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Thread: OALD / OS / Pump Weaning / Other Complications

  1. #1
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    Nov 2007
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    Default OALD / OS / Pump Weaning / Other Complications

    After 9 weeks of a terrible latch and mostly exclusive pumping, Baby is finally taking milk "off the cow" (yay!! ) but now we're dealing with issues of OALD / OS. I was pumping more than 40 oz when she was bottle-feeding.. always more than double what she ate, even at only 4 pumpings daily. I think most LC's deal with low supply, so their concern was to make sure I maintained. Yeah, no worries there.

    Now I'm trying to transition off the pump. On the first day that she started nursing well, I tried to quit the pump cold-turkey and gave myself a nice case of mastitis. Not eager to repeat that one. So I'm down to 2 pumpings per day (early morning and just before bed). Trying to slowly reduce the amt I pump, as initially it was in the range of 12-15 oz both times -- just to relieve the engorgement!

    So my questions are:

    * Block feeding ... I understand the principle, but with such a HUGE supply, how does it work? I tried it for 4-hr blocks yesterday (only two feedings) and I thought the other breast was going to explode: hot, full, plugged-feeling ducts that were very sore and achey even after being emptied. And that doesn't include the times where we give her a bottle and both breasts feel that way! Just grit my teeth and bear it and it will get better? How long will that take, and is there a way to prevent mastitis in the meantime?

    * Letting the breast drip for a while before letting LO on. She's still not quite latching right... I'm afraid if I take her off and make her wait after a good latch / let-down she's going to get frustrated and give up. Also, because of her latching issues, she latches best on a firm breast / nipple and doesn't suck well ... if I eliminate the OS by hand expression, she won't latch and may not get enough milk (she's on the edge weight-wise already). Help! Is there some comfy middle ground?

    Thanks in advance...

  2. #2
    Join Date
    Jan 2006
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    Quote Originally Posted by rosesforlily View Post
    After 9 weeks of a terrible latch and mostly exclusive pumping, Baby is finally taking milk "off the cow" (yay!! )
    Yeah for you!! That's really good news!!

    but now we're dealing with issues of OALD / OS. I was pumping more than 40 oz when she was bottle-feeding.. always more than double what she ate, even at only 4 pumpings daily.
    That is quite a bit to be pumping. Most babies your daughter's age are taking an average of 19-30oz every 24 hours.


    So my questions are:

    * Block feeding ... I understand the principle, but with such a HUGE supply, how does it work? I tried it for 4-hr blocks yesterday (only two feedings) and I thought the other breast was going to explode: hot, full, plugged-feeling ducts that were very sore and achey even after being emptied. And that doesn't include the times where we give her a bottle and both breasts feel that way! Just grit my teeth and bear it and it will get better? How long will that take, and is there a way to prevent mastitis in the meantime?
    Easy does it! If you are starting to feel engorged, you need to express some milk. Try to hand express just enough to be comfortable. You are currently producing a lot more than your daughter actually needs, so it will take some time to slow your production down to meet her demand. Encouraging short, frequent feedings can help your comfort level.

    If you can, try to avoid bottle feeding during this time. You want your body to get used to how much milk it actually has to make to feed your baby. Babies are much better at removing milk--and preventing mastitis--than pumps are.

    * Letting the breast drip for a while before letting LO on. She's still not quite latching right... I'm afraid if I take her off and make her wait after a good latch / let-down she's going to get frustrated and give up. Also, because of her latching issues, she latches best on a firm breast / nipple and doesn't suck well ... if I eliminate the OS by hand expression, she won't latch and may not get enough milk (she's on the edge weight-wise already). Help! Is there some comfy middle ground?

    Thanks in advance...
    It sounds as though your little one has gotten used to latching onto an engorged breast. This is okay. It just means that it may take her some time to get used to latching onto a not-so-full breast. Given your abundant supply, I would say that it is doubtful that your daughter is not getting enough to eat. Make sure to monitor diaper output--6-8 wet cloth/5-6 really wet disposables and 2-5bms per day is considered normal at your baby's age. Remember that the most commonly used growth charts in the USA are based largely on formula fed babies, that the charts are just an average and do not necessarily indicate a problem, and that your baby's growth is mostly based on genetics.

    HTH. Hang in there!

    Tiana

  3. #3
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    Nov 2007
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    Quote Originally Posted by LLLTiana View Post
    That is quite a bit to be pumping. Most babies your daughter's age are taking an average of 19-30oz every 24 hours.
    Yes. The LCs (I presently have two main ones that I work with, and two others I've contacted briefly) were concerned about undersupply -- I think because they see that a lot more often. I followed the instructions to "pump until dry" for the first few weeks, and ended up in this predicament. My freezer is full and I'm presently pouring milk down the drain.

    If you can, try to avoid bottle feeding during this time. You want your body to get used to how much milk it actually has to make to feed your baby. Babies are much better at removing milk--and preventing mastitis--than pumps are.

    It sounds as though your little one has gotten used to latching onto an engorged breast. This is okay. It just means that it may take her some time to get used to latching onto a not-so-full breast. Given your abundant supply, I would say that it is doubtful that your daughter is not getting enough to eat.
    You and me both! -- but the before-and-after scales (I have one), and the diaper counts, disagree. Our problem is not supply but a very weak transfer; she can take up to ten minutes just to get one ounce, at which point she's exhausted and will sleep for a while before trying again. When I ditch the bottles altogether (and believe me, I've tried... I'm so sick of washing / remembering to pack bottles and pump equipment!) I get a severely decreased diaper count. Ordinarily the baby would be more efficient at milk removal than a pump, but this one is not. I have to continue compressions while she nurses or she gets next to nothing.

    Her problem is a weak suck coupled with a badly shaped mouth. She's also ... hee hee... "passive aggressive" in that when she doesn't get enough, she just sleeps forever (instead of crying). It's a rather dangerous combination that we've been dealing with since the beginning. Recently we've been seeing an OT who is also IBCLC to keep an eye on Baby's side of things and decide how quickly to move forward. So right now I'm only changing things on my end, concerning supply.

  4. #4
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    Have you considered contacting a LC who is an IBCLC? This credential will mean hours and hours of rigorious testing, extra education and a well rounded background behind lactation. It sounds like some latching help might be useful to you! Have you contacted your local LLL leader?

    Here is some information on gentle chiropractic adjustment on infants working to improve latching.

  5. #5
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    Quote Originally Posted by carpentergirl View Post
    Have you considered contacting a LC who is an IBCLC? This credential will mean hours and hours of rigorious testing, extra education and a well rounded background behind lactation. It sounds like some latching help might be useful to you! Have you contacted your local LLL leader?
    Four of them, actually (LC / IBCLC). This is just a really tricky situation. My MIL is a 20+ year LLLLeader and is constantly on call with us.

    Here is some information on gentle chiropractic adjustment on infants working to improve latching.
    We tried the ICPA chiro, but it didn't do a thing. CST is beyond our budget at present.

  6. #6
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    Ok! Just covering all the bases.
    Do you think some of the nursing difficulties might resolve themselves as baby gets older? Once their mouth gets a little bigger it can get easier.

    What a drag that you are having so much trouble. I am sure all you want to do is relax and enjoy your baby.

    Also want to mention that your local milk bank would be a happy recipient of your extra milk. I donated 19 ounces a day.

  7. #7
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    Default Re: OALD / OS / Pump Weaning / Other Complications

    I'm hoping it gets better... it already has improved greatly as she's gotten bigger, but now we have this OS issue and I feel like I can hardly nurse her anymore (again) because it either makes her tummy hurt or she can't get milk... or, presently, both. Sigh.

    On the plus side, I'm becoming quite the expert about all sorts of BF problems I didn't know existed. Someday this experience will be a great resource. In the meantime, it's a bit discouraging.

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