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Thread: Dr. has given up hope on me!(long)

  1. #1
    Join Date
    Mar 2007
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    4

    Default Dr. has given up hope on me!(long)

    Hi, I posted last week about how my two week old was not latching and not gaining weight. Since then, I have attended a breastfeeding medical clinic that supposedly has the experts in breastfeeding. After being see, the Dr. assessed that my daughter and I had three challenges to overcome: One of my nipples was flat, the other inverted, my daughter has a retracted chin, and she is showing very poor suck ability, despite a good latch. So they gave me a nipple shield, told me to try each side for 10 minutes, then top off with the bottle. Fast forward a few days,and we go in for a second assessment. While LO did gain weight, it seemed like it mostly came from bottle supplementing, as she would sometimes take 2 oz after bf'ing for the 10 minutes each side. So they said she was having major difficulty with sucking, and should be just given the bottle for a few days to improve her suck (A method I had never heard of before). In the meanwhile, I was supposed to stop trying to put her to the breast (Another bizarre request, I thought, but I followed through). So today I had my third appointment. and when they weighed her after she fed on one breast, she took less than an ounce with the nipple shield. Personally, I thought this was progress, since at least she was getting something from the breast! But they seemed discouraged. They said I could continue what I was doing ( Bf'ing each side for 10 minutes with nipple shield, then pumping and giving the rest in a bottle), or I could consider just pupming exclusively or even giving formula! Now, I know it may take awhile for LO to become strong enough to nurse exclusively from the breast, but am I crazy to think that this may even work? Also, is the regimen they have me on the best way to go? After I got home, I nursed my LO for a longer period of time (maybe 40 minutes total), and she didn't even want the bottle after that. so maybe I am giving up on her too quickly at the breast? Ladies, tell me what you think about this situation!
    Laurie
    Gwynne June 9/07

  2. #2
    Join Date
    Sep 2006
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    2,539

    Default Re: Dr. has given up hope on me!(long)

    I think as long as your LO is thriving you should trust your instints and it sounds like BFing is important to you, and how great that she latched on and nursed! Do you have a LC or LLL group near you? Have you considered using a SNS? I think it's fishy that they are telling you to not nurse

  3. #3
    Join Date
    Apr 2007
    Location
    NW OH
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    Default Re: Dr. has given up hope on me!(long)

    while I have no experience, and have never used one, but I thought I read on here before that babies take in a lot more air with a nipple shield, and they dont get as much milk. again, I'm not sure , maybe someone can confirm that. Have you tried nursing her recently without the shield? Does your letdown feel stronger if you do? I would also agree to check in with a LC or if you ahve an LLL group close by. I wish you luck!!


    I'm Heather, SAHM to Cooper , born 1/2007
    and Bennett, our precious NICU grad born 8/2009
    and wife to Bill since 10/2003!
    We're young, but we know we can do it!
    Life with the Stevens-blog

    I'm an Ergo Baby Carrier affiliate!

  4. #4
    Join Date
    Jun 2007
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    79

    Default Re: Dr. has given up hope on me!(long)

    I agree dont give up! I had to supplement both my lo's but I still breast feed them and pumped to try EBFing but I never got that far ended up giving up both times at 5 months . I am expecting another lo soon and I am determined to stick with it I know alot more now. My point is some is better than none and who knows as your LO gets older the suck may improve... How old is your LO? You may just need more practice for the both of you to learn. and you know whats best your the mommy. If you feel sometimes your LO needs some extra then you can choose to give EBM or formula. I wouldn't stick to the 10 minute rule though if your LO is clearly getting BM such as SUCK PAUSE SWALLOW then let her/him finish and forget the clock. You may be pulling off the breast too early and not geting enough high calorie hindmilk. I am in no way an expert but stick around and you will find alot of answers that make much more sense than that dr.. IMO

  5. #5
    Join Date
    Jan 2007
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    out of my right mind
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    Default Re: Dr. has given up hope on me!(long)

    Maybe it's just me, but I don't get it. What kind of breastfeeding clinic recommends switching to formula? Huh? I agree with the PP. If your LO is content to nurse longer, then nurse longer. I believe the shield is just supposed to be used for a few minutes, just to help your LO latch on initially. Then you take it off and nurse without it. Have you tried a breast shell between nursings to try to help draw out your nipples? I think you should definitely look for your local LLL leader. Sounds like you may be getting some lousy advice!

  6. #6
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    Apr 2007
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    NW OH
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    Default Re: Dr. has given up hope on me!(long)

    Oh yes I forgot about the breast shells!! I used them for a few days and they seemed to work for me! I have to problems now...just wanted to add that!


    I'm Heather, SAHM to Cooper , born 1/2007
    and Bennett, our precious NICU grad born 8/2009
    and wife to Bill since 10/2003!
    We're young, but we know we can do it!
    Life with the Stevens-blog

    I'm an Ergo Baby Carrier affiliate!

  7. #7
    Join Date
    Jun 2007
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    2,770

    Default Re: Dr. has given up hope on me!(long)

    It sounds a little weird to me too. It almost sounds like they're just setting you up for failure! If your LO is happily nursing, even if it's for a longer time, and if that's important to you, then I'd say keep trying. It may just take some time, but there is definitely hope!

    I too had trouble with flat nipples. I used a shield several times early on, and only for a few minutes, until the nipple was drawn out. Then I switched Haley right to the breast, and she did ok. It only took a few tries with the shield before she adapted to the breast. I'm not saying this is the case for every baby, but I'm saying that if you keep working at it, your LO will get the hang of it eventually.

    I was also told there's a way to start with the shield and sneak it away without baby noticing, but I never had to try it, so I don't know how. Maybe someone else does?

    It sounds like your mama's instincts are telling you to keep up the BF'ing, and I would say to trust your instincts. You know what's best for your LO. Hang in there!
    I love my kids. I care for them accordingly. What more can I say?

  8. #8
    Join Date
    Sep 2006
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    562

    Default Re: Dr. has given up hope on me!(long)

    Hi Laurie -- congratulations on your new daughter Gwynne June, and welcome to the forums.

    It sounds like you and Gwynne are facing some real struggles in your breastfeeding relationship. I'm glad that you have been able to find skilled local lactation help. We will do our best to help guide you to reliable information and to support you as you work through these problems.

    When there are complications in getting the hang of breastfeeding, there are three "rules" that lay the groundwork for future success.

    Rule #1 is "Feed the Baby!" This means, by whatever means necessary and appropriate, you get the milk (EBM if available, formula if not) into the baby, so that she can grow and get stronger while the other pieces of the puzzle are getting sorted out. Let diaper output be your daily guide as to whether your baby is getting enough to eat: a minimum of 6-8 good wets and 2-3 dirties per 24-hour period. Gwynne's growth over time will also be an important benchmark: an average of 1/2 to 1 ounce gained per day is a solid sign that your baby is growing and thriving.

    Rule #2 is "Protect the Milk Supply." This means frequent, effective emptying and stimulation of the breasts, so that they will keep making enough milk to satisfy your baby, when the happy day comes that she gets the hang of her job and can nurse exclusively. Since Gwynne is nursing some for every feeding, you can continue to pump after she nurses as the best way to protect your milk supply. If you are collecting at least enough EBM this way to keep her well-fed and growing, then your milk supply is good. To keep it good, be sure you are using a double-electric pump; if your milk supply begins to falter, let's talk about upgrading to a rental hospital pump (if you're not already using one) along with some other strategies.

    Rule #3 is to stay in touch with qualified breastfeeding specialists and be patient and persistent with the whole breastfeeding thing. You're doing a great job already with this, by seeking out local skilled help and doing research to find reliable sources of information (like LLL!) If at all possible, continue meeting with an IBCLC who has expertise in suck problems. Remember that different experts have different skills and areas of expertise, but the IBCLC credential is the "gold standard" for broad knowledge and experience in supporting breastfeeding dyads through all kinds of problems.

    I have actually heard of babies whose suck improved with some practice on a bottle. This is rare, but the suck issues that Gwynne seems to have are also rare. It sounds as if the combination of breast shield while nursing and bottle supplements after nursing did bring some progress in Gwynne's ability to breastfeed. I'm not sure why you were advised to stop nursing for a few days; was Gwynne starting to show signs of frustration or aversion to the breast at that time?

    At any rate, she is back to nursing, and it is a very good sign that she nursed today for a good long session and appeared to be satisfied afterwards! The more she can do that, the better. Just keep watching the diaper output to make sure that she is getting a good tummyfull and not just wearing herself out by nursing.

    With one flat and one inverted nipples, are you having any pain with breastfeeding? How does it feel when Gwynne latches with the breast shield? Without it?

    If you are concerned that the bottles are confusing her rather than helping her learn to nurse (and this is certainly the more common scenario with early use of artificial nipples), then be aware that there are other ways to offer the supplemental feeds that she needs. Read the link below about a mother who had good luck using an SNS (supplemental nursing system) while her daughter's suck improved.

    http://www.llli.org/NB/NBSepOct04p169.html

    To encourage you that you are NOT crazy for believing that Gwynne will get the hang of nursing, here is a link (not a LLL resource, but written by a leading IBCLC whose reputation in LLL circles is rock-solid) full of stories of babies who did just that:

    http://www.wiessinger.baka.com/bfing...e/babyget.html

    Hang in there -- don't expect an overnight miracle, but do keep the faith that you and your daughter will someday breastfeeding successfully, and that it will happen fairly soon in the grand scheme of things. Please keep us posted, and don't hesitate to ask questions, share concerns, vent, etc. We'll do our best to point you to the information that will help you reach your goal.

  9. #9
    Join Date
    Mar 2007
    Posts
    4

    Default Re: Dr. has given up hope on me!(long)

    Thanks everyone for you replies-especially for those stories of hope Rebecca. It was really needed on this otherwise tear-filled day. My experience with my Dr. has left me doubting myself and my instincts. I should be glad that I have so far achieved the first two goals-feed the baby (she's been gaining over an ounce a day), and keep up my supply. I guess I am at a loss as to what to do next, because there are so many different ways to go. I mean, I do have a nipple shield, an SNS system, and bottles, but I don't want to be trying too many different things at once- I'd like to stick with something for awhile to see if it works. I guess for now I will continue to try her at the breast with the nipple shield, and then top her off with the bottle.(even though the Dr. didn't mention it, I guess her reasoning was that a bottle would be less likely to tire Gwynne out, as compared to fingerfeeding/SNS system, which took her a long time to feed) I will be meeting with my LC next week, and since I find her so much more supportive than my Dr., I hope we can make a plan to move to the next step.
    I will keep everyone posted, and will definately be coming here with more questions!
    Laurie
    Gwynne June 9/07

  10. #10
    Join Date
    Sep 2006
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    2,539

    Default Re: Dr. has given up hope on me!(long)

    Please do!

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