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Thread: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

  1. #1
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    Default Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Hello-- I am new to this site and appreciate all of the info! I am in need of encouragement.....sorry so long...

    Our LO will be 5 weeks old in a few days. She had been nursing nonstop (literally I get a 15 minute break after 45 min nursing; then fussing until back on the boob.) She does nap once or twice& sleep 3-4hrs at night. At first I thought this was the 3 week growth spurt & went with it, then it turned into 9 days of this so I began researching why she was nursing sooo much. She was having LOTS of wet/green smeared diapers & passing gas -- I came across info on hindmilk and began feeding from one side for 2 hrs at a time & her poop became dark yellow/tan within hours.

    Went to the pediatrician the next day & told her all of this; pediatrician thought it was a low supply issue & said to "top her off" with formula to satisfy LO with more volume. (Baby is small for her age was 6#8oz at birth, 7#12oz at 1 month checkup)

    So for 3 days I did just that with LO taking anywhere from 2-4 oz formula after nursing several times each day. I tried to pump to keep my supply up but was getting exhausted from all the nursing, mixing bottles, pumping & only getting 1-2 oz; plus feeling very terrible that the more formula she got the less chance of nursing exclusively long term, if at all. I was worried that she was taking the formula just because it was there because I don't know where she could fit 4 oz of formula after nursing, but she ate it anyway.

    I am not sure I have low supply as I get engorged during the 4 hr streches at night & have milk spraying everywhere when LO latches & the other side leaks like crazy during the whole feeding. I started a supplement for more milk just incase the pediatrician is right.

    Today I haven't given her any formula & we had a 3 hr stretch of continuous nursing; then usual nursing with a short break in between; so I am not sure she is getting enough from me.

    If this is normal maybe I am better off giving formula as I cannot spend every day like this, I get nothing done & it is really wearing me down. I don't have time to get out of my pajamas let alone leave the house. Sorry for venting, my hubby is supportive but doesn't understand. Any advice is soooo appreciated!

  2. #2
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Hi! I have reccently been worried about the same thing. My LO is only 2 weeks old, but the past two days her poop has been bright green. So I've been doing the one side thing too. I am eager to hear the responses you get. Sorry I don't have much advice, I am still learning a lot myself! But I just wanted to let you know you're doing a great job... getting on here and looking for information, and trying your hardest for your LO makes you a great mommy so don't feel guilty!! Good luck!

  3. #3
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    the 1st few weeks are hard!
    IT sounds like you were on the right track with the block feeding.

    Some babies just want to nurse alot up to 12 times in 24 hours and thats normal for them.
    It does get beter as they get older and beter at nursing.
    http://www.llli.org/FAQ/enough.html

  4. #4
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    Arrow Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula



    You came to the right place.

    Quote Originally Posted by katsmom13 View Post
    Our LO will be 5 weeks old in a few days. She had been nursing nonstop (literally I get a 15 minute break after 45 min nursing; then fussing until back on the boob.) She does nap once or twice& sleep 3-4hrs at night. At first I thought this was the 3 week growth spurt & went with it, then it turned into 9 days of this so I began researching why she was nursing sooo much. She was having LOTS of wet/green smeared diapers & passing gas -- I came across info on hindmilk and began feeding from one side for 2 hrs at a time & her poop became dark yellow/tan within hours.
    Okay so the block feeding changed her poop color. Did it seem to do anything else?

    Went to the pediatrician the next day & told her all of this; pediatrician thought it was a low supply issue & said to "top her off" with formula to satisfy LO with more volume. (Baby is small for her age was 6#8oz at birth, 7#12oz at 1 month checkup)
    I do not understand why the pediatrician thought this meant low supply. Frequent nursing doesn't mean you have low supply, neither does a foremilk/hindmilk imbalance (actually it's usually the opposite) and it sounds like your LO was making plenty of wet and dirty diapers (is that right?) So this low supply theory introduced by your pedi is a real eyebrow raiser for me. But even if you DID have low supply (which again it doesn't remotely sound like-- gaining well over a pound in a month is great weight gain) then the cure isn't to substitute formula instead of breastmilk. And the truth is, when you feed formula, it's never just in addition to breastmilk, it's in place of it. It takes longer to digest and then that throws off the timing of the next feeding.

    So for 3 days I did just that with LO taking anywhere from 2-4 oz formula after nursing several times each day.
    Did you know that babies will often suck down a bottle after nursing, even though they are full?

    Plenty of other excellent advice in this link (do check it out if you have time! ) but here's a good quote:

    ... the following things do NOT mean that you have a low milk supply:
    ...

    --Your baby guzzles down a bottle of formula or expressed milk after nursing. Many babies will willingly take a bottle even after they have a full feeding at the breast. Read more here from board-certified lactation consultant Kathy Kuhn about why baby may do this and how this can affect milk supply. Of course, if you regularly supplement baby after nursing, your milk supply will drop (see below).
    from Is your milk supply really low?

    I tried to pump to keep my supply up but was getting exhausted from all the nursing, mixing bottles, pumping & only getting 1-2 oz; plus feeling very terrible that the more formula she got the less chance of nursing exclusively long term, if at all. I was worried that she was taking the formula just because it was there because I don't know where she could fit 4 oz of formula after nursing, but she ate it anyway.
    Of course you're tired, all that extra work! Arg! It probably hasn't even taken off any of the pressure of the frequent nursing. You are right that when supplements are given, the sooner weaning tends to occur. That is absolutely true, and a pitfall of trying to do both that your doctor should have warned you about.

    Babies, particularly very young ones, will often suck whatever is put in their mouths. If you suck on the end of the bottle you drink. There is no "comfort nursing" from a bottle.

    There are a few much better ways to tell if the baby is getting enough to eat. Counting diapers (at her age it should be a minimum of 6 wets and a couple of dirties every day, although the poops will begin to become less frequent around 6 weeks or so) is a great way. If it's coming out, it's going in. Secondly weight gain, and it sound like there's no problem whatsoever in that department. The average breastfed baby gains about 6 ounces a week, and you're well over that. Last of all, during feedings you should notice the baby start off with quick sucks then move into a suck-swallow-pause to breath rhythm that starts just after you feel letdown. Your breasts should feel somewhat softer after the feeding. These are signs that your LO is getting a good feed.

    Question-- are you offering both breasts now per feeding?

    I am not sure I have low supply as I get engorged during the 4 hr streches at night & have milk spraying everywhere when LO latches & the other side leaks like crazy during the whole feeding. I started a supplement for more milk just incase the pediatrician is right.
    I really, really think that you should get a second opinion from a board-certified lactation consultant, or a breastfeeding-friendly pediatrician, before going forward with the supplementing. You seem to already know that it's not what the problem was.

    Today I haven't given her any formula & we had a 3 hr stretch of continuous nursing; then usual nursing with a short break in between; so I am not sure she is getting enough from me.
    What have the diapers been like today so far?

    If this is normal maybe I am better off giving formula as I cannot spend every day like this, I get nothing done & it is really wearing me down. I don't have time to get out of my pajamas let alone leave the house. Sorry for venting, my hubby is supportive but doesn't understand. Any advice is soooo appreciated!
    I totally understand. Your daughter sounds like mine was. I had a constant nurser for the first 7-8 weeks. It was really tough. No one tells you when you're pregnant that in those first months nursing can mean you're literally nursing all day long and half the night. My daughter was a real boob monster. Some babies are. Who knows why. Could be a number of reasons. Adding formula will maybe stop the behavior, but there was nothing "wrong" with the behavior to begin with-- other than the fact that it is hard on mama for a while.

    I coped by planting a rocking chair in front of the television and watching DVDs. I know it seems like a rough way to spend some weeks, but if you hang in there and keep the faith the feedings WILL spread out more, and she'll also become more efficient at nursing so those feedings will get shorter. I bet you're more than half-way through the hump. If you can just stay strong for a little longer then things will iron themselves out.

    Here's another link that I think might have useful information for you. I'm so sorry you're having a hard time, and I hope this helps.

    Frequent Nursing

    There are some good coping tips in that link.

    You're doing a great job mama, these weeks can be hard to deal with but well worth it in the long run. This too will pass.
    Erin (32), breastfeeding CLW, knitting cloth-diapering crocheting, heirloom tomato-growing philosophizing poker-playing feminist artist mama to my 19 month old daughter! Baby #2 due January 2009.


  5. #5
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Quote Originally Posted by katsmom13 View Post
    Hello-- I am new to this site and appreciate all of the info! I am in need of encouragement.....sorry so long...
    Welcome!

    Quote Originally Posted by katsmom13 View Post
    Our LO will be 5 weeks old in a few days. She had been nursing nonstop (literally I get a 15 minute break after 45 min nursing; then fussing until back on the boob.) She does nap once or twice& sleep 3-4hrs at night. At first I thought this was the 3 week growth spurt & went with it, then it turned into 9 days of this so I began researching why she was nursing sooo much. She was having LOTS of wet/green smeared diapers & passing gas -- I came across info on hindmilk and began feeding from one side for 2 hrs at a time & her poop became dark yellow/tan within hours.
    Sounds like you were back on track! And output was good!

    Quote Originally Posted by katsmom13 View Post
    Went to the pediatrician the next day & told her all of this; pediatrician thought it was a low supply issue & said to "top her off" with formula to satisfy LO with more volume. (Baby is small for her age was 6#8oz at birth, 7#12oz at 1 month checkup)
    ....nothing you mentioned thus far sounds like low supply! Pediatricians, unfortunatley, are one of the biggest contributors to all the misinformation that is out there!
    Quote Originally Posted by katsmom13 View Post
    So for 3 days I did just that with LO taking anywhere from 2-4 oz formula after nursing several times each day. I tried to pump to keep my supply up but was getting exhausted from all the nursing, mixing bottles, pumping & only getting 1-2 oz; plus feeling very terrible that the more formula she got the less chance of nursing exclusively long term, if at all. I was worried that she was taking the formula just because it was there because I don't know where she could fit 4 oz of formula after nursing, but she ate it anyway.
    If you keep up with these supplements, it is going to kill your supply. Your baby will drink way more than necessary, fill up and not take enough milk from you, which would signal your body to make more.

    Quote Originally Posted by katsmom13 View Post
    I am not sure I have low supply as I get engorged during the 4 hr streches at night & have milk spraying everywhere when LO latches & the other side leaks like crazy during the whole feeding. I started a supplement for more milk just incase the pediatrician is right.
    The pediatrician is not right. Please trust your body and do your own research!

    Quote Originally Posted by katsmom13 View Post
    Today I haven't given her any formula & we had a 3 hr stretch of continuous nursing; then usual nursing with a short break in between; so I am not sure she is getting enough from me.
    She will get your supply where she needs it. Nurse, nurse, nurse. Sleep when she sleeps. Let the chores go, they will be waiting on you when you're rested!

    Quote Originally Posted by katsmom13 View Post
    If this is normal maybe I am better off giving formula as I cannot spend every day like this, I get nothing done & it is really wearing me down. I don't have time to get out of my pajamas let alone leave the house. Sorry for venting, my hubby is supportive but doesn't understand. Any advice is soooo appreciated!
    Being exhausted and sleep deprived and nursing around the clock is VERY normal in the beginning. Expect things to ease up in the next two weeks or so.

    Be glad your hubby is supportive, mine was scared to death with dd1, b/c he couldn't see what was going in and after 16.5 months of successful nursing with her and nearly 8 months with dd2, my hubby is the ultimate lactivist!
    Mother - Wife - Artist - Cook - Writer - EnvironMENTAList - Cloth Diaperer (but we are soooo done with diapers) - Organic Health Nut...I'm sure there's more.

    DD1 - 12/15/05 Breastfed for 16.5 months
    DD2 - 8/6/07 Breastfed for 3 whole years and 3 little, extra days.

  6. #6
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    You've gotten some fabulous advice so far. The only thing I'd like to add is that wearing your baby might help you get some things done. Mind you, I agree that chores can wait, but if you just want to fix something to eat or get out for a walk, these things might do a world of good for your state of mind! Check out the babywearing forum for info on slings, wraps and carriers to help you comfort, nurse and hold your baby on the go!

    One more thing that saved my sanity in the early days was learning how to nurse while lying down. Besides eating and getting fresh air, there is nothing that will help you have enough energy for this newborn business than getting more sleep! Sidelying is fine if you can manage it, but it is tough in the beginning for some. Here are some photos that might help: http://www.biologicalnurturing.com/i...ite-locked.pdf

    L e i l a, married to hubby, loving our "bock-ee" kinda girl, 6.23.06
    Learn about the prepuce before you have a boy.
    Dental issues? Find out how to Cure Tooth Decay.

  7. #7
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Thank you everyone for the responses & encouragement. I am going to hang in there & look forward to this getting better in a few weeks. Looks like I will be catching up on daytime TV. I think all of your advice is right on target with what my hunch was with all of this! Now I know it is normal for some babies to be boob obsessed at this age.

    DD is finally asleep. Nursed all evening & she got fussy spitting my nipple out (I don't think she was getting much--felt empty) so hubby gave her some pumped BM, then I was able to nurse her again a little later. Her output is good...lots of wet dipes & back to the yellow/tan poop. I am trying to stay on one side at a time to make sure she gets the hindmilk so we don't go back to the green poop & gas of last week.

    Yes, I will be careful of what the pediatrician says in regard to supplementing formula. I have done some side-lying nursing but it seems like somehow I leak all over when she keeps unlatching and then I have an empty breast & a big puddle on the bed. When her head control is a little better I will try it again.
    thanks again, I feel much better now

  8. #8
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Hi,

    I'm glad you found us here. You've received some fantastic information and support already, and I'm glad you're feeling better today.

    I just want to reiterate that the engorgement, "milk spraying", and leaking breasts you describe sound like oversupply, not low supply. You can visit us over at the Too Much Milk! forum for more information.

    Hang in there and keep us posted!!

    Tiana

  9. #9
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Thanks again mamas for all of the support....

    Today I am trying to not give any formula....which is hard & here's why....

    Even though I think I have oversupply overnight & in the morning (when there are long stretches between feedings when DD is asleep my milk seems to build up) during the day when she is marathon nursing I seem empty & unable to satisfy her. Is this possible?

    She nurses for 2-3 hours, during which times she will become fussy, spit out my nipple, then cry until back on the boob. This cycle continues....today I gave her 1.5 oz of BM that I had pumped & now she is napping...that satified her. I try to hand express when this is happening to see if I am empty but it is hard to tell.

    I hope this makes sense!

  10. #10
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    Default Re: Foremilk/Hindmilk imbalance vs. poor supply--feeling guilty about giving formula

    Yup! Makes sense.

    A lot of babies who are dealing with oversupply seem to have a "love-hate" relationship with the breast. Babies have a strong need to suck, so they often want to nurse "all the time" even if they are getting more than enough milk. You might try nursing in a sidelying position, using the clutch/football hold, or nursing while reclined in a chair or propped up in bed with a few pillows. This might help her to gratify her sucking needs without overwhelming her with too much.

    If you are worried at all about your daytime supply, the best thing to do is nurse frequently. The engorged feeling you get at night is not really a normal part of breastfeeding that you should expect to experience all day long. It is normal to feel "softer" and "emptier" when baby is removing milk from the breast frequently.

    Hang in there!!

    Tiana

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