Breastfeeding crisis...at major risk.. HELP!

[Blessed_Mom]

Synopsis: LO born Sep 1- 10 day old. Vaginal and no complications..except induced at 38 weeks and 3 days due to previous stillbirth. Strained myself during labor and spiked a small fever so in hospital for 2 days- just for observation.

Birthweight- 7 pounds 1 ounce.

Nursing like a champ , good latch and everything.

Second day of hosp visit in the night... a nurse checked LO right aftr breastfeeding session and found that his temp was slightly higher. Snooty female told us to stop cradling him and put him in the crib (which he wasn't liking) and asked us to give him a paci if he cried (since I couldn't take his crying). We were against pacis.. but she said doc might ask for blood draws for infection checks if temp continues to be higher after an hour. So - a frazzled us..after 3 nights of no sleep thought..what the hey and gave an hour of paci.

We come home and on the way back (30 mins drive..we give him paci again.. for some time). And once more when he acted frantic at my breast (just before milk came in that night). Our fault.

After that found that his latch was painful and nips were bleeding. He kept popping my nipples out or chomping on them. So called an LC. She found two things - One- tooo large breasts and he has a small mouth and a tight jaw. So she suggested football hold (made complete sense) and occ.therapy for tight jaw.

Our LO is an impatient guy - flew into purple rage to the point of stopping breathing a couple of times 'cos he gets impatient at the breast. LC suggested sometimes to pacify him with a bottle of expressed milk to calm him down. Did it a few times (used avent nipples from our daughter's stash..'cos no time to shop)

Now we think he has gotten used to the fast flow of milk. He is refusing to nurse constantly (meaning he will nurse a couple of sessions and some sessions he will just sleep....also 10th day and baby is still sleepy...sleepy....sleepy).

Don't know what I should do. Tried Jack newman's cup method to feed but he still gulped it down and flew into a madddd rage when we tried to slow the flow. I think all this LC handling has also stressed him out.

I don;t know what I should do anymore.... pump and feed him? And continue the vicious cycle? Feel supply is dwindling...letdowns are taking longer (which is again making him go into the 'purple rage situation')

Devastated. How do I train my LO to nurse and not nod off at the breast. 

Oh- saw the occ.threrapist..who said he had no tight jaw and he actually nursed very well in the offiuce and she said he had no problems.

But I can see the problem. Sleepy baby..doesn't want to nurse..is going hungry until we are forced into supplementing him.

Am afraid of ALL methods of supplementing now..including SNS... want to just offer breast and have him do what should come naturally.................am giving myself a week for the situation to improve. :'(((((((((((((((

His weight yesterday was 6 pounds 13 ounce. Lowest was 6 pounds 7 ounce. Poops and pees good.. but we were also bottle feeding - remember. Am afraid if I stop...and wait for him to take the breast.. he may actually dwindle at his 2-week appointment

Don't want to go to anymore LC appointments... feel am stressing him out..with them measuring, prodding, checking his latch , unlatching him, forcing his head , etc..

Sorry for rambling but am at the end of my tether.....HELP!!!!!!!!!!!!!!!!!

[seraf]

Can you get a second opinion?

If you are pumping anyway, can you pump until you get letdown and then latch him on so it's fast flow/immediate gratification for a couple of days until he gets the hang of it? Can you just lay back in a recliner with him on your chest, so the boob is constantly right in his face? Can you offer very frequently so he doesn't have a chance to get desperately hungry?

If you make it through the first week with challenges, the second week is the hardest. If you can find your way through, it gets better pretty quickly.

Good luck.

[treehugz]

Oh, that sounds tough.  I'll second ALL of seraf's suggestions, especially pumping till you get let down and a steady flow and then offer the breast... that should help get to the hindmilk quicker too, which is the fatty milk that will help him gain.weight.  Getting enough hindmilk makes my ds sleepy, so he'll fall asleep at the breast and just sleep and nurse... worked great for getting my supply up after it dipped during a hospital stay at 5 days old.  My LC said the hindmilk comes after 5-8 minutes of sucking... so you could try to keep him on ONE breast for 20 minutes (or longer) if you can.  Ds was very sleepy too... he was born early (36 weeks) and had jaundice, so it was very important that he feed every two hours to flush out the bilirubin and not lose weight.  I did all sorts of things to wake him up and keep him awake for 20 minutes... I stroked his cheek, wiggled his arms and legs, took his clothes off, put them back on, diaper changes, gave baths, repositioned him... I tried everything.  I set an alarm at night to make sure I fed him every two hours and reset it to make sure each feeding lasted at least 20 minutes in case I fell asleep.  I did this for probably 5-7 days and it worked.  He's 5 weeks now, nursing like crazy, and gaining like a champ.  

Is there a different LC you can see?

[phathui5]

PM'd you.

[Blessed_Mom]

nak

two qs

how do i speeden up subsequent letdowns. my first couple of 'spurts' of milk come fast enough for my li'l impatient guy...but then he has to work for subsequent letdowns..which he is inefficient at...unwilling to do.....how can i speeden them up?

2. he has started using my breast as pacifier. which would be ok except he first drinks a li'l milk and then starts drifting off...........i want him to feed completely first and then sleep......which means i should discourage all his efforts at using my breast as paci - right? Else he is getting confused and nursing to sleep...WITHOUT feeding completely first.This is again not draining my breast and I will he is hurting my supply really badly........ plus at the end of the sesssion he makes me so scared that i want to supplement... AGAIAN...a big no-no. Do NOT want to supplement. Everything abt it is bad - either a cup/bottle/syringe....he is just getting used to the quick and easy drop of milk without the work...

[MichelleZB]

I think your instincts about the LC are right. It looks like that's just stressing you both out at this point, and stress can be the enemy of nursing success.

You guys are going to nurse for two years or something, and the troubles of these first few weeks are going to seem so far away. Hang in there!

I'm going to suggest something radical. Don't worry if he's falling asleep at the breast at this point, or if he's using you as a pacifier. Comfort and love are what he SHOULD be feeling at the breast, and it's going to encourage him to keep at it. Just feed him, and let him sleep when he is tired, and then just feed him again when he wakes up again. Have faith that he will get more efficient as he gets older--they all do. This may mean that you're feeding him for 5 minutes every half an hour for a few days. Enlist family help to ensure you don't go mad during this period.

Just get into bed with your baby, strip both of you naked so you're skin to skin (a diaper on him is okay) and hang out in bed all day, watching movies and nursing on and off. Let him nurse until he sleeps, while he sleeps, when he wakes, whatever. Just let him do his thing and see if it isn't a bit better in a few days.

Pour yourself a glass of wine or something and try to do what you can to relax. This is just my opinion, but I kind of feel like some LCs and breastfeeding experts focus too much on the "shoulds". Your baby should be eating this way, should be eating this much or this frequently. It's kind of when I let go of what my son should be doing and focused on what he wanted that we started to get real breastfeeding success. My son ate for about 5 minutes every 30 minutes or something for the first few weeks. Once I relaxed and realized that this was just how he rolled, everything got better.

[Blessed_Mom]

Trying to relax...am trying to follow what you guys are saying..although some information (like - letting my breast be used as a pacifier- or not..is conflicting from LC to LC to here )

What about an oxytocin spray for faster letdowns (so my guy doesnt get impatient or sleep?)

How does one use it? Obtain it? Is it effective? Is it addictive (if I stop..will I get slower than normal?)...side-effects?

[MichelleZB]

Who knew it comes in a spray? Listen, are you in that bed with a naked baby yet?

[seraf]

How many let downs are you expecting?

All my babies have nursed to sleep, I never heard there was anything wrong with that from the perspective of milk supply. I think of using a pacifier as a replacement breast rather than using a breast as a pacifier. My kids don't like binkies and only used them for a short time in the car, though.

[Blessed_Mom]

I tried nursing in bed but it is next to impossible ...i have very very large breasts and need props. plus the bed is making me sleepy....

...and he has thrown up a couple of times...........i think due to the wavy motion of the bed :-(

I gave up.

[treehugz]

Originally Posted by MichelleZB 

Don't worry if he's falling asleep at the breast at this point, or if he's using you as a pacifier. Comfort and love are what he SHOULD be feeling at the breast, and it's going to encourage him to keep at it. ... Just get into bed with your baby, strip both of you naked so you're skin to skin (a diaper on him is okay) and hang out in bed all day, watching movies and nursing on and off. Let him nurse until he sleeps, while he sleeps, when he wakes, whatever. Just let him do his thing and see if it isn't a bit better in a few days.

DITTO!  One bonus of leaving him attached when he goes to sleep is that you'll likely get that second (and third, etc) hindmilk letdown sometime while he's asleep... my ds will fall asleep, not suck for a while, then surprise! he does a little sleep/comfort suck that catches me off guard and my milk lets down... then I just encourage him with a little cheek rub to keep sucking.  I couldn't just let my ds nurse and then fall asleep when he wanted for the first two weeks though... he was just too sleepy, so I had to make him stay away/wake up for the hindmilk. 

How often are you nursing now and for how long?  I've not heard of the oxytocin spray... I had difficulty getting let-down with my dd1.  Relaxing was definitely key for me... and working up all those good mommy feelings by gazing at her, stroking her head, cuddling and loving her.

[tropicana]

the point of being in bed together is that you take the time to do nothing.but.nurse. then he has NO CHOICE but to take the milk and learn to nurse. it might take a few days.

is he still biting you? if not, that's huge. i went through similar fiasco with my first -- bottle in the hospital, the paci, then painful latch that lasted for 10 weeks. we (she and i) kept at it and she went on to nurse long and proud!

it's fine if you need props in the bed with your baby. here's what i use: pillow at my back, pillow at baby's back, pillow in between my knees, plus couple pillows under my head. you get him next to you in whatever position puts his face right at your nipple. you switch off with the other breast, this position done by leaning slightly over the baby, again placing your nipple right in his mouth. 

when you get tired or he finishes on, that side (both breasts), turn yourself over to face the other way, and lift the baby over you and re-position him on the other side, pillows at your and his backs, nipple going straight in his mouth. if he sleeps, fine. if you feel sleepy, fine. just find a way to sleep next to him where you won't roll on top of him and his face won't get under a pillow or under sheets or blankets. 

when he wakes up, repeat the cycle. 

sounds like you also have a daughter? can you get someone or a number of people to take turns keeping her occupied while you make this important investment of time in teaching your baby to nurse exclusively?

i agree with michelle z that the LCs can be confusing and frustrating. i tried to follow so so much advice. i actually finally got it while watching "Friends" the TV show, reruns, that showed Carol just using a simple sofa pillow under the baby's head and putting him on her breast. 

it CAN be that simple.

the naked baby in a bed method is very very simple too. it is an investment in time, but you concentrate all the time in one weekend (or whenever in the week) and then it's done. no more LC visits, no more tricks or gimmicks (oxitocin spray?) to get the baby to latch. 

i highly recommend baby in bed method.

[Sol_y_Paz]

Spend some time here  It is a great resource for helping get him back on the breast.

http://www.llli.org/faq/back.html

For some views on comfort sucking:

http://forums.llli.org/showthread.php?112069-Think-your-baby-is-nursing-too-much-Read-this!

http://kellymom.com/bf/normal/comfortnursing/

 

http://www.todaysparent.com/baby/breastfeeding/nursing-comfort?page=0,0

 

http://thefunnyshapedwoman.blogspot.com/2011/01/breasts-feeling-full-good-thing-myth.html

[Blessed_Mom]

Not biting me anymore. My sole problem now is that he will rather sleep than nurse...he will half-feed and go back to sleep and nothing seems to wake him up (although I must clarify that when I take him out or change his diaper etc. he is wide awake and crying. Which is different from the 3-day 'almost lethargic' period he had drifted off into on his 11-12-13th day of his life (I think))

Letdowns- what I think of as a letdown is - as soon as he latches he gets a burst of milk (letdown) which forces him to suck+swallow up to 20 times (approx 20-30). Then he gets a second letdown - another 20-30 suck+swallows (very distinct and no doubt he is swallowing and getting milk). After that the pause between 2nd and 3rd gets longer (30 secs to 3-4 mins) and he gets another.

Earlier he used to drink up to 5 letdowns. Now he drinks 2..maybe 3 and falls asleep.

The nursing vacation - if I am doing a variation where all I am doing is sitting on the sofa (more comfy with back and props and position) and letting him sleep beside me with half his body touching my stomach in the football hold and let him sleep +nurse+sleep+nurse)..is that good too? The lying naked in bed is kind of logistically difficult- if not impossible :-(

ETA: Mom and hubby are taking care of daughter. She is not really taking my time... except I am cuddling with her to sleep for 2 hours in the night. Night time my guy sleeps 2 stretches of 3 -3.5 hours each in his bassinet and I sleep on the bed with my already asleep daughter.

[tropicana]

Blessed_Mom: i think you are doing well! not biting you is HUGE! if he's sleepy, so what? do people think that's a problem? i thought newborns are supposed to be sleepy? it seems to be yet another thing that doctors, LCs etc. "worry" you over. i can recall being worried about the baby (actually both of mine, several years apart) being sleepy.

YET now that i'm away from the situation of nursing a newborn and have observed and talked with so many moms over the past several years... the sleepier babies grow faster. that's when they grow. could it be that he is growing when he sleeps? i would think that if he has many many opportunities in a day to suckle and nurse (go for 12-20 times on), if he is popping off on his own in favor of drifting off to sleep... then he's doing fine. 

what can you do? never deny him. always offer, never refuse. 

yes stay comfortable on the couch. make sure your shirts are basically "always open" to him. literally. let him get well and truly used to those breasts being for HIM and ALL THE TIME.

you are doing well! now just keep going!

[Blessed_Mom]

Thank you Tropicana!

I feel we have made some progress since I started this thread. I also know that he is currently intaking half of what I know he can take (based on one great day we had 3 days back when he fed on upto 6 'letdowns' each feed and didn't sleep at the breast and seemed alert and active)

I just hope he gets back to that great day.......

[Blessed_Mom]

At the same time...since my breasts are not getting drained completely...they are acting engorged and I am sure I am hurting my supply massively.

Seems like this ordeal will never end! I just never imagined something as natural can be this difficult. 

Another thing - kind of unrelated...two of the LCs told me to not let the baby suckle for too long because apparently they then 'expend more energy sucking than the calories they take in'.

Phathui5 was kind enough to dispel this myth for me....but has anyone else heard of this? Why would the LCs hold such a myth as true?

[seraf]

It might be true for some set of babies? Like premies? No idea.

I remember feeling very engorged a lot in the beginning. I don't know that that means he is taking less or you are making more (like around 4 months when you won't ever feel full probably but the baby still eats). If he is peeing enough and gaining weight, you can probably stop worrying. My babies don't take anywhere near 6 letdowns a feed. I think 2-3 is all they get at a time.

I have also been thinking about your baby pulling off the breast a lot. We practice EC and when our babies do that, it usually means they need to use the bathroom. I'm not suggesting you start pottying him, but I remember how much more I would have struggled with nursing in the beginning if I had taken their "need to pee" pop offs as "I'm done/I refuse"

It sounds like you have him exclusively at the breast now? Have you checked his weight? Is he peeing enough? Like I said, if those things are good, you can probably relax quite a bit. It is easy to worry when there's not really anything wrong. Hopefully you have moved past the difficulties and you will har smooth sailing from here.

[treehugz]

Wow, 6 let-downs at a feeding!  That's great... usually I expect 2-3 over 20 minutes, more if he's alert and actively sucking, more during times when I think he's having a growth spurt, less if I'm agitated/distracted/hungry/need to pee/etc. I've never heard that you shouldn't let them suck too long... can't imagine why unless there's some medical problem.  

Also, just re-read your original post that said you were induced at 38 weeks... are you by chance caucasian?  If so, your ds may have a touch of the "wimpy white boy syndrome"... not to sound racist, but that's what they call it.  Studies show that caucasian males need more time to develop and do more poorly when born early.  Usually I think it refers to them having more trouble breathing, but our doctors referred to it because of the sleepiness and not feeding well for my son born at 36 weeks (we're caucasian).  He grew out of the sleepiness slowly and started feeding really well after 2-3 weeks of determinedly trying to keep him awake for feeding.  Just thinking that might account for some of the challenges... just a thought!

Looking forward to hear how he's doing and his weight!

[Blessed_Mom]

Err... what I think of 6 letdowns..may not be letdowns but 'bursts' of active sucking and longish pauses in between 

Not caucasian at all.

Weight - won't know for a while... today...was a bit better in the morning. Sucked and swallowed well.... since evening he has turned a bit 'sluggish' (can I write that?) again. But so far better than yesterday...hopefully he will have some good feedings in the night too .....