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Thread: Needing support... should I give up?

  1. #1

    Question Needing support... should I give up?

    This is my first time posting here. I have an 11 week old daughter with whom breastfeeding has been a challenge. With my first, breastfeeding was a breeze, despite colic and reflux. I have had an OS with my infant, and have been working with a local lactation consultant to resolve this. In addition, my girl has significant reflux, and between that and OS has experienced a lot of choking. This is better controlled with my work to reduce my supply and treatment of her reflux. However, in the last five days, she has begun refusing to nurse. We went through a 36 hour period in which she nursed only twice- otherwise would come to the breast, get really upset, and only take a bottle of pumped milk. We got going again a little better after that- it seems if I catch her when she is sleepy, or before she gets really hungry, she does okay. I can't always catch her at the right time, with chasing after my 4 year old. But this afternoon my infant has refused again... I know she will benefit my breastmilk whether from a bottle or from my breast. But of course I love the bonding that comes with bf. I am hoping that if I stick with it and continue to gently try, she will come around and be more willing. Anyone with any experience like this? Any words of wisdom? Thanks so, so much.

  2. #2
    Join Date
    May 2006
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    Default Re: Needing support... should I give up?

    Welcome to the forum and congratulations on the new baby!

    You nursed your first baby, so you know just how easy, fun, and healthy breastfeeding can be, and how worthwhile it is to try to get to the point where the road smooths out. So for that reason alone, I don't think you should give up.

    The other reason I think you should continue to nurse is that no matter how hard nursing is right now, exclusively pumping (EP) is generally much, much harder. Pumping doesn't remove milk as effectively as nursing, so it's harder to maintain supply when EP. Milk in the breast is always immediately available, clean, fresh, and at the right temperature. Pumped milk is a lot more work- it needs to be pumped, stored, warmed, transported, and fed to the baby. It can spill in the diaper bag, get forgotten on the counter, spoil in the heat, or fall on the floor. And while nursing generally gets easier with time, pumping does not. If it takes you 20 minutes today to produce a bottle, it will take you the same 20 minutes (or longer) in 6 months- and you'll have to find time to pump while managing a busy preschooler and increasingly mobile baby.

    Is a nursing vacation an option for you? If it were me, I'd want to try shelving the bottles completely for a few days, and seeing what happens.
    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!"

  3. #3
    Join Date
    Jun 2009
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    Default Re: Needing support... should I give up?

    I am a little confused about what the issue is. When baby is refusing to nurse, what do you mean? Baby is not cueing, or baby cues and then will not latch, or latches but then pulls off?
    when were bottles introduced? could baby's breast refusal have to do with bottles? are you pumping?
    Does it appear baby is unhappy with the flow-and is baby upset about slow or fast flow?
    What have you done for the os? have you been block nursing? is it possible the flow is now too slow for baby due to your efforts?

    As far as if you should continue-only you can answer that. But imo oversupply and breast refusal are typically issues that can usually be resolved and the breastfeeding relationship continue just fine. os is usually a temporary situation.

  4. #4

    Default Re: Needing support... should I give up?

    Thank you mommal. I appreciate your encouragement- And you're right, I do know what it's like to have a great experience, and so badly want it again. I hadn't considered the challenges of exclusive pumping. I may be able to do a brief nursing vacation- I took the afternoon a few days ago and that seemed to help- I'll definitely try that again.

    Lllmeg, she will cue and not latch, or latch briefly and come off. Either way she gets very upset. She first had a bottle when she had a cold and ear infection... she was so miserable that I gave in, though I had been avoiding the bottle up to that point because I did not feel that our nursing relationship was yet well established- she was around 7 weeks. I pump each time she has a bottle, which we offer to her when she has refused to nurse and can't be distracted or calmed. I have been dealing with OS for many weeks- I was block feeding at first, but I ended up with her totally favoring one breast and refusing the other. I called a LC at that point, who has had me doing one pumping in the morning, draining both breasts to balance out the OS. My baby does better in the morning and struggles more as the day goes on. I would love to hear if you have other thoughts... Thanks so much.

  5. #5
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    Default Re: Needing support... should I give up?

    (First- for clarity- I prefer the term overproduction, or op, but you can call it os if you like! it does not matter at all, it's just that is how I think and I keep writing op instead of os. Sorry.)

    Did you see the LC for an appt? Was latch and suck assessed? Or was this a phone only appt? Sometimes the issue appears to be overproduction , or only op, but actually is a latch or sucking issue that may be exacerbated by op. And also, op can make latch much more difficult, as it can cause engorgement. And if latch is poor, it makes it more likely mom is going to get the possible ill affects of op, like engorgement and plugs and mastitis. So latch issues and op can be tied up and tangled to make a larger breastfeeding issue. There are things to do for this. but I am unclear if that is even part of the issue.

    With the daily pumping, Do you think your op is getting better? What symptoms have you had and are they improving? Because I have a question about that.
    Pumping once a day (or as needed) to "drain" the breasts is something that is suggested for op, but in my understanding, it is to be done along with block nursing. In fact this is a technique called "Full Drainage and Block Nursing." Both are required. Because pumping "extra" on top of normal nursing would increase milk production, and consequently, be causing worse op. Block nursing reduces milk production. (Please note, I am not saying to block nurse! That has to be approached carefully and I am unclear if it would be appropriate in this situation.)

    So I am unclear what the pumping once a day without block nursing is supposed to do. You say it makes the flow less in the morning and your baby nurses better- that is good. but could that be treating the symptom while possibly exacerbating the underlying issue? Are/were you experiencing engorgement or other ill affects of very full breasts? That would be a good reason to pump, assuming nursing alone is not doing the job. But again, you would need to understand that pumping, particularly pumping so much that you are "emptying" the breasts, is going to increase milk production. It would have to be managed carefully, in other words, with adjustments made as needed, so as not to keep increasing milk production.

    Also, I assume(?) baby is having difficulty with the flow of the milk-it is too fast. This is typically what might cause breast refusal when a mom has op, although if I have this wrong, please correct me.

    If this- forceful letdown- is part of what is going on, typically the best thing to do for THAT is to nurse very, very frequently. (there are some other ideas in article linked below) Because the shorter the time between nursing sessions, the less milk buildup in the breast, and the less forceful flow.
    So, if baby is being given a supplemental feeding, that means baby will not nurse as frequently as baby would otherwise. Longer time between nursing session = more milk buildup, and more force to the flow.

    Now, I guess you are counteracting that by pumping- but again, I worry about all that pumping, if the problem is op. Why? Because a pump is going to keep extracting milk as long as you pump. A baby stops nursing when they are full.

    To try to explain: biologically, it makes sense for milk production to be high the first few weeks when the body is trying to make sure there is enough milk for whatever the situation is- baby not nursing well, twins, whatever. But after a while, maybe, a month or so, typically, mom's body wants to make ENOUGH milk but not too much. Because making milk takes energy, and making too much is a waste of energy.

    How does the body know how much is enough? Because baby tells the body. by nursing as often and as long (or short) as baby likes.
    A baby has a small tummy and will normally only take in a small amount of milk at a time when nursing. So baby needs to nurse often. If the milk is flowing quickly, baby will only need to nurse a short time. At the same time, Baby knows how much baby needs overall. So, in the normal course of things, a baby will nurse as long and as often as baby NEEDS in order to get enough. And assuming this is what happens, baby tells the body what is needed, and the body responds. This takes a little time, maybe a few weeks if there was noticeable op, and is usually all that is needed to address overproduction, although of course in some cases, the op is so extreme more drastic measures are required.

    So when a mom does any pumps and bottle feeds, instead of nursing, she can only guess at how much baby would actually have taken at the breast at that nursing session. Also, you cannot go by how much baby takes with the bottle, and pump exactly that much, because it is so easy & common for a baby to overfeed at a bottle. (OR, if baby hates the bottle, underfeed.) Also, If baby overfeeds at the bottle, then baby may not want to eat again for too long. And we get the super full breasts and forceful letdown again, so baby refuses again, so mom must pump & bottle feed again, and it becomes a never ending cycle until mom is so frustrated and exhausted she understandably feels she cannot go on!

    ON the other hand, encouraging frequent nursing will NOT increase milk production. It only encourages the body to make enough. Because baby only needs and will only take from the breasts a certain amount overall. So while you might end up pumping "extra," baby will not nurse extra.

    Here is another thought. Why are you so worried about intake? Typically, when a mom has OP, baby is gaining very fast. Has this been the case? Because I would suggest that in that case, think about what your expectation are for your baby as far as feeding goes. For example,
    She first had a bottle when she had a cold and ear infection... she was so miserable that I gave in,
    But why? She was not asking for a bottle, she was saying it hurts to eat. OK, If baby is ill, baby did not want to eat. This is just a normal reaction to being ill. Assuming weight gain has been good, "missing" feedings on occasion are not a problem. But pushing a baby to eat when they neither need or want to, or more than they need or want to, is possibly going to create more issues.

    now, if weight gain has been poor, that is another kettle of fish entirely.

    Of course in any case, a baby this age not eating at all for 36 hours is not acceptable-I am not suggesting never give a bottle. But I would suggest that the bottles and feeling the need to 'give in' to them are possibly part of the problem.

    So, my next question is-what symptoms of overproduction do you currently have? (both you and baby) including, weight gain?
    How much milk do you pump when you pump? (amount)
    Have you tried the ideas in this article for helping baby handle a fast flow (again, ignore the block nursing info for now! I have good articles to suggest for that but don't want to encourage block nursing if it is not needed.) http://kellymom.com/bf/got-milk/supp.../fast-letdown/
    any latch issues? pain, baby having difficulty latching?

    Hope the above makes sense. It is late and I am a bit tired! Sorry.
    Last edited by @llli*lllmeg; June 23rd, 2014 at 12:36 AM.

  6. #6
    Join Date
    Mar 2014
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    Central FL
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    Default Re: Needing support... should I give up?

    Sometimes latch problems related to tongue tie or just some other jaw/facial/tongue muscle weakness can cause baby to have problems with flow (even if it isn't especially forceful) and cause choking and some people even claim reflux can be made worse by tongue tie etc.
    Might be worth getting an assessment of her suck and latch and check for tongue tie if any of those are a problem then get help with them and possibly seeing a speech therapist if there is any disorganization to her suck that you can work on with exercise.

  7. #7

    Default Re: Needing support... should I give up?

    Thanks so much for all that information!

    Did you see the LC for an appt? Was latch and suck assessed? Or was this a phone only appt?
    I met with her in person. Latch and suck are in good shape.

    With the daily pumping, Do you think your op is getting better?
    One way or another things are improving. I'm not sure if my LO is managing better or my supply is lower, but the choking has definitely decreased.

    So I am unclear what the pumping once a day without block nursing is supposed to do. You say it makes the flow less in the morning and your baby nurses better- that is good. but could that be treating the symptom while possibly exacerbating the underlying issue? Are/were you experiencing engorgement or other ill affects of very full breasts?
    The primary concern was baby's breast refusal after significant choking. My let down was forceful, and she became overwhelmed.

    Here is another thought. Why are you so worried about intake? Typically, when a mom has OP, baby is gaining very fast. Has this been the case?
    SHe was 7 lb 2 oz at birth and 12 pounds at 10 weeks... her gain has been good. I am not worried about intake so much as what to do when she appears to be crying because she is hungry, but then refusing my breast. I think I figured out that she is using the bottle for comfort. If she is relatively calm and hungry, she will take my breast... but if she is overtired or over hungry, then forget it. I try to offer my breast to her and she screams at it, and often will not be pacified until she gets a bottle.

    So, my next question is-what symptoms of overproduction do you currently have? (both you and baby) including, weight gain?
    Mostly the choking, and quick weight gain.

    How much milk do you pump when you pump?
    When I pump to drain in the morning, I get as much as 10 oz. If I pump at other times of the day, when she refuses to nurse and takes a bottle, I usually get a total of 4 oz.

    I have been trying to nurse more frequently today, and have managed to be successful many times (!). I'm going to continue to work on this- mostly trying to figure out how to get her back to taking comfort from nursing or rocking rather than using the bottle. I spoke with my LC today, and she was essentially out of other ideas...

    Thank you again, so much.
    Last edited by @llli*kelseymc; June 23rd, 2014 at 04:52 PM.

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