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Thread: Ready to give up -- lazy nurser, TT and low milk supply

  1. #1

    Default Ready to give up -- lazy nurser, TT and low milk supply

    I could really use some advice. My 6-week-old son and I have had a hard time nursing. Basically, I have been forced to supplement from his fifth day of life due to weight loss and because he was unable to transfer enough milk from me. We have never given him a bottle or pacifier. Right now, he is breastfed for 30 minutes, supplemented via finger feeding/syringe with pumped milk and formula, and then I pump. He is an active baby who is growing well, but only when he has enough supplements.

    Here's what is going on now:
    - He is a lazy nurser. He starts out great and gives up after a few minutes. He often pulls off my breasts just as he triggers letdown.
    - I had his tongue tie and lip tie revised via laser two weeks ago. He now has a stronger suck. My LC told me to continue using a nipple shield, which I had to start using when he was born due to a latch that severely damaged my nipples.
    - My breast pump is more efficient than my baby. When I have taken him for weigh-feed-weighs, he gets anywhere from 1/3 of an ounce to 1 ounce of breastmilk in 40 minutes.
    - I am pumping about 7 times a day. I can only pump 1 ounce total in 20 minutes. My breasts do not seem to run out of milk -- they continue to drip slowly for as long as I pump them. The longest that I have tested this theory for is 50 minutes.

    Here's what we have tried:
    - Supplements. I have been taking Go Lacta, Fenugreek and Blessed Thistle for weeks. I am currently upping my Fenugreek intake as I do not smell like maple syrup yet. I do not believe that any of these supplements has increased my output. I've eaten plenty of oatmeal and have drank some Mother's Milk tea with a side of lactation cookies. No change, as far as I can tell.
    - Waking the baby up. Even if I am very aggressive in waking him while he eats, he still only maxes out at an ounce during a feeding if I am lucky.
    - Asking all of the right questions. I do not have any markers for not producing enough milk, like PCOS or a lack of breast changes. The only thing that I dislike is that my breasts (no IGT here) do not become engorged. They either feel soft or slightly less soft. They have gotten bigger since I gave birth.
    - Testing my thyroid. It's normal.
    - Pumping with a Medela Symphony. It increased my output from 1/2 ounce per 20 minutes to 1 ounce per 20 minutes since I picked it up nearly a month ago. My pumping output has stayed the same ever since.

    As I see it, one or both of these two things is happening:
    - My baby is a terrible nurser. He has just started figuring out how his tongue works. He falls asleep on the job all of the time and gets frustrated at my slow-flow nipples.
    - I have a low milk supply.

    I go to my midwife for my six week checkup tomorrow. I'm planning on asking her to check my prolactin levels on the theory that it might tell me if the issue is me or not.

    Am I missing something? If the issue is my baby, will he actually grow out of lazy nursing now that I have fixed his TT/LT? If the issue is me, how much longer do I have before I cannot increase my milk supply?

    I would appreciate any suggestions or guidance that you have. I have a wonderful LC, but at this point, I feel like she is out of suggestions.
    Last edited by @llli*boobvampire; March 26th, 2014 at 01:02 PM.

  2. #2
    Join Date
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    Default Re: Ready to give up -- lazy nurser, TT and low milk supply

    how much total is baby being supplemented each day?
    how much of your own milk and how much formula? and what is your babies weight gain for the last two weight checks done on the same scale?

    You pump seven times a day. Is that how often baby gets supplements? How often does baby nurse each day? Do you ever have a chance to JUST nurse, no supplements or pumping, at least a few times a day?

    When a mom is feeling done, maybe its not that she is done with breastfeeding but that the current plan/approach is not working for her. So I wonder, why stop now? Your baby does nurse and you do make milk. even if neither is optimal, they may become so. And even if they never did, that would still allow for combo feeding long term, which is an option you can consider. If it's a quality of life issue, which I get, perhaps you can tweak what you are doing now so that it all felt more manageable and normal.

    I do not recall your previous thread-did supplementing at the breast not work for you? Many moms find that supplementing at the breast simplifies feedings in a situation like yours where baby is getting supplements and mom is pumping. see http://cwgenna.com/smartnothard.html

    For the pump output-actually, if you are pumping 7 times a day on top of frequent nursing, one ounce per session is pretty good pump output.
    BUT, have you tried different flanges? Different sizes? Pumpin Pals? Your slow pump output when there is clearly milk in your breasts makes me question the effectiveness of your pump and since its a good pump, I wonder about flange fit. Have you tried hand expression as well?

    How many before and after nursing checks have you done and when was the last one?

    Have you tried breast compressions while nursing or pumping? http://www.breastfeedinginc.ca/conte...agename=doc-BC

    Your lc said to keep using shields. But certainly things are different now with normal growth and all the interventions than at day 5. Do you agree you need the shields still? Will your baby latch and nurse without them? Shields are a great tool when there is no other way baby can latch and nurse, however they often cause poor transfer and supply issues long term.

    you can always stop nursing. but if you stop now, getting back to where you are now would be hard and would get harder every day that passes.
    He is a lazy nurser. He starts out great and gives up after a few minutes. He often pulls off my breasts just as he triggers letdown
    this confuses me. Why would a 'lazy' nurser stop nursing the minute their efforts paid off? What happens if you try to get baby to relatch? Have you tried instant reward to encourage baby to nurse?

    have you talked to your IBCLC about other herbal galactatgogues? Shatavari? Fennel? Have you or she considered galactagogue medications such as reglan or domperidone?

    engorgement is painful and not normal (although fairly common.) Do you mean your breasts never feel/have felt full or 'fuller' at certain times?

    If the issue is my baby, will he actually grow out of lazy nursing now that I have fixed his TT/LT? If the issue is me, how much longer do I have before I cannot increase my milk supply?
    theoretically a woman can always increase her milk production. Baby learning to nurse after tt revision is going to vary, and again, theoretically latch and nursing efficiency can keep improving indefinitely. There are no end dates on these things.

    A baby who is being over supplemented may also present as a 'lazy' nurser. Baby typically needs to be somewhat hungry to want to nurse with normal frequency and effectiveness. This is why I asked the opening questions.

    It's hard when you have a good LC who seems to be running out of ideas. Your LC presumably has colleagues she can bounce ideas off of or even refer you too, if they are local. Or she may be able to get suggestions through an online resource for IBCLC's such as Lactnet. You could give her permission to share your story and ask for input. There is lots of amazing knowledge and experience out there.
    Last edited by @llli*lllmeg; March 26th, 2014 at 07:18 PM.

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