From Engorgement to Low Supply...

[kitchensqueen]

I was so engorged through Sunday that I was miserable and it was hard for my little guy to nurse. Then I woke up Monday to next to nothing. My breasts are actually smaller than they were pre-pregnancy. And to top it all off, at our check up at the pediatrician today, he hasn't regained his birth weight (he's 12 days old). 

I'm so frustrated and worried. He wants to nurse constantly, but I'm just not sure how much he's getting. He seems to have an average number of poopy and wet diapers every day, but the lack of weight gain is so concerning to me. Our ped says I need to offer him each breast per feeding for at least 20 minutes each, plus offer him a bottle of pumped breast milk until he's full. Every 2-3 hours during the day, and whenever he wakes up (not exceeding 4 hours) at night. She's hoping this will re-increase my milk supply. 

I've been doing this all day, but he always falls asleep at the breast. It's so hard to keep him awake. And the constant nursing is making my nipple so sore. It's so painful sometimes I want to (and often do) cry. I can't help but feel like I'm failing, and I'm an emotional nutcase... 

[scottishmommy]

Hey sweetie! I'm in your due date club btw. We have the same problem! Our babes are a day apart. I'm just gonna try to nurse my little cutie round the clock. I'm also taking fenugreek seed pills. For the pain, see if you can get an ointment called Newmans nipple cream. It needs to be mixed by the pharmacist. I think you need a prescription.
I live in Chicago and know an awesome lactation consultant. pM me if you need anything!

[kitchensqueen]

I'm going to ask me ped at our next visit on Wednesday about the Newmans...my nipples are a wreck. I feel like I've been mauled by a grizzly bear!

How's it going for you so far? My son seems to be getting more now and my breasts are a bit fuller, so I'm slowly rebuilding my supply. But my god the pain - I finally really understand the phrase "grin and bear it".  

[etsdtm99]

have you ruled out tongue tie? it sounds like baby might not be effectively removing milk from the breast (which would cause you to get very engorged and then your milk to decrease because it was not being removed ).. have you done a before/after weight check ? 

[kitchensqueen]

He doesn't have tongue tie. We are doing weekly weight checks with our ped. He spent almost a week in NICU when he was born and they gave him formula and pacis before we started breastfeeding. So he's had nipple confusion and latching issues mostly, coupled with my poor balance of breastfeeding versus pumping when we got home.

[etsdtm99]

Have you heard of laid back breastfeeding/biological nurturing?  http://www.biologicalnurturing.com/

That may help with latch, pain and a number of other things..  i would aim for as much skin to skin as possible, nursing far more often than every 2-3 hours and not worry about the 20 mins on each side thing.. as long as you hear swallowing and he isn't just falling back asleep -  i would still worry a bit about the milk removal thing.. if he is not latching well and not removing milk well that really messes with your supply..

Also, on the pumping - i recently read about a method where you leave the pump all put together on the counter or where ever for 4-6 hours - pumping whenever you get a chance for 5-10 mins - then at the end of the 4-6 horus you put the milk away and wash everything (or you can be feeding it to the baby as needed, but you don't have to put it in the fridge)  less washing, less of a must pump after nursing mentality .. sounded like a good method for bumping up supply quickly.. more so if you're having trouble with the usual nurse, supplement, pump thing. 

[E m i c h i e e]

I would suggest feeding him pumped milk through a nipple shield*. A bottle can confuse your very young baby early on and your breast won't get enough stimulation to make more milk (a pump does not stimulate as well)

Plus the shield will give your nipples a break to heal from the soreness.

What also greatly helped me heal (my nipples bled :/) was rubbing a bit of breast milk on them and using gel pads.

Skin to skin and fenugreek (herbal supplement) also work wonders. 

It will get easier. I have been through breastfeeding hell and back and even at 6 weeks there is still challenges, I have a very lazy, fussy, sleepy baby. But it is worth the effort :)

*lactation aid works with or without shield, pumped milk is filled into a syringe with a thin tube attached, the tube is either placed into the shield to fill it or in the corner of the babys mouth while latched on the breast.

[gemasita]

Sounds like a before- and after-feeding weighing could be a useful tool at this point.  Just to make sure he's removing milk effectively.  We should have done this during the first week...it would have helped us narrow down what was going on.  My son ended up losing a full pound due to low milk supply and it took him over 3 weeks to get back to his birth weight.  You could at least narrow it down to low supply, ineffective removal, or rule those things out entirely.  The lactation aid could also save you time and I like etsdtm's suggestion about pumping for short periods during a 4-6 hour window without washing items.  Much less stressful than sitting down to pump for 20 minutes every 3 hours or after each feeding, etc.

[scottishmommy]

Originally Posted by kitchensqueen 

I'm going to ask me ped at our next visit on Wednesday about the Newmans...my nipples are a wreck. I feel like I've been mauled by a grizzly bear!

How's it going for you so far? My son seems to be getting more now and my breasts are a bit fuller, so I'm slowly rebuilding my supply. But my god the pain - I finally really understand the phrase "grin and bear it".  

I know, the pain can be unbearable! I hope you are feeling a little better by now. Are you taking ibuprofen? I bet that would help. I'm also a big fan of calcium/magnesium supplements to help calm nerves. Maybe that's something you could try? I wish I could make this easier for you. I have so much sympathy for new moms who are struggling with breastfeeding. I hated nursing so much when DD1 was little. I know how hard it is!