Is she getting enough? First time mom, CLUELESS.

[november]

My daughter is now 3 days old. I don't want to get into specifics quite yet because quite frankly, I am at my limit with trying to breastfeed. I want this to work so bad but I have inverted nipples and she is NOT having the nipple. I've tried the nipple shield and desperately did NOT want to do it but it was the only thing that was working. Only it's not working that well because she's constantly hungry. Violent fits where she's trying to eat her fingers, etc. She was literally on my breasts for HOURS and HOURS last night and still screaming the whole time because she obviously wasn't getting enough (or anything at all?).

I've already begun to start pumping colostrum because I'd rather go that route than formula. I only have a hand pump at the moment and only started this morning, but it is taking me quite a while to pump 1-1.5 ounces and she is eating every 2.5-3 hours.

Is this enough for the time being? If I keep pumping regularly, will my milk eventually still come in or will pumping somehow delay that?

I just need some reassurance that pumping CAN be successfully be done from the get-go even if that was not my original plan. It's better than formula but I need to know that I am doing this right. She seems full and content afterward. I've only started this morning so I'm not super sure on the diaper situation--she's only had one pee diaper but I'm assuming there will be more to come now that she's had her third feeding this way...

Help. And before anyone suggests it, I do NOT have an LLL in my area or I would have already gone or contacted someone there. DD throws an absolute FIT if I try to put my nipple in her mouth and we both just end up in tears so I'm making do with what I have at the moment.

Signed,

Very frustrated first time mom.

[Ruthla]

Congrats on the new baby!

It's normal to only have colostrum at 3 days PP. Babies only need a few teaspoons of colostrum per serving- if you got over an ounce, then your supply is fine at this point. Sometime in the next 1-5 days your mature milk should come in, making your output much, much larger in quantity.

Screaming at the breast is not always an indication of "not enough milk." Some babies are unhappy for other reasons. Nursing for several hours straight is a wonderful way to boost your milk supply (assuming the baby is able to effectively suckle milk out of the breast.)

Are there any breastfeeding consultants or experienced nursing moms available who could help you get the baby latched on properly?

If you're going to EP (exclusively pump) then you need a good double-electric pump. It's hard enough to maintain a full supply just pumping, and having the right tools can make the job easier (and sometimes, easier means you have the reserves to keep going rather than throwing in the towel.) I also suggest that you're very careful about how to feed a supplement- giving bottles at this point would only make it harder for her to learn how to latch onto you. If you decide to EP, then bottles are fine- but right now, when you're still not sure where you'll be heading, it's best to feed the supplement (pumped milk) via a syringe, cup, finger feeder, or SNS, rather than bottle.

[november]

Thank you for your response, I'm sorry my first post is a jumbled mess. I'm bawling over here and just don't know what to do. I want so badly to just BREASTFEED and not pump and no formula .. nothing , I just can't get it figured out. I mean, she may be getting enough to eat from the shield but I just don't know. I wish I KNEW because if I did I would gladly keep suffering through the pain of the nipple shields.

I can't believe I'm failing at this after 3 whole days. Wow, three whopping days. Just pathetic.

[UptownZoo]

Originally Posted by november

Thank you for your response, I'm sorry my first post is a jumbled mess. I'm bawling over here and just don't know what to do. I want so badly to just BREASTFEED and not pump and no formula .. nothing , I just can't get it figured out. I mean, she may be getting enough to eat from the shield but I just don't know. I wish I KNEW because if I did I would gladly keep suffering through the pain of the nipple shields.

I can't believe I'm failing at this after 3 whole days. Wow, three whopping days. Just pathetic.

You are NOT failing! In fact, you are kicking ass and taking names, and don't let anyone tell you anything different!

This is your first baby. Both of you are learning something brand new. Some babies have a hard time learning what to do at the breast. My youngest would scream frantically with hunger, and when I brushed his face with my nipple he'd pull away and scream as if to say, "Can't you see I'm hungry? Why are you sticking that thing in my face?"

Hang in there. Keep her at the breast as much as you can stand. Is there a lactation consultant near you? You said there's no LLL; what about an experienced breastfeeding mom? Any midwives in your town or nearby? WIC offices sometimes have breastfeeding counselors.

As to whether or not your baby is getting enough to eat, a better indicator of that is her diapers, not her behavior. Newborns are very unorganized little critters and it can be really hard to know what they want. Is she still pooping meconium or is it starting to clear out? (Mec is green and sticky; when it's all gone, her poop will be yellowish, liquid, and almost odorless.) Is she peeing?

[Bokonon]

Have you seen this?
http://www.kellymom.com/bf/normal/newborn-nursing.html

You are NOT failing - you have just given birth and are trying something you've never done before!

In my non-professional opinion, I think the pumping is just going to be more frustrating for you both. Check with the hospitals around you for breastfeeding support groups or classes. I know my hospital has IBCLCs available for consultation even if you did not deliver there. It's not free, but it will be cheaper than what you would spend on a good electric pump and bottles. Also check with any nearby cloth diaper stores, as many of them have breastfeeding classes run by LCs as well.

Right now your baby's stomach is the size of a marble. If you are already pumping 1.5 oz., you are doing great! Your baby can sense your frustration - don't forget, she's never done this before either! You both need to try to be as relaxed as possible, and I promise, with practice, it will "click".

Get in bed with your baby, strip her down to her diaper, and just hold her against your bare breasts with a blanket over her so she doesn't get cold. Let her find her way to your nipple - don't try to put it in her mouth if she isn't ready.

[lifeguard]

The biggest shock for me with breastfeeding was that at first it is absolutely constant. I had NO idea about that beforehand & once I accepted that that was how we were going to spend the majority of our time I was much more relaxed about it.

Is she having wet diapers? That is a good indication they are getting enough. We never know for sure how much they are getting but output is a pretty clear indication.

Try to avoid the pumping/bottles for now if you can. The more she bf's the better for your supply.

I haven't had experience with nipple shields but a friend of mine did. She did find she was able to wean dc off of it pretty easily once the bfing relationship was well established.

You're doing GREAT! It's not easy at this point but it does get better.

[PatioGardener]

Keep going, Mama! You're doing great.

Have you tried to let baby latch on her own? She may decide to take your breast if she's the one who decides how to latch. (Baby sometimes knows best with latches). If you want to try it, here are some good videos:
www.breastcrawl.org
www.drjacknewman.com - click on videos and scroll down to the self latching ones.

As for is she getting enough, at this stage she should be having 4 heavy wet diapers in 24 hours on day 4 of life, 5 on day 5, and 6 from day 6 on. Babies usually have 3-4 small poops (bigger than a 25 cent coin if you are in the USA or Canada) in 24 hours at that age. By day 5 they should stop being brown/green and be yellowy orange. Babies lose weight for the first 3-5 days, but then start to gain it back.

Hope that helps!

[november]

Thank you so much for your advice and encouragement, ladies. I appreciate it so much more than you know. When I posted this, I was in the middle of a MAJOR heartbreak/meltdown.

The GOOD news is that the reason it was hurting me sooo bad to use that shield especially this afternoon was because....my milk came in! Needless to say, that explains why my boobs were all of a sudden THROBBING and I was at my breaking point. So, instead of taking an hour or so to pump out an ounce of colostrum it only took me 10 minutes to pump 1 ounce of milk. Drastic difference. One ounce was all I could get for the first time from both of them combined, is that normal/typical?

I know pumping isn't advised/encouraged right now, but she has her little meltdowns at night and I don't want to have a major breakdown and do the formula again if things really go to blows. I know it was only one ounce but I'm trying to avoid that temptation and I would prefer her to have my pumped milk to the formula.

I think you're on to something with the nipple shield. I didn't realize they came in different sizes and I found the package mine came in and it's a 20mm or size 'small'. How do you know what size you need? Mitchell is going to run to Wal-Mart tonight and get me a bigger size but I'm not sure what to tell him exactly. I do know that when she latches on and starts feeding, my nipple is reeally squished in there tight/rubbing against the edges. Is ONLY the nipple supposed to go through the nipple part or is a portion of the aerola supposed to get drawn up as well?

I watched that video about three times, Lexi, and sat down calmly with her to try and reenact it and still no luck. SO frustrating. Not once has she NOT flipped out when I stick my nipple in her mouth--she absolutely wigs out and I don't know why!! My nipple will be fully erect, with dribbles of the colostrum on it so she can taste what it is and she *still* freaks out. Is this something I should just put on the backburner for a week or two and just encourage/embrace the nipple shield feeding (once I get the proper size) for the meantime since she's content with that most of the time?

Oh, and another thing. I would like to pump a few 'reserve' ounces of milk in case of freak-outs when she absolutely WILL NOT take the nipple shield or anything but I know she's hungry. I'm afraid if I do too much pumping tonight that it will cause me to make TOO much milk too fast..is that possible? Should I just let her feed and pump as much as feels comfortable for right now? The engorged feeling sucks -- I had no idea your nipples could THROB like that.

Ugh, sorry so many questions. I'm just so clueless.

[Bokonon]

I am just very concerned that with breast and bottle feedings so early, she is going to experience nipple confusion, which is very difficult (though possible) to overcome, and usually goes the way of the bottle and not the breast.

Yes, if you pump you can very easily make too much milk, which will make you more uncomfortable and be harder for her to latch. These early days are so critical for establishing NORMAL breastfeeding and milk supply that I would strongly caution against too much pumping. Oversupply sounds good, but it makes it very difficult for the breastfeeding relationship to get established.

Instead of pumping, you can always hand express a small amount to make you more comfortable.

Are you offering the breast at the start of feeding cues - rooting, licking lips, etc.? Crying is a late-stage hunger cue and babies get frantic and harder to latch when to that point.

If the nipple shield is working for you right now, I'd say continue with it. You won't have to use it forever, and it's much easier to wean from a nipple shield than try to get a baby back to the breast after bottlefeeding.

You are doing SUCH a great job!

[november]

This is going to sound like a stupid question, but since I'm already using an artificial nipple similar to that of a bottle (nipple shield), how is she going to have nipple confusion if I give her a bottle at night?? Aren't those two more similar than if I were able to get her to latch onto my actual nipple and also offering her a bottle at night?

DH bought me a larger nipple shield and it's not quite as painful to use as the other one (size small). It's still definitely uncomfortable, especially when she first latches on and is going to town on it. It gets more manageable the longer she sucks, thankfully, but I will definitely admit it's not what I'd call pleasant. Is using a nipple shield always uncomfortable to some degree? Our Wal-Mart and Target only carry size small and medium nipple shields and I don't know if I have the right size still.

Now that my milk has come in I really hope I don't NEED to resort to the pumped milk but I would like to have a little ready and waiting as a backup so I don't feel the pressure to resort to formula again like I did last night. We do have a syringe that I could use, but like I said, I guess I don't 'get' the difference between the two artificial nipples.

[november]

Also, she hasn't pooped now since yesterday and I am starting to get concerned. She's been eating but there's no poop. What gives??? She's only had one pee diaper today too. This is so frustrating.

[Latte Mama]

You got some great advice so far. Here's a link to find an IBCLC , I highly suggest getting one for help mama.

http://www.ilca.org/i4a/pages/index.cfm?pageid=3337

[Latte Mama]

Originally Posted by november

This is going to sound like a stupid question, but since I'm already using an artificial nipple similar to that of a bottle (nipple shield), how is she going to have nipple confusion if I give her a bottle at night?? Aren't those two more similar than if I were able to get her to latch onto my actual nipple and also offering her a bottle at night?

DH bought me a larger nipple shield and it's not quite as painful to use as the other one (size small). It's still definitely uncomfortable, especially when she first latches on and is going to town on it. It gets more manageable the longer she sucks, thankfully, but I will definitely admit it's not what I'd call pleasant. Is using a nipple shield always uncomfortable to some degree? Our Wal-Mart and Target only carry size small and medium nipple shields and I don't know if I have the right size still.

Now that my milk has come in I really hope I don't NEED to resort to the pumped milk but I would like to have a little ready and waiting as a backup so I don't feel the pressure to resort to formula again like I did last night. We do have a syringe that I could use, but like I said, I guess I don't 'get' the difference between the two artificial nipples.

YESm the bottle is different. The flow is faster, the way baby sucks to get the milk is different and most babies prefer the bottle. They have to work harder at the breast and newborns don't want to work hard!

Once BF is established it's usually fine to intro a bottle because then baby prefers you. Please heed this advice. As far as the shield, yes it may be uncomfortable but that's probably from nursing. Your nipples are sensitive because they're not used to to the suckling. I also used to a shield and it was painful in the beginning. It gets better.

If you have to give her expressed milk, use a syringe. She shouldn't need much extra but a syringe or cup is much better than a bottle.

[november]

I think I will go ahead and pump at least an ounce tonight to have on hand tonight and try using a syringe to feed her if we need it. I only plan on doing that if for some reason she is throwing a fit and won't latch with the nipple shield. We're heading to bed now and I pray pray pray tonight goes better than last night. It was a nightmare-ish disaster and I don't want to ever feel that low again.

[ewe+lamb]

Congratulations on your baby - you're doing a great job and you are definitely NOT a failure.
OK your baby has only had one wet nappy in 24 hours? But you're pumping and that seems to be fine?

for inverted nipples you can also do this, get a large syringe (25ml) at the pharmacy,
1. take off the needle part
2. take the middle part (which you push down) out
3. cut off completely the end part where the needle goes - so the tube is the same diametre the whole length
4. take the middle part and put back into the tube; but in the end that you have just cut off
5. now the top part is the bottom
6. you need to cover your nipple with the bottom - not the cut end but the smooth part which was the top
7. then pull the middle part gently up
8. when nipple is extended (yes it can happen even with inverted nipples) then offer the breast to baby.

Goodness it sounds completely when all written out but actually isn't - if you have any other questions about this please feel free.

Check that the position of your baby is optimal, ear, shoulder and hip in a straight line, tummy to tummy, point your nipple at your baby's nose let the baby take the breast just supporting the nuc of the neck - don't push baby's head towards the breast, when baby is well latched on you should be able to see a little bit of the tongue covering the bottom gums and a suck suck suck swallow breath.

For giving baby expressed breastmilk I would like to suggest using a cup or a Medela soft cup - which is like a little cup and the amount of milk can be regulated by whoever gives the breastmilk - my personal experience with a syringe was that our dd would try to nurse by pushing her lips together like a 'kiss' - it wasn't a good experience for us - but can be different for others. I would also strongly suggest that you find a LC in your area, there may not be a LLL group in your area but you can call the national helpline for LLL and you'll get a Leader at the other end of the phone - worth a try

Also a baby's tummy is tiny newborn is the size of a small marble, 3 days the size of a large marble and then 10 days the size of a ping pong ball - so if you think that you're not making enough milk then that's not necessarily true, however getting someone to evaluate the latch and mouth of the baby may be worthwhile at the moment.

Lastly, can you go to bed with your baby for a couple of days, just nurse nurse nurse and bond with your baby, follow your instincts, listen to your heart and watch, observe your baby, they may not have words yet but they can communicate with you, take the time to get to know your baby.

Good luck and keep posting ....

[sunshynbaby]

Originally Posted by november

The GOOD news is that the reason it was hurting me sooo bad to use that shield especially this afternoon was because....my milk came in!

That would explain the hours and hours of nursing too. Sometimes they can "smell" that the milk is coming and nurse constantly until it comes in.

The first six weeks of breastfeeding are the hardest. Hang in there, and visit Kellymom.com and their forums for help. That site saved me!

[november]

Okie dokie, I'm just going to copy and paste what I sent to my friend because I'm too lazy to retype it all. THANK YOU all for all of your advice/encouragement -- seriously you have no idea how much that helped!! It kept me optimistic and on the right track--no formula last night and it was infinitely better than the prior night. Didn't give her any pumped milk or anything either, so it was all breast!


Oh man, I feel like a different mama this morning, I swear. First off, last night was 10x better than the night before. I sincerely hope we never sink that 'low' again -- it sounds pathetic, but Mitchell and I were both just crying and crying because we just did NOT know what to do. Aaaaaanyway, so last night when I was having my little melt down again and posted this after my milk came in, every stinking time I fed her she would SCREAM bloody murder for the next hour or so afterward. I could tell she was full, she wasn't rooting or wanting more food, her diaper was changed, but her tummy was just gurglin' and she was absolutely miserable and I felt so helpless because no matter what I did, I couldn't seem to calm her down.

Finally got ahold of the lactation consultant this morning and she could sense the stress in my voice over the phone and said she was going to clear room in her schedule and she'd be right over in an hour. Thank God. First off, she was absolutely wonderful. I was really nervous and tense and within 5 minutes of her being here, I was totally at ease. She's not IBCLC certified yet, but she's been a lactation consultant for over 5 years (works with Parents as Teachers for the school district) and is going to test to certify for the IBCLC this coming Spring, so she knows her stuff. Thankfully.

She was very impressed with how we were doing, surprisingly . I never would have guessed that I was doing so much correctly, but I was. I was holding her right, supporting her head in the right places, Piper has a wonderful latch / sucking skills, etc. The thing I *didn't* realize was that I was pulling her from each breast way too soon. I thought you HAD to let them nurse from both breasts every time so I was having her nurse on one side for a little bit, pulling her off, burping her, putting her on the other side. The only thing she was getting was foremilk which explains why she was so gassy/miserable afterward -- she was full of foremilk which apparently makes them miserable, lol. There's no way she was getting ANY hindmilk because I wasn't leaving her there long enough. When I told her that's what I was doing, how Piper was freaking out every time I fed her since my milk came in, and the fact that she had the world's most DISGUSTING poop that was green and explosive and reeeeally stinky, that's how she knew Piper wasn't getting the hindmilk. So when she got here, she wanted me to show her what we'd been doing so she could observe -- and since I was doing everything else correctly, she was just showing me what to look for as far as signs of Piper being full, etc. She showed me how to do the compressions to boost the milk flow when Piper was starting to slow down so she would keep feeding long enough to get the hindmilk. Sure enough, Piper fed for about a good 45 minutes, and as soon as she finished, she gave out this loud, happy sigh and nuzzled right to sleep. It's like she was a different baby all of a sudden. Who knew hindmilk was so important?! LOL.

She said I definitely need to keep using the shield for the time being. She doesn't typically encourage that, but she said in my case, I really do NEED it. Apparently, I don't have inverted or flat nipples, I just have short ones, lol! Since they do/are 'out' most of the time, she said the problem is that right now they aren't long enough for Piper to get latched on to. She said once they've been stimulated for a few weeks and Piper's suction gets better/stronger, they should get to a point where I don't need the shield at all, but for now right, to keep with it because what we're doing is definitely working well.

So .... let's just hope the next feedings go as well! I am so excited--she is happy as a little lark in there just sleeeeeeping away, no screams, no pain! I hope I can do it as successfully the next time she feeds!!!!!

(Geez, didn't think you were getting my life story, did ya?)

[lifeguard]

I'm so glad the lc was able to help you & your babe. Good job Mama!

[Bokonon]

This is wonderful news!!!

[OperaDiva]

So glad the LC helped!! I have oversupply, so most feedings I only feed off one side to avoid foremilk/hindmilk imbalance, that green poo really is icky!