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Thread: 10 day old baby and inadequate milk supply

  1. #141
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    Default Re: 10 day old baby and inadequate milk supply

    On a positive note, we were visiting daddy's parents yesterday and grandma had the trick to getting baby to take the bottle finally. (We still need to supplement since without it baby is loosing weight and the SNS has become a bit of a problem.)

    Grandma put a tiny dab of Karo Syrup (corn syrup) on the tip of the bottle nipple. Now I don't necessarily like using corn syrup for such things, it is a tiny amount and we have been able to let daddy supplement now using expressed breast milk and achieve a positive weight trend again.

    Nipples are still really bruised and baby is not able to transfer milk well enough on his own yet.

    The Bottle nipples we are using are the Kiinde Active Latch nipples that I've read a few reviews that they seemed to help babies get an even deeper latch when put back to the breast. I don't know if they help reduce the compressions I'm experiencing (probably not) but I don't know if there are any bottle nipples that would be any better for the purpose. We have only been giving 1-2 oz at a time by bottle either just before or after nursing (trying to keep it changed up and only supplementing in the afternoon/evening for the most part.) Total supplement yesterday was 6 oz (only about 1 oz was formula from a bottle mixed up the day before.)
    I managed to pump 6 1/3 oz yesterday in only 6 pumping sessions.

    Today I've already pumped 2 oz overnight and I have 5 oz frozen so hopefully we can continue supplementing with just breast milk for a while again. (The formula affects his bowel habits for such a long time after he gets any though it may take most of a week to get back to normal after only about 2 oz of formula.)

  2. #142
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    Default Re: 10 day old baby and inadequate milk supply

    Well the syrup trick only works some of the time.

    I wound up supplementing today mostly with the SNS to make sure I got enough into him.

    Yesterday weight check we were 2 oz up for the day and today it is about 1.7 oz up.

    Today we only supplemented 5 oz. But I only pumped 2 3/4 oz.

    He had formula a few days ago so he hasn't pooped yesterday or today. I am hoping I can manage to keep him gaining extra this week until the next weight check because I swear I'm gonna flip out if they start pushing me to formula feed.

  3. #143
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    Default Re: 10 day old baby and inadequate milk supply

    what can be done to improve milk transfer?
    I already do compressions.
    We got the tongue tie/lip tie revised.
    But now it seems we are having to supplement more and more each day in order to maintain a steady weight gain and I'm not going to be able to keep up with pumping if this seeming backslide continues.

  4. #144
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    Default Re: 10 day old baby and inadequate milk supply

    I'm not sure if this helps you, but this quote from dr. Newmans website helped me stay positive - " baby learns to breastfeed by breastfeeding". I then started thinking about breastfeeding as a skill he needs to learn. In the beginning my LO was only able to transfer 1oz in a 40 minute session! Every week he got better and I started seeing small improvements. It is a slow process for sure
    I hope this helps!!

  5. #145
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    Default Re: 10 day old baby and inadequate milk supply

    I wish there were enough hours in the day to let him completely learn by doing. But between needing to get enough food into him and pumping to keep my supply up enough.........
    But My right nipple really hurts bad sometimes (though I count myself lucky that it is only compression, vasospasm and bruising rather than cracking/bleeding that I hear of so many dealing with.)

    My problem is that because of the tongue/lip ties he learned to do it kinda wrong and has never been quite good enough at milk transfer. I need help re-teaching him.

  6. #146
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    Default Re: 10 day old baby and inadequate milk supply

    I wonder if part of the problem is you are expecting (or aiming for) 'steady' weight gain, when in fact weight gain in infants is not normally steady? I am sorry but I have lost sight of where baby is, gain wise.
    weight check we were 2 oz up for the day and today it is about 1.7 oz up.
    ? Are you weighing baby each day? Are you saying baby gained 2 ounces in one day and then 1.7 the next?

    Good gain in about the first three months is about an ounce a day AVERAGED over that period of time. This means, baby will not gain an ounce every day. it will sometimes be more, and sometimes less. It will sometimes be nothing. And a daily weight check is going to be hard to read accurately, as every meal and every pee or poop will make the weight appear to go up and down.

    Looking back over the last two months, what is your child's overall gain? or what is the gain since the frenectomy? Any improvement in gain overall since then?

    I do not have another suggestion for increasing milk transfer. How do you know the transfer is not adequate?

  7. #147
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    Default Re: 10 day old baby and inadequate milk supply

    Quote Originally Posted by @llli*lllmeg View Post
    I wonder if part of the problem is you are expecting (or aiming for) 'steady' weight gain, when in fact weight gain in infants is not normally steady? I am sorry but I have lost sight of where baby is, gain wise.
    ? Are you weighing baby each day? Are you saying baby gained 2 ounces in one day and then 1.7 the next?
    Yes but we had time previously where there was weight loss or no weight gain so are kinda trying to make up for lost time as the Ped office is getting antsy about him dropping in the percentiles. Which actually really bugs me since they should have caught onto the tongue/lip ties when he wasn't gaining back in the beginning!!! Anyway. I know weight gain isn't normally steady. I try to make the "daily" weight check at roughly the same time each day before bed and I had not been getting too worried about not gaining every day but then we had the Ped appointment where they made note that he was down to the 10% which is apparently a drastic drop in % from the 1 month check so we are going back in for another weight check on Thursday.

    Good gain in about the first three months is about an ounce a day AVERAGED over that period of time. This means, baby will not gain an ounce every day. it will sometimes be more, and sometimes less. It will sometimes be nothing. And a daily weight check is going to be hard to read accurately, as every meal and every pee or poop will make the weight appear to go up and down.
    I realize the weight goes up and down. It tends to be down in the afternoon before the afternoon/evening cluster feeding marathon and I usually aim to add enough supplement into that marathon to try to make sure we are getting at least a little bit of gain by bed time.

    Looking back over the last two months, what is your child's overall gain? or what is the gain since the frenectomy? Any improvement in gain overall since then?
    Birth 8 lb 14.5 oz
    discharge 8 lb 5 oz
    1st ped appointment 5 days 7 lb 11 oz
    3 weeks we got back to 8 lb 15 oz
    1 month appointment 9 lb 7 oz
    8 weeks Frenectomy 10 lb 2 oz (aprox)
    9 weeks (2 month ped appointment) 10 lb 2 oz
    63 days (my scale for the rest) 10 lb 3 oz
    64 days 10 lb 5 oz
    65 days 10 lb 6 oz
    66 days (tonight) 10 lb 6 oz

    So that is 43 ounces in 60 days or 0.7 oz a day average so not terrible actually, but it has not been very steady.

    We have not gone a day totally without supplementing with either formula or expressed breast milk since he was 5 days old. Started out supplementing an ounce at each feeding (which has normally been about 11 times a day) and got down to as low as a couple ounces or even 1.25 once but never managed to cut it out entirely since weight gain seems to stall or we even see weight loss when I've reduced it too much. For the past couple weeks we are almost off the formula, I think he has only gotten 2 oz of formula in the last two weeks and we are mostly on expressed breast milk in the supplementer or the few bottles he has taken. I have only just barley been keeping up with the expressed breast milk and will probably have to use formula again soon to let me catch back up unless things start getting better quick.

    I do not have another suggestion for increasing milk transfer. How do you know the transfer is not adequate?
    When I have done weigh feed weight it is usually only about an ounce to just under 2 ounces difference (I weigh him in the same diaper before and after the feeding.) Now I know that some feedings are going to be bigger than others and I haven't done a weigh feed weigh for a feeding that I think is really big yet (those are usually the overnight feeds when I'm engorged and can really push the milk into him with compressions) but with only an ounce to one and three quarters ounces getting into him during most of the feeds I've weighed, I Know he isn't getting enough from me during 11 feeds without the supplement.

    Now there was a day 5 days ago where I decided I needed a day off from the pump (I only pumped after the overnight feedings) and I only supplemented 1 1/4 oz but he gained almost an ounce that day even though he pooped 4 times that day. This is making me think I need to take another pump vacation and see what happens, could the pumping after each feeding actually be causing more problems?

    That said the day of his 2 month Ped appointment I only pumped three times, we supplemented 2 1/2 ounces he pooped 4 times but he lost 2 1/2 ounces that day but I wasn't worrying about that too much since he got vaccinated and was fussy that day.

    I know I am probably getting a bit overboard with the scale but when the Ped starts making noises like they think I should give up and switch to formula......
    Well I want to make sure we average an ounce a day until the next weight check which means I need try to get babe to 10 lb 10 oz by Thursday morning.

  8. #148
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    Default Re: 10 day old baby and inadequate milk supply

    Did a mind morning weigh feed weigh
    Feeding took an hour, He got 2 ounces.
    I doubt there are many feedings without supplement where he is getting much more than that.

    I'm taking the day off from pumping again to see if we manage to do much better through the day.
    Seeing as we are feeding every 2 hours and feeding usually takes between 50-70 minutes it means that if I pump it is generally under an hour from when I finish pumping to when I need to feed again which might be making it more difficult for him to extract as much milk. So maybe by not pumping through the close spaced feedings during the day he will actually get more milk and I will maybe be less sore.

    On another note, Ped office called back about the lactation consultation. Hopefully I can actually get in to see the Peditrician who kinda specializes in Behavior and feeding, Hopefully they call back soon.

  9. #149
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    Default Re: 10 day old baby and inadequate milk supply

    ok, so gain has been slow overall. But that would be expected given the tongue tie. And I guess it's actually a bit too soon after the clip to tell if there has been much overall improvement, especially since the 8 week check was iffy?

    Here is how I would stand back to look at this gain overall. I would start the clock at lowest known weight. I am also ignoring for the moment the numbers since the 2 month apt (even though it looks good, esp the last few days) because I don't think it has been long enough to draw any conclusions.
    So that leaves:
    Lowest known weight: 7lbs 11 ounces at 7 days old
    Two month apt (60 days?) 10 lbs 2 ounces
    So that is gain of 2 lbs 7 ounces (or 39 ounces) in 53 days, or an average of .73 ounces a day.

    This is below average rate of gain. But it does represent steady gain. I call it steady because overall, baby has continued to gain. Baby never lost weight between checks, and the only place baby appeared to stand still was between week 8 and 9 which 1) is right after clip and that may have caused issues and 2) I take it the week 8 check was on a different scale or is for some other reason "approximate?"

    This playing around with the numbers may not help you at all, and if it doesn't, please just ignore me. I just want you to see that your incredible dedication is resulting in a baby who IS gaining. I do not know what else is going on growth or health wise, but baby is gaining.

    I do thing the per session intake is on the low side, which indicates baby is continuing to have difficulty transferring milk.

  10. #150
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    Default Re: 10 day old baby and inadequate milk supply

    Quote Originally Posted by @llli*lllmeg View Post
    ok, so gain has been slow overall. But that would be expected given the tongue tie. And I guess it's actually a bit too soon after the clip to tell if there has been much overall improvement, especially since the 8 week check was iffy?

    Here is how I would stand back to look at this gain overall. I would start the clock at lowest known weight. I am also ignoring for the moment the numbers since the 2 month apt (even though it looks good, esp the last few days) because I don't think it has been long enough to draw any conclusions.
    So that leaves:
    Lowest known weight: 7lbs 11 ounces at 7 days old
    Two month apt (60 days?) 10 lbs 2 ounces
    So that is gain of 2 lbs 7 ounces (or 39 ounces) in 53 days, or an average of .73 ounces a day.

    This is below average rate of gain. But it does represent steady gain. I call it steady because overall, baby has continued to gain. Baby never lost weight between checks, and the only place baby appeared to stand still was between week 8 and 9 which 1) is right after clip and that may have caused issues and 2) I take it the week 8 check was on a different scale or is for some other reason "approximate?"

    This playing around with the numbers may not help you at all, and if it doesn't, please just ignore me. I just want you to see that your incredible dedication is resulting in a baby who IS gaining. I do not know what else is going on growth or health wise, but baby is gaining.

    I do thing the per session intake is on the low side, which indicates baby is continuing to have difficulty transferring milk.
    Yep I pretty much agree with you.

    There is some room for error on exact weights because of different scales being used in some cases (like my scale I track with just to keep an eye on trends but I don't think my scale matches the doctor's scales exactly.) My scale is actually an inspected produce scale which reads in Pounds and hundredths of a pound so math is required for me to convert to pounds and ounces.

    Baby seems happy/health otherwise. He just has to work too hard and long and still can't get enough to eat from the breast alone and He is hard on mommy's nipples.

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