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Thread: Totally confused now

  1. #1
    Join Date
    Dec 2008
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    Default Totally confused now

    I'm a new mother with an 11 week old preemie son (4 weeks adjusted today). We've been having tremendous difficulties with BFing. He only spent one week in the NICU, where I had a very easy time pumping milk (I'd get 6 oz+ both sides).

    Once we got him home we did a combination of bottles and BF attempts. He was very sleepy initially and we had to pack some weight on. He was 4 lbs when he was born and he's now up to a whopping 9 lbs, so he's right on schedule.

    I was doing more and more BFing when about 1 1/2 weeks ago he turned super fussy. A LC diagnosed that he wasnt latching on properly, when she came to observe us a few days ago. Well that problem has mainly been cured but the fussiness persists. The longest I can get him to latch is 3 - 5 mins tops and inevitably ends with him screaming, crying, generally having a huge melt down. Once or twice a day I can do a full BF. Normally, we give up in frustration and give him EBM.

    The LC had advised me to get a better pump and start pumping every 3 hours ago so that I'd have a huge supply and help him deal with the extra effort vs. the bottle. Well I think that maybe she was wrong and I already had an oversupply? I've been using the new pump for ~ 3 days. I pump every few hours (I go a bit longer at night), whether or not I've managed to BF. If he's had the EBM, I can usually pump about 4 oz from the two sides in 10 - 15 mins.

    Last feeding I tried to pump for a few mins before latching him on. This worked to start with -- he latched on without too much fuss. But he was obviously gulping / straining and got overly upset after 5 mins. Typically when he unlatches, milk comes out of his mouth.

    He also has reflux issues (on Zantac and Mylanta, per Dr.) I should add.

    He rarely gets frustrated with the bottle feed so I dont think its an allergy. It can take him quite some time to drink his 3 oz unless he's super hungry. I have cut out dairy as of a few weeks ago.

    Most of his poops are yellow, though at least a couple a day end up being of the green variety. Usually a rather dark green, some times a little syrupy. The Dr. thinks that's due to his immature gut from the prematurity more than an imbalance.

    Any advice would be very welcomed. I'm kind of at the end of my rope on BFing. He's so much happier with the bottle and I seem to be able to keep up w/ him using the pump. He was born so little and I'm disinclined to stress him out so many times a day with the BF attempts. And I've ended up in tears at least once a day the last 1 1/2 weeks


    Edit: I should add that I hope the only solution isnt to cut down on pumping as when he has a fit its really impossible to continue the BF and I don't want to lose the option of giving him EBM / hurt the supply I get from that, while he remains so challenging to BF.
    Last edited by @llli*scummings; December 7th, 2008 at 05:48 PM.

  2. #2
    Join Date
    Oct 2008
    Location
    St. Louis, MO
    Posts
    2,242

    Default Re: Totally confused now

    Quote Originally Posted by @llli*scummings View Post
    I'm a new mother with an 11 week old preemie son (4 weeks adjusted today). We've been having tremendous difficulties with BFing. He only spent one week in the NICU, where I had a very easy time pumping milk (I'd get 6 oz+ both sides).

    Once we got him home we did a combination of bottles and BF attempts. He was very sleepy initially and we had to pack some weight on. He was 4 lbs when he was born and he's now up to a whopping 9 lbs, so he's right on schedule.

    I was doing more and more BFing when about 1 1/2 weeks ago he turned super fussy. A LC diagnosed that he wasnt latching on properly, when she came to observe us a few days ago. Well that problem has mainly been cured but the fussiness persists. The longest I can get him to latch is 3 - 5 mins tops and inevitably ends with him screaming, crying, generally having a huge melt down. Once or twice a day I can do a full BF. Normally, we give up in frustration and give him EBM.

    The LC had advised me to get a better pump and start pumping every 3 hours ago so that I'd have a huge supply and help him deal with the extra effort vs. the bottle. Well I think that maybe she was wrong and I already had an oversupply? I've been using the new pump for ~ 3 days. I pump every few hours (I go a bit longer at night), whether or not I've managed to BF. If he's had the EBM, I can usually pump about 4 oz from the two sides in 10 - 15 mins.

    Last feeding I tried to pump for a few mins before latching him on. This worked to start with -- he latched on without too much fuss. But he was obviously gulping / straining and got overly upset after 5 mins. Typically when he unlatches, milk comes out of his mouth.

    He also has reflux issues (on Zantac and Mylanta, per Dr.) I should add.

    He rarely gets frustrated with the bottle feed so I dont think its an allergy. It can take him quite some time to drink his 3 oz unless he's super hungry. I have cut out dairy as of a few weeks ago.

    Most of his poops are yellow, though at least a couple a day end up being of the green variety. Usually a rather dark green, some times a little syrupy. The Dr. thinks that's due to his immature gut from the prematurity more than an imbalance.

    Any advice would be very welcomed. I'm kind of at the end of my rope on BFing. He's so much happier with the bottle and I seem to be able to keep up w/ him using the pump. He was born so little and I'm disinclined to stress him out so many times a day with the BF attempts. And I've ended up in tears at least once a day the last 1 1/2 weeks


    Edit: I should add that I hope the only solution isnt to cut down on pumping as when he has a fit its really impossible to continue the BF and I don't want to lose the option of giving him EBM / hurt the supply I get from that, while he remains so challenging to BF.

    First off, . You are trying so hard and going through so much right now. Good for you for sticking with it. You're a real trooper.

    What kind of bottles are you using? I am wondering if your lo is getting so frustrated because he is getting the milk quickly from the bottle and he has to work much more at the breast. It is important to use a slow flow nipple that is most shaped like the breast if possible.

    Your lo's green poop can be caused by a number of things. I would guess that it is from your oversupply which may lead to baby getting more foremilk than hindmilk. It is essential that your baby get a good balance of both. The foremilk serves as a "thirst quencher" for baby, whereas your hindmilk is more rich and fatty. Here is a great article about the many different colors of baby poo.

    http://www.drjaygordon.com/developme...ricks/poop.asp

    I haven't had to deal with reflux, so no advice there. Sorry.

    It's okay to pump. If that's the only means that you can feed your baby breastmilk than so be it. My best advice would be to continue to work with a lactation consultant to try and get your baby happy at the breast. Remember there is a pumping forum here that you can post question at also.

    Hang in there mamma!


    I'm Laura, mamma of 2

    5-27-06

    8-30-08

    We love and

    We have been nursing for over 2 years now!

  3. #3

    Default Re: Totally confused now

    Congratulations on your new baby! What a wonderful weight gain he's had--from 4 lbs. to 9 lbs. in 11 weeks. Great work!

    I agree with the previous poster that you might find it helpful to check out the pumping forum. Also, the premie forum could be helpful. (Maybe you've already been there, too? I generally only read the milk supply issues boards, so I don't know what is going on in the rest of the boards :-)

    Have you heard about the "finish at the breast" method of bottle supplementation? There is info about it on the lowmilksupply.org website. Perhaps that is an approach worth trying.

    You are doing amazing things for your baby! Keep it up.
    Marianne
    LLL Leader

  4. #4
    Join Date
    Dec 2008
    Posts
    10

    Default Re: Totally confused now

    Thanks for all the encouragement. I will check those links. Yes I have visited the preemie forum which has had some wonderful info.

    We use the Medela bottles and the nipples for newborns which came with those bottles. (The 5 oz bottle size) Do you have an opinion on those? We've used the Dr. Brown newborn version before too but he seemed to respond better to these and I like that their BPA free.

  5. #5
    Join Date
    Jul 2008
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    Default Re: Totally confused now

    Quote Originally Posted by @llli*scummings View Post
    We use the Medela bottles and the nipples for newborns which came with those bottles. (The 5 oz bottle size) Do you have an opinion on those? We've used the Dr. Brown newborn version before too but he seemed to respond better to these and I like that their BPA free.
    Those Medela nipples are still very fast, even the newborn ones. What we had to do in the beginning was switch to Breastflow bottles. They are "most like the breast" and the nipple is very slow. They are not BPA free, but we didn't heat the milk anyways so the short time we had to use them we felt ok about it.
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  6. #6
    Join Date
    Oct 2008
    Location
    St. Louis, MO
    Posts
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    Default Re: Totally confused now

    Quote Originally Posted by @llli*scummings View Post
    Thanks for all the encouragement. I will check those links. Yes I have visited the preemie forum which has had some wonderful info.

    We use the Medela bottles and the nipples for newborns which came with those bottles. (The 5 oz bottle size) Do you have an opinion on those? We've used the Dr. Brown newborn version before too but he seemed to respond better to these and I like that their BPA free.
    They make BPA Dr. Brown bottles if you are still interested in trying those. I got ours at Babies r Us.


    I'm Laura, mamma of 2

    5-27-06

    8-30-08

    We love and

    We have been nursing for over 2 years now!

  7. #7
    Join Date
    Dec 2008
    Posts
    10

    Default Re: Totally confused now

    I'm confused though --- if the issue is (likely) my fast let down gagging him, why would that lead you to think fast flow nipples are a problem? If anything, I would think fast flow nipples would make it more likely he'd want the fast flow let down?

    My LC suggested I try sitting him up to BF him so that he has more control over the flow and also to try a nipple shield for the same. So going to give that a try. At the moment, I'm trying once a day to BF him so we both limit the stress. He did pretty well yesterday (side lying) and stayed full for a good 2.5 hrs so he definitely got milk. I'm not sure how great his latch was but good enough apparently.

    I'm also going to avoid pushing him onto the breast -- my LC admitted some babies just dont like that and mine seems to be one of them. Going to try to go with meeting him half way and see how that goes.

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