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Thread: Nipple confusion?

  1. #1

    Default Nipple confusion?

    Hi
    My son is 4 1/2 months and at his most recent MD appointment he only gained .4 lbs and dropped to the 4th percentile. In hindsight he was fussing a lot more at the breast but I chalked it up to his 4 month growth spurt. The MD suggested I supplement with breastmilk in a bottle after each feeding. If I couldn't sustain that, I should give formula. Prior to this I was pumping 1x/day to increase my frozen supply for my return to work. I can pump between 2-4 oz. I started taking fenugreek bc for a while it was only like 2 oz and he was fussing so I thought I had a supply issue. now that I've given him a bottle of either formula or breast milk with each feeding he won't breast feed anymore. After about 30 seconds to a minute into breast feeding he pulls off screaming. I am unsure if he's frustrated that my letdown isn't fast enough or that my supply isn't good enough. What do you suggest I do? I don't want to not give him a bottle bc of his weight gain issues. But I really do want to continue breast feeding.

  2. #2
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    Default Re: Nipple confusion?

    Quote Originally Posted by @llli*leeshies View Post
    Hi
    My son is 4 1/2 months and at his most recent MD appointment he only gained .4 lbs and dropped to the 4th percentile. In hindsight he was fussing a lot more at the breast but I chalked it up to his 4 month growth spurt. The MD suggested I supplement with breastmilk in a bottle after each feeding. If I couldn't sustain that, I should give formula. Prior to this I was pumping 1x/day to increase my frozen supply for my return to work. I can pump between 2-4 oz. I started taking fenugreek bc for a while it was only like 2 oz and he was fussing so I thought I had a supply issue. now that I've given him a bottle of either formula or breast milk with each feeding he won't breast feed anymore. After about 30 seconds to a minute into breast feeding he pulls off screaming. I am unsure if he's frustrated that my letdown isn't fast enough or that my supply isn't good enough. What do you suggest I do? I don't want to not give him a bottle bc of his weight gain issues. But I really do want to continue breast feeding.
    Keep working on your supply with extra pumping and get a lactation aid (like a Medela SNS or Lactaid) so you can supplement directly at the breast and hopefully that will help with him get back to the breast and reverse his flow preference.

    Are you on any hormonal birth control that could be affecting your supply?
    Is there something else that might be affecting your supply?
    Is baby having any problems with milk transfer?
    How often is baby nursing? can you nurse more often?

  3. #3
    Join Date
    Apr 2014
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    Default Re: Nipple confusion?

    Babies will fluctuate weight gain wise... What centile was he on previously?

    If your baby is struggling to latch/ stay latched is there someone locally who can help? Maybe a LL group or other bf group, or a lactation consultant you can see to check for latch/milk transfer issues?

    Have you tried breast compressions and 'breast sandwiches' (where you use your hand in a c shape to flatten your breast in the direction of babies mouth) to help keep him interested and take a deep latch?

    I agree with the PP about maybe using an at the breast supplementer. In theory tho while this helps with weight gain it doesn't help it the underlying issue; whatever that may be!

  4. #4
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    Default Re: Nipple confusion?

    Quote Originally Posted by @llli*bsua65 View Post
    I agree with the PP about maybe using an at the breast supplementer. In theory tho while this helps with weight gain it doesn't help it the underlying issue; whatever that may be!
    I agree that it is not a good solution for always/long term. The tubes get fiddly to deal with and there may still be a "flow preference" but I think weaning off the supplementer to bare breast is probably easier than trying to get baby back to breast after deciding they like the bottle better. They are really just my recommendation of what to do while trying to deal with the real problem.

  5. #5
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    Default Re: Nipple confusion?

    I would agree at the breast supplementing is best; it's what we did! My comment was meant to mean don't let any HCP say a baby needs supplementing without going further into the why's and trying to sort those

  6. #6
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    Default Re: Nipple confusion?

    Quote Originally Posted by @llli*bsua65 View Post
    I would agree at the breast supplementing is best; it's what we did! My comment was meant to mean don't let any HCP say a baby needs supplementing without going further into the why's and trying to sort those
    I agree, supplementing might be necessary in some cases but if it is, the health care provider really should be looking into WHY and helping get that addressed so that the supplementing is only temporary. Needing to supplement is usually a symptom of something else being wrong.

  7. #7
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    Default Re: Nipple confusion?

    so baby gained .4 pound- do you mean, around 6 ounces? Between when and when?

    Was weight gain prior entirely normal? Any latch pain, injury?

    Did you notice baby nursing much less often or less effectively? How many times each 24 hours would baby normally nurse? Was baby taking longer sleep stretches? Was a pacifier, swaddling, or sleep training introduced during this time?
    How about your health-on any new meds, diet restrictions, dehydration?

    Prior to this I was pumping 1x/day to increase my frozen supply for my return to work. I can pump between 2-4 oz
    . So this is what you pumped, once a day, when baby was nursing all day as well? So, this is good output in that circumstance. Even 2 ounces is good output in that case.

  8. #8
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    Default Re: Nipple confusion?

    if you must supplement and do not want to use an at the breast supplementer, you can try making sure bottles are small and given via paced feeding. I would also say that a bottle after EVERY feeding is not a very specific instruction. Some babies nurse 12 or more times a day and some 8. Your doctor may think 'after nursing' means 6 times a day, or even less. I don't know. Know what I mean? It is important baby is not over supplemented even if baby needs some supplement, as overfeeding will certainly cause breast refusal. Also, in some cases, bottles AFTER nursing makes baby associate bottles with satiety and mom panic if a nursing session is taking 'too long" . Supplemets (when needed) can happen between nursing sessions, before nursing sessions, and during nursing sessions. They do not always have to be after.

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