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Thread: Preemie, Tongue Tie, Static Milk Supply- Oh My!

  1. #1

    Default Preemie, Tongue Tie, Static Milk Supply- Oh My!

    Hello all. My son was born 8 weeks premature due to a surprising preeclampsia diagnosis and spent two weeks in the NICU. He's now two months and has been consistently growing. Breastfeeding has been a struggle and there are so many competing issues that it's hard to determine a good plan of attack for eventually breastfeeding my son.

    When he arrived home, we met with a wonderful lactation consultant who was impressed by his commitment to latching and sucking. Unfortunately, he was not pulling milk from the breast. He had a restricted frenulum, but was also very small and not particularly strong, so difficult to determine what was preventing him from getting milk.

    I spent weeks "breastfeeding" prior to each feeding, bottle feeding, and then pumping. My milk supply wasn't great, but it covered about 75% of his daily intake. Everything was generally uncomfortable, but I though that was how it was supposed to be.

    Fast forward two months. Two weeks ago I was diagnosed with mastitis and put on an antibiotic. I feel much better and my pumping sessions are a bit more fruitful now, but I am staying pretty static around 16 - 17 ounces per day; thus, still needing to supplement with formula.

    After lots of breast shield on and off, but still no actual ingesting of any real amounts of milk, last week the lactation consultant determined that the culprit was likely a tongue tie. We met with an ENT who determined the tongue tie to be severe and noted that he had an upper lip tie as well. Both were clipped and I thought we be back in action.

    Breastfeeding is still a struggle. There are a few rare twenty minute sessions on one breast, but generally he is screaming and I am shoving my nipple and areola into his mouth for twenty minutes until we both mutually decide that we have absolutely had enough. I know that getting him on breast will increase my milk supply and I so want that to happen. My mom breastfed us in the early 1980s when there was much less support and fewer products to help along the way. I remain optimistic that I, too, will be able to have the wonderful bonding that breastfeeding provides, but do feel like this dance has been going on for such a (relatively) long time.

    I'd love to hear from anyone who has thoughts on or experience with similar issues. Thank you!

  2. #2
    Join Date
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    Default Re: Preemie, Tongue Tie, Static Milk Supply- Oh My!

    Hi. Try to not compare yourself to your mom. You have a challenging set of circumstances.
    I think each mom knows in her heart when and if a breastfeeding problem feels insurmountable and it is time to move on. Just remember you can always stop. But once you do stop and you milk production reduces, it becomes very very hard to nurse or make as much milk again.
    Exclusive breastfeeding is not the only possible goal. Many mothers supplement long term while continuing to nurse. Some EP while also supplementing with formula or donor milk as needed. There are many possibilities.
    Some babies really do take many months to nurse efficiently.

    Why are you trying to get baby to nurse for twenty minutes?
    How many times in 24 hours does baby nurse? How many times does baby get a supplement?, how many times do you pump, and how much is given in bottles each day, over how many feedings?
    Since you have to supplement anyway, my suggestion would be to try a combo of a small amount of supplement and nursing at most meals. I think it would probably be nice to have some sessions each day be just nursing. But let baby decide when baby is done.
    Have you tried using a lactation aid? If you are using a bottle or cup, Do you typically supplement after or before baby nurses?

  3. #3

    Default Re: Preemie, Tongue Tie, Static Milk Supply- Oh My!

    Thank you very much for your reply. I really appreciate it.

    I really don't want to stop at all- I want to get things rolling so that I can confidently breastfeed my son while ensuring that he's getting an adequate amount of milk.

    Twenty minutes was a "goal", I suppose. After a visit from my lactation consultant on Friday where she observed my son pulling milk from the right breast, but not the left, I am feeding him on the right until he gets sleepy or pulls himself off (or around 10 minutes), switching to the left breast which he is less interested in and less efficient in getting milk from (~10 minutes, though often very little suckling occurs), and back to the right breast for another ten or so. If he is nursing efficiently, the ten minute guideline can be extended until he grows tired. After each feeding session, he's getting 90 ml (3 oz.) of expressed breast milk offered to him (he generally takes it all). I then pump for his next feeding. He's no longer taking formula (for the past 5 days), as I am able to keep up. I couldn't keep up with his previous 120 ml (4 oz.) per session, but 90 is doable. He eats 6 times per day. When I was supplementing, I supplemented after the baby nursed.

    The nursing has been improving, but there are still some sessions (and even days- yesterday was a great example) where he fusses and cannot be soothed, thus never really adequately latches on and sucks. There are other sessions where he is well latched and sucking well for 10 - 20/25 minutes. I wish it were more consistent, but it does feel like progress.

    Thanks again for taking this on. I appreciate it!

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