Help me?? Nursing at risk due to my Pedi.

[mamalink4]

Hello mama's with much knowledge. I am at a loss right now. Here's a summary of my story.
At almost 3 months of age my ds had lost around a pound, so much consulting with 2 LC's and one of them was a LLL Leader, we started doing frequent weight checks and changed it over to our pedi. He initially wasn't overly concerned as ds started to gain weight again (albeit slowly). Well last week he lost another 5 oz, gained 3 and then only gained one from last wednesday to today. He told me today that he wants me to quit nursing him and switch completely to the bottle. I am VERY uncomfortable with this. I know my supply is low and has been for around 5 weeks now, so I have been supplementing with formula to make sure he gets full at each feeding. He told me that he had been "flexible" with it to this point but he wasn't gaining enough now, so he wants him on strictly bottles with formula or breastmilk fattened up with formula. My ds weighed 9lbs 13 oz today and he will be 4 months on the 21st. I have some dom on the way to me (maybe today or tomorrow hopefully) have been taking Mother's Lactation Tonic (3x's daily), eating more, drinking more water, was taking fenugreek (didn't notice much difference with or without it) so I stopped taking it. I also tried metamucil. I really don't know what to do here. He says that if strictly formula doesn't get him to gain weight then he will want to hospitalize him to see if that helps. He says that nursing is just taking too many calories from him. He is a happy, smiley, talkative little boy. His wets and poops are just fine and he sleeps fine. He has said on numerous occassions that he is "physiologically perfect". He just isn't gaining they way they want/expect to see. I might add that when I was a baby I never hit the "suggested" weight milestones either and even after 5 kids (I am 27 yrs old) I still struggle to keep my weight up to 123 . I am 5' 4.5" tall, so I am not a large person myself. I know I must sound like I am rambling, but I need any helpful suggestion I can get right now. I really want to preserve our nursing relationship, but now I feel like I am being a bad mom for it Someone help me please??

[PinkinPA]

What does your mothering instinct tell you? Do you feel concerned in your heart or are you just anxious because of peds advice? Have you asked the LLL leader what she has seen on this topic?

[mamalink4]

My mothering instincts tell me that he is completely fine, that's just it. But if the ped disagrees and puts him in the hospital and puts him through a whole boat load of tests that aren't needed, I would feel awful for my poor baby. I think he is just meant to be small, honestly. But my ped clearly doesn't agree. I can't call the same LLL leader, as she is even more of a debbie downer than my ped is. Why is it that they all say he is completely healthy, but he needs to "Tank up" ( I now HATE that phrase btw). What is wrong with a healthy baby that is petite?

[pinky]

Don't have time to post more right now, but he sounds very ill-informed about breastfeeding. Can you get a suggestions for a bf-friendly ped and get a second opinion? What do your LC (are they IBCLC?) and LLL leader think?

It's downright crazy to suggest that he's not gaining well b/c nursing uses up too many calories.

[PatioGardener]

Mama, do you know why your supply is low? Has baby been evaluated for a tongue-tie (posterior ones are hard to diagnose)? Have you had your prolactin levels checked? Thyroid? Iron stores? Has baby been evaluated for issues that would cause him to lose weight?

Have you considered supplementing at the breast?

It sounds like you have an ped who is not breastfeeding supportive. While it is not normal for a baby to lose ANY weight, taking away your breastfeeding relationship is NOT the way to fix any problems!

[mamalink4]

Originally Posted by PatioGardener

Mama, do you know why your supply is low? Has baby been evaluated for a tongue-tie (posterior ones are hard to diagnose)? Have you had your prolactin levels checked? Thyroid? Iron stores? Has baby been evaluated for issues that would cause him to lose weight?

Have you considered supplementing at the breast?

It sounds like you have an ped who is not breastfeeding supportive. While it is not normal for a baby to lose ANY weight, taking away your breastfeeding relationship is NOT the way to fix any problems!

I really appreciate the taking away the relationship statement!!! My supply is low because when he lost that first BIG chunk of weight, he had become a lazy eater who was sleeping through his hunger pains, and I mistakenly trusted him to lead the schedule. I learned from that though, that not all babies can be trusted like that. I have not been checked for anything. He had a cath to test for a UTI, he had his liver and kidney functions tested. He had his white blood cell count checked, they ran some metabolic tests on him, everything came back NORMAL! I tried to use a tube to supplement, but he has a strong dislike for it, even at such a young age. He had been gaining very well in the beginning, then he just kind of stopped eating so well and it went into a downward spiral from there.

[PatioGardener]

It's great that all his testing came back normal.

I'd still look into a tongue-tie if I were you - if he is tongue-tied, a clipping may help him to transfer milk better. Sometimes tongue-tied babies can gain well at first, relying only on Mam's forceful letdown. When let down regulates a bit they don't effectively transfer milk from the breast and Mam's supply drops accordingly.

As for your ped - well, I can understand why he is concerned with the lack of weight gain, but as I said above, that doesn't mean he should be taking away your breastfeeding relationship. Your doctors should be helping you to make more breastmilk, and helping to make sure that baby can transfer milk well!

Dr Jack Newman has some great videos about milk transfer, and a nice article that may be helpful (on slow weight gain after gaining well). http://www.nbci.ca/index.php?option=...tion&Itemid=17

(Also, make sure baby is weighed naked on the same scale each time!)

[Latte Mama]

I agree with PatioGardener about getting the baby checked for TT. Aside from that, I would keep doing what you're doing now and wait for the Dom. Dom is truly a wonder drug for supply issues. Start right away with taking 3 pills 3 times a day and within several days you should see a difference.

Do you get engorged still? Do you still feel let down? Do you pump at all?
IME, mother milk tea and fenugreek do little to nothing to increase supply though everyone tries them. I would tell the pedi you want to give the dom 2 weeks to work and then go from there. Oh and yes to the 2nd opinion, go to find your tribe and see if you can get a BF friendly pedi in your area!

Good luck!

[daddyofthree]

This is my first post but I felt compelled to add my experience in hope that it would help you as well.
My wife and I recently went through something quite similar and we chose to go see a feeding specialist to see what could be done to save the relationship and also to find out what was going on with our son.
There were 2 questions that you have not answered that we were asked. The first is what is the babies feeding schedule like? Does the baby eat at least every 2 to 3 hours day and night? Are you waking him up to eat?
Also how many calories are you taking in on a daily basis? An average person needs between 1500 and 2000 so to maintain a good milk supply you would need that amount of MORE.
We were able to succeed with the help of our specialist and our ped, we did have to pump the milk and fatten it up to get him to gain, but after the gains returned my wife was able to to return to nursing and get her supply back up.
Good luck and keep us posted

[daddyofthree]

My wife wanted me to post a couple links that were helpful to her
http://www.kellymom.com/babyconcerns..._increase.html
http://www.kellymom.com/newman/25slow_weight_gain.html
http://www.kellymom.com/nutrition/mi...e-milkfat.html

[hezasan]

Look into everything!

I recently have had difficulties breastfeeding -- 12 weeks of nipple pain, blisters, VERY long feeding sessions. I think my baby gained weight well simply because he would not give up eating, even though it was hard for him.
I finally found a lactation consultant who was willing to listen to my experience and try to get to the bottom of the problem. (Look up thenewbornbaby.com). As others mentioned before, the POSTERIOR tongue tie is a likely culprit, based on what you've described. Kids with this TT are generally described as lazy eaters and it is often (though not always) coupled with persistent nipple pain for the mother. My pediatrician and lactation consultant here in Oregon didn't recognize it. They both recommended limiting his feedings, since he was spending so much time at the breast, but this only served to reduce my milk supply, which I have been trying to build back up. Pumping and feeding it to him is arduous, but it does seem to be working. If you don't feel like you are getting the help you need, KEEP LOOKING! I basically had to search for what I thought was the problem, and then find someone who would give that idea the time of day. If that isn't the problem, at least it was taken seriously and you can keep looking.
Help is no doubt out there somewhere, and if you really want to keep nursing I'm SURE it is absolutely possible. If you need any help, please feel free to ask me, or thenewbornbaby.com mentioned above.

[rizzosanders]

My best friends baby at 4 months was only 9lbs too- fine, happy, healthy, just petite- just like her mama. At 6 months, she is only 12lbs- still healthy, still petite. Trust your instincts... and change your ped! Good luck to you both!

[daddyofthree]

Hi there, I am the wife and I wanted to add to what my dh said. I first wanted to offer a hug, it is very hard and not an easy thing to go through on so many levels.
Keeping my supply was very hard but I was devoted to not loose my bfing relationship. I pumped after every feeding, I fed every 2 hours and when that didn't work and we had to suppliment still I would feed our son til he was not getting anything and dh would give him a bottle while I pumped some more. I didn't get much sleep at all during those times. I was getting up every 2 hours to feed him, sometimes I was only getting an hour of sleep at a time by the time I finished nursing, pumping and giving him a bottle. But looking back on that time I can tell you that it was all worth while. I got tired of hearing how he needed to gain weight, how skinny he was and all of that, but really he was, he was so close to dying that it was scary.
If you need to talk, send a pm, I will answer any questions that you may have. Do have your baby checked to make sure it is not some form of TT as that can be a huge problem. And remember that you can make it through this, it won't be easy but it is possible.
Many many hugs to you and hang in there.

[daddyofthree]

Originally Posted by rizzosanders

My best friends baby at 4 months was only 9lbs too- fine, happy, healthy, just petite- just like her mama. At 6 months, she is only 12lbs- still healthy, still petite. Trust your instincts... and change your ped! Good luck to you both!

I just wanted to point out that this baby has lost weight, its not that he is just a slow gainer, there is something going on that he is loosing weight, under NO circumstances is it ok for a baby to be LOOSING weight.

[hezasan]

More thopughts on building supply

Since I have been trying to up my supply in the last week, these are some more things that seem to be helping. For us, the problem is efficiency of milk transfer (ie, getting enough out of the breast). If that is not the reason your milk supply is low, these may or may not help, but it’s worth a try!:
-- Nursing side-lying position. The pressure on the side of the breast, where my milk tends to collect, seems to help push the milk out just a little more, evidenced by the fact that he audibly and visibly drinks over the span of at least 10 minutes (usually that doesn't happen for him!) It also helps the breast to become empty, to stimulate milk production. (Note -- this is my own idea, I didn't get this from lac consultants etc so use with caution.)
-- Breast compression. Often recommended by professionals, for the same reasons above, see Dr. Newman’s site http://www.drjacknewman.com/help/Breast-compression.asp
-- Pumping and feeding. I have done this mainly to allow my nipples to heal, but it also serves to empty the breast and I sometimes do entire feedings this way, or have him feed and then pump what he didn't get. Then if he is still hungry soon after, I'll feed it to him then. I think it’s hard to say whether this is good in all cases – pumping may not be as efficient as the baby who eats normally http://www.lowmilksupply.org/pumping.shtml , so again this is helpful in the non-efficient milk transfer case.
I, like you, have tried lactation teas, and also making things with oatmeal, flax seed or oil and brewers yeast. I really couldn’t say whether it helps or not, but it is healthy in any case so not a bad idea. It plays into the general advice to eat a nutritious, plentiful diet and drink plenty of water.
I have found this page from Dr Newman helpful as well: http://www.drjacknewman.com/help/Bre...ng%20Myths.asp
I wanted to mention that your ped may not necessarily be wrong about nursing using too many calories – it’s just that giving up nursing is not the answer to that problem. Finding the reason why nursing takes up too many calories and fixing the problem or learning how to work with it is the way to go. In our case, it seems to be posterior tongue tie (http://www.thenewbornbaby.com/breast...breastfeeding/) There may be other issues that lead to difficulty getting enough milk, which would also use a lot of calories if not addressed. Also, if getting enough milk is really hard for the baby, he or she may decide it’s not worth it, and this is where “lazy eater” comes in. Again, it’s not that the baby just won’t eat; It’s a symptom of a problem that needs to be addressed. The hard part, as you’ve discovered, is finding what that problem is!

[jacie87]

Wanted to mention an attached upper lip frenulum as a possibility as well, since that's not something everyone thinks to check for.

[daddyofthree]

I wanted to ask you too, are you a cosleeper? I found that another thing that really helped me to get my supply back up after our son was gaining again was letting him sleep with me. He was able to nurse whenever he wanted/needed and helped me to be able to get a bit more sleep as well. I really think that this was a huge help for us.
And what I ate made a huge difference. I have a hard time eating many calories in a day because I am so busy that I forget to eat. But if I made an effort to eat an egg in the morning, some sort of snack, a lot of times peanut butter with either crackers or celery, or if I was not hungry but knew I needed to add something I would just eat a couple spoons of peanut butter, lots of fat and protein. Then for lunch I would eat a sandwich of some sort, either peanut butter or my favorite was to have a fried egg and cheese or tomato and cheese sandwich. Then I would have some sort of snack in the afternoon, maybe something with peanut butter but I did get tired of all the eggs and peanut butter and went to having cheese slices and sticks for snacks. Then I would eat pastas a lot for dinner because it seemed to help me to have more milk.
You need to find what foods work good for you, and I would try to eat at least a little something every time I fed the baby, I was told by my dr that every time I took something out I needed to put something else back in. The other thing the dr told me was that milk shakes and smoothies were good for my calories as well.
I hope that at least some of what I keep thinking of is helpful, Its been 3 years now since we battled this and so I have to put it down each time I think of something.

[mamalink4]

Hello all!!

Thanks so much for all your really nice input. It has me feeling hopeful, as I did some research on posterior tongue tie and he seems to have quite a few of the signs of it. One's that I have overlooked for so long now, things that I never would have thought anything of. I can't answer all the ?'s tonight, as it's getting late and I need some sleep. But I will do my best to. His weight loss has only happened twice once in the beginning (1 lb 1 oz) and then last week he lost 5 oz. He has since gained. So we suffered a set back, but I am trying really hard to stay positive about it (crossing fingers). He eats about every 3 hours on the nose right now, except for at night. His last feeding is between 1 and 2. Then he likes to take a longer stretch (and WILL NOT wake, no matter what kind of prodding we do). So I have just learned to adapt to it. We have started co-sleeping as much as he will allow (he prefers his own space). I know that I have overlooked a few ?'s, but I will try to get them answered for you all tomorrow.

[mamalink4]

Originally Posted by daddyofthree

I wanted to ask you too, are you a cosleeper? I found that another thing that really helped me to get my supply back up after our son was gaining again was letting him sleep with me. He was able to nurse whenever he wanted/needed and helped me to be able to get a bit more sleep as well. I really think that this was a huge help for us.
And what I ate made a huge difference. I have a hard time eating many calories in a day because I am so busy that I forget to eat. But if I made an effort to eat an egg in the morning, some sort of snack, a lot of times peanut butter with either crackers or celery, or if I was not hungry but knew I needed to add something I would just eat a couple spoons of peanut butter, lots of fat and protein. Then for lunch I would eat a sandwich of some sort, either peanut butter or my favorite was to have a fried egg and cheese or tomato and cheese sandwich. Then I would have some sort of snack in the afternoon, maybe something with peanut butter but I did get tired of all the eggs and peanut butter and went to having cheese slices and sticks for snacks. Then I would eat pastas a lot for dinner because it seemed to help me to have more milk.
You need to find what foods work good for you, and I would try to eat at least a little something every time I fed the baby, I was told by my dr that every time I took something out I needed to put something else back in. The other thing the dr told me was that milk shakes and smoothies were good for my calories as well.
I hope that at least some of what I keep thinking of is helpful, Its been 3 years now since we battled this and so I have to put it down each time I think of something.

You sound like me! I forget to eat since my days are pretty hectic also. But i never thought of eating just a couple spoonfuls of peanut butter, which I would HAVE to have milk with, so YAY more calories and fat and protein! I think that if I make it more manageable it will be more manageable. Your input has been very invaluable (everyone).

[haydn'smommy]

I didn't read through 100% of the replies, but have you thought of using a supplemental nursing system so that baby gets the formula calories while giving you the stimulation to make more milk?
I will say this as a PNP. Your ped, although he sounds highly unsupportive, has a valid concern with the weight loss. And not to scare you, but if he slaps the FTT label on your child and you aren't being cooperative in his eyes, then he can and very likely will report you to DCS/child services. I think that would be a horrible disservice and injustice to you and your child, but it's how most of them think. So, I would strongly encourage you to find a way to continue to nurse while supplementing and the SNS or lactaid system would be a perfect way to do that.
While you are waiting on the dom, try oatmeal, brewer's yeast, and Gatorade. And mother's milk tea. Those are my magic weapons!! I can drink a 32oz gatorade and see an almost immediate increase in my supply. Nurse as much as humanly possible. Do compressions to help that milk come out a little easier for your baby. Lots of skin to skin and get the latch/tongue checked out for tongue tie.
You can do this, mama!!!! Good luck. I'll be saying prayers for you. And please keep us posted.