've done enough? I'm not sure there is enough time between feedings if it actually requires getting more than a fraction of a teaspoon out.

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