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Thread: Why can't I fill her? Any ideas?

  1. #1
    Join Date
    Apr 2008
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    Default Why can't I fill her? Any ideas?

    My 32 weeker (now almost 39 weeks) has been trying to BF pretty much since birth, and while she is now doing much better at latching-on (she doesn't always latch, but is getting better) - which is the good news, HOWEVER when she does latch and BF she never seems to be full.
    I know I have more than adequate milk (as I have pumped milk for her since she was born - and every pumping session I get between 4 and 7 oz, both breasts combined).
    Today for example, I BF her. She fed for about 20 minutes each side, and once she came off each breast I checked it (by sqeezing the areola) to see if it was "empty" - this morning, she "emptied" the first side, but not the second. She seems to have her fill, she starts to fall asleep after feeding for 40 minutes, and stops showing interest in the breast. BUT as soon as I try to put her into her crib (or even if I let her sleep in my arms) she won't settle, and ends up screaming and crying - along with this, she starts rooting, putting her hands to her mouth, and sucking them. I have tried giving her a pacifier (in case she just needs to suck for a while), but nothing works - I then have to get a bottle ready for her, and once she has had that, she will settle and sleep.
    I'm now not concerned about getting her to BF exclusively (the reason being, that I return to work in a few weeks, so it seems like a pointless endevour to try to have her ONLY BF, then have to switch back to having both bottle and breast) BUT I would like to be able to BF her when we are together, and through the night. I just don't know how to get her to do this - and I don't know why she never seems to be full after BF-ing.
    Any ideas? Is it because she is still mastering the art of BF-ing, and is just pooping herself out trying?
    I wouldn't mind feeding her every 2 hours......but I literally cannot get her to settle AT ALL if she has only BF (and not had a supplementary bottle) - so I either give the bottle, or would NEVER ever get to sleep.

    I'd appreciate any thoughts - I'm pumping milk after every feeding session - so everytime she feeds it take approx 1.5 hours (to BF, bottle feed, then pump). I'd really like to get her to BF without supplement for some of her feeds, as I don't think I can keep this up once I have to go back to work.

    HELP!

  2. #2
    Join Date
    Jan 2006
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    Default Re: Why can't I fill her? Any ideas?

    Perhaps try breast compressions to keep her actively nursing for a longer period of time? It really helps to assure that she is latched on well (mouth open wide, lips landing far back on the areola, chin touching breast) everytime. If it's comfortable and effective, it's right. This page tells how to do breast compressions and there is a link to videos on that page:
    http://www.kellymom.com/newman/15bre...mpression.html
    And here's a video that shows latching on:
    http://www.ameda.com/breastfeeding/s.../latch_on.aspx

    What happens if you put her back to the breast when she doesn't settle after a feeding?

  3. #3
    Join Date
    Feb 2006
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    Default Re: Why can't I fill her? Any ideas?

    Interesting that the heading of this is “why can’t I fill her?” when it sounds as if this has very little to do with your end of the breastfeeding! From what you describe, you’re working fine – but your baby may not quite be there yet -- not unusual for a "recovering" preterm baby. (The breast compressions are a terrific suggestion, and there are video clips of it under Breastfeeding Help at: www.drjacknewman.com.)

    A mom can lead a baby to the breast and give baby 24/7 access, but a baby has the biggest role. The baby needs to be able to effectively remove enough milk prior to tiring out. There’s a couple of research reports that found that breastfed newborns transfer the bulk of the milk taken in during a feeding within the first 10-20 minutes; however, many babies continue to remain attached and do remove more milk with more time. Some of the later part of feeding may be related to the need to feel close and secure vs. taking in food… One of the most difficult things about learning to “let go” for good breastfeeding is reaching the “ah ha” that breastfeeding is far more to a baby than physical food – it is also food for baby’s soul. (This is difficult because our artificial-formula-feeding culture emphasizes scheduled eating for physical food intake.) It’s not at all unusual for a “just out” newborn, which is what your baby is re: gestational age, to breastfeed a bit, rest a bit, breastfeed a bit, etc. for more than 12 bigger and smaller feedings over 24 hours. During a term newborn’s first month, coordination of suck-swallow-breathe improves and baby becomes more efficient; baby also grows and can accommodate more in what still is a small stomach.

    And who can blame baby for preferring mom’s body to a firm, flat crib mattress or a reclining seat of some sort? If your baby seems to have had a good breastfeeding, what happens if you put your baby in a sling or front carrier and go about your business? Does your baby want to feed as quickly or is your baby content with being part of the rhythmic dance of your body movement?

    Are you working with an IBCLC (International Board Certified Lactation Consultant) and/or an inexperienced La Leche League leader? If so, have you discussed test-weighing with her/them? Test-weighing involves renting a sensitive digital scale that can detect differences in weight to 2-3 gm (about 1/16 oz), such as Medela's BabyWeigh scale. (Many Medela rental stations carry these.) Baby is weighed immediately before breastfeeding and then immediately after with no change in clothes, diaper, etc. Mom then subtracts the "before" weight from the "after" weight (or the scale does it for her) to figure out how much a baby has taken during breastfeeding. Since a baby who breastfeeds effectively regulates intake and intake will vary over 24 hours, it usually is helpful to test-weigh several feedings over a 24 hour period -- at least at first.

    Test-weighing can help when trying to make that last leap to full breastfeeding -- can hurt if a mom gets to compulsive about weighing. The idea is to be reassured that baby now knows how to transfer milk from the breast or that baby is not quite there yet. Usually a few days with a few test-weights per day give an idea whether baby is now transferring milk well.

    If you learn that your baby is transferring milk well, you can relax a bit and assume her feeding “quirks” are related to her own self-regulation of the amount of food coming in – that she prefers smaller amounts more frequently. (Some think this self-regulation plays a role in why breastfed babies are less likely to be obese during childhood and adolescence – they are less likely to be overfed.) If you learn she still is not quite “there” in terms of milk transfer, you’ll know she still needs some EBM after some/all BF.

    Enough for now – and sorry to go on and on! You and your baby are doing so well – I hope you know how well you are doing considering how early your baby arrived! And I find it often takes preterm babies a few extra weeks past term to totally “get” it – possibly because they’ve had so many oral experiences prior to full-term age and possibly because they are also recuperating from the NICU experience!

    Hang in – you and your baby are doing an awesome job! You are so “almost there”!

  4. #4
    Join Date
    Apr 2008
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    Default Re: Why can't I fill her? Any ideas?

    Thanks for the advice.
    I always do breast compressions to keep her going when she is BF - so that does work to extend the amount of time she is feeding.
    I'm so sleep deprived that I'm trying to remember if I have actually put her back onto my breast AFTER I have tried to put her in her crib....I can't remember
    I'm normally so exasperated by that time (because I do try to get her to re-latch for a while after she comes off the second breast.....which I only now offer is she has emptied the first and is still rooting) that I give a bottle.

    I'll consciously try that today and see what she does.

  5. #5
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    Apr 2008
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    Default Re: Why can't I fill her? Any ideas?

    Karen - Thanks for your post too (we must have been posting at the same time as I only just saw your reply!)
    I'm working with a LC who is an RN in the NICU, and also an IBCLC. I haven't spoken to her in a little while as the little routine that I was doing (which was offering BF every feed, then offering a bottle) was working for me. My LC did suggest having a period in every 24 hours where I ONLY BF....but as you can see, I have not made it for more than one feed before I have to give a bottle.

    I'll try to answer all of the questions you asked:

    1 - I haven't used our front carrier yet as she is not yet big enough to use it. It's for 8lbs and up, and she's not that big yet.

    2. I would be interested in weighing her to see just how much she takes in during a BF session. I'll have to speak to my LC, or maybe the rental shop at the hospital, to see if they have the scales available.
    The one thing I can say about this, is that if I pump immediately after BF her, I only get about 1oz of milk (from the side she mainly feeds from), whereas normally I get closer to 3oz. I know that is not an exact science, as the amount I pump changes each time, but I feel like I get some idea that she is at least getting an ounce or two from BF.

    Next time she wants to feed I'm going to try exclusive BF - and I'll offer the breast to her again if she still wants to eat after I put her in her crib.

    I know we are doing well - even from a week ago, she is so much better at BF - so it's nice to have reassurance that maybe she does just need a little more time to become an efficient eater when BF. I certainly don't want to take away her bottle supplements if she actually needs them - which I think she does right now - I'd just love it if I could get through a night without pumping, bottle-feeding, and washing all of the equipment, in addition to BF!

  6. #6
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    Apr 2008
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    Default Re: Why can't I fill her? Any ideas?

    OK, so we tried offering the breast again after the initial BF, then crib process......and it wasn't really effective. She latched back on, but just lay there pacifying herself with it. I tried all the 'wake-up' techniques but it didn't work.....so I put her BACK in her crib....and she started to cry.....so we ended up doing the bottle feed anyway.
    The whole process took so long that she was ready for her next feed by the time we finished.

    I honestly think she just doesn't transfer enough when BF-ing and tires out. I'm looking into renting a Baby Weigh scale - so if I find somewhere that rents them I will use that to see exactly how much she is transfering.

  7. #7
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    Default Re: Why can't I fill her? Any ideas?

    It sounds to me more like she doesn't want to be away from you than anything else. Often children get there fill on one side. But simply do NOT want to sleep anywhere but on/with their mothers. The rooting around could very well just be her looking for you and wondering why you have left her. I know being the mother of a newborn can be overwhelming, but whenever you are feeling that way I suggest thinking about it from their perspective. You are all she knows. And she is used to being with you 24/7. That is how her life has been since conception. And now she is in this big wide open world and sometimes you leave her alone in the dark. Where she can't smell you. Infants don't understand the concept of themselves as separate from their mothers and when they finally begin to grasp the concept, when they learn to crawl and walk, it is a very ver traumatic realization for them. At this point, even if you held and fed the baby for 12hours a day, that'd still be a 50% reduction in what she considers to be normal. And what she is used to.
    I recommend getting a sling or wrap and getting used to the idea of keeping her with you/on you more throughout the day. And you may want to consider doing some co-sleeping. You sound sleep deprived. Why not try co-sleeping during the day for a nap? See if that buys you longer than 40 minutes between feeds. And if your really are opposed to co-sleeping on all levels(some women feel comfortable doing it with just the baby but not the DH)try swaddling her in something you are wearing like a shirt or night gown. Then she can at least smell you!
    It sounds like you are making plenty of milk, and are getting plenty of wet and poopy diapers, I would look at the possibility that she simply may be higher needs in regards to being with you. HTH!

    Way too lazy for formula

  8. #8
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    Feb 2006
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    Default Re: Why can't I fill her? Any ideas?

    Quote Originally Posted by Jazzle View Post
    OK, so we tried offering the breast again after the initial BF, then crib process......and it wasn't really effective. She latched back on, but just lay there pacifying herself with it. I tried all the 'wake-up' techniques but it didn't work.....so I put her BACK in her crib....and she started to cry.....so we ended up doing the bottle feed anyway.
    The whole process took so long that she was ready for her next feed by the time we finished.

    I honestly think she just doesn't transfer enough when BF-ing and tires out. I'm looking into renting a Baby Weigh scale - so if I find somewhere that rents them I will use that to see exactly how much she is transfering.

    I don't think it could hurt to rent the Baby Weigh scale -- possibly just to reassure you. But, in all honesty, wanting to be held when put down in a crib sounds as per normal and full-term behavior to me -- especially since she seemed more interested in "reassurance" BF than "hungry" BF. (Even a baby pleasantly full after BF is likely to take in even more via bottle-feeding because a baby has a reflex to suck -- and then keep sucking -- when fluid enters the mouth. So a baby could be perfectly well-nourished via BF but still take in more if offered a bottle, because of how reflex sucking works.)

    We live in an unusual culture in that we expect babies to be "happy" on their backs on a flat surface after eating. Throughout time, young babies pretty much lived on mom's body -- or someone else's if mom had to do something else for a bit. In addition to the emotional benefits that living on a body must give to these "just out of the womb-cave" newborn humans, living on a body also has lots of physical benefits. Mom's body gives off heat and baby can use her body to help stabilize his/her own; mom's movement helps baby's nervous and balance systems.

    So, it may be that your baby didn't transfer quite enough, but it seems just as likely that your baby was saying "I'd rather be with you than alone in this crib..."

  9. #9
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    Default Re: Why can't I fill her? Any ideas?

    I would recommend getting a sling or wrap to since they don't go by weight.
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    First time mommy of Robert Nicolas, now 9 whole months(), and loving it!

  10. #10
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    Default Re: Why can't I fill her? Any ideas?

    I was going to say something very similar to DJ's Mom. Some new mothers are very surprised at how incredibly content their baby is at the breast. They assume this means the baby is hungry all the time or something is wrong. But, really, babies have a very intense need to be with their mothers and at that young age they have a strong desire to be held. They are used to being in womb where all of their needs are being met at all times, they are warm, fed, and constantly feeling movement. Then when they come into this world they find that the 2nd best place to being in the womb, is being at mommy's breast where they are again warm, feeling the movement and touch of mommy and drinking warm, sweet milk.

    When my DD was first born, I would usually feed her until she was in a deeper sleep...like when you can move their arm up and down with no resistance. Then I'd transfer her to the bed or her crib. But, I also had read a lot about BF and knew to expect her to spend much of the time attached to me


    Jeanne (my middle name IRL)


    Mommy to two girls (M & M), born Sept. '07 and Sept. '09

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