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Thread: Does this advice sound reasonable?

  1. #1
    Join Date
    Jul 2006
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    Default Does this advice sound reasonable?

    Thank you all again,

    I posted this in the "getting started with breast feeding" forum as well. so appologies.

    As far as the breast feeding is concerned it is an ongoing journey.


    Gemma has been quite fussy. Gassy I guess (nothing to compare it to) Explosive poos.

    The lactation consultant said that I was not emptying each breast enough and I should go bacck to the same breast if Gemma wants to feed within 2.5 or 3 hrs again. She showed me how to tell if the really heavy hind milk was coming (by squirting/squeezing the nipple)

    She said that Gemma is getting lots of sugary for milk which is fattening her up, but it is causing gas in her tummy. the hind milk will help. Also she tends to get hungry faster because the sugary stuff digests quickly.

    Her goal for me is to reduce the number of feedings, reduce the milk supply buyt make the quality of the milk higher. She wants to get me down to 8 feedings a day (Gemma is 18 days old )

    So all this is different from what I'd been reading and been told.

    Now Gemma is kind of pissed when she is forced to work harder for the hind milk on the second feeding on the same breast. If Gemma stops sucking then I am to squeeze milk into her mouth to get her to swallow, and to tap her jaw if she doesn't. Gemma is not really into this program. She is a little lazier than that. Feedings are not the "loveydovey" experiences they are supposed to be. Often ending with both of us frustrated.

    Which is the lesser evil I wonder?

    I think Gemma needs to gradually learn/be taught to work a little harder for the hind milk (The lactation consultant is pretty strict about what she means here. Not just "more opaque than the initial milk" but milk that is so thick it will not squirt if you gather and pinch your areola. It will only bead beccause it is so thick.

    I will give this another 3 days I think. (doubling up on same breast for two feedings if within a short time frame, and trying to get Gemma to work harder for the heavy milk.

    Thank you if you took time to read this.

    Love
    Carrie

  2. #2
    Join Date
    Jun 2006
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    Default Re: Does this advice sound reasonable?

    Jee, I don't know. Everything I have read talks about 10-12 feedings a day in those early months. Hopefully others will chim in on this.

  3. #3
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    Apr 2006
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    Default Re: Does this advice sound reasonable?

    Hmmm, returning to the same breast when baby wants to nurse in a short period of time is generally the recommendation for oversupply and/or foremilk/hindmilk imbalance. This is often called block feeding. Breast compressions (which is what it sounds like she has suggested with sqeezing your breast when she stops sucking, are also effective in making sure baby gets enough hindmilk. It may be that as your baby gets older, and her suck gets stronger, and your supply calms down, she will get to the hindmilk more easily. Most of the time, however, when I've seen breast compressions used, once the compressions are no longer effective in increasing milk flow (i.e. the breast is pretty much drained and only a tiny trickle remains) then its ok to go ahead and switch to the other side. I'm not sure about this, though. The advice about getting down to eight feedings per day seems unusual. It is my understanding that the fat content of breastmilk decreases the longer you go between feedings--you'd be more likely to get more foremilk and less hindmilk with feeding every three hours say then feeding every 2 hours. It seems to me that as long as you returned to the same breast until it is drained, that you would want to continue to feed on demand and not try to space feedings to only 8 if that's not what the baby wants. The problem more frequent feedings comes in if you're constantly switching breasts after only short nursings, rather than going back to the same breast until it is drained.

    These, of course, are my unexpert opinions, so maybe someone else will have further insight. Let know how its going, and congratulations on your new baby!

  4. #4
    Join Date
    Jan 2006
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    Default Re: Does this advice sound reasonable?

    http://www.lalecheleague.org/FAQ/foremilk.html
    http://www.lalecheleague.org/FAQ/oversupply.html

    block feeding is a good idea, but I don't know about the limiting feeds?
    Some babies need to eat alot! Sometimes 12 times in 24 hours, and when the are growing they might want to eat more.
    Diapar count is the way to go..
    what does the babies poop look like? green or seedy and yellow?
    Some babies are very high needs
    dr sears has alot of good ideas for fussy babies on his web site or in his books.
    http://www.askdrsears.com/html/5/T051200.asp

  5. #5
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    Default Re: Does this advice sound reasonable?

    Quote Originally Posted by carrieabresch
    The lactation consultant said that I was not emptying each breast enough and I should go bacck to the same breast if Gemma wants to feed within 2.5 or 3 hrs again. She showed me how to tell if the really heavy hind milk was coming (by squirting/squeezing the nipple)

    She said that Gemma is getting lots of sugary for milk which is fattening her up, but it is causing gas in her tummy. the hind milk will help. Also she tends to get hungry faster because the sugary stuff digests quickly.

    Her goal for me is to reduce the number of feedings, reduce the milk supply buyt make the quality of the milk higher. She wants to get me down to 8 feedings a day (Gemma is 18 days old )

    So all this is different from what I'd been reading and been told.
    Is it solely based on your baby's gassiness and weight gain that the LC believes she's getting too much foremilk, not enough hindmilk?

    I don't think it is right to pin down any set number of feedings per day for any baby, but especially one as young as your Gemma. You need to watch your baby's cues and she will tell you when she's hungry. LLL has great resources regarding this ... see:

    Does My Baby Need to Be on a Schedule?
    This is an excerpt from that page:

    Many mothers are surprised at how quickly and easily human milk is digested (often within 90 minutes of the last feeding). Rather than watching the clock, it is recommended that a mother watch for signs that her newborn is hungry, such as the rooting reflex, chewing/sucking on hands or fingers, or crying. According to the American Academy of Pediatrics, crying is a very late cue that your baby is hungry.

    Healthy, full-term infants need to nurse every two to three hours during a 24-hour period. This equates to eight to twelve feedings per 24 hours. Your newborn should not go longer than three hours between feedings for two significant reasons:

    1) Your newborn needs frequent feedings for adequate nourishment and hydration.
    2) Frequent feedings ensure that your breasts are stimulated enough to establish a full milk supply.

    In the first few weeks, your baby actually needs to breastfeed ten to twelve times per day. Your baby's feedings will gradually space out as he grows older and his stomach grows larger. Any schedule that prevents babies under six weeks of age from breastfeeding at least every two to three hours (or less during growth spurts!) could potentially cause poor weight gain. Research now shows that restricting the amount of time at the breast and extending the time between feedings can reduce not only your milk supply, but also the fat content of your milk. So, for a healthy, thriving baby breastfeed according to your baby's schedule.

    Also, you said she wants to reduce your milk supply? Do you have symptoms of an oversupply?? Here is some info on that ... Oversupply ... does any of that ring true?

    Another couple good resources to check out:

    What is the difference between foremilk and hindmilk?

    I'm confused about foremilk and hindmilk - how does this work?

    Forceful Let-down (Milk Ejection Reflex) & Oversupply

    Baby wants a faster milk flow

    Mama to Adeline Brett, breastfed for 4.5 years (12/14/05) and little Eliza June, new tiny sprite in my arms and still learning the ropes (7/18/10)

    Family Blog • If I'm here I'm nursing and typing one handed ... forgive the typos!
    And I'm not a newbie at all ... I'm trying to get my old user ID working from back in the day ... paint-the-moon

  6. #6
    Join Date
    Feb 2006
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    Default Re: Does this advice sound reasonable?

    Carrie, thanks for the update, and I'm glad you are posting with your questions and concerns.

    From what I have read in your two posts today, your lactation consultant gave you good information on how to handle an oversupply problem (too much foremilk, not enough hindmilk) and how to help your baby learn to drain the breast more thoroughly.

    Nursing from the same breast for a stretch of several hours, then switching to the other breast for the next stretch of hours is called "block feeding," and it is the best way to get more hindmilk into the baby and also to signal your body to slow down its milk production.

    The breast compressions and other ways of encouraging your daughter to work a little harder for her food are going to work towards that same goal -- getting more hindmilk into her tummy.

    As you together with your baby correct the oversupply and become more efficient at getting to the hindmilk, then it is possible -- but not required -- that your daughter may space out her feedings a bit. I think eight feedings per day should not be your goal -- but if it turns out that way, that will be one sign that she is getting enough hindmilk to be satisfied for longer stretches, and thus that oversupply is no longer an issue for you.

    Does that make sense? Basically, I'm saying -- yes, it's good advice, all except the part about trying to feed only 8 times a day! Babies nurse for lots of reasons, not only for hunger, so it is a mistake to conclude that frequent nursing always means a baby is constantly hungry. I think it would also be a mistake to go overboard and deny baby the breast when she is cuing to nurse. Just tweak the "management" aspect (which breast you nurse from, that kind of thing).

    I truly would not worry overmuch about what the milk looks like when you squeeze some out. There are many ducts inside the breast, and they don't all empty at precisely the same rate or produce the same fat density at every moment of the feeding. So baby might have gotten some great hindmilk from one duct, but then another duct might release a slightly less-fatty version of the milk, and you might worry if you are watching the opacity closely at that moment. Does that make sense?

    Just do the block feeding and the breast compressions, be patient with yourself and with your daughter as she learns to nurse more effectively, and give it all some time. If, after three days, you are seeing NO improvement in the oversupply situation, you can stretch out the block feeding to 4 or even more hours per breast. We once had a mom on these boards with such a vicious case of oversupply that she had to go to 6-hour blocks! But that eventually did the trick.

    --Rebecca

  7. #7
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    Default Re: Does this advice sound reasonable?

    in my opinion her poos would tell you if she is getting too much foremilk and not enough hindmilk- her poos would be green and watery- i have done the block feeding, but only to correct an overactive letdown problem... i wouldn't limit her feedings though- esp at 8 days old!

  8. #8
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    Default Re: Does this advice sound reasonable?

    Quote Originally Posted by kayleigh_my_love
    in my opinion her poos would tell you if she is getting too much foremilk and not enough hindmilk- her poos would be green and watery- i have done the block feeding, but only to correct an overactive letdown problem... i wouldn't limit her feedings though- esp at 8 days old!

    Is her poo green and frothy? I just saw explosive poos. Even green stools don't always indicate an oversupply. After I corrected our oversupply she still had green poops, and I found out that she had an allergy to cow's milk.

    Consistently green poop in a baby who is breastfed can indicate:
    • oversupply which causes an imbalance of foremilk/hindmilk,
    • a sensitivity to something in the mother's diet, such as cow's milk.
    • a sign that baby has an illness. Babies with an intestinal virus or even a simple cold will sometimes have green, mucusy stools.

    But I think the consensus is not to limit your babies feedings. I think quakerm0mma's advice was excellent (as it always is), when she said, "I think eight feedings per day should not be your goal -- but if it turns out that way, that will be one sign that she is getting enough hindmilk to be satisfied for longer stretches, and thus that oversupply is no longer an issue for you.

    Does that make sense? Basically, I'm saying -- yes, it's good advice, all except the part about trying to feed only 8 times a day! Babies nurse for lots of reasons, not only for hunger, so it is a mistake to conclude that frequent nursing always means a baby is constantly hungry. I think it would also be a mistake to go overboard and deny baby the breast when she is cuing to nurse."

    See, I really contributed a lot there by just quoting what she said and posting it all over again. Doh! Ha, ha.

    Mama to Adeline Brett, breastfed for 4.5 years (12/14/05) and little Eliza June, new tiny sprite in my arms and still learning the ropes (7/18/10)

    Family Blog • If I'm here I'm nursing and typing one handed ... forgive the typos!
    And I'm not a newbie at all ... I'm trying to get my old user ID working from back in the day ... paint-the-moon

  9. #9
    Join Date
    May 2006
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    Default Re: Does this advice sound reasonable?

    I totally agree with most everybody who posted, don't limit the amount of feedings to just 8 per day. In fact, just this morning my 4 1/2 month old added an extra feeding an hour after the first, which he doesn't usually do. Even though lo is 4 1/2 months old, he still eats about every 2 hours during the day except for one long nap and at night, where I now get a 4-5 hour stretch and then 2, 2- 3 hour stretches. I also deal with overactive letdown and oversupply issues, and what worked for me too was the block feeding. In fact, after block feeding for maybe a week or so (but everyone is different, just look for signs that lo has finally emptied your breast), my supply went down enough to quit block feeding all together, and just feed lo on one breast per nursing session. Although, once in a while, lo will need more milk than just one breast and occasionally will take the second one too. I just have to remember to feed baby on the breast he was last on after he has taken both in one session the time before. Lo only does that during growth spurts now though. Good Luck! Maybe check and see if your LC is actually affiliated with LLL, because I've never heard any advice on this website about limiting the number of feedings a breastfed baby gets at that age.

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