Nursing but not Drinking

[KellyAAnn]

My son is 9 weeks old and breastfeeding has been a struggle.  We needed to use the nipple shield and we had to suppliment at 6 weeks.  He has finally started latching but it is not the solution I had hoped. 

His milk transfer is still bad. I hardly ever see swallows even with breast compressions.  His latch isn't horrid but my nipple is still a little smashed when he is done.  My milk supply is OK but not great.  I can pump 2.5 - (rarely) 4 oz a session but he is not satisfied at the breast even after an hour plus.  I have been taking domperidone and pumping for nearly all of his feeds to try to get it up.  I thought when he latched we were on the road to success but we are still stuck.

Thank you

[foreverinbluejeans]

Pumping 2-4 ounces is a huge amount. Remember your baby's stomach is a little bigger than a golf ball. That is why babies need to eat small amounts frequently. The amount you can pump does not equal the amount a baby gets. A mother can be exclusively breastfeeding and her baby and she may  be able to only pump less than an ounce. You can't tell how much a baby gets by how much you can pump. However, since you can pump sooo much you can be confident in your ability to make milk.

It's normal for your nipple to look smashed. A baby doesn't have to be perfect at breastfeeding to be able to breastfeed.

It sounds like you are so busy with pumping and trying to diagnose how he is nursing that you aren't believing in your and his ability to breastfeed. It's normal for your nipple to look a little smashed. It's normal for a young baby's latch to not be perfect. Frequent nursing can build supply better than long nursing. Nursing for an hour may be too long.

A baby can't regulate intake with supplemental bottle feeding. The baby may nurse and then suck a lot down from the bottle even if they don't need it. That can make them gain too much weight and have digestive problems.  If your baby is gaining 4 ounces a week (1 pound a month) then he is getting enough. He may have other physical issues that can't be detected or that show up later.

The only time my breastfed grandson didn't cry was when he was on the breast. He cried until he was almost a year old and started walking. He still cried and fussed much more than normal. It turned out he is allergic to everything. He tests allergic to peanuts, wheat, eggs, chicken, beef, & pork and that's just the foods. He has had head to toe eczema since he was around 6 months.

Some babies just seem not satisfied. Try to relax, meditation can do wonders. Babies get stress hormones through the milk. Your baby may like massage. Lots of skin to skin contact can help. Try to move towards enhancing the symbiotic relationship rather than relying on pumps, drugs, and manipulating feedings.

[Marissamom]

has he been checker for tongue-tie? often it can cause difficulty learning to latch and milk transfer issues. has his sucking mechanic been checked? even without structural anomalies they need help learning to use their tongue correctly (especially after artificial nipples/nipple shield)

[KellyAAnn]

Thanks for the feedback.

foreverinbluejeans - the problem is that when he is supplimented he is happy and content.  I can't not give him more food when he is screaming I know that will fix his issue.  I do try to nurse him whenever he asks and am stopping when he stops eating (for the sake of my nipples).  I pump multiple times after nursing as his poor early nursing messed with my supply.  Before I started that I was getting maybe 1.5 ounces.

Marrissamom - no tongue tie.  The hospital LCs and my LC says his mechanics look fine.  I do think maybe he needs more time to learn.  But it is so hard.  I just want to do things to fix it!

[tashantx]

Have you had a before and after weight taken? That may give you a better idea of the amount he's getting. I don't think it's normal to have a squished nipple after a feeding. Are there any clicking sounds when he nurses? Have you or your lc's (preferably IBCLC) checked for an upper lip tie or a far less noticed and diagnosed posterior tongue tie? I know you said you stop the feed once he stops actively sucking to save your nipples so I'm sure you have some pain? I would not rule out a tongue tie or other antanomical issue completely, yet. When you supplement are you using a bottle? sns? lact aid? syringe? cup?? Could he be used to a faster flow with a bottle maybe? Does he tire easily at the breast? HUGS!!