Thoughts on our situation?

[countrygirl28]

My DD is 3 weeks old and we are having problems with breastfeeding. She weighed 7lbs 2oz at birth, and got down to 6lbs 5oz at her lowest, which was about 1 week after birth. At that point, we saw a LC who suggested we supplement because DD had lost so much weight and was not producing very many wet diapers and had yet to stool. So we supplemented with formula for a few days while I started pumping, taking fenugreek, drinking Mother's Milk, and eating lots of lactation bars to increase my supply. Well, my supply has now increased, and I'm making more than enough milk for my DD, which she gets in a bottle, but she does not get very much while actually nursing at the breast.

Whenever I put DD to the breast, she does short, quick sucks, but never really gets to the point where she is actually sucking and swallowing. I've seen the LC several times, and she always weighs DD, then I attempt to nurse her and then we reweigh. The most milk she has ever gotten from me is 1/2oz. DD enjoys being on the breast, and typically falls asleep while there, so it's nice to know that the breast is a source of comfort to her, but I really want her to actually feed at the breast! I used to think that DD's latch was the problem, but I'm not so sure anymore. I've had the latch evaluated by the LC, who says it's not the best, but should be good enough for DD to transfer milk. She does deform my nipple when she nurses. It ends up looking like a tube of lipstick when she is done. I have pretty large nipples, and DD has a relatively small mouth, so we've thought maybe she kinda has to "grow into me" to be able to successfully nurse.

I'm so tired of pumping because it's taking precious time away from bonding with my DD. I have to put her down to pump, which just doesn't feel right. I am very committed to actually nursing DD; it would make things so much easier on us both. Does anyone have any thoughts on our situation? I'm so afraid that the longer this goes on the less likely we will be successful in actually breastfeeding.

[mzpuff]

I don't have any advice for you but just wanted to say I'm in the EXACT same position.. even down to my daughter making my nipples look like a tube of lipstick. I was in so much pain with my nips that I just started pumping exclusively and I too hate it, Now DD is 10 weeks old and I'm going searching for ways to get her back to my breast. You can do it, your LO is so young that with a little more help from a LC it shouldn't be too hard. I wish you luck!!

[countrygirl28]

Thanks for the encouragement mzpuff! Sucks that you are going through the same thing. Hopefully we can both get our DDs nursing soon!

[tibeca]

This sounds like what happened to a friend of mine. Her babe had a upper labial frenulum lip tie. Baby was never able to nurse properly, until she had it snipped by a pediatric dentist. Look into it and see if that may be the case for your babe.

In the interim, have you tried breast compressions to increase milk transfer. Sometimes that little bit of encouragement is what a baby needs to really get going.


"Try breast compression to keep your baby interested in breastfeeding. Squeeze the breast firmly with your thumb on one side and fingers on the other to increase milk flow. Keep squeezing until baby is no longer actively sucking, then release. Rotate fingers around the breast and squeeze again. Then switch to the other breast, using both breasts twice at each feeding. Squeeze firmly but be careful not to cause injury to your breast tissue."
From: http://www.llli.org/NB/NBSepOct08p44.html

[countrygirl28]

Thanks for the reply tibeca. The LC looked to see if DD might have upper labial frenulum lip tie, but didn't see any evidence of it. I'll look more into it though. I regularly do breast compressions when DD is latched on, but unfortunately, they don't seem to really help.

[AislinCarys]

When DD was born, she'd only do the effective suck-suck-swallow for the first few minutes. But I didn't know that, as I had no idea swallowing could be a problem - I'd been told if the latch is good, you're fine! DD lost weight at 4 weeks, and this when we found out. The LC taught me to put my finger on DD's neck, to feel for swallowing since I couldn't hear it. And then we had to learn to feed actively, to keep her going. And to get my supply up, as it had dipped, due to DD taking so little.

www.drjacknewman.com

This site has a lot on low supply, but also a bit on feeding actively, (suck-suck-swallow), switch-nursing and other neat tricks.

We got there in the end, in our case getting my supply up was the real issue, as time went on. But we made it!

[AislinCarys]

Oh, and have you tried using an SNS or lact-aid? We used them for months, and I can really recommend them!

That way you can give your supplemented milk to your baby at the breast, while the baby gets better at feeding (hopefully).

[Parker'smommy]

The quick short sucks could be part of the problem. When they do that, it doesn't allow compression of the breast. They need to do the LONG drawn out swallows. When my dd would do that, I would pull down on her chin gently to make her do the long drawn out swallows. Just a thought.

Good luck!

[countrygirl28]

AislinCarys - I'll try feeling DD's neck to really make sure she is swallowing. I've seen Dr. Jack Newman's videos on youtube, but I'll check out his website. We definitely need help on feeding actively. We have tried using an SNS, but haven't been able to get the hang of it and DD and I both get really frustrated. I've tried taping it on putting the tube in when I latch her and I've tried inserting the tube after she's already on. Any suggestions? Also, the couple of times we have been successful with the SNS, her sucks haven't really been any different. It seems like she just has to suck a little to get milk from the SNS, and she still doesn't get milk from the breast.

Parker'smommy - I've tried pulling her chin down because it seems like her bottom lip is the lip that has a more shallow latch. Are you saying to constantly pull down on the lip while she is feeding? I've only just pulled on it briefly to make sure her lip is not turned in, since she likes to suck on her lips.

Thanks so much for the suggestions, mamas!

[khaoskat]

Have her evaluated for tongue tie. And sometimes it not always a visible tie, as it could be posterior.

http://www.llli.org/llleaderweb/LV/LVAprMay02p27.html


Look at the 5th paragraph down for your description of the lipstick.

Again, it may not be noticable, as it could be posterior and tight..so you want to check around and find out who the best in your area is to evaluate.

[AislinCarys]

Ok, this is what we did (guided by LC, and according to Dr Jack newman's protocols):

Each feed started about every 3 hours, and lasted about 1 hour (45 min-1 h 15 min). I would get DD latched on and feeding actively. Does your DD do this when you latch her on? At least for the first minute or so, and when the flow is faster? Then I'd keep it up for as long as I could, by tickling, blowing on her face, caressing her cheek, even a wet cloth. Usually worked for about 10-20 min. Then I'd change to the other breast and do the same. And then a nappy change, burping etc, and I'd prepare the SNS at this point. And then back on the first breast again, for as long as possible, usually 5-15 min. And then I'd put the SNS on (and I can't remember if I put the tube in with the nipple, or latched her on first and then put the tube in, possibly the second?), and feed on the second breast 5-10 min. Then we'd play for about 1/2 hour, and then we went out for a walk to sleep. In the later afternoon and evening she fed about every two hours, and didn't sleep in between.

Switching breast helps keep/get supply up, and it encourages baby to take more. And definitely, feed the pumped milk after working hard on a good feed, at the end of the feed, it goes down quite quickly, so baby doesn't have to work for it.

Yes, the SNS takes a while to get used to, it can be very fiddly. But it will get easier. If was doing it again, I'd get a lact-aid, apparently they are much easier to deal with!

[teton1898]

Google MOBI (mothers overcoming breastfeeding issues) group on Yahoo. I think there are some mothers over there who could really help you diagnose and treat whatever is going on. I also think your babe may have a posterior tongue tie, and they often go undiagnosed.

[Somemyrrh]

Not sure if this would work for you, but I am able to pump around my daughter when I wear her in a Moby-style wrap (sleepywrap).  Just a thought.

Also, have you had your little one's suck evaluated?  My son had a weak suck but a great latch.  We were able to do feeding therapy with a bottle that cleared up the suckling problem.

[texmati]

You have gotten lots of great advice! I'd also suggest trying FYT forums for a recomendation on a really, really, really good LC.

[Parker'smommy]

Originally Posted by countrygirl28 

 
Parker'smommy - I've tried pulling her chin down because it seems like her bottom lip is the lip that has a more shallow latch. Are you saying to constantly pull down on the lip while she is feeding? I've only just pulled on it briefly to make sure her lip is not turned in, since she likes to suck on her lips.

Thanks so much for the suggestions, mamas!

Yes! Keep pulling down ( very gently!) to get her to do the long drawn out sucks. It's not to pull out the lip ( which you should also do) but to get her to suck differently. Does that make sense? For example, next time you're in the shower, squeeze your areola, right below the nipple rapidly in short motions. You'll get a little bit of milk...but not a ton. Now do it SLOWLY and hold your hand for a few seconds squeezing and then a few seconds not squeezing. You get SO Much more milk, and big ole sprays!

So, pull on her chin to stop her from chewing and sucking so fast. You should feel her jaw moving. When she does a long drawn out suck, you can remove your finger. BUT...have it ready. As soon as she starts chewing and sucking too fast, get your finger in there ( or get someone to help you) and pull down on her chin. You'l lhave to reteach her how to nurse properly, and it will take time. But she'll get it. I've had it happen with my last two nurslings.

[bella99]

I know so many people here are against them, but using a nipple shield really saved my breastfeeding relationship with my daughter.  They aren't the devil.

She had a tiny mouth (no tongue tie), but my nipples were not particularly large.  But I would get her latched on perfectly, she'd suck a bit and then pull back immediately and pinch down on my nipple.  I did have a forceful letdown, but she was also doing this before my milk came all the way in, so it wasn't the only reason.

We used it for 11 weeks total.  Tried it wean off at 6 weeks and she wasn't ready, weaned off of it within a couple days when she was 11 weeks.