Baby refusing to nurse

[AustinMom]

Ok, so I don't think I'm missing anything, but to make sure, I'm going to ask the plethera of you moms with babies the same age-ish.

Baby 'had' to be given a bottle in the NICU due to 'dehydration' once we got home we got rid of fast flow nipples, used the SNS to supplement as I don't have enough glandular tissue to exclusively BF. That is a pain EVERY time you have to feed, or just when baby wants to snack or munch, so yes, we did stop that and went to slow flow playtex drop in bottles, where the nipples are big enough to simulate a breast and she actually had to suck to get milk out, unlike the SNS where milk dripped out.

Fast forward to now....when she hungry, I offer the breast, after the foremilk is gone, she pulls away, fusses, I relatch, she pulls away, stays on for a second or two (literally) and then pulls away, fusses, I relatch....this goes on till I give up and give her a bottle before she really starts to scream and get really frustrated (me included).

So now, we are pumping every 2 hrs ish, once during the night, and giving her expressed milk. I'm taking domperidone, more milk plus, goat's rue, eating oatmeal, having a half beer every now and then. What else can i do?

I have nipple shields that she will sometimes nurse with, and she still suckles through the night when she just wants comfort, but won't nurse when she's hungry.

Here is the KICKER..........when she drinks from a bottle, it LITERALLY takes an HOUR for her to drink 1 OUNCE!!!! I KNOW my milk comes faster than that because in a pumping session of 15 min I get an ounce there, and I KNOW she sucks harder than the pump. Is it a flow thing? Like the bottle is more reliable? Also, when she begins to pull off, I look at my breast, barely do a hand expression and milk squirts 8'' out! So I KNOW she can get milk from me, she just won't. What can I do? How do I get her to go back to the breast?

[Just1More]

I have different issues, but I'll commiserate by saying that this is the first time (baby 4!) I've understood why people give up on bfing...

I am NOT an expert, and if someone contradicts me, I totally suspect they are right, but here's my two cents...

If she likes to drink from a bottle better, and she takes so long about it...maybe she doesn't want to nurse because it comes faster? Maybe if you pump first, then nurse, she won't get as forceful (or quick) letdown?

And, how often are you feeding her? Could you maybe nurse her more frequently so she gets more from you? Or maybe give her a little from the bottle to ease her hunger, and then nurse her and then finish up with the bottle?

Oh, and maybe you could consider going back to the SNS? You don't have to do it every time, do you? Couldn't you just pay attention to how much she gets supplemented, and space it out over the course of the day? So, most of the times you don't use it, and maybe every 4-6 hours you do? Then it's not a hassle over and over all day, but she still doesn't get a bottle?

[RedOakMomma]

I would cross-post this in the breastfeeding forum...you'll get lots of advice and help there, likely from people who have experienced something similar.

[Amanda_Reyasmom]

Originally Posted by Just1More

If she likes to drink from a bottle better, and she takes so long about it...maybe she doesn't want to nurse because it comes faster? Maybe if you pump first, then nurse, she won't get as forceful (or quick) letdown?

This would be my first guess too. I have to hand express before feeding Lila otherwise she might drown!

[porcelina]

Also not an expert, but it sounds like you may have strong let down, so she can't handle it when it comes out so fast. I know my little guy chokes and pauses a lot when there is lots of milk coming out. It is hard for them to get used to! Also, is it like that at every feeding, or just certain times? My guy does that when he wants to comfort nurse but doesn't really want the milk -- pops off and cries. This mostly only happens in the evening hours, though.

It sounds frustrating! I feel for you! I would imagine that you might just have to persist? Definitely get some help from professionals!

[sattygirl99]

I agree with the strong letdown suggestions....

But you don't need to use the SNS EVERY time you put the baby to breast... Figure out how much you need to be supplementing and spread it over typical feeds, every 2-3 hours apart.

I'm on my 2nd babe supplemented at the breast and he nurses ALOT without the lact-aid (which I highly recommend over the Medela SNS, it's TONS better). He is very much a booby baby but he only gets supplemented every other feeding (so every 4ish hours or so) and he comfort nurses whenever he wants. You're obviously making milk (and btw - an oz per side pumped is not that low and she will get more, why are you supping again?) so theres really no reason to supplement every time you put baby to breast.

I'm just speaking from experience... With DD, I used the lact-aid EVERY feed, even to comfort nurse and we never weaned from it. This time, I use it purely for feedings and I always nurse both sides first and THEN offer supplement if it seems like he needs it. My hope is to wean from it by 6-8 weeks old once my supply is better established and he nurses more effectively.

The best way to get her back to the breast IMO (and experience, take it for what it's worth as I'm NOT a professional) is to cut out bottles, completely. Do any supplemental feeding at the breast and space out those supplements throughout the day when you need them. You may find (like me) that you don't need to supplement the middle of the night and first morning feeds. I only supplement in the afternoons and evenings when my supply is lower. Pump off your letdown or lay down and nurse with baby on top of you. To make that image clear, lay on your back and place babe across your tummy. The gravity should slow the letdown. And you may want to meet with a professional and do some test feeds because if you're pumping that much, I don't think you have low supply and a need to supplement.... Maybe it's a transfer issue and not a supply issue. I pump 1-1.5 oz combined both breasts and still only supplement minimally...

Hugs and good luck! I know how much of a PITA supping can be but really, you can nurse your baby lots without the SNS and if you're looking to use an at breast supplementer long term, look into the lact-aid. It's much more user friendly and it's uber discreet! Feel free to PM me if you need any other insight from a fellow low supply, supplementing mama.

ETA: with the lact-aid, she will have to work for it... it doesn't work on gravity like the SNS (which is a bottle turned upside, of course it's going to just leak out!)... The LA works on suction... Milk doesn't come out unless they suck!

ETA again...: The average transfer for a baby ages 10 days to 6 months is 2-4 oz per feeding. I would highly suggest you contact a lactation consultant and do some test feeds...

[AustinMom]

Ok, so, more info. I'm kinda confused....if I have a strong let down, which would kinda make sense, I don't see how adding a lactation aid or SNS would help with this, only make it worse. Wouldn't it just be more milk she is getting?

When she pulls off and cries, I'll squirt some in her mouth and she'll frantically latch back on, that's what makes me feel like she isn't getting milk.

We saw 5 LC in the Baby Friendly Certified hospital, and sadly, this wasn't going on at that point.

When I wait 6 hrs to pump or so (like first thing in the morn) I get almost 2 oz combined. When I pump every 2 hrs, I get .5-1 ounce at MOST.

I can't really use the Lactation aid or the SNS due to the formula we use. We homemake it, and it has a little bit of granules of ingredients and won't fit through the LC. We don't plan on switching to commercial formula, as both my kids have had health issues and GI issues with the protein in milk, and need the raw enzymes to help break those down.

I asked my MW and she said it sounds like it may be coming too fast, but that didn't make much sense to her either, as she would cry and then want more milk once she feels it in her mouth. The thing is, she doesn't suck before she pulls off and cries, she simply has the breast in her mouth, nipple not even to the back, and it like she waiting for it to drip in her mouth before she sucks, like she does with foremilk.

Maybe if I use a nipple shield, it's more like a bottle feel, and it does gather some milk in it so that could drip and get her stimulated to suck? I don't know, I have two, so I could just put one on each breast?

After a feeding when she was in the NICU, (before my milk came in) she had to be supplemented as she was clearly more hungry after a BF, so we started using the SNS. Then we were put on a time schedule to feed, and she drank faster from a bottle, and we 'had' to go with that. She would take about 1-1 1/2 hrs to drink 30ccs of milk. That's what lead to the 'dehydrated' need to push fluid, etc. When we got home, day 8 my milk FINALLY came in, and it still wasn't enough to satiate her as we were just getting off pushing 60ccs of milk in her after a 10min per side BF every 3 hrs around the clock. So now, when we bottle feed her, she will take 2-3 ounces a feed, and when I pump, I only get 1 ounce, rarely 2 per pumping. I know she would get more from the breast.....but I'm trying to get her to take the breast again. With the nipple shield, she'd take it, but I don't think she would get as much milk as she would without because of the lack of stimulation and and compression, right?

[happydaymomma]

Cheryl at Special Additions is an amazing consultant. I've been working with her on some issues I'm having.

[happydaymomma]

Just thought that I'd add - with DD1 I could never get more than 1/2 oz when pumping. But when we went to the Special Additions consultants they weighed her, I nursed her, then they weighed her again and she'd gained 3 oz! So
pumping is not always a good indicator of how much milk you're making.

[FireWithin]

Ddcc (oct mama)

Do you think babe might have a posterior tongue tie? Ptt are hard to diagnose and they can be hard for a baby to latch and sustain a latch. I believe there is a long sticky/thread on problems with hreastfeeding forum.

Good luck

[DoulaLMT]

Babies can be really funny. Not sure if this is it, but here's something else to consider.

I used a nipple shield with DS due to major tissue damage from his initial latch difficulties and the pain that followed for the next couple months of healing. He liked the oral stimulation that a plastic nipple gave, and would nurse ok like you say until the formilk was gone, then he'd pull off and fun and not nurse until my milk let down. I basically would nurse with a nipple shield until my milk let down, then pull it off and he'd nurse just fine once the milk was flowing. That's one thing about bottles, even if baby has to work to get the milk out, there t not that same period of nursing and getting nothing while waiting for let-down. Anyway, something to consider.