Getting baby back to breast... SNS question

[sattygirl99]

So after the past few days of being unsure as to whether or not she's getting enough, I've made the decision to nurse on the 'good' side (the right side is bunk for latching, lol) with the help of the SNS and pump the other. LC says that after a bit of nursing on that side, it'll pick up it's supply and to pump it for 10 min in between feeds to demand it.

Anyway... How much should I put in the SNS? We first nurse the breast until she shows that it's slowing down (and she does, lol) and then I open up the tubing on the SNS. When I pump, I get between 1 an 1.5oz on that side so I'm thinking she'll get about double that (so 2-2.5oz). Should I put 2oz in the SNS?

I'm hoping that over time, we can wean her off the SNS but until she's 45th to 50th percentile for weight, she needs supplement.

[AllyRae]

How old is your baby? The amount you put in depends on lots of things...how old the baby is, how often you're feeding her, and how low your supply is. How much you can pump is not an indication of how much milk you have...most people pump a lot less than what they actually have.

With my son, he needed 4-5 ounces at a time starting from when he was 6 months old. But his before and after feed weights showed that he was transferring less than half an ounce of breastmilk at a feeding. With my daughter, I feed from both breasts, and then offer a 1 oz supplement every 2-3 feedings...she's gaining weight really well with that (so about 5-6 oz of supplement a day). When I did 1.5-2 oz, she would get too full and skip her next feeding. With the low supply, I really want her going no longer than 2.5 hours without eating, except 1 longer stretch for an extended nap/sleep, so I don't feed her so much that she'll skip a feeding. She is satisfied after the ounce, so we leave it at that.

So, I personally would start with the bare minimum and increase it only if she seems really hungry still.

[AllyRae]

I also want to add that your baby does not need to be in the 50th percentile at all. The percentiles are for healthy babies...some healthy babies need to be in the 10-20th percentile, some need to be in the 80-90th percentile. The charts are also for bottlefed baby.

Do you actually have low supply, or is the ped/LC getting hung up on the antiquated charts? As long as she's following *her* curve, having enough wets/dirties, and gaining .5-1 oz a day (in the first 4 months...less following that), she is likely getting enough. The 50th percentile might be overweight for your particular baby....

[sattygirl99]

she wasn't gaining, at all. despite transfering milk (3-5 oz).

sorry short, baby waking!

[AllyRae]

How old is she? If she's a newborn, and not gaining at 3-5 oz per feeding, assuming you are feeding her at least every 3 hours, I would definitely have her checked for other issues (malabsorption, etc.) A typical 1-2 month old should be eating 3-4 ounces every 2-4 hours and gaining well on that... Supplementing wouldn't really help if something else was going on. Is she fussy or otherwise indicating that she's in pain/not getting the nutrition from milk/etc?

[AllyRae]

Ok, I just went back to your earlier posts...she's the same age as my DD (about 7 weeks). At 7 weeks old, most babies need between 23-27 oz per day.

http://www.kellymom.com/bf/pumping/milkcalc.html

That breaks down to about 3 oz a feeding if you are only feeding 8-9 times per day. So if she's getting at least that at every feeding, and is feeding a minimum of 8 times per day (which is the minimum at this age) and still not gaining, I would say that it's not a supply issue at all...you are making exactly the right amount for this age. I'm not you, but if this were my little one, I'd be in to the ped ASAP if I were positive she was getting 3-5 oz a feeding and still not gaining....

:

[sattygirl99]

She gains fine on bottles of breastmilk. I think she's burning too many calories nursing (she had a tongue tie) and she does fine on a bottle.

The ped didn't seem concerned and they didn't find anything wrong at the hospital when she was sick. She does have reflux.

She's a little fussy but no fussier than my son was. She's hitting developmental milestones and gaining well now just doesn't thrive when breastfeeding.

She's 6 weeks. It's been hell and back though since birth. An emergency c-section, 6 hours in the NICU, 14 hour nursing strike, tongue tie and poor latch, infection and 3 days on IV antibiotics... She dropped to 6lbs 12oz (bw 7 lbs 9oz) and gained back to 7lbs 7oz at 4 weeks, starting supplementing and she went to 7lbs 14oz and stopped supplements and she stayed the same over 3 days.

[AllyRae]

Poor thing! That's a rough one, for sure... Do you have a scale at home (a baby one)--the way I figured out how much to supplement with is by using a baby scale and a lot of trial and error...if I weighed her every other day and she gained an ounce or close to it, and she was not acting hungry the previous days, I'd assume her supplement was right on. If there is a 2 day span where she loses weight or only gains a tenth of an ounce, etc., I increase her supplement for that day a little until she's gaining again. For us, the 1 oz per every 2-3 feedings works well because it is keeping her gaining... For your little one, I guess you would need a bit more because of her burning all of those calories. If you have a scale at home, you could tell if you were right on for the day or not....

[sattygirl99]

It's been rough to say the least..

And I won't say she hasn't gained... She did start gaining... right before she got sick. And then it went to hell in a handbasket, lol. She's so much happier with breastmilk in a bottle. Though I think she may need a bit more than I'm giving... I've been doing 3 or 3.5 oz every 3-4 hours and I think she could do 4 oz and be happier. She even paces herself and stops 1/2 way through the bottle for cuddles an burps, lol.

[justthinkn]

here's a guide to estimate how much to give from Making More Milk:

"Take baby's weight gain deficit from the previous week and then multiply it by 2 for the ounces of total extra milk he may need per 24 hours. So if baby should be gaining 7 ounces a week but only gained two the previous week, then he may need 10 ounces of supplement (5 ounces x 2) a day to start."

Kellymom on average weight gain by age: http://www.kellymom.com/babyconcerns...ight-gain.html

This is me now - You might divvy that up that evenly over SNS feedings throughout the day, or you might notice that baby needs more at certain times, less at others. If baby still seems hungry, offer a little more - but definitely don't insist on finishing the SNS - baby can wean off naturally by taking less and less supplement!

[sattygirl99]

The thing is that I'm not positive that she's getting that every feed. For a long while she wasn't transfering more than .5 oz. Then she started transfering more.

I have to say that I disagree that something more has to be wrong if she isn't gaining... I know a fair share of babies that don't thrive on breastfeeding because they have a high metabolism and burn too many calories. She seems to be thriving fine on a bottle of breastmilk but it's a lot less work than nursing is. She seems so uncomfortable and unhappy at the breast that I'm not even going to push it. I'm just going to pump what I can and supplement with donor breastmilk or home made formula when I need to.

[Megan73]

I'm sorry you're struggling
I made a decision to EP when my son was a few weeks old and kept refusing the breast. Feedings were miserable for both of us.
But after a few days of just bottle-feeding I tried latching on just to see if he would – and we've been BFing (first supplementing with bottles then the Lact-Aid) ever since. I wouldn't ever advocate using artificial nipples as a first resort but I think we both just needed a breather from all the stress.
Good luck – whatever you decide works for you and your LO.