Please reassure me; feeling like a failure

[saffrongirl]

I am really struggling and feeling like I'm failing my dd. I need some perspective if someone can help...

DD is 14 days old today. Her birth weight was 7lb, 12oz. At her one week appointment (which was actually at 9 days old), she weighed 7lb, 9oz. My midwife said it was normal weight loss, etc. and that she should gain it back. Well she had her two week appointment yesterday (at 13 days old) and she still weighs 7lb, 9oz. She's also a bit dry and her poopy diapers are mostly that bright yellow, but there is definitely some green to the poop as well. Midwife was mildly concerned and encouraged supplementing (me) with fenugreek and alfalfa. I already drink at least a gallon of water a day plus tea. She also said to try to get DD to suck longer so that she's getting hindmilk.

DD latches on well and sucks well but really only sucks wholeheartedly for about 15 minutes. She keeps the nipple in her mouth for a long time and sort of half-heartedly sucks after the first 15 minutes. If I tickle her toes or change her after that, she might suck again for awhile. After seeing the midwife yesterday, I sort of broke down and was crying all day. I've been basically non-stop feeding dd since yesterday. I've done the three-hour block thing so that she can get hindmilk if she does peeter out after the initial 15 minutes. DD does not seem lethargic and she has probably 6-8 poopy/pee diapers a day (at least). Since yesterday though she's been spitting up more. I'm wondering if this has to do with me just feeding her all the time since yesterday and perhaps she just has nowhere to put it (if she's full)?

Anyway, am I being paranoid? Can someone give me some good outcomes? I just feel like she's dwindling away to nothing and I'm failing her. As I said, I need perspective.

[rizzosanders]

Keep with it, many babies do this- good luck to you both!

[paulamc]

You're doing a great job, mama!! Hang in there - I'm sure everything is going to be fine.

But, I do think you'd expect some weight gain in that second week. In case there's a problem you want to identify what it is ASAP. Is there a lactation consultant you can see? Or a La Leche League group? The LLL group leader in your area, if there is one, should be able to give you some good advice or direct you to a good lactation consultant.

Check here for LLL in your area:
http://www.llli.org/WebIndex.html

I'd get in to see an LC immediately and in particular, request to measure milk transfer. (Perhaps your MW could do that as well?) They can weigh her before and after a feeding and see how much milk she took in. A LC can also check her latch and make sure there's no physiological issue like tongue tie.

If you have issues with supply (not at all saying you do) there are things you can do about it. I've read there is some evidence that taking fenugreek+blessed thistle in combination can help. I tried that and it didn't seem to do much. But I saw a marked increase in supply after taking domperidone/ Motilium. That's available online at In House Pharmacy (in New Zealand I think).

http://www.inhousepharmacy.com/general/motilium.html

In case you haven't come across the following websites, these are both great resources for virtually any problem you might have, including low supply.

www.kellymom.com
http://www.drjacknewman.com/

Good luck and keep us posted!

[paulamc]

By the way, I should add that your daughter's nursing behavior sounds pretty normal to me. And, a 3 ounce loss is not very much at all. Most likely she lost more than that, and then gained. I do wonder why she did not continue to gain in that second week though.

I hope I did not sound alarming in my earlier post. I do think everything's probably fine - but in your shoes, and having had my own experience with a slow gainer, I would want to check out a range of things, including milk transfer. I went to see an LC myself early on with concerns mainly about thrush at the time. I wish she had explored the weight thing more than she did. Now I will always wonder if I should have done more to help him gain better early on. I did not get on the domperidone until recently, and he's 12 months now! He seems totally happy and healthy, but he's way below the chart on weight.

[Barefoot~Baker]

You're doing such a wonderful job!

I agree that it would be beneficial to see a lactation consultant if that's possible. My dd2 had the same issue with her weight. The lc had us frequently switch positions while nursing to keep the milk flowing fast from different ducts, which helped her to get more milk and keep her awake and interested. Also, if you haven't, try massaging your breasts while nursing to help the milk flow.

Hang in there, and keep us posted if you can

[PatioGardener]

I agree with what the PPs said - find a good LC and get latch checked and baby checked for tongue-tie. Was baby born at term? Sometimes little ones who come a little early (36-38 weeks) have extra trouble with breastfeeding for a couple of weeks and need an extra eye kept on them.

Are you able to hand express at all? You could hand express after a feed and refeed baby that milk with a spoon or a cup. Jack Newman has some good videos on this here: www.dr.jacknewman.com . That would keep your milk supply up and give baby a little extra of the good stuff that may help her to get more energy to nurse more.

ps Forgot to say Go Mama Go! You can do this! Hang in there!

[ShwarmaQueen]

Can't add anymore to what the PPs have said, only you're doing great! Keep it up mamma!

[Llyra]

Do you think your midwife would let you use that same scale to do a few before-and-after weights? You weigh baby before nursing, let baby nurse until full, and then without changing clothes or diaper, and without wiping any spitup that comes, weigh baby again. You need an accurate scale to do this, one that is accurate to a half an ounce. The difference between the two weights will let you know how much milk baby is taking, so you can estimate baby's intake over a day.

That will alert you to possible issues with low supply or with milk transfer.

And I wouldn't do block feeding if you suspect low supply, or if baby is losing interest in the breast after a short time-- block feeding is a technique for reducing oversupply. Try switch nursing instead-- when baby's sucking slows down, switch sides. Keep switching sides until baby won't nurse anymore, so that you're using each side three or more times during a feed. Switch nursing will help elicit further letdowns of milk, and send the signal to your breasts and hormonal system that more milk is needed.

Breast compressions can help get more milk to baby. So can pumping after a feed, and putting what you get into a supplemental nursing system to use at the next feed.

I wouldn't worry too much. The general guideline is that baby should have regained birthweight by 2 weeks. And your baby has almost done that. But I would keep on top of it, and look for help, and have baby weighed again in a week on that same scale.

[APToddlerMama]

It sounds like you're doing pretty well to me! My son was preterm and so we had to work with a speech therapist when he was maybe two or three weeks old, as well as three lactation consultants. One thing....drinking a gallon of water is probably too much. I was told drinking too much can cause your supply to dwindle. Also, the speech therapist had me stop breastfeeding after 7 minutes on each side. Of course, not what was suggested by the lc, but it turned out that my son was getting too tired going this long, and actually burning more calories working to keep feeding. She told me by 5-7 minutes, 90% of the milk is gone. Again, he was preterm, but that might help. Also, he got too tired to keep at it for the first month, so after he nursed, I pumped immediately and then gave him that bottle. As soon as he turned one month old, we no longer had to do this. Never any problems with nipple confusion, and since he was in the NICU, I also allowed him to have a pacifier (the soothies are apparently best if you're going to breastfeed according to the lc) right from the start. Good luck and don't worry too much...it will all come together for you in time! For him, one day it just "clicked" and he was off to the races...17 pounds by his 4 month check and in the 90th percentile, even being early and dropping weight the first few weeks.

[hezasan]

I am sorry to hear that you are having so much trouble! We finally got our issues resolved and are improving very much, after 12 weeks! I'm sure with all the resources identified here, you will see improvement much sooner.
I agree with APToddlerMama that babies get 90% of the milk in 5-7 minutes, IF they are efficient in getting the milk. I did this on recommendation from LC, but since (we later discovered) he had a structural problem getting in the way of milk transfer – getting milk efficiently – sticking to 5-7 min per side ended up decreasing my supply. He was tired because his jaws had to work so much harder than they should to get the milk he needed. Some structural issues to explore –
Jaw not properly aligned
Tongue, lip or cheek ties
Cleft mucosal something (ENT mentioned, can’t remember exactly)
High palette
In our case, it turned out to be posterior tongue tie. The LC who finally found this said that switch nursing with as many rounds as it takes, rather than limiting overall feeding time, was helpful in this case. That way they get the letdowns, as mentioned above, and still have enough time on the breast to get the milk that they need, because they get it slower. That is, until the structural problem can be fixed. Don’t despair, and keep looking for solutions, you will find the right one!

[saffrongirl]

Thank you. It's hard for things to not feel apocalyptic right now; like my baby is dying and dwindling away and I'm failing her.

I called an LC which was really hard because I absolutely abhor calling people, let alone random strangers, for help. Anyway, hopefully she'll call back soon.

I'm switching breasts about every 20 min now. I'm just worried about her getting enough hindmilk since her poops are a bit green.

Still doing the fenugreek and alfalfa. I'll prob chill on the water since maybe it's too much?

I probably need to just chill out and stay on top of this but realize that more than likely she'll be okay. Damn these PP hormones.

[Violet2]

You are doing everything you can. There is nothing else you can do. So try to relax and let things fall into place (if you can, easier said than done, I know!).

And remember you're in a partnership here, not everything is fully under your control or even your fault.



V

[PatioGardener]

Hang in there, Mama. You're doing great. How are your baby's wet diapers these days? Is she still having 6 heavy wets in 24 hours? If so, that is really reassuring. I know you are working hard to increase your milk supply, and to get her to successfully transfer more. With both of those she'll start to gain more soon. Weight gain is important, but at least with those wet diapers you know that she is getting enough fluids and not getting dehydrated, which is awesome.

Your baby is in good hands, Mama!

[wanderinggypsy]

Just wanted to say you're doing great and don't worry too much about foremilk/hindmilk at this point in time. ALL human milk is over 3% fat, so she's getting fat one way or the other. Just nurse her however you must to ensure she's drinking lots. I predict her weight gain will improve quickly and you'll be on your way! You can hammer out details later, once you get a good push on her intake/growth.

Keep up the wonderful work!

[rivkah]

Just want to add not to worry too much about green poops. They can be typical in the first few weeks, and babies usually eventually start having yellow poops as their digestive systems mature.

[AislinCarys]

Originally Posted by paulamc

http://www.drjacknewman.com/

Good luck and keep us posted!

I second this! We had similar problems, DD was just half asleep on the breast most of the time, only sucking actively for a very short time. You need to bump up your supply, your baby isn' t helping at the moment. Start switch-nursing right away! Make sure baby feeds actively (look at clips and pictures on the site) for at least an hour at a time, switch breast when she isn't feeding actively.

Check out Domperidone, use it sooner rather than later. We waited, and we really shouldn't have. In the end it took us 6 months to sort it all out, very difficult. But we got there, and DD is still feeding a lot!

The earlier you get started the better.

And find a good LC. They are worth gold!

Please pm me if you'd like to talk, or have questions.

[APToddlerMama]

Just checked back, and I think its great you're talking to an LC. Obviously, you're getting tons of well meaning advice from all of us, but it is all based on our experiences--and we don't know the details of your baby or your particular situation. I think being able to weigh your baby on a scale that measures to the gram would really help. I know that was the first step with us figuring out what was wrong with my son (who just was not effectively sucking at all). There is a really good article in the current Mothering magazine about a mom going through a similar struggle and having to pump for a while too. Good luck.

[lovemybubus]

Great advice so far!! Just wanted to add that I know EXACTLY how you feel! I went through this with my 3rd child, if you can believe that? After nursing the first for 18mos and the second, well, he's still nursing at 2.5 Then my 3rd came along and I was exhausted, nursing con.stant.ly. and everyone was worried about her weight and I felt awful, tired, sad and like I was failing. Everything turned out fine and currently she is 6 mos and looks more like an 8-9month old, lol! BTDT, you are not alone and apparently no amount of experience was able to help me...I think it just happens with some babies. You are doing a great job. I can't remember dd weights exactly but the situation was very similar to yours! It's like it becomes an obsession for a short time but believe me it will pass.

Sending you hugs...

[saffrongirl]

Thanks again. I called an LC last night and she told me much of what you all said. She did say to do the 2-3 hour block feeding on one side just to make sure dd is getting enough hindmilk. I've sort of adjusted that and if she gets sleepy, I just switch. She still only actively nurses where I can hear her swallowing for around 10-15 minutes though.

I'm having some issues sorting out my pump with my insurance so I have to meet with my doc today. I'm going to ask her if I can weigh dd while I'm there to get a feel for where we're falling now.

I told the LC that I'll call her and maybe she can watch dd nurse to make sure the physiology of her suck is ok.

I'm just bogged down by all the details. So much to remember and think of. Sometimes I can't believe people have thrived for so long. I worked so hard to keep my pregnancy intervention-free, we had an amazing homebirth and now this part is just so hard. It just seems that something so natural should be easier. Ug.

[paulamc]

It might be that the next time you do a weight check everything is just fine and she's gaining great. If not, and if it seems like something you're going to have to really keep tabs on, I highly recommend you get a scale. I so wish someone had recommended this to me earlier on (and the domperidone). We had a two month time period when he hardly gained. If only I'd known.

This is the one we bought. It's been so helpful to be able to check how he's gaining every couple of days. It seems to be quite accurate - when we go to the doctor his weight there is normally exactly what we have measured at home.

Just a thought...

http://www.amazon.com/gp/product/B00..._ya_oh_product

By the way, look at Jack Newman's website about "breast compressions". Someone mentioned massaging the breast while you nurse, but I would describe it more as squeezing, sort of like you're putting pressure on on the breast to force the milk out. That can help her take in more faster.