Trying to switch from pump/bottle to breast - baby totally refusing me!

[mousebandit]

Okay, trying to breathe.  Today we are trying to make the switch back to bf from pumping and bottle.  Dd is 12-weeks old, and has been almost exclusively bottle-fed pumped bm (came a little early, very small, latch issues, the usual).  We have tried repeatedly to go back to bf, but she just isn't latching deeply, and not taking much more than first rush of let-down milk.  I have been seeing an LC and weighing before and after feedings, and tracking how much she's taking in, etc.  She is finally up to 9-1/2 pounds, and has been gaining well for about a month now.  I am VERY concerned about the supply from just pumping, as it gets harder and harder for me to maintain consistent pump schedule.  Hubby and I talked about it and we really felt like it was time to make the switch.

Today was supposed to just be focus on nursing day.  Prior to today, dd has never rejected my breast, and we've also tried a nipple shield a couple of times, and she didn't reject that.  Today, she is MAD and rejecting everything.  I finally broke down after about 45 minutes of working with her and tried to give her a bottle just to get something in her poor little tummy, and she even got mad about that after a few seconds.

Help!  I am digging out the SNS tube thingy, and going to try that at the next feeding.  Dd fell asleep finally but she is waking up now.  Basically, she missed her last entire feeding.  I doubt she got even an ounce, even with trying the bottle at the end. 

Gonna go try again, but any suggestions gladly welcomed!!  I am a little afraid I have ruined this. 

THANKS!

Tracey aka MouseBandit

[jdejong]

Hi, I rarely post but don't despair!  A few things to consider if you've not done so (speaking as a mom who had to coach both of her babies back to the breast for various reasons).  Have you been doing finger feedings at all, in addition to the bottle?  If not, that might be a good way to start supplementing now, as it mimics the breast much better.   I don't know exactly where you are, but if you have an LC already, you might ask her for help in how to do this, especially because if you can find a periodontal syringe... you might find this a lot easier than an SNS.

Also, you might try supplementing BEFORE nursing, just 1/2 ounce, to take the edge of hunger off.  Here's a link discussing the advantages of this method, although most often you hear about supplementing afterwards instead:  http://www.bfar.org/FINISHATTHEBREAST.pdf

You're welcome to PM me if you want to talk further, by phone too, I've been there - and volunteer with breastfeeding support in other capacities :)

[tincia]

I went through a very similar situation. I started off feeding half the bottle, then when we'd normally stop to burp, instead of continuing with the bottle, give the boob. Then each time you do it, offer the breast sooner. The other thing that worked well was not waiting until he was hungry. Say for example that he normally went around 2 hrs between feeds, then at 1.5 hrs, i would offer the breast and that often worked.
I think the best thing you have done is made up your mind and set aside the time to focus on it. I remember in those days thinking it was never gonna work out, but i hung in there and it really took less time them i expected once he came around. I had to remind myself numerous times that it was my job to decide what is best for him, and in my opinion it was getting him back to the breast in order to optimize my supply.
Good luck, you can do this, and it really feels like a huge weight off your shoulders when u can put away the pump and stop watching the clock!

[mousebandit]

Thank you mamas!  I got out the feeding tube thingy for the next feed, and tried that but she was screaming too much and way too mad to even take my nipple in her mouth, much less get the tube in there next to it.  I also have the SNS one that hangs from your neck - I might try that too, since I don't have nearly enough hands to juggle the baby, the boob, and all the equipment, LOL!  I also tried finger feeding with the tube, but she couldn't seem to maintain suction for more than 1 suck.  Maybe she was still too upset or maybe I was holding my finger wrong.  Holding her in the cradle hold with my right arm, using my left hand, middle finger upside down so the pad of my finger was against the roof of her mouth with the end of the tube on the pad of my finger.  Is that right?  We did this a lot the first few weeks, but then gave up because the bottle was so much faster and I foolishly thought it would all work out once she gained some weight and her mouth got bigger.

We ended up going to the bottle and she drained it really fast and then fell asleep.  The feeding after that, we tried starting with finger feeding, and she did give it a fair shot, but it felt like my finger was too big (same finger I used when she was under 5# though, I think) and it almost seemed like something was hurting her.  Maybe I was poking the roof of her mouth with the dumb tube, I don't know.  So, we very briefly tried boob and that was a no-go.  Oh, and I had done some reading by that time on nipple refusal, so I was topless and had my boob and nipple right next to her face while we were trying to finger feed.  Anyway, that feed ended up being bottle as well.

Something that really struck me in the reading, and that had occurred to me but just in a generic sense of trying to get her to relax, was the idea of getting in the warm tub and "re-birthing".  We had a horrendously difficult end of pregnancy, and there was a lot of preterm labor ctx, and I felt very strongly that she NEEDED to be born asap, despite being only 34 weeks (and yes, I've had 4 other preterm/preemies so I know how bad that is).  Then, suddenly the feeling reversed, the ctx stopped, and I just knew that she was afraid to be born.  I truly thought it was down's syndrome or something and that she was afraid we wouldn't love her.  Anyway, I ended up with pre-e, and after a partial placental abruption she was born via c-section.  Turned out she had vasa previa, and if I had not had the abruption and transferred to the hospital she certainly would not have survived and I possibly would not have either.  Even the way it went, it was pretty miraculous.  98% fatality rate.  SO - yes, there was massive birth trauma for both of us, and I believe she was experiencing trauma in-utero for 3-4 weeks prior to the birth.  (Most everyone else would think I'm nuts, but I hope that you all will understand what I'm saying with all this!)

So, I had already been thinking about the tub thing just to relax her, but when I read about it from the viewpoint of re-birthing, it really struck me.  She never even got her original birth.  And we had a very rushed postpartum, as my husband had just gone back to work out of town the week she was born, and we moved to the other end of the state to be with hubby when she was 10 days old.  So it's been chaotic to say the least. 

I am going to try the tub thing tomorrow when the other little ones (3yo and 1yo) are napping and see if we can get anything going then. 

Is the best supplement aid the one that hangs from your neck, or is there a way to juggle everything using a bottle with the tube through the nipple?  I'm guessing you simply have to have them attempting to latch on first before you can get that tube inserted into their mouth, right?  Any tips for doing the finger feed a better way?  She is up to 9-1/2 pounds now, so I don't think my finger is actually too big, unless I'm using the wrong finger. 

Thank you so much!

Tracey aka MouseBandit

[jdejong]

For finger feeding - try your index finger instead, it's a little smaller than your middle finger.  But do you have a medicine dropper?  Because what is nice about that (or a periodontal syringe) is that you can control the milk.  So if you had one of those, what you would do is put your finger in her mouth, pad side up, and then put the dropper/syringe just inside her mouth, just past her lips, and when she clamped down on your finger with a suck, then depress a little milk into her mouth to 'reward' her suck.  So really, she's sucking on your finger, not sucking the milk out, but she doesn't realize that.  You need to be very careful with this method because you don't want to "drown" her with milk, so you'll want to just give her a little bit, but you might find this method much more manageable than trying to get the whole SNS tube in her mouth, up by your finger.

Then, also with the syringe, you can squirt a tiny bit of milk on your nipple to entice her, and/or if she does latch on to your nipple, you can also edge in the dropper/syringe a bit while she's latched, and squeeze a tiny bit in while she's at your breast, to show her that milk is there.  Does that make sense? 

That's why I like the syringe or dropper a lot better for finger feeding, I feel like you can control the situation a bit more, and the baby receiving milk is not dependent upon whether they are latching, because you are delivering the milk by depressing the syringe. 

And one more plug for finding a periodontal syringe - this is what I'm talking about (a picture at the bottom of the link: http://www.aafp.org/afp/20000401/2093.html) if you call your LC or local LLL leader, they might be able to find one for you. Otherwise, I've heard stories of women finding them at veterinarian offices... I know it sounds crazy, maybe worth a try.  I clearly loved the periodontal syringes for both of my kids! 

Best of luck to you, you're doing great, and again, please PM me if you want to talk.

Julie

[mom2tig99Nroo03]

i wish you luck mama! it can be done in many cases :)

[gemasita]

I totally understand all that you are saying about the rebirthing.  It sounds like you are very intuitive towards this LO and if you think it would help her, get in that nice warm tub with her and relax with her!!!  I think there is something to that....

Also, you said she did ok with the nipple shield. Maybe it would work as a transition to full breastfeeding for her?  It would give her the feel of the bottle nipple but she would start to get the hang of extracting the milk differently.

[silvermist]

i went thru something similar. my tactic was to basically lock her and me in a quiet room together for 24 hrs. i sat in the rocking/nursing chair nd we both cried alot. she was so hungry but she would take my breast for about 2 minutes at a time and then resume crying. after that horrible 24hrs was over, she was exclusively breastfeeding and had forgotten the bottle. she began nursing longer as she got used to the breast. i never did catch up on the lost night of sleep but it worked.

[mousebandit]

We're still here and still pumping.  We still haven't gotten a quiet time to try the tub/rebirthing, but the baby and I are going away to a ladies' retreat this weekend, and I will at least have some alone time with her, so we will be trying the breast throughout the weekend.  And, if that fails, my sister is coming from Hawaii for 2 weeks, and we will do a full-on lock-in-the-bedroom type thing while she watches the other kids.  We will be back at our home-base house while hubby is up here working, so there will be no interruptions or responsibilities.  She's gonna cook all the food, and make me "production smoothies" ha ha - loaded with super yeast and galactagogues!  (not sure how to spell that!)  So, I will just hang on until then if I have to.  Thank you all so much for the support and suggestions - it really means so much and helps a lot, even if it's just helping me to keep going and not despair! 

Mouse Bandit

[mousebandit]

Hi everyone.  Another update.  Had some small breakthroughs, although still pumping.  Went to an Above Rubies retreat this weekend and met some awesome mamas who had been through the same thing.  First off, they suggested a chiropractor, and we had about 3 other instances in the last few days of parents suggesting this.  We have an appointment tomorrow!  :-) 

Also, they sat with me through a feeding, and she started off totally rejecting the breast at first and mad, but then one of the ladies took the bottle and squirted milk all over my nipple and areola, and baby Rachel went for it, and we just kept squirting milk all over (yeah, it was a mess but I didn't care!) and she stayed on the nipple.  She even latched on for a second or two at a time, then when she had slurped up all the readily-available milk, she'd pull off to holler, and we'd squirt a bunch more.  She went at it long enough to relax and be happy and even get sleepy.  I don't know how much she actually took because it was going all over the place, but we squirted about 5 oz out of the bottle, so I'm guessing she got at least half of that!!!!   And the big conclusion from that is that she won't reject the nipple as long as she can get the milk fast enough.  So, we immediately went out and bought a new bottle set with slower-flow nipples (the Playtex Aire-Vent - vents air from the bottom, not through nipple).  Next is to slow her down even from there by not letting the nipple completely fill with milk while it's in her mouth.  Since the air vents out the bottom, she shouldn't get a tummy full of air if we do this.  And keep trying to get her on my breast when she's happy.  So, I am hopeful that the chiro appt tomorrow will be a turning point.  All the other ladies (and one husband that my hubby talked to) said the babies were nursing the same day, although one baby had to go back twice for re-adjustments because the muscles pulled things back out of alignment a couple of times.  And, if that fails, I am still holding out for when my sister comes.  We will make it!!  I feel a lot more certain of that since she "nursed" this weekend at the breast.  Since then, she's still doing the rejection thing, but tonight hubby will try holding the bottle for me while we do it again - I just don't have enough hands to do everything at once, LOL! 

Oh, and she's not totally rejecting the nipple shield, but she's not happy about it, and she didn't get much through it last time we tried it, what with all the pulling off and hollering.  May start trying that again this week if chiro doesn't show immediate improvment.