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Thread: Weight loss & BF

  1. #1
    Join Date
    Sep 2006
    Posts
    5

    Default Weight loss & BF

    Hello,

    Please excuse me if this question was asked repeatedly before, but I would appreciate any input the forum members might have on our specific situation.

    We just had a baby by c-section (due to failed induction) 10 days ago. His birth weight was 7lbs 5oz and his discharge weight (day 4) was 6-14. His weight at pediatrician at day 6 was 6-11 and his at day 10 is 6-10.

    Mother is feeding him at an average of every 2-3 hours, 15 min. on both sides. He's often sleepy during feedings and lately he's been asking for it more often occasionally (almost every hour at night sometimes or right after a 30 min. feeding). Mother loves to feed him but the problem is pain at nipples. This might be due to some early wrong latching right after birth; there is also blistering at the nipples. She used these gel pads for relief for 5-6 days and she's also using a lansinoh lotion. Every time he starts feeding, she goes through severe pain which gets relieved as he continues. We try to keep him awake and alert by tickling his chin, blowing air on his face, etc.

    We're fairly certain he's latched on right, but we wonder if this pain is normal or will ever go away. We also wonder if he's getting enough milk. The pediatrician told us to pump one breast while he feeds on the other, I guess in an effort to see how much milk he gets? She also said that if that doesn't work, formula supplementing might be necessary.

    We are considering investing in a home visit by a lactation consultant, but appreciate any help you might provide. Thank you.

  2. #2
    Join Date
    Jun 2006
    Posts
    1,020

    Default Re: Weight loss & BF

    I experienced similar pain with nursing and it seemed I had forceful letdown. It does go away once the little beeb got used to nursing (around 3 weeks). And then actually just came back and he is 10 weeks (growth spurt). I think it has to do with the milk regulating to his needs. I wouldn't worry about formula just yet. My little guy was put in the hospital at 2 weeks for an unrelated issue and the constant supervision of everything had me stressed that he wasn't eating enough, but as long as there are wet and dirty's you are ok in that department. I also did block feeding for a while. Nursing a couple of times in a row on the same side. This also helps baby get to the fattier hind milk (which may help with weight gain). Also, it might take away from the preciousness of nursing if you are trying to pump and nurse at the same time. I think thats what you meant?? I would wait to pump until after you are finished nursing...But I am no doctor...just speaking from experience. Finally my little guy was sleepy at first too and NOTHING would wake him up. So I undressed him and changed his diaper before we nursed. It helped! Hope some of my experiences help you.

  3. #3
    Join Date
    May 2006
    Posts
    929

    Default Re: Weight loss & BF

    I think it's a good idea to meet with an LC. Are there any at the hospital that you delivered at? Often times meeting with them is free. You might also contact your local LLL leader.

    Discomfort and some soreness is normal in the beginning but there shouldn't be PAIN or blistering. My guess is that the latch isn't quite right. Does your LO have a wide mouth (covering most of the areola) and lower lip out? Are you scheduling feeding/timing them or letting you LO set the pace. If he wants to nurse more frequently than every 2-3hrs then let him. It's important to let him demand dictate nursing frequency to ensure that supply keeps up.

    You should not pump the side that is not being nursed. All you have to do is count wet/poopy diapers to find out if your LO is getting enough. There should be several of each in a 24hr period.

    Don't get discouraged. You can do this WITHOUT supplementing! Hang in there and nurse as often as possible. Don't let your LO go longer than 2-3 hrs without nursing (wake him up if he's sleeping), at least until he has regained his birth weight.

    Keep us posted on progress and ask more ?????? as they come up. I'm sure input from others here will follow with more ideas for you.

    Congratulations and Welcome!
    Last edited by luke's mom; September 18th, 2006 at 10:32 AM.

    Jennifer
    Amazed and Proud mom of Luke (Lucas) - 4/5/2006; 9 lbs 12 oz , 22in
    Wife to best friend Carl - 11/4/2001

  4. #4
    Join Date
    Jun 2006
    Posts
    1,020

    Default Re: Weight loss & BF

    Oh, one last thing...For the severe pain...Sometimes I took a motrin about 20 minutes before feeding. I don't know if you are supposed to, but there were times I wouldn't have been able to breast feed other wise.

  5. #5
    Join Date
    Jun 2006
    Posts
    4,894

    Default Re: Weight loss & BF

    Congratulations on your baby and welcome to the forum!

    I have a few questions about the nipple pain. Is it just pain in the nipples or is there breast pain? Is it painful during let-down or throughout the entire feeding? Does it hurt even without feeding? Was mom given antibiotics during or after the c-section?

    I would hold off on the formula supplementing just yet. When she pumps, how much is she getting? I would continue to nurse on demand, not going any longer than 2 hours - including overnight. I know it's hard to wake a sleeping baby, especially when you are exhausted yourself and love the break, but it is important to do especially when the baby is still losing weight.

    Sorry I don't have more answers for you right now, but I don't want to give you bad advice without more information.

  6. #6
    Join Date
    Feb 2006
    Posts
    1,168

    Default Re: Weight loss & BF

    Hi new parent, and welcome to the boards. I'm glad you are posting on behalf of this new mother, and I hope that she also will feel welcome to participate on these boards as her time and energy allow.

    The weights you gave for the baby (what is his name?) are in fact a little worrisome. He started at 7 lbs. 5 oz, which is 117 ounces. By day 10, he was down to 6 lbs. 10 oz., which represents a loss of 11 ounces total. This is pushing very close to a loss of 10% of his birth weight, and it is important that he start gaining as soon as possible.

    There are various ways forward, and supplementing with formula is just one option and probably not the best and should not be the first option, so let's keep that in mind and see if some other, more breastfeeding-friendly measures will work first.

    You didn't mention the baby's diaper output. In any 24-hour period, the minimum should be 5-6 wet diapers (if disposables) and 2-3 dirty diapers, where the poop is at least the size of US quarter (about an inch across). Start writing down this info at each diaper change; it will be very helpful to any IBCLC or LLL Leader that you work with.

    The first step is to make sure that the baby is nursing frequently and that his time at the breast is not limited. You wrote that the mother is nursing him every 2-3 hours on average. Newborns need to nurse at least 8-12 times per 24 hours, but if there is a concern about weight gain, then I think 12 feedings should be the minimum, and more often is even better. Try to wake him in time to begin each feeding no more than 2 hours after the start of the previous feeding.

    Also, you wrote that the mother is nursing for 15 minutes on each breast. Is the baby coming off the breast himself, or is she watching a clock and taking him off after 15 minutes? It's important that the baby be allowed to "finish" the first breast first -- which means watch the baby, not the clock, and when he either comes off contented or falls asleep after a period of active suck-swallow-breathe nursing, then try the other breast. He needs to "finish" that first breast in order to get the higher-fat hindmilk, which contains more calories and thus will promote good weight gain.

    About the nipple pain -- OUCH! Oh, blisters, I'm so sorry, I know that is incredibly painful. Yes, it is possible that incorrect latch in the first day or so could have caused damage, but if the latch is now correct, then that damage should heal quickly, and any pain at latch-on should be COMPLETELY gone (not just more bearable) within the first minute of nursing. If the mother while nursing feels more than a good solid tug at her breast, and if the visible damage is not healing, then I think these are clear signs that the baby is still latching incorrectly -- and poor latch can be a contributing factor to problems with weight gain, so this problem kind of fits together with the other problem, too.

    I strongly encourage you to consult face-to-face with an IBCLC or a local LLL Leader. A Leader might or might not make a home visit; her services are free, and she does have training in lactation support issues like proper latch and positioning. An IBCLC has more training and probably more resources (like a super-accurate baby scale). If you can find an IBCLC who will make a home visit, I think it would be a very worthy investment, and the sooner the better.

    Good luck -- keep us posted -- we're here for any of your questions or concerns. Please don't delay in calling someone locally, and let us know how that goes.

    --Rebecca

  7. #7
    Join Date
    Sep 2006
    Posts
    5

    Default Re: Weight loss & BF

    It seems to be pain in the nipples. They remain very sensitive at non-feeding times and hurt most when the baby gets started. After that, she seems to be OK. She was given motrin, oxicodone, and a stool softener for c-section, she's still taking them now (trying to phase them out).

    I'll submit more info re. pumping when she gets started. Thanks.

    Quote Originally Posted by kst7399
    Congratulations on your baby and welcome to the forum!

    I have a few questions about the nipple pain. Is it just pain in the nipples or is there breast pain? Is it painful during let-down or throughout the entire feeding? Does it hurt even without feeding? Was mom given antibiotics during or after the c-section?

    I would hold off on the formula supplementing just yet. When she pumps, how much is she getting? I would continue to nurse on demand, not going any longer than 2 hours - including overnight. I know it's hard to wake a sleeping baby, especially when you are exhausted yourself and love the break, but it is important to do especially when the baby is still losing weight.

    Sorry I don't have more answers for you right now, but I don't want to give you bad advice without more information.

  8. #8
    Join Date
    Sep 2006
    Posts
    5

    Default Re: Weight loss & BF

    We get plenty of diapers, now with yellowish stool, almost at every feeding. We can't judge the wetness too well unless the urine is visibly yellow. That's why we were surprised at the weight loss, but I understand all the issues brought up so far. This would have been so much easier if the pain was not an issue. I am waiting for a few consultants to call me back and I will try to schedule a home visit asap depending on the cost. Otherwise, I'll see if a local leader would be willing to help.

    Since the baby gets sleepy quickly on the breast, we can't judge if he's just comforting or if he's actually getting fed. So we use 15 min. as a general guideline. Frequent switching (to keep him awake) causes more pain on the mother, so we can't try it quite yet.

    Quote Originally Posted by quakerm0mma
    Hi new parent, and welcome to the boards. I'm glad you are posting on behalf of this new mother, and I hope that she also will feel welcome to participate on these boards as her time and energy allow.

    The weights you gave for the baby (what is his name?) are in fact a little worrisome. He started at 7 lbs. 5 oz, which is 117 ounces. By day 10, he was down to 6 lbs. 10 oz., which represents a loss of 11 ounces total. This is pushing very close to a loss of 10% of his birth weight, and it is important that he start gaining as soon as possible.

    There are various ways forward, and supplementing with formula is just one option and probably not the best and should not be the first option, so let's keep that in mind and see if some other, more breastfeeding-friendly measures will work first.

    You didn't mention the baby's diaper output. In any 24-hour period, the minimum should be 5-6 wet diapers (if disposables) and 2-3 dirty diapers, where the poop is at least the size of US quarter (about an inch across). Start writing down this info at each diaper change; it will be very helpful to any IBCLC or LLL Leader that you work with.

    The first step is to make sure that the baby is nursing frequently and that his time at the breast is not limited. You wrote that the mother is nursing him every 2-3 hours on average. Newborns need to nurse at least 8-12 times per 24 hours, but if there is a concern about weight gain, then I think 12 feedings should be the minimum, and more often is even better. Try to wake him in time to begin each feeding no more than 2 hours after the start of the previous feeding.

    Also, you wrote that the mother is nursing for 15 minutes on each breast. Is the baby coming off the breast himself, or is she watching a clock and taking him off after 15 minutes? It's important that the baby be allowed to "finish" the first breast first -- which means watch the baby, not the clock, and when he either comes off contented or falls asleep after a period of active suck-swallow-breathe nursing, then try the other breast. He needs to "finish" that first breast in order to get the higher-fat hindmilk, which contains more calories and thus will promote good weight gain.

    About the nipple pain -- OUCH! Oh, blisters, I'm so sorry, I know that is incredibly painful. Yes, it is possible that incorrect latch in the first day or so could have caused damage, but if the latch is now correct, then that damage should heal quickly, and any pain at latch-on should be COMPLETELY gone (not just more bearable) within the first minute of nursing. If the mother while nursing feels more than a good solid tug at her breast, and if the visible damage is not healing, then I think these are clear signs that the baby is still latching incorrectly -- and poor latch can be a contributing factor to problems with weight gain, so this problem kind of fits together with the other problem, too.

    I strongly encourage you to consult face-to-face with an IBCLC or a local LLL Leader. A Leader might or might not make a home visit; her services are free, and she does have training in lactation support issues like proper latch and positioning. An IBCLC has more training and probably more resources (like a super-accurate baby scale). If you can find an IBCLC who will make a home visit, I think it would be a very worthy investment, and the sooner the better.

    Good luck -- keep us posted -- we're here for any of your questions or concerns. Please don't delay in calling someone locally, and let us know how that goes.

    --Rebecca

  9. #9
    Join Date
    Apr 2006
    Posts
    1,064

    Default Re: Weight loss & BF

    Quote Originally Posted by new_parent_03
    We get plenty of diapers, now with yellowish stool, almost at every feeding. We can't judge the wetness too well unless the urine is visibly yellow. That's why we were surprised at the weight loss, but I understand all the issues brought up so far. This would have been so much easier if the pain was not an issue. I am waiting for a few consultants to call me back and I will try to schedule a home visit asap depending on the cost. Otherwise, I'll see if a local leader would be willing to help.

    Since the baby gets sleepy quickly on the breast, we can't judge if he's just comforting or if he's actually getting fed. So we use 15 min. as a general guideline. Frequent switching (to keep him awake) causes more pain on the mother, so we can't try it quite yet.
    To help judge urine output, you can take a dry diaper and pour two to four tablespoons of water in it. Note the weight and feel--you should have 5-6 diapers of about that wetness in 24 hours. The frequent stooling is a good sign.

    When the baby is actively nursing, you should see long rythmic movement of his lower jaw. You can often see the jaw bone move by his ears, and you may also hear swallowing. Comfort sucking is generally more shallow, you won't hear swallowing, and it may be off and on. An LC will be able to help you recognize if your baby is actually swallowing. She can also weigh the baby before and after a feed to see how much milk was taken (this requires a professional, highly accurate scale).

    It sounds like you are on the right track with finding some help. Keep us posted!

  10. #10
    Join Date
    Sep 2006
    Posts
    5

    Default Re: Weight loss & BF

    I just wanted to give a quick update on this: We met with an LC and she thinks that there might be a yeast infection, possibly due to antibiotics during c-section. So we are using a healing ointment and combining direct feeding with pumping, which seems to be going OK so far (can do 1oz. max w/ pumping). We are also looking into ways of increasing the milk supply as recommended by the LC. Thanks for all your help. We have another ped. appt. soon to check the weight.

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