How to preserve the nursing relationship we DO have?

[starling&diesel]

We had our 6 week midwife appointment yesterday which ended up with a trip to the pediatrician and several long hours of me bawling my eyes out. :

DD just is NOT gaining, even though she nurses like a champ and I'm doing everything I can do boost my supply. Domperidone, fenugreek, blessed thistle, oatmeal, pumping, switch nursing, block nursing, no pacis or bottles ever ... seriously, the only other suggestion the MW had was to check if I'd retained any placenta and/or do acupuncture. Alright, will do.

In the meantime, I've been strongly advised to supplement. We managed to get about a week's worth of donor milk, but after that, we'll be on our own.

How do you supplement without diminishing what supply you DO have?

Right now, we supplement with an SNS at the breast. But won't it decrease the demand?
But if I cup feed, she won't be as hungry at the breast, right? So again, diminishing demand?
If I bottle feed (NO WAY) that'll just do the same ... decrease demand.

How do I supplement while encouraging my milk? I've just DOUBLED my dom, and I'd really felt like we'd turned a corner last week, so finding out that she hasn't even gained an ounce in two weeks is just DEVASTATING.:

I feel like such a friggin' failure. Why can't it just WORK? Why does it have to be so bloody hard? I feel like everyone has lied to me about how easy it would be. "Oh, if you have a natural labour, breastfeeding will be soooo easy for you. You won't have ANY problems at all." Bull hooey.
Her latch is great, her diaper output is great, her demeanor is great ... I JUST DON'T GET IT. :

Help? Wise mamas?

[SmoothieMom]

Did she lose weight or just not gain any? I had this problem with my baby when she was first born. What we did was I pumped and stored that and when I fed her I had a tiny feeding tube that came from the bottle taped to my breast and the end of the tube was at my nipple so when she latched and sucked she got my breast milk plus my breast milk from the bottle.

I am sorry you are going through this

[starling&diesel]

Originally Posted by SmoothieMom

Did she lose weight or just not gain any?

She was born Jan 31st at 6 lbs 14 oz and went down to 6 lbs and now at 6 weeks she's only 7 lbs 2 oz ... which is not enough, according to pretty much everyone, MW, LC and ped.

I am pumping, but my breasts don't respond to pumping, so I only get an ounce over a day of pumping. DD gets way more than that when she's at the boob. I've tried two different pumps, and have on from the hospital right now. The pumping is so demoralizing and time consuming ... it is the biggest drag, but I keep doing it when I can.

I do keep whatever I get and give it to her via the SNS ...

[Megan73]

BTDT.
I was in the exact same position with my son – who's now 7.5 months.
What I did was give him increasing amounts of supplement – pumped BM and formula – spaced over the day's feedings (except the first of the morning, when my supply is best) until he was gaining 5-7 oz a week. You can find weight calculators and growth charts on Kellymom.com. You're doing GREAT to use the SNS. I used bottles until I found an at-the-breast supplementer that worked – the Lact-Aid.
I rented a baby scale and weighed him every other day. I also pumped after every feed. I took dom (3 X 10 mg, 3X a day – although Dr. Newman says you can take up to 4 pill, 4X a day) and fenugreek.
I've struggled with exactly the same feelings of failure – and this after losing my first child at full term. I felt like I just couldn't nourish a child for some reason. Those feelings have really faded as my son has grown – and I've seen how much he loves being at his mama's breast, even if some of what he gets there is formula.
I'm still supplementing via Lact-Aid but DS hasn't had a bottle since he was two months old – which I think is a victory given the obstacles we overcame, including the sleepiest newborn ever, tongue tie and refusing the breast.
You CAN preserve your nursing relationship – but job one is a thriving, well-fed babe.

[northwoodsmom]

In nearly the same boat as you... DS was born 6+ weeks ago at 8 lb 11 oz and just finally exceeded his birthweight this past weekend. I've been supplementing with the SNS and things are starting to improve for us... started at 8oz/day of formula and now at 6oz/day and baby is still gaining. I'm taking fenugreek (4 caps/3x per day) and eating a large bowl of oatmeal every day, and it seems to be helping. The LC is saying that we can continue to decrease the supplement. I haven't been pumping or doing anything else, just nursing as much as possible and using the SNS with every other nursing.

I just wanted to let you know that it is possible that things will improve for you... supplementing with the SNS is not necessarily the beginning of the end. For me, it's been the extra help DS needed to get over the hump, so to speak. Let's hope that we continue to go this way.

Good luck! s Just remember that whatever the outcome, you're doing all the right things for your baby.

[BoringTales]

Can you nurse on one side while pumping on the other? That was the only way I could ever get anything off the pump. It would take me all day to fill a bottle, and a small 6 oz one at that!

If you do that all week long while using the donated milk, you might be able to build up a bit of a surplus to carry you through a few more weeks.

[Vegan Princess]

Just wanted to offer up some hugs. I am so sorry things are still rough for you! You are trying so hard and really doing all you can to give your daughter your milk. I wish I could offer up some advice. I personally couldn't figure out the sns so I've been doing bottles. And I do feel that the formula gets in the way of trying to increase my supply by nursing bc she feeds every 3 hours instead of 2...but I am still getting in 7 or so feedings a day and I think that is fine. I don't think my supply is going to increase much more at this point so I am just trying to enjoy nursing my daughter and giving her what milk I do have and have accepted that I need to give her formula for her to thrive. I finally decided to ditch the pump this week...it was making me crazy and wasn't doing anything to increase my supply. So I'm just nursing DD for 1/2 hour and then giving her her bottle. And also dealing with some nipple confusion because of it. I am still considering trying the lactaid.

I do agree...nourishing your baby has to be the first priority. My DD was born 2 days before Esme at 5 lbs 12 ounces and is up to 8.5 lbs now (thanks to formula). I did read that antibodies are more concentrated when you have limited quantities of milk so I feel good that the baby is still getting all that good stuff from me.

Hang in there! I pray that you soon find a routine that works for both you and DD so she gains weight and you can enjoy your time with her at your breast and enjoy your baby! This time is so precious...it's a shame to have it marred by constant pumping and crying.

Cindy

[justthinkn]

I'm totally not qualified to offer specifics, just my story - I've BTDT bawling over the need to supplement. After a month of trying everything, we started to supplement at 2mo - we used the SNS, except for the very occasional bottle from Daddy. DD took from 10-20 oz. of supplement/day - the higher numbers toward the beginning, as she was catching up on weight gain. I don't think the SNS reduces demand if you're careful to make sure both breasts get emptied each feeding. I SNS-nursed after each waking, and before bed... That reduced the frequency naturally over time. I would let DD latch onto one breast, then switch breasts when I couldn't keep her interest any longer, start the SNS on the 2nd side, then let her finish comfort nursing on the original side. I also did lots of comfort nursing without SNS, esp. the nursing to sleep, so DD didn't associate nursing exclusively with the flow of the SNS. (And I really didn't want to have to SNS at night if I could avoid it!)

She used the SNS until almost 18mo's, tho it was just a few ounces a day and a few (2-3) times a day from about a year on. We're still nursing at nearly 21mo's - you'd never know from looking at us now the battle we had those first few months. I grieve at times that we never had that uncomplicated nursing relationship - but I'm so glad we have what we do!

[starling&diesel]

Thank you, mamas for all your support.
I'm still very sad, tired, disappointed, frustrated and angry that we're facing such challenges, but it helps a lot to have MDC mamas to lean on.
I weigh her again on Monday, and if she hasn't gained with the supplements via the SNS, then we're probably looking at a malabsorption issue as well as low supply. I'll take low supply issues anyday over her having a health issue.
I've had her on the supplements for two full days now, and I don't see any difference in her demeanor or wakefulness or energy or sleep pattern.
Does that seem odd?

[AngelaM]

Oh, S&D, I don't have advice, just . I'm so sorry you are going through this. It really is so emotionally trying, I know.

Please know that I'm thinking of you, and hoping that Monday's weigh-in brings good news.

[3daughters]

Originally Posted by starling&diesel

T
I weigh her again on Monday, and if she hasn't gained with the supplements via the SNS, then we're probably looking at a malabsorption issue as well as low supply. I'll take low supply issues anyday over her having a health issue.
I've had her on the supplements for two full days now, and I don't see any difference in her demeanor or wakefulness or energy or sleep pattern.
Does that seem odd?

Yes!

I was going to suggest making sure that she doesn't have any sort of infection. A friend's baby wasn't thriving and they were challenging her breastfeeding. Turned out that he had a urinary tract anomaly and had a UTI. She was so relieved to find out that she wasn't harming him by insisting on breastfeeding him and that it was another (fixable) issue causing him not to gain weight.

[starling&diesel]

Originally Posted by MommytoC

Unlike you though, I still need to get me an SNS. They're just so expensive and we don't have a lot of money right now.

I got our set up from the local Public Health nurse ... it's just a one ounce syringe and a feeding tube. But it means you have to do one ounce at a time. It was free though! Good luck with the weigh in!

[rainashine]

I had similar issues with my now 13 month old. My problem finally turned out to be retained placenta. That can REALLY mess with your supply. If you're still bleed and/or having any cramping, insist on getting checked out. My doctor ignored my symptoms even with an ultrasound showing "something" in my uterus. I finally passed it at 10 weeks pp and had enough milk within three days. I cried my eyes out for weeks and finally resigned myself to supplementing when it resolved. It is sooooo hard. Good luck to you mama!

[starling&diesel]

Well, we have appointments on Thursday with a private Lactation Consultant, and then a Breastfeeding Clinic at the university in the city. Hopefully they can coach us on latching (I think it's a little shallow?) and help us figure out if my hormonal situation or thyroid is contributing to the problem (primary ammenorhea).
I feel hopeful that having someone watch and assess her nursing should help some. I also think the increased domperidone is helping too ... I'm getting a little more when I pump.
She did gain 4 oz since last Thursday ... isn't that great!?!

[Vegan Princess]

Great news! Hopefully you can relax a bit knowing she is gaining. I hope the LC and clinic can help you. :-)

My prescription for dom still hasn't come...it is stuck in customs. But I found out today I can have it compounded...so hopefully I'll be starting it tomorrow. Wish me luck!

Cindy

[Megan73]

The weight gain is great!
I found that I was much more able to focus on improving the latch and other problems when I knew for sure my LO was getting enough to eat.
Good luck, mama.