BreastFeeding- low supply, nipple confusion, NICU...

[DomestiKater]

here is the situation-
i have low supply...my daughter will be 6 weeks on tuesday...

Here is the short version of my story--

my home water birth turned into a 28 hour natural labor in a hospital that turned into an emergency c-section because my DD's heart rate kept dropping - we were in the hospital because i was 42 weeks 4 days pregnant and still my cervix was closed and i was not going into labor naturally- because of my post dates once DD was out she was immediately intubated with a severe case of meconium aspiration - we spent the next 30 days in the NICU and were not able to attempt breastfeeding until she was two weeks old. in this time i pumped 6 - 8 times a day but have never been able to produce more than 3 oz's every three hours.
in the meantime because she was in a hospital she had to also eat from a bottle (even though i was there 12 hours a day, because of the hospital's feeding schedules, i was only able to try to BF 4 times a day) and since she had to eat a certian amount every three hours, she had to take the bottle.

thankfully she still takes to my breast but because my supply is low i cannot supply her with all she needs in a day. i am able to give her a little over 1/2. i am ordering donor breast milk (it's cleaned and pasturized) for the bottle. She also gets frustrated with my breasts because the flow is much slower than the bottle...

since we're home i am offering her the breast everytime she's hungry (unless i've just pumped) and hoping the supply will go up- i'm also taking herbs and oatmeal/flax/brewers yeast- annnyyywayyy....

i'm just unsure if i should still pump 8 times a day or what..she BFeed's really well at night and last night she fed from me 4 times so i didn't pump all night and then fed her again this am and did pump (it had been 12 hours since pumping) and almost an ounce came out between both- not that much but she had been eating....

i guess i'm afraid that my supply will lower even more if i don't pump but if she's really taking from me than that's the same right? should i just do every 2 to 3 hours during the day and feed her all night from me and not pump?

hope this wasn't too much info- i just really want to exclusively BF and don't want to lower my supply by not pumping enough...

i have the SNS coming in next week - hopefully that will work...

any thoughts/suggestions etc....?

thanks to everyone - you ladies are the best!

[AislinCarys]

Just wanted to let you know, from my experience, that it isn't too late. You can still bring your supply up to full. I did, and we are still breastfeeding.

We didn't have your NICU experience, but DD lost weight at 4 1/2 weeks, and it was obvious something was wrong, as she was feeding THE.WHOLE.TIME without gaining. By the time we'd seen the specialist ped, and found an LC, DD was 6 weeks old.

If you don't have a really good LC, find one, it is really important! Then, check out this site:

www.drjacknewman.com

He's got a breast-feeding clinic in Canada, and is an expert on breastfeeding, specialized in low supply issues. You'll find lots of great, specific info there on how to deal with low supply, and videos showing good latch and transfer etc.

We did switch-nursing, feeding 1-1 1/2 hour at a time, then the next feed started about 3 hours after the first (sooner if she woke up and cried, or wouldn't sleep). Switch-nursing is described on that web-site, it means that you feed on one breast for as long as there is plenty of swallowing (if baby is sleepy or feeding too passively, do what you can to keep her on task, tickle, wet cloth, remove clothes etc), for me about 10-20 min. Then you change breast, and do the same there. And then change back again. And again. Up to about 4 times on each breast (we did twice on each breast). And halfway through a diaper change or potty, that helps too, if baby is a bit sleepy or feeding slowly. Switch-nursing can make a baby feed more effectively, and it is also a good way of increasing supply.

I took fenugreek capsules. You'll find info Dr Jack Newman's site again on how much to take. Just for the record, i know that a lot of this stuff is in that site, but I didn't find the site until later, so all we did was on my LC's rec.

We got donated breast milk and fed that in the SNS at the end of a feed, the last change, the last 5-10 min. This way DD had to take as much as possible from me before she got the extra milk.

All of this made quite a big difference quickly, DD started gaining, and quite soon we could face out the extra milk. Around 3 1/2 months, however, DD plateued, and needed a little bit more milk (as my supply, I guess, was JUST what she had needed until then). We got more donated milk, and this time my Dr prescribed Domperidone, and the specialist ped suggested we started weaning off the donated milk, slowly, to give the Domp. a chance to work. And it did. By 6 months DD was off the extra milk, and a month or so later I was off the Domp. DD was just starting to self-feed then.

In the meantime, settle yourself in for a long time of feeding, cuddle up with your sweet baby, watch tv that makes you laugh (laughter makes you relax, which aids with let-down), make yourself a comfortable corner, and make sure you eat and drink well. And enjoy spending time with your precious baby!

Hugs

Just adding that I tried pumping, but I can't get much for the pump, so I just gave up on that after a while. And it worked well for me anyway.

[AustinMom]

I haven't read the whole reply of the other poster, but I will say our situations are similar, but mine not as intense. I'm so sorry you had to go through that by the way. In short for me, my daughter was a home vbac water birth transfer, 43 weeks, meconium, CS due to heart tones that were nonreassuring, possible aspiration, then suctioning deeply which caused her to crash, 1, 4, 7 APGARs, so she was in the NICU 1 week. I know that's nothing compared to your's. Again, I'm so so sorry you had to go through that, and your baby too. I know their feeding schedules are crazy, every 3 hrs, ect and all you can do is pump. I've had supply issues as well (or thought) with my first son and stopped BFing at 3 weeks. This one, my milk didn't come in till 8 (YES 8) days after she was born. So I was SNSing, pumping like crazy, taking goat's rue, more milk plus, domperidone, oatmeal, etc. She did get bottles in the NICU, and we stopped the SNS due to it being a pain, and went to slow flow breast like bottles at home (as breast like as is out there without paying a million $) She began to refuse my breast and prefer the bottle. I'm talking, being frantically hungry, pissed off, latch on, latch off, scream, then take a bottle calmly. When I pumped every 2-3 hrs, I'd get half an ounce to only once or twice almost 2 ounces. We were supplementing with doner breastmilk from the bank and other moms, and then a homemade formula as well.


Ok, that's my story, here was my solution. It wasn't my lack of supply, it was that I HAD milk that let down too fast for her to be able to control like she could with the bottle, and that is why she wanted the bottle. I would say if you are getting 3 ounces when you pump you don't have a supply issue. I was reading on Kellymom.com (another great site) http://www.kellymom.com/bf/pumping/p..._decrease.html and she was saying that if a mom pumps more than .5-2 ounces a pumping she probably has an OVER supply issue. I doubted this entirely till our Doula came over, saw her breastfeed and said, she's gaging on your let down. You have plenty of milk, she can just control the flow with the bottle and have it come out slower. She said to go cold turkey off the bottle for 3 days and see if that works. She said baby's gonna be really confused and upset and wat a bottle, but if you HAVE to supplement use a siringe. We did, and we've gotten the supplementing down to only an ounce maybe 3 times in the past 3 days. Seriously, I'd consider you HAVING enough milk. 3 ounces is A LOT to pump, and if you are pumping every couple/few hours, I'd think that would almost be enough to feed him/her, depending on your baby. AND, a bay will ALWAYS get more from the breast than a pump will. So, when he/she does feed, they'll be getting more than 3 ounces.

Also, another tip, try doing some hand expression after you pump into the flanges. The pump gets milk through suction, the baby through suction WITH compression (this is how they get more milk), so since the pump only works with suction, compression will usually get some more milk out. Especially if you have that much milk in your breasts.

I really really hope that over production is your problem as that's a much easier problem to have than under production. You are in my thoughts and prayers

[emilysmama]

My dd wasn't in the NICU quite as long as yours, but she wasn't a strong nurser like you say yours is now. If you want to bring your supply up, 6-8 pumping sessions is not enough. I pumped 10-12 sessions (baby wasn't able to get any milk at all from the nursing sessions) for every 24 hour period, and it took 2 weeks to bring up my supply up from almost nothing to enough to keep up with my child.


So IF your child is getting lots of milk from your nursing sessions, then I think you need to have:

#of nursing sessions+# of pumping sessions > 10-12 times per 24 hour period

If you child is not getting a lot of milk from the nursing sessions, then I think you need to have:

# pumping sessions > 10 - 12 times per 24 hours



So yes, I think you need to be concerned and not stop pumping. If 2-3 hours go by and she doesn't nurse, then I would strongly suggest that you pump, because yes, your supply could go down.

And no, it is by no means too late to bring up your supply.