
Originally Posted by
@llli*lllmeg
Hi andrebaby thanks for answering my questions!
So, here is what I am thinking. I wonder what would happen if baby nursed more often and was supplemented less each feeding. Because what you are basically trying to do with a regimen like this, with the pumping/nursing/supplementing, is to try as much as possible to mimic what would be happening if baby was exclusively breastfed, right? And a newborn breastfeeding infant almost universally needs to nurse at least 8-12 times a day, and normal size feedings would be much more like 1-3 ounces at a time. Sometimes a little less for some sessions is normal too. but rarely as much as 4 or 5! I am sorry you were told to never wake a sleeping baby. This is not appropriate advice for a breastfed baby, especially who has not been getting enough milk via exclusive breastfeeding.
So, baby is being fed via supplements a total of about 20 ounces per day, (5 feedings X 4 ounces = 20.) Normal daily intake by a breastfed baby at this age for normal gain would typically be something like 25-30 ounces per day, or more. So I suspect your baby must be getting something directly at the breast, because I think it is unlikely baby would be gaining so well drinking only 20 ounces a day. (A gain of 1 ounce a day at this age is considered very good, normal gain. Yes, some babies gain more rapidly, but if your baby is gaining faster than one ounce a day, I wonder if it is possible that the total amount of supplements could be decreased.)
So let's guess baby gets 1 ounce from the breast each time baby nurses. This is a low ball guess. That would mean baby actually gets 5 ounces each time baby is fed, or, 25 ounces per day. I know that some of your before and after nursing weight checks show a lower amount, but 1) fluctuations in intake amount over the course of the day are normal and 2) I wonder if baby is nursing more vigorously and/or longer when using the sns and consequently, maybe getting more from the breast when using the sns than when not(?) What do you think?
What if instead, you nursed baby 10 times a day, supplementing 1 or 2 ounces each time, and we again assume baby can get at least 1 ounce directly from the breasts each time. That would easily amount to the same amount into baby overall, right?
Or you could continue to supplement those 5 feedings, or maybe 6, but maybe 2- 3 ounces each time, and nurse without the sns for an additional 4 or 5 times a 24 hour day?
Basically, I am suggesting you consider playing around with a schedule that works for you and gives baby the supplements he needs, but with the idea of increasing the amount of time baby spends at the breast, especially in the frequency of at the breast feedings, and decreasing the size of individual feedings to something more normal. I also think it would be very helpful to have at least one or two nursing sessions each day without the sns. If baby is refusing to nurse without the sns, you can try instant reward techniques (dribbling milk onto your nipples, for example,) to get baby suckling. Because the idea is to start to move away from the supplements and pumping toward more exclusive breastfeeding. This may take time, and it is possible you will always need to supplement a little, that is unknowable at this point. But it sounds to me as if you are waiting for your pump output to increase in order to start moving toward less supplements, and I think that pump output can be misleading (many moms find they get less from pumping than baby takes in when nursing) and also that, as a first step away from supplements, it is very important to increase overall the time baby spends at the breast.
The more time baby nurses at the breast the less often you need to pump. So I know this sounds like I am asking you to do more work, but it's actually the opposite. Most moms find it easier to nurse than to pump. And we know babies who do not have latch or sucking issues are far more effective at extracting milk from the breasts than are pumps.
What do you think? Was it ever suggested to you to increase the number of nursing sessions each day? Does that seem doable to you at all?
So baby is asleep/not nursing from 7 pm until 7 am? 12 hours every day!? A 12 hour stretch every day with no feedings is highly, highly unusual, even for a much older baby. For a one month old, it is very unusual! Yes your baby is gaining well, because when he is being fed, he is getting way more than what is normal for an individual feeding. This might be why he is sleeping so long. Also, the reason I asked about pacifiers and swaddling is that these are sleep lengthening techniques. So if a baby is sleeping really long, it may help if these are not used. Also some babies do not wake with normal frequency if they sleep in a different room from mom.